GAO STUDY AND REPORTS ON MEDICARE CAPITATION.

SEC. 4017. GAO STUDY AND REPORTS ON MEDICARE CAPITATION. (a) Study.— The Comptroller General shall conduct a study on medicare capitation rates that shall include an analysis and assessment of— (1) the current method for computing per capita rates of payment under section 1876 of the Social Security Act (including the method for determining the United States per capita cost); (2) the method for establishing relative costs for geographic areas and the data used to establish age, sex, and other weighting factors; (3) ways to refine the calculation of adjusted average per capita costs under section 1876 of such Act (including making adjustments for health status or prior utilization of services and improvements in the definition of geographic areas); (4) the extent to which individuals enrolled with organizations with a risk-sharing contract with the Secretary under section 1876 of such Act differ in utilization and cost from fee-for-service beneficiaries and ways for modifying enrollment patterns through program changes or for reflecting the differences in rates through group experience rating or other means; (5) approaches for limiting the liability of the contracting organization under section 1876 of such Act in catastrophic cases: 101 STAT. 1330–65 (6) ways of establishing capitation rates on a basis other than fee-for-service experience in areas with high prepaid market penetration; and (7) methods for providing the rate levels necessary to maintain access to quality prepaid services in rural or medically underserved areas (while maintaining cost savings), (b) Reports.— (1) Not later than January 1 of 1989 and 1990, the Comptroller General shall submit to the Committee on Finance of the Senate and the Committee on Energy and Commerce and Committee on Ways and Means of the House of Representatives interim reports on the progress of the study conducted under subsection (a). (2) Not later than January 1, 1991, the Comptroller General shall submit to each such committee a final report on the g results of such study.