Adjustment in benchmark for low-base payment counties in Puerto Rico
Title II — MEDICARE › Subtitle C — Medicare Advantage (Part C)
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Section 1853(n) of the Social Security Act (42 U.S.C. 1395w–23(n)) is amended— (1) in paragraph (1), by striking and (5) and inserting (5), and (6); (2) in paragraph (4), by striking In no case and inserting Subject to paragraph (6), in no case; and (3) by adding at the end the following new paragraph: (6) Special rules for blended benchmark amount for territories (A) In general Subject to paragraph (2), the blended benchmark amount for an area in a territory for a year (beginning with 2026) shall not be less than 80 percent of the national average of the base payment amounts specified in subparagraph (2)(E) for such year for areas within the 50 States and the District of Columbia. (B) Limitation In no case shall the blended benchmark amount for an area in a territory for a year under subparagraph (A) exceed the lowest blended benchmark amount for any area within the 50 States and the District of Columbia for such year..