3.0.0 4903 2023-01-14T22:48:18Z 2023-01-14T22:48:18Z House H HR 2004-07-22 108 hswm00 Ways and Means Committee House Standing hswm02 Health Subcommittee Referred to 2004-08-03T18:02:56Z Referred to 2004-07-22T14:06:00Z hsif00 Energy and Commerce Committee House Standing hsif14 Health Subcommittee Referred to 2004-07-22T18:31:26Z Referred to 2004-07-22T14:06:05Z 2004-08-03 hswm02 Health Subcommittee 1 House committee actions Referred to the Subcommittee on Health. Committee 2004-07-22 hsif14 Health Subcommittee 1 House committee actions Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman. Committee 2004-07-22 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. IntroReferral H11100 2 House floor actions hsif00 Energy and Commerce Committee 2004-07-22 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. IntroReferral H11100-A 9 Library of Congress 2004-07-22 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. IntroReferral H11100 2 House floor actions hswm00 Ways and Means Committee 2004-07-22 Introduced in House IntroReferral Intro-H 9 Library of Congress 2004-07-22 Introduced in House IntroReferral 1000 9 Library of Congress B000944 Rep. Brown, Sherrod [D-OH-13] Sherrod Brown D OH 13 N D000355 Rep. Dingell, John D. [D-MI-15] JOHN DINGELL D MI D. 15 2004-07-22 True R000053 Rep. Rangel, Charles B. [D-NY-15] CHARLES RANGEL D NY B. 15 2004-07-22 True S000810 Rep. Stark, Fortney Pete [D-CA-13] PETE STARK D CA 13 2004-07-22 True W000215 Rep. Waxman, Henry A. [D-CA-30] HENRY WAXMAN D CA A. 30 2004-07-22 True Health Auditing Coinsurance Commerce Congress Congressional reporting requirements Consumer education Cost accounting Drugs Federal employees Finance and Financial Sector Financial statements Government Operations and Politics Government contractors Government employees' health insurance Government paperwork Health insurance Inspectors general Insurance premiums Investments Legislation Managed care Medical economics Medical fees Medicare Medigap Physicians Prescription pricing Profit Social Welfare Health 00 2004-07-22 Introduced in House 2004-09-01T13:49:16Z Medicare Advantage and Prescription Drug Accountability Act of 2004 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSA) to: (1) require the contract with a Medicare Advantage (MA) organization to provide for a minimum loss ratio and a maximum administrative cost ratio both to be established by the Secretary of Health and Human Services (HHS); and (2) provide for the audit of administrative costs and compliance with the Federal Acquisition Regulation.

Applies all the requirements of this Act, with appropriate adaptations, to contracts with prescription drug sponsors and prescription drug plans under part D (Voluntary Prescription Drug Benefit Program) of SSA title XVIII.

Amends part C of SSA title XVIII to require each MA organization to provide annually to the Secretary information on each MA plan it offers to establish financial transparency, including a functional listing of the organization's administrative costs, profits, and investment income.

Provides that an election to enroll with an MA plan shall not be effective unless the election form is signed by the individual and specifically acknowledges: (1) that premiums, cost sharing requirements, and benefits under the plan may change at the beginning of each 12-month contract period; (2) the individual may lose coverage of the individual's physician or other provider at the beginning of each such period; (3) the plan may be terminated at the beginning of any such period; and (4) premiums and benefits under the plan may vary based on the county or other MA area in which the plan is offered.

Directs the Secretary to transmit to Congress annual Medicare Advantage accountability and prescription drug reports that include, among other things, a detailed analysis of geographic variation in cost-sharing and premiums.

Requires the HHS Inspector General to audit periodically a representative sample of determinations made by the Secretary regarding MA plans that provide for an actuarially equivalent level of benefits to ensure that the Secretary is only approving plans with benefits that are actuarially equivalent.

Directs the Secretary to report to Congress a comparison of the average benefit payments, administrative costs, profits, and investment income for MA plans with corresponding aspects of the fee-for-service programs under Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance) and for group and individual Medicare supplemental policies.

]]> Medicare Advantage and Prescription Drug Accountability Act of 2004 Display Title Medicare Advantage and Prescription Drug Accountability Act of 2004 Official Title as Introduced To amend title XVIII of the Social Security Act to provide for improved accountability in the Medicare Advantage and prescription drug programs. Introduced in House IH Short Titles as Introduced Medicare Advantage and Prescription Drug Accountability Act of 2004 Introduced in House 2004-07-22T04:00:00Z 2004-08-03 Referred to the Subcommittee on Health. text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Congressional Research Service, Library of Congress This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.