[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1403 Introduced in Senate (IS)]







109th CONGRESS
  1st Session
                                S. 1403

 To amend title XVIII of the Social Security Act to extend reasonable 
                     cost contracts under medicare.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 14, 2005

   Mr. Wyden introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to extend reasonable 
                     cost contracts under medicare.

    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 Cost Contract Extension and 
Refinement Act of 2005''.

SEC. 2. EXTENSION OF REASONABLE COST CONTRACTS.

    (a) Extension of Period Reasonable Cost Plans Can Remain in the 
Market.--Section 1876(h)(5)(C)(ii) of the Social Security Act (42 
U.S.C. 1395mm(h)(5)(C)(ii) is amended--
            (1) in the matter preceding subclause (I)--
                    (A) by striking ``January 1, 2008'' and inserting 
                ``January 1, 2012'';
                    (B) by striking ``year'' and inserting ``two 
                years''; and
                    (C) by inserting ``entirely'' after ``was'';
            (2) in subclause (I), by inserting ``, provided that all 
        such plans are not offered by the same Medicare Advantage 
        organization'' before the semicolon at the end; and
            (3) in subclause (II), by inserting ``, provided that all 
        such plans are not offered by the same Medicare Advantage 
        organization'' before the semicolon at the end.
    (b) Extension of Period Reasonable Cost Plans Can Expand Their 
Service Area.--Section 1876(h)(5)(B)(i) of the Social Security Act (42 
U.S.C. 1395mm(h)(5)(B)(i)) is amended to read as follows:
            ``(i) the conditions for prohibiting an extension or 
        renewal of a contract under subparagraph (C)(ii) are not 
        applicable to such service area at the time of the 
        application.''.

SEC. 3. APPLICATION OF CERTAIN MEDICARE ADVANTAGE REQUIREMENTS TO COST 
              CONTRACTS EXTENDED OR RENEWED AFTER 2003.

    Section 1876(h) of the Social Security Act (42 U.S.C. 1395mm(h)), 
as amended by section (2), is amended--
            (1) by redesignating paragraph (5) as paragraph (6); and
            (2) by inserting after paragraph (4) the following new 
        paragraph:
    ``(5)(A) Any reasonable cost reimbursement contract with an 
eligible organization under this subsection that is extended or renewed 
on or after the date of enactment of the Medicare Cost Contract 
Extension and Refinement Act of 2005 shall provide that the provisions 
of the Medicare Advantage program under part C described in 
subparagraph (B) shall apply to such organization and such contract in 
a substantially similar manner as such provisions apply to Medicare 
Advantage organizations and Medicare Advantage plans under such part.
    ``(B) The provisions described in this subparagraph are as follows:
            ``(i) Section 1851(d) (relating to the provision of 
        information to promote informed choice).
            ``(ii) Section 1851(h) (relating to the approval of 
        marketing material and application forms).
            ``(iii) Section 1852(a)(3)(A) (regarding the authority of 
        organizations to include mandatory supplemental health care 
        benefits under the plan subject to the approval of the 
        Secretary).
            ``(iv) Section 1852(e) (relating to the requirement of 
        having an ongoing quality improvement program and treatment of 
        accreditation in the same manner as such provisions apply to 
        Medicare Advantage local plans that are preferred provider 
        organization plans).
            ``(v) Section 1852(j)(4) (relating to limitations on 
        physician incentive plans).
            ``(vi) Section 1854(c) (relating to the requirement of 
        uniform premiums among individuals enrolled in the plan).
            ``(vii) Section 1854(g) (relating to restrictions on 
        imposition of premium taxes with respect to payments to 
        organizations).
            ``(viii) Section 1856(b)(3) (relating to relation to State 
        laws).
            ``(ix) Section 1857(i) (relating to Medicare Advantage 
        program compatibility with employer or union group health 
        plans).
            ``(x) The provisions of part C relating to timelines for 
        contract renewal and beneficiary notification.''.
                                 <all>