3.0.0 2392 2023-01-11T13:32:21Z 2023-01-11T13:32:21Z Senate S 2015-12-10 114 ssfi00 Finance Committee Senate Standing Referred to 2015-12-10T22:20:42Z Medicare Advantage Bill of Rights Act of 2015 114 4227 HR 2015-12-11 Referred to the Subcommittee on Health. Identical bill CRS 2015-12-10 ssfi00 Finance Committee Senate Read twice and referred to the Committee on Finance. IntroReferral 2015-12-10 Introduced in Senate IntroReferral 10000 9 Library of Congress B000944 Sen. Brown, Sherrod [D-OH] Sherrod Brown D OH N B001277 Sen. Blumenthal, Richard [D-CT] Richard Blumenthal D CT 2015-12-10 True W000802 Sen. Whitehouse, Sheldon [D-RI] Sheldon Whitehouse D RI 2016-04-27 False Health Administrative law and regulatory procedures Administrative remedies Business ethics Business records Consumer affairs Department of Health and Human Services Health care costs and insurance Health care coverage and access Health facilities and institutions Health personnel Medicare Health 00 2015-12-10 Introduced in Senate 2016-09-22T15:08:16Z Medicare Advantage Bill of Rights Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to establish limits on the removal of Medicare Advantage (MA) providers by MA organizations. Within 60 days before the first day of the annual coordinated election period for an MA plan, an MA organization may remove a provider from the plan only if the provider is: (1) medically negligent, (2) in violation of a legal or contractual requirement, or (3) otherwise unfit to furnish items and services as required.

An MA organization may remove a provider from an MA plan only after the completion of a fair notice and appeal process. Additionally, the MA organization must: (1) provide written notification of the removal to each enrollee receiving items or services from the provider, and (2) ensure that the removal satisfies certain continuity of care requirements.

The bill also establishes network adequacy requirements. Specifically, when establishing a plan network, an MA organization shall consider specified factors related to provider availability and the timely provision of care. Furthermore, an MA organization must annually certify to the Centers for Medicare & Medicaid Services that providers in each of its plan networks are able to provide services and meet enrollees' needs as required.

Sanctions for noncompliance with the bill's requirements apply.

]]> Medicare Advantage Bill of Rights Act of 2015 Display Title Medicare Advantage Bill of Rights Act of 2015 Official Title as Introduced A bill to enhance beneficiary and provider protections and improve transparency in the Medicare Advantage market, and for other purposes. Introduced in Senate IS Short Titles as Introduced Medicare Advantage Bill of Rights Act of 2015 Introduced in Senate 2015-12-10T05:00:00Z https://www.govinfo.gov/content/pkg/BILLS-114s2392is/xml/BILLS-114s2392is.xml 2015-12-10 Read twice and referred to the Committee on Finance. 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.