[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4748 Introduced in House (IH)]

  2d Session
                                H. R. 4748

 To amend title XVIII of the Social Security Act to require 6-months' 
     advance notice to enrollees of Medicare managed care plans of 
        termination of hospital participation under such plans.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 8, 1998

  Mr. Quinn 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 require 6-months' 
     advance notice to enrollees of Medicare managed care plans of 
        termination of hospital participation under such plans.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Seniors' Right to 
Health Care Notification Act of 1998''.
    (b) Findings.--Congress finds the following:
            (1) A lack of health care options for seniors forces them 
        to give up their family physician and preferred hospital.
            (2) Pressure nationwide in the Medicare market is creating 
        hardships for senior citizens.
            (3) The Institute of Medicine of the National Academy of 
        Sciences published a report on the value of primary care for 
        patients and communities in which a researcher documented that 
        the forced break-up of the relationship between a doctor and a 
        patient results in a decrease in quality and patient 
        satisfaction with care.
            (4) The short notification period in cases of policy 
        changes and terminations causes confusion and strikes fear in 
        senior citizens.
            (5) An extended notification period would allow seniors to 
        explore their health care options.

SEC. 2. ADVANCE NOTICE OF TERMINATION OF HOSPITAL PARTICIPATION UNDER 
              MEDICARE MANAGED CARE PLANS.

    (a) In General.--Section 1852(c) of the Social Security Act (42 
U.S.C. 1395w-22(c)) is amended by adding at the end the following new 
paragraph:
            ``(3) Notice of termination of hospital participation.--
                    ``(A) In general.--If a participation agreement 
                between a Medicare+Choice organization and a hospital 
                covering the provision of inpatient or outpatient 
                hospital services to enrollees with the organization 
                under this part is terminated, the organization shall 
                provide all enrollees who are patients of doctors at 
                the hospital or who have been seen on a regular basis 
                at the hospital with notice of such termination at 
                least 180 days before the effective date of such 
                termination. Such notice may include information on 
                alternative participating hospitals from which such an 
                enrollee may secure inpatient and outpatient hospital 
                services in such area.
                    ``(B) Exception authority.--The Secretary may waive 
                the requirement of subparagraph (A) (or shorten the 
                period for advanced notice under such subparagraph) in 
                the case of circumstances beyond the control of the 
                Medicare+Choice organization and in such other cases as 
                the Secretary deems appropriate.''.
    (b) Application to Eligible Organizations.--Section 1876(k)(4) of 
such Act (42 U.S.C. 1395mm(k)(4)) is amended by adding at the end the 
following new subparagraph:
            ``(E) Advance notice of termination of hospital 
        participation under section 1852(c)(3).''.
    (c) Effective Date.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by this section apply to terminations of participation 
        occurring on or after the date of the enactment of this Act.
            (2) Transition.--In no case shall notice of a termination 
        of participation be required under such amendments earlier than 
        30 days after the date of the enactment of this Act.
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