(2) Establishment of MA regions (A) MA region For purposes of this subchapter, the term “MA region” means such a region within the 50 States and the District of Columbia as established by the Secretary under this paragraph. (B) Establishment (i) Initial establishment Not later than January 1, 2005 , the Secretary shall first establish and publish MA regions. (ii) Periodic review and revision of service areas The Secretary may periodically review MA regions under this paragraph and, based on such review, may revise such regions if the Secretary determines such revision to be appropriate. (C) Requirements for MA regions The Secretary shall establish, and may revise, MA regions under this paragraph in a manner consistent with the following: (i) Number of regions There shall be no fewer than 10 regions, and no more than 50 regions. (ii) Maximizing availability of plans The regions shall maximize the availability of MA regional plans to all MA eligible individuals without regard to health status, especially those residing in rural areas. (D) Market survey and analysis Before establishing MA regions, the Secretary shall conduct a market survey and analysis, including an examination of current insurance markets, to determine how the regions should be established.