To amend title XVIII of the Social Security Act to provide protections for medicare beneficiaries who enroll in medicare managed care plans.
Medicare Patient Choice Act of 1995 - Amends title XVIII (Medicare) of the Social Security Act to require health maintenance organizations and competitive medical plans, among other things, to: (1) have a minimum 85 percent loss-ratio of benefits-to-premiums; (2) assure Medicare enrollees timely access to in-network primary and specialty health care providers and out-of-network providers as well; (3) establish a cost-sharing schedule for out-of-network services; (4) establish a grievance process with board of appeals hearings within 30 days of the filing of a complaint; and (5) provide each enrollee with an explanation of the enrollee's rights and a copy of the most recent consumer report card for the organization. Prohibits provider incentive plans that fail to meet specified criteria.
Applies the same requirements to Medicare select policies.
Introduced in House
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on 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.
Referred to the Committee on Ways and Means, and in addition to the Committee on 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.
Referred to the Committee on Ways and Means, and in addition to the Committee on 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.
Referred to the Subcommittee on Health.
Sponsor introductory remarks on measure. (CR H9646-9647)
Referred to the Subcommittee on Health and Environment, for a period to be subsequently determined by the Chairman.
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