[Congressional Record Volume 151, Number 95 (Thursday, July 14, 2005)]
[Senate]
[Pages S8317-S8318]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. WYDEN:
  S. 1403. A bill to amend title XVIII of the Social Security Act to 
extend reasonable cost contracts under medicare; to the Committee on 
Finance.
  Mr. WYDEN. Mr. President, when Congress passed the Medicare 
Modernization Act, Medicare cost contracts

[[Page S8318]]

were kept as a health plan option for seniors. However, Congress also 
limited the ability of cost contracts to operate in areas if a Medicare 
Advantage plan decided to offer service in that area and stayed for a 
year.
  Medicare cost contracts are plans that offer more benefits than basic 
Medicare and are often available in areas in which Medicare Advantage 
plans are not offered. Many of the thousands of Oregonians who have 
cost contract plans are in rural Oregon, where there are few options 
for care. The legislation I am introducing today, ``The Medicare Cost 
Contract Extension and Refinement Act of 2005'', would allow seniors to 
keep their cost contracts longer even if a Medicare Advantage plan is 
offered. The bill also adds more consumer protection provisions that 
are similar to those already in law for Medicare Advantage plans. I 
believe that it is not only important to ensure seniors have choices, 
but that they can keep the choice that works best for them as well. I 
ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1403

       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.''.
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