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To enhance beneficiary and provider protections and improve transparency in the Medicare Advantage market, and for other purposes.

USA115th CongressHR-7340| House 
| Updated: 1/2/2019
Rosa L. DeLauro

Rosa L. DeLauro

Democratic Representative

Connecticut

Ways and Means Committee, Health Subcommittee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Medicare Advantage Bill of Rights Act of 2018 This bill establishes limits on the removal of Medicare Advantage (MA) providers by MA organizations. Within 60 days before the first day of the annual coordinated election period for an MA plan, an MA organization may remove a provider from the plan only if the provider is: (1) medically negligent, (2) in violation of a legal or contractual requirement, or (3) otherwise unfit to furnish items and services as required. An MA organization may remove a provider from an MA plan only after the completion of a fair notice and appeal process. Additionally, the MA organization must: (1) provide written notification of the removal to each enrollee receiving items or services from the provider, and (2) ensure that the removal satisfies certain continuity of care requirements. The bill also establishes network adequacy requirements. Specifically, when establishing a plan network, an MA organization shall consider specified factors related to provider availability and the timely provision of care. Furthermore, an MA organization must annually certify to the Centers for Medicare & Medicaid Services that providers in each of its plan networks are able to provide services and meet enrollees' needs as required. Sanctions for noncompliance with the bill's requirements apply.
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Timeline
Dec 19, 2018
Introduced in House
Dec 19, 2018
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.
Jan 2, 2019
Referred to the Subcommittee on Health.
  • December 19, 2018
    Introduced in House


  • December 19, 2018
    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.


  • January 2, 2019
    Referred to the Subcommittee on Health.

Health

Administrative law and regulatory proceduresAdministrative remediesBusiness ethicsBusiness recordsConsumer affairsDepartment of Health and Human ServicesHealth care costs and insuranceHealth care coverage and accessHealth facilities and institutionsHealth personnelMedicare

To enhance beneficiary and provider protections and improve transparency in the Medicare Advantage market, and for other purposes.

USA115th CongressHR-7340| House 
| Updated: 1/2/2019
Medicare Advantage Bill of Rights Act of 2018 This bill establishes limits on the removal of Medicare Advantage (MA) providers by MA organizations. Within 60 days before the first day of the annual coordinated election period for an MA plan, an MA organization may remove a provider from the plan only if the provider is: (1) medically negligent, (2) in violation of a legal or contractual requirement, or (3) otherwise unfit to furnish items and services as required. An MA organization may remove a provider from an MA plan only after the completion of a fair notice and appeal process. Additionally, the MA organization must: (1) provide written notification of the removal to each enrollee receiving items or services from the provider, and (2) ensure that the removal satisfies certain continuity of care requirements. The bill also establishes network adequacy requirements. Specifically, when establishing a plan network, an MA organization shall consider specified factors related to provider availability and the timely provision of care. Furthermore, an MA organization must annually certify to the Centers for Medicare & Medicaid Services that providers in each of its plan networks are able to provide services and meet enrollees' needs as required. Sanctions for noncompliance with the bill's requirements apply.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline
Dec 19, 2018
Introduced in House
Dec 19, 2018
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.
Jan 2, 2019
Referred to the Subcommittee on Health.
  • December 19, 2018
    Introduced in House


  • December 19, 2018
    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.


  • January 2, 2019
    Referred to the Subcommittee on Health.
Rosa L. DeLauro

Rosa L. DeLauro

Democratic Representative

Connecticut

Ways and Means Committee, Health Subcommittee, Energy and Commerce Committee

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Administrative law and regulatory proceduresAdministrative remediesBusiness ethicsBusiness recordsConsumer affairsDepartment of Health and Human ServicesHealth care costs and insuranceHealth care coverage and accessHealth facilities and institutionsHealth personnelMedicare