1.This Act may be cited as the
Medicare Cost Contract Extension and
Refinement Act of 2009
.
2.Extension of reasonable cost
contracts
(a)Extension of period reasonable cost plans
can remain in the marketSection 1876(h)(5)(C) of the Social
Security Act (42 U.S.C. 1395mm(h)(5)(C)) is amended—
(1)in clause (ii), by striking January
1, 2010
and inserting January 1, 2013
; and
(2)in clause (iii), in the matter preceding
subclause (I), by striking if the service area for the year
meets
and inserting if the portion of the plan's service area
for the year that is within the service area of a reasonable cost reimbursement
contract meets
.
(b)Extension of period reasonable cost plans
can expand their service areaSection 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;
and
.
3.Application of certain Medicare Advantage
requirements to cost contracts extended or renewed after date of
enactmentSection 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 the enactment of the Medicare Cost Contract Extension and Refinement Act of
2009 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(g) (relating to restrictions
on imposition of premium taxes with respect to payments to
organizations).
(vii)Section 1856(b)(3) (relating to relation to
State laws).
(viii)Section 1857(i) (relating to Medicare
Advantage program compatibility with employer or union group health
plans).
(ix)The provisions of part C relating to
timelines for contract renewal and beneficiary
notification.
.