109 STAT. 192 PUBLIC LAW 104–18—JULY 7, 1995

Public Law 104–18

104th Congress

An Act

To amend the Omnibus Budget Reconciliation Act of 1990 to permit medicare

select policies to be offered in all States.

Be it enacted by the Senate and House of Representatives of

the United States of America in Congress assembled,

SECTION 1. PERMITTING MEDICARE SELECT POLICIES TO BE

OFFERED IN ALL STATES FOR AN EXTENDED PERIOD.

Section 4358(c) of the Omnibus Budget Reconciliation Act of

1990, as amended by section 172(a) of the Social Security Act

Amendments of 1994, is amended to read as follows:

‘‘(c) EFFECTIVE DATE.—(1) The amendments made by this section shall only apply—

‘‘(A) in 15 States (as determined by the Secretary of Health

and Human Services) and such other States as elect such

amendments to apply to them, and

‘‘(B) subject to paragraph (2), during the 61⁄2-year period

beginning with 1992.

For purposes of this paragraph, the term ‘State’ has the meaning

given such term by section 210(h) of the Social Security Act (42

U.S.C. 410(h)).

‘‘(2)(A) The Secretary of Health and Human Services shall

conduct a study that compares the health care costs, quality of

care, and access to services under medicare select policies with

that under other medicare supplemental policies. The study shall

be based on surveys of appropriate age-adjusted sample populations.

The study shall be completed by June 30, 1997.

‘‘(B) Not later than December 31, 1997, the Secretary shall

determine, based on the results of the study under subparagraph

(A), if any of the following findings are true:

‘‘(i) The amendments made by this section have not resulted

in savings of premium costs to those enrolled in medicare

select policies (in comparison to their enrollment in medicare

supplemental policies that are not medicare select policies and

that provide comparable coverage).

‘‘(ii) There have been significant additional expenditures

under the medicare program as a result of such amendments.

‘‘(iii) Access to and quality of care has been significantly

diminished as a result of such amendments.

‘‘(C) The amendments made by this section shall remain in

effect beyond the 61⁄2-year period described in paragraph (1)(B)

unless the Secretary determines that any of the findings described

in clause (i), (ii), or (iii) of subparagraph (B) are true.

‘‘(3) The Comptroller General shall conduct a study to determine

the extent to which individuals who are continuously covered under

42 USC 1320c–3

note.

July 7, 1995

[H.R. 483]
PUBLIC LAW 104–18—JULY 7, 1995 109 STAT. 193

LEGISLATIVE HISTORY—H.R. 483:

HOUSE REPORTS: Nos. 104–79, Pt. 1 (Comm. on Ways and Means) and Pt. 2

(Comm. on Commerce), and 104–157 (Comm. of Conference).

CONGRESSIONAL RECORD, Vol. 141 (1995):

Apr. 6, considered and passed House.

May 17, considered and passed Senate, amended.

June 26, Senate agreed to conference report.

June 30, House agreed to conference report.

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a medicare supplemental policy are subject to medical underwriting

if they change the policy under which they are covered, and to

identify options, if necessary, for modifying the medicare supplemental insurance market to make sure that continuously insured

beneficiaries are able to switch plans without medical underwriting.

By not later than June 30, 1996, the Comptroller General shall

submit to the Congress a report on the study. The report shall

include a description of the potential impact on the cost and availability of medicare supplemental policies of each option identified

in the study.’’.

Approved July 7, 1995.

Reports.