[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4720 Introduced in House (IH)]







105th CONGRESS
  2d Session
                                H. R. 4720

To amend title XVIII of the Social Security Act to extend for 6 months 
the contracts of certain managed care organizations under the Medicare 
                                Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 7, 1998

  Mrs. Capps (for herself and Mr. Gejdenson) 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 title XVIII of the Social Security Act to extend for 6 months 
the contracts of certain managed care organizations under the Medicare 
                                Program.

    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 HMO Beneficiary Emergency 
Relief Act of 1998''.

SEC. 2. SIX-MONTH MORATORIUM ON TERMINATION OF RISK-SHARING CONTRACTS.

    (a) In General.--Subject to subsection (b), and notwithstanding 
subsection (k) of section 1876 of the Social Security Act (42 U.S.C. 
1395mm), if an eligible organization has a risk-sharing contract under 
section 1876 of such Act in effect on December 31, 1998, and does not 
covert such contract to a contract to offer a Medicare+Choice plan 
under part C of such Act (42 U.S.C. 1395w-21 et seq.) effective on 
January 1, 1999, then such risk-sharing contract shall be deemed to be 
extended through June 30, 1999, under the same terms and conditions 
applicable to such risk-sharing contract.
    (b) Exception.--Subsection (a) shall not apply to an eligible 
organization with a risk-sharing contract if the Secretary of Health 
and Human Services determines that the reason for not converting such 
contract to a contract to offer a Medicare+Choice plan is that the 
organization is unable to offer such plan due to financial hardship on 
the part of the organization.
    (c) Open Enrollment.--Notwithstanding section 1851(e)(6) of the 
Social Security Act (42 U.S.C. 1395w-21(e)(6)), a Medicare+Choice 
organization that is offering a Medicare+Choice plan in an area that is 
affected by a contract extension described in subsection (a) shall 
accept, during the period beginning with November 1, 1998, and ending 
on June 30, 1999, elections to enroll in such plan by individuals who 
are currently enrolled under the contract that is being extended.
    (d) Authority to Renegotiate Contract.--During the period that a 
risk-sharing contract is being extended pursuant to subsection (a), the 
Secretary and the eligible organization whose contract is being 
extended may negotiate for a new contract under section 1857 of the 
Social Security Act (42 U.S.C. 1395w-27), including the submission by 
the organization of a new adjusted community rate for benefits, which 
may enable such organization to convert such contract to a contract to 
offer a Medicare+Choice plan. In negotiating the new contract, the 
Secretary shall ensure that individuals enrolled under the risk-sharing 
contract are not adversely affected by the new contract.
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