[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2249 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 2249

    To amend the Social Security Act to require health maintenance 
 organizations under the medicare program to disclose to enrollees and 
     potential enrollees certain information on the credentials of 
   physicians providing services by or through the organization, the 
  financial status of the organization, and the compensation paid to 
              officers and executives of the organization.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 4, 1995

   Mr. Shaw introduced the following bill; which was referred to the 
   Committee on Ways and Means, and in addition to the Committee on 
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

_______________________________________________________________________

                                 A BILL


 
    To amend the Social Security Act to require health maintenance 
 organizations under the medicare program to disclose to enrollees and 
     potential enrollees certain information on the credentials of 
   physicians providing services by or through the organization, the 
  financial status of the organization, and the compensation paid to 
              officers and executives of the organization.
    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Managed Health Care 
Sunshine Act of 1995''.

SEC. 2. PROVIDING HMO ENROLLEES WITH CERTAIN INFORMATION ON PLANS.

    Section 1876(c) of the Social Security Act (42 U.S.C. 1395mm(c)) is 
amended by adding at the end the following:
    ``(9)(A) Upon the request of a member enrolled with the 
organization under this section, or an individual considering 
enrollment with the organization under this section, the organization 
shall provide the enrollee or individual with the following:
            ``(i) Descriptive information regarding the credentials of 
        each physician who is authorized by the organization to provide 
        services by or through the organization to enrollees under this 
        section, including the medical education and training received 
        by the physician, the physician's history of medical practice 
        (whether domestic or foreign), and the positions held by the 
        physician at the time of the request.
            ``(ii) An audited financial statement of the organization 
        for the most recently concluded fiscal year that complies with 
        generally accepted accounting principles and includes a balance 
        sheet, income statement, and statement of changes in financial 
        position.
            ``(iii) A statement identifying the salaries, bonuses, and 
        other remuneration paid to the 5 highest-paid officers or 
        executives of the organization, as well as the other benefits 
        provided to such officers or executives.
    ``(B) The organization shall include in any brochure, application 
form, or other promotional or informational material that is 
distributed by the organization to (or for the use of) individuals 
eligible to enroll with the organization under this section a statement 
that the information described in subparagraph (A) is available from 
the organization upon request.''.

SEC. 3. EFFECTIVE DATE.

    The amendment made by this Act shall apply with respect to contract 
years beginning on or after the date that is 6 months after the date of 
the enactment of this Act.
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