A bill to amend title XVIII of the Social Security Act to provide for enhanced medicare managed care activities, and for other purposes.
Medicare Managed Care Act of 1990 - Amends title XVIII (Medicare) of the Social Security Act to provide health maintenance organization (HMO) enrollees with payments equal to five percent of the lowest adjusted average per capita cost of care among all classes of those aged 65 or older in all areas in the United States and pay HMOs the difference between 100 percent of the adjusted average per capita cost of care for their classes of enrollees and such payments.
Provides for the certification of a Medicare Supplemental policy which would meet the National Association of Insurance Commissioners' Model Standards except that its benefits are restricted to items and services furnished by certain entities if: (1) full benefits are provided for items and services through a network of entities which have contracted with the policy issuer; (2) full benefits are provided for items and services furnished by other entities when such items and services are necessary and cannot reasonably be obtained through the network; (3) the network offers sufficient access; and (4) the policy issuer has arranged ongoing quality assurance of the items and services furnished through the network.
Introduced in Senate
Read twice and referred to the Committee on Finance.
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