Medicare Advantage Bill of Rights Act of 2018
Latest action · Jan 2, 2019 Referred to the Subcommittee on Health.
Progress
Where this bill reached, and when. A stage with no date was not reached; one that failed a vote and later carried shows the date it carried.
- IntroducedDec 19, 2018
- Passed HouseNot reached
- Passed SenateNot reached
- To the PresidentNot reached
- Became lawNot reached
Summary
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.
Cosponsors
Members who signed on, in the order they did.
Committees 2
Where it was sent and what each committee and subcommittee did with it, in order.
| Chamber | Committee | What it did |
|---|---|---|
| House | Ways and Means Committee | Referred Dec 19, 2018 |
| Health Subcommittee | Referred Jan 2, 2019 | |
| House | Energy and Commerce Committee | Referred Dec 19, 2018 |
Actions 3
Everything that happened, newest first.
- Jan 2, 2019Referred to the Subcommittee on Health.
- Dec 19, 2018Introduced in House
- Dec 19, 2018Referred 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.
Research
What has been written about this bill: committee reports, cost estimates, the sponsor’s authority statement, printed hearings and the Congressional Research Service’s work.
Constitutional authority
The sponsor’s statement, as printed in the page H10337.
Related bills 1
Companion bills and other measures the record links to this one.
| Bill | Title | Relationship | Latest action |
|---|---|---|---|
| HR 4227 | Medicare Advantage Bill of Rights Act of 2015 | Reintroduction of | Dec 11, 2015 |
Titles 2
Every title it has carried, official and short, at each stage.
- Official Title as Introduced
- To enhance beneficiary and provider protections and improve transparency in the Medicare Advantage market, and for other purposes.
- Short Titles as Introduced
- Medicare Advantage Bill of Rights Act of 2018
Subjects
Assigned by the Library of Congress. Policy area: Health.
Text 1
Each version as it was printed, newest first.
- Dec 19, 2018Introduced in House
Everything here is as published by Congress: the summary is the Congressional Research Service's, the action wording is the clerks', and the subjects are the Library of Congress's. How far it got is read from the actions themselves, taking the most recent one of each kind, so a bill that failed a vote and later passed is shown as having passed. Records come from this bill on Congress.gov and govinfo.gov; cost estimates are the Congressional Budget Office's, and the hearings are the printed hearings GovInfo publishes, which can appear months after the hearing.
