[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3267 Introduced in House (IH)]
107th CONGRESS
1st Session
H. R. 3267
To amend part C of title XVIII of the Social Security Act to provide
for continuous open enrollment and disenrollment in Medicare+Choice
plans, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 8, 2001
Mr. Stark (for himself, Mr. Gephardt, Mr. Rangel, Mr. Dingell, Mr.
Brown of Ohio, Mr. Waxman, Mr. Kleczka, Mrs. Thurman, Mr. Cardin, and
Mr. Tierney) introduced the following bill; which was 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
_______________________________________________________________________
A BILL
To amend part C of title XVIII of the Social Security Act to provide
for continuous open enrollment and disenrollment in Medicare+Choice
plans, and for other purposes.
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+Choice Consumer Protection
Act of 2001''.
SEC. 2. CONTINUOUS OPEN ENROLLMENT AND DISENROLLMENT.
(a) In General.--Section 1851(e)(2) of the Social Security Act (42
U.S.C. 1395w-21(e)(2)) is amended to read as follows:
``(2) Continuous open enrollment and disenrollment.--
Subject to paragraph (5), a Medicare+Choice eligible individual
may change the election under subsection (a)(1) at any time.''.
(b) Conforming Amendments.--
(1) Medicare+choice.--Section 1851(e) of such Act (42
U.S.C. 1395w-21(e)) is amended--
(A) in paragraph (4)--
(i) by striking ``Effective as of January
1, 2002, an'' and inserting ``An'';
(ii) by striking ``other than during an
annual, coordinated election period'';
(iii) by inserting ``in a special election
period for such purpose'' after ``make a new
election under this section''; and
(iv) by striking the second sentence; and
(B) in paragraphs (5)(B) and (6)(A), by striking
``the first sentence of''.
(2) Permitting enrollment in medigap when m+c plans reduce
benefits or when provider leaves an m+c plan.--
(A) In general.--Clause (ii) of section
1882(s)(3)(B) of such Act (42 U.S.C. 1395ss(s)(3)(B))
is amended--
(i) by inserting ``(I)'' after ``(ii)'';
(ii) by striking ``under the first sentence
of'' each place it appears and inserting
``during a special election period provided for
under'';
(iii) by inserting ``the circumstances
described in subclause (II) are present or''
before ``there are circumstances''; and
(iv) by adding at the end the following new
subclause:
``(II) The circumstances described in this subclause are,
with respect to an individual enrolled in a Medicare+Choice
plan, a reduction in benefits (including an increase in cost-
sharing) offered under the Medicare+Choice plan from the
previous year or a provider of services or physician who serves
the individual no longer participating in the plan (other than
because of good cause relating to quality of care under the
plan).''.
(B) Conforming amendment.--Clause (iii) of such
section is amended--
(i) by inserting ``the circumstances
described in clause (ii)(II) are met or'' after
``policy described in subsection (t), and'';
and
(ii) by striking ``under the first sentence
of'' and inserting ``during a special election
period provided for under''.
(c) Effective Date.--The amendments made by this section shall take
effect on January 1, 2002, and shall apply to reductions in benefits
and changes in provider participation occurring on or after such date.
SEC. 3. LIMITATION ON MEDICARE+CHOICE COST-SHARING.
(a) In General.--Section 1852(a) (42 U.S.C. 1395w-22(a)) is amended
by adding at the end the following new paragraph:
``(6) Limitation on cost-sharing.--
``(A) In general.--Subject to subparagraph (B), in
no case shall the cost-sharing with respect to an item
or service under a Medicare+Choice plan exceed the
cost-sharing otherwise applicable under parts A and B
to an individual who is not enrolled in a
Medicare+Choice plan under this part.
``(B) Permitting flat copayments.--Subparagraph (A)
shall not be construed as preventing the application of
flat dollar copayment amounts (in place of a percentage
coinsurance), such as a fixed copayment for a doctor's
visit, so long as such amounts are reasonable and
appropriate and do not adversely affect access to items
and services (as determined by the Secretary).''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply as of January 1, 2003.
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