I 
110TH CONGRESS 
2D SESSION 
H. R. 6359 
To amend title XVIII of the Social Security Act to enhance beneficiary 
protections under parts C and D of the Medicare Program. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 24, 2008 
Mrs. BIGGERT introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to enhance 
beneficiary protections under parts C and D of the Medi-
care Program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Beneficiary 
Protection Act of 2008’’. 
SEC. 2. MEDICARE PLAN COMPLAINT SYSTEM. 
(a) SYSTEM.—Section 1808 of the Social Security 
Act (42 U.S.C. 1395b–9) is amended— 
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(1) in subsection (c)(2)— 
(A) in subparagraph (B)(iii), by striking 
‘‘adjustment; and’’ and inserting ‘‘adjust-
ment);’’; 
(B) in subparagraph (C), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(D) develop and maintain the plan com-
plaint system under subsection (d).’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(d) PLAN COMPLAINT SYSTEM.— 
‘‘(1) SYSTEM.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
develop and maintain a plan complaint system, 
(in this subsection referred to as the ‘system’) 
to— 
‘‘(i) collect and maintain information 
on plan complaints; 
‘‘(ii) track plan complaints from the 
date the complaint is logged into the sys-
tem through the date the complaint is re-
solved; and 
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‘‘(iii) otherwise improve the process 
for reporting plan complaints. 
‘‘(B) TIMEFRAME.—The Secretary shall 
have the system in place by not later than the 
date that is 6 months after the date of enact-
ment of this subsection. 
‘‘(C) PLAN COMPLAINT DEFINED.—In this 
subsection, the term ‘plan complaint’ means a 
complaint that is received (including by tele-
phone, letter, e-mail, or any other means) by 
the Secretary (including by a regional office or 
the Medicare Beneficiary Ombudsman) from a 
Medicare Advantage eligible individual or a 
Part D eligible individual (or an individual rep-
resenting such an individual) regarding Medi-
care Advantage organizations, Medicare Advan-
tage plans, prescription drug plan sponsors, or 
prescription drug plans, including complaints 
relating to marketing, enrollment, covered 
drugs, premiums and cost-sharing, and partici-
pating providers. 
‘‘(2) PROCESS
CRITERIA.—In developing the 
system, the Secretary shall establish a process for 
reporting plan complaints. Such process shall meet 
the following criteria: 
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‘‘(A) ACCESSIBLE.—The process is widely 
known and easy to use. 
‘‘(B) 
INVESTIGATIVE
CAPACITY.—The 
process involves the appropriate experts, re-
sources, and methods to assess complaints and 
determine whether they reflect an underlying 
pattern. 
‘‘(C) 
INTERVENTION
AND
FOLLOW- 
THROUGH.—The process triggers appropriate 
interventions and monitoring based on substan-
tiated complaints. 
‘‘(D) QUALITY
IMPROVEMENT
ORIENTA-
TION.—The process guides quality improve-
ment. 
‘‘(E) RESPONSIVENESS.—The process rou-
tinely provides consistent, clear, and substantive 
responses to complaints. 
‘‘(F) TIMELINES.—Each process step is 
completed within a reasonable, established time 
frame, and mechanisms exist to deal quickly 
with complaints of an emergency nature requir-
ing immediate attention. 
‘‘(G) OBJECTIVE.—The process is unbi-
ased, balancing the rights of each party. 
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‘‘(H) 
PUBLIC
ACCOUNTABILITY.—The 
process makes complaint information available 
to the public. 
‘‘(3) STANDARD
DATA
REPORTING
REQUIRE-
MENTS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
establish standard data reporting requirements 
for reporting plan complaints under the system. 
‘‘(B) MODEL
ELECTRONIC
COMPLAINT 
FORM.—The Secretary shall develop a model 
electronic complaint form to be used for report-
ing plan complaints under the system. Such 
form shall be prominently displayed on the 
front page of the Medicare.gov Internet website 
and on the Internet website of the Medicare 
Beneficiary Ombudsman. 
‘‘(4) ALL
COMPLAINTS
REQUIRED
TO
BE 
LOGGED INTO THE SYSTEM.—Every plan complaint 
shall be logged into the system. 
‘‘(5) CASEWORK NOTATIONS.—The system shall 
provide for the inclusion of any casework notations 
throughout the complaint process on the record of a 
plan complaint. 
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