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Advising the Congress on Medicare issues
MedPAC > Recommendations > Medicare Advantage payment areas and risk adjustment (A)

Medicare Advantage payment areas and risk adjustment (A)

June 15, 2005

The Congress should establish payment areas for Medicare Advantage local plans that have the following characteristics:
* Among counties in metropolitan statistical areas, payment areas should be collections of counties that are located in the same state and the same metropolitan statistical area.
* Among counties outside metropolitan statistical areas, payment areas should be collections of counties in the same state that are accurate reflections of health care market areas, such as health service areas.

Topics: Part C (Medicare Advantage) and Regional issues.