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108th CONGRESS
1st Session
H. R. 841
To amend title XVIII of the Social Security Act to improve access to
Medicare+Choice plans for special needs Medicare beneficiaries by
allowing plans to target enrollment to special needs beneficiaries.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2003
Mr. Ramstad (for himself and Mr. Cardin) 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 title XVIII of the Social Security Act to improve access to
Medicare+Choice plans for special needs Medicare beneficiaries by
allowing plans to target enrollment to special needs beneficiaries.
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 Improvements for Special
Needs Beneficiaries Act of 2003''.
SEC. 2. SPECIALIZED MEDICARE+CHOICE PLANS FOR SPECIAL NEEDS
BENEFICIARIES.
(a) Treatment as Coordinated Care Plan.--Section 1851(a)(2)(A) of
the Social Security Act (42 U.S.C. 1395w-21(a)(2)(A)) is amended by
adding at the end the following new sentence: ``Specialized
Medicare+Choice plans for special needs beneficiaries (as defined in
section 1859(b)(4)) may be any type of coordinated care plan.''.
(b) Specialized Medicare+Choice Plan for Special Needs
Beneficiaries Defined.--Section 1859(b) of such Act (42 U.S.C. 1395w-
29(b)) is amended by adding at the end the following new paragraph:
``(4) Specialized medicare+choice plans for special needs
beneficiaries.--
``(A) In general.--The term `specialized
Medicare+Choice plan for special needs beneficiaries'
means a Medicare+Choice plan that exclusively serves
special needs beneficiaries (as defined in subparagraph
(B)).
``(B) Special needs beneficiary.--The term `special
needs beneficiary' means a Medicare+Choice eligible
individual who--
``(i) is institutionalized (as defined by
the Secretary);
``(ii) is entitled to medical assistance
under a State plan under title XIX; or
``(iii) meets such requirements as the
Secretary may determine would benefit from
enrollment in such a specialized
Medicare+Choice plan described in subparagraph
(A) for individuals with severe or disabling
chronic conditions.''.
(c) Restriction on Enrollment Permitted.--Section 1859 of such Act
(42 U.S.C. 1395w-29) is amended by adding at the end the following new
subsection:
``(f) Restriction on Enrollment for Specialized Medicare+Choice
Plans for Special Needs Beneficiaries.--In the case of a specialized
Medicare+Choice plan (as defined in subsection (b)(4)), notwithstanding
any other provision of this part and in accordance with regulations of
the Secretary and for periods before January 1, 2008, the plan may
restrict the enrollment of individuals under the plan to individuals
who are within one or more classes of special needs beneficiaries.''.
(d) Report to Congress.--Not later than December 31, 2006, the
Secretary of Health and Human Services shall submit to Congress a
report that assesses the impact of specialized Medicare+Choice plans
for special needs beneficiaries on the cost and quality of services
provided to enrollees. Such report shall include an assessment of the
costs and savings to the medicare program as a result of amendments
made by subsections (a), (b), and (c).
(e) Effective Dates.--
(1) In general.--The amendments made by subsections (a),
(b), and (c) shall take effect upon the date of the enactment
of this Act.
(2) Deadline for issuance of requirements for special needs
beneficiaries; transition.--No later than 1 year after the date
of the enactment of this Act, the Secretary of Health and Human
Services shall issue final regulations to establish
requirements for special needs beneficiaries under section
1859(b)(4)(B)(iii) of the Social Security Act, as added by
subsection (b).
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