[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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