A bill to amend title XVIII of the Social Security Act to provide an optional part C insurance program to provide coverage of certain vision, hearing, and dental services and prescription drugs.
Medicare Part C Program Act of 1985 - Amends title XVIII (Medicare) of the Social Security Act (the Act) to add a new part C entitled "Insurance Program for Vision, Hearing, and Dental Services and Prescription Drugs." (Redesignates the current part C as part D.) Provides for coverage in such new program on a voluntary basis. States that the program will: (1) provide benefits for aged and disabled individuals, and individuals with end stage renal disease; and (2) be financed from premium payments by enrollees and receipts from certain excise taxes on tobacco products.
Provides that the program shall provide the following benefits: (1) routine eye care including an annual vision examination and prescription eyeglasses; (2) dental services, including teeth cleaning, extractions, examinations, and dentures; (3) hearing examinations and aids; and (4) prescription drugs and biologicals. Directs the Secretary of Health and Human Services to provide for a hearing aid certification program.
Provides for payment from the Medicare Part C Trust Fund established by this Act for the incurred expenses of covered individuals. Provides, subject to certain conditions, for a payment rate of 100 percent of the reasonable cost, after payment of a deductible of $75.
Sets forth procedures for the payment of claims to providers. Authorizes the Secretary of Health and Human Services to enter into agreements with carriers for administrative purposes.
Provides that the following individuals shall be eligible for the program: (1) those entitled to benefits under part A (Hospital Insurance) of title XVIII; and (2) those residents aged 65 and older who are either citizens or lawfully admitted aliens who have resided in the United States continuously during the five years preceding their application. Permits individuals to enroll only during specified enrollment periods.
Directs the Secretary of Health and Human Services to annually determine the premium rate. Requires that the premiums be deposited in the Medicare Part C Trust Fund.
Establishes the Medicare Part C Trust Fund in the Treasury. Provides that the Trust Fund shall consist of gifts, bequests, premium deposits, and a portion of the tobacco excise tax. Requires the Board of Trustees of the Trust Fund to make certain reports to the Congress.
Directs the Secretary, at the request of a State, to enter into an agreement with such State under which enrollment in the program established by this Act will be provided to certain individuals receiving assistance under titles I (Grants to States for Old-Age Assistance), XVI (Supplemental Security Income), and XIX (Medicaid) of the Act.
Sets forth conforming amendments.
Directs the Secretary to provide for a demonstration project on the cost-effectiveness of providing services and appliances, as a benefit under the new Medicare part C program, to assist or compensate for visual impairment in low-vision individuals. Provides that expenditures for such project shall be made from the Medicare Part C Trust Fund.
Amends the Tax Equity and Fiscal Responsibility Act of 1982 to extend indefinitely the current rate of the excise tax on cigarettes.
Introduced in House
Introduced in House
Referred to House Committee on Energy and Commerce.
Referred to House Committee on Ways and Means.
Referred to Subcommittee on Health and the Environment.
Referred to Subcommittee on Health.
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