Congress 107 - HR 3584 - Medicare+Choice Improvement and Stabilization Act of 2001

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Topics

California Capitation (Medical care) Case mix (Medical care) Chronically ill Congress Congressional reporting requirements Debarment of government contractors Federal preemption Finance and Financial Sector Government Operations and Politics Government paperwork Health Health insurance Health maintenance organizations Managed care Maryland Medicaid Medical fees Medical savings accounts Medicare Medicare managed care Ohio Preferred provider organizations (Medical care) Quality of care Social Welfare State laws Welfare recipients Wisconsin

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Summary

Medicare+Choice Improvement and Stabilization Act of 2001 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSA) to make each annual Medicare+Choice capitation rate for a Medicare+Choice payment area for a contract year equal to the largest of the amounts specified under current law or, for 2003, 100 percent of the fee-for-service costs for the Medicare+Choice payment area for services covered under Medicare parts A (Hospital Insurance) or B (Supplementary Medical Insurance) for individuals entitled to benefits under part A and enrolled under part B who are not enrolled in a Medicare+Choice plan under this part for the year.

Revises the calculation of the national standardized annual Medicare+Choice capitation rate used in determining the input-price-adjusted annual national Medicare+Choice capitation rate for a Medicare+Choice payment area for calculation of annual Medicare+Choice capitation rates for 2003.

Eliminates budget neutrality in such calculation for a year other than 2003. Modifies requirements for establishment of standards (other than solvency standards) for provider-sponsored organizations for Medicare+Choice organizations and plans in relation to State laws to avoid duplicative State regulation.

Directs the Secretary of Health and Human Services to conduct a demonstration program under which payment rules for Medicare+Choice organizations are modified in order to promote: (1) the offering of Medicare+Choice plans by preferred provider organizations, of Medicare+Choice plans that provide point-of-sale coverage for other than participating providers, and of MSA plans: and (2) the use of disease management programs by Medicare+Choice plans.

Amends SSA title XVII part C to: (1) suspend the limitation for program reentry for Medicare+Choice organizations for 2003 and 2004; and (2) set forth rules governing specialized Medicare+Choice plans for special needs beneficiaries.

Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to provide for extension of municipal health service demonstration projects.

Actions

Dec 28, 2001

Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman.
Dec 20, 2001

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.
Dec 20, 2001

Introduced in House

Amendments

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