H.R. 7340 · 115th Congress
Medicare Advantage Bill of Rights Act of 2018
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Never voted on. It didn't reach a floor vote before the 115th Congress ended, so it expired. A bill has to be introduced again to be considered in a new Congress.
D
DeLauroSponsorNo cosponsors.
This bill establishes limits on the removal of Medicare Advantage (MA) providers by MA organizations.
What it does: CRS summary · Introduced in House · Dec 19, 2018
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.
Written by the nonpartisan Congressional Research Service. All summary versions on Congress.gov
About this bill and sources
Official title: Medicare Advantage Bill of Rights Act of 2018
Latest action (Jan 2, 2019): Referred to the Subcommittee on Health.
Policy area: Health · Origin: House · Introduced: Dec 19, 2018
Official page on Congress.gov · Bill text (GovInfo) · Status record (XML)
No recorded floor vote found.