I
107TH CONGRESS
1ST SESSION
H. R. 2709
To amend title XVIII of the Social Security Act to improve access to
Medicare+Choice plans for special needs medicare beneficiaries by allow-
ing plans to target enrollment to special needs beneficiaries and by
eliminating the beneficiary lock-in and other administrative barriers to
serving this population.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 1, 2001
Mr. RAMSTAD (for himself and Mr. CARDIN) introduced the following bill;
which was referred to the Committee on Ways and Means, and in addi-
tion to the Committee on Energy and Commerce, for a period to be sub-
sequently determined by the Speaker, in each case for consideration of
such provisions as fall within the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to improve
access to Medicare+Choice plans for special needs medi-
care beneficiaries by allowing plans to target enrollment
to special needs beneficiaries and by eliminating the ben-
eficiary lock-in and other administrative barriers to serv-
ing this population.
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 Improve-
ments for Special Needs Beneficiaries Act of 2001’’.
SEC. 2. SPECIALIZED MEDICARE+CHOICE PLANS FOR SPE-
CIAL NEEDS BENEFICIARIES.
(a) TREATMENT AS COORDINATED CARE PLAN.—
Section 1851(a)(2)(A) of the Social Security Act (42
U.S.C. 1395w–21(a)(2)(A)) is amended by adding at the
end 
the 
following 
new 
sentence: 
‘‘Specialized
Medicare+Choice plans for special needs beneficiaries (as
defined in section 1859(b)(4)) may be any type of coordi-
nated care plan.’’.
(b) SPECIALIZED MEDICARE+CHOICE PLAN
FOR
SPECIAL
NEEDS
BENEFICIARIES
DEFINED.—Section
1859(b) of such Act (42 U.S.C. 1395w–29(b)) is amended
by adding at the end the following new paragraph:
‘‘(4) SPECIALIZED
MEDICARE+CHOICE
PLANS
FOR SPECIAL NEEDS BENEFICIARIES.—
‘‘(A) IN GENERAL.—The term ‘specialized
Medicare+Choice plan for special needs bene-
ficiaries’ means a Medicare+Choice plan that
exclusively serves special needs beneficiaries (as
defined in subparagraph (B)).
‘‘(B) SPECIAL NEEDS BENEFICIARY.—The
term ‘special needs beneficiary’ means a
Medicare+Choice eligible individual who—
‘‘(i) is institutionalized (as defined by
the Secretary);
‘‘(ii) is entitled to medical assistance
under a State plan under title XIX; or
‘‘(iii) meets such requirements as the
Secretary may determine would benefit
from enrollment in such a specialized
Medicare+Choice plan described in sub-
paragraph (A).’’.
(c) RESTRICTION ON ENROLLMENT PERMITTED.—
Section 1859 of such Act (42 U.S.C. 1395w–29) is
amended by adding at the end the following new sub-
section:
‘‘(f) RESTRICTION ON ENROLLMENT FOR SPECIAL-
IZED MEDICARE+CHOICE PLANS FOR SPECIAL NEEDS
BENEFICIARIES.—In 
the 
case 
of 
a 
specialized
Medicare+Choice plan (as defined in subsection (b)(4)),
notwithstanding any other provision of this part and in
accordance with regulations of the Secretary, the plan may
restrict the enrollment of individuals under the plan to in-
dividuals who are within one or more classes of special
needs beneficiaries.’’.
(d) 
CONTINUOUS
OPEN
ENROLLMENT
PER-
MITTED.—Section 1851(e)(2)(D) of such Act (42 U.S.C.
1395w–21(e)(2)(D)) is amended to read as follows:
‘‘(D) CONTINUOUS
OPEN
ENROLLMENT
FOR SPECIAL NEEDS BENEFICIARIES.—At any
time after 2001, in the case of a special needs
beneficiary 
(as 
defined 
in 
section
1859(b)(4)(B)), the beneficiary may change the
election under subsection (a)(1).’’.
(e) WAIVER OF REQUIREMENTS PERMITTED.—Sec-
tion 1857 of such Act (42 U.S.C. 1395w–27) is amended
by adding at the end the following new subsection:
‘‘(j) WAIVER OF REQUIREMENTS FOR SPECIALIZED
MEDICARE+CHOICE PLANS.—The Secretary is author-
ized to waive those requirements of this part which the
Secretary finds to be impediments to a Medicare+Choice
plan’s ability to optimize the care being provided to indi-
viduals enrolled in a specialized Medicare+Choice plan for
special needs beneficiaries (as defined in section
1859(b)(4)).’’.
(f) EFFECTIVE DATES.—
(1) IN GENERAL.—The amendments made by
this section take effect upon the date of the enact-
ment of this Act.
(2) DEADLINE
FOR
ISSUANCE
OF
REQUIRE-
MENTS FOR SPECIAL NEEDS BENEFICIARIES; TRAN-
SITION.—No later than September 1, 2002, the Sec-
retary of Health and Human Services shall issue
final regulations to establish requirements for special
needs beneficiaries under section 1859(b)(4)(B)(iii)
of the Social Security Act, as added by subsection
(c).
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