I
105TH CONGRESS
2D SESSION
H. R. 4748
To amend title XVIII of the Social Security Act to require 6-months’ advance
notice to enrollees of Medicare managed care plans of termination of
hospital participation under such plans.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 8, 1998
Mr. QUINN introduced the following bill; which was referred to the Committee
on Ways and Means, and in addition to the Committee on 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
A BILL
To amend title XVIII of the Social Security Act to require
6-months’ advance notice to enrollees of Medicare man-
aged care plans of termination of hospital participation
under such plans.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; FINDINGS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Seniors’ Right to Health Care Notification Act of 1998’’.
(b) FINDINGS.—Congress finds the following:
(1) A lack of health care options for seniors
forces them to give up their family physician and
preferred hospital.
(2) Pressure nationwide in the Medicare market
is creating hardships for senior citizens.
(3) The Institute of Medicine of the National
Academy of Sciences published a report on the value
of primary care for patients and communities in
which a researcher documented that the forced
break-up of the relationship between a doctor and a
patient results in a decrease in quality and patient
satisfaction with care.
(4) The short notification period in cases of pol-
icy changes and terminations causes confusion and
strikes fear in senior citizens.
(5) An extended notification period would allow
seniors to explore their health care options.
SEC. 2. ADVANCE NOTICE OF TERMINATION OF HOSPITAL
PARTICIPATION 
UNDER 
MEDICARE 
MAN-
AGED CARE PLANS.
(a) IN GENERAL.—Section 1852(c) of the Social Se-
curity Act (42 U.S.C. 1395w–22(c)) is amended by adding
at the end the following new paragraph:
‘‘(3) NOTICE OF TERMINATION OF HOSPITAL
PARTICIPATION.—
‘‘(A) IN
GENERAL.—If a participation
agreement between a Medicare+Choice organi-
zation and a hospital covering the provision of
inpatient or outpatient hospital services to en-
rollees with the organization under this part is
terminated, the organization shall provide all
enrollees who are patients of doctors at the hos-
pital or who have been seen on a regular basis
at the hospital with notice of such termination
at least 180 days before the effective date of
such termination. Such notice may include in-
formation on alternative participating hospitals
from which such an enrollee may secure inpa-
tient and outpatient hospital services in such
area.
‘‘(B) EXCEPTION
AUTHORITY.—The Sec-
retary may waive the requirement of subpara-
graph (A) (or shorten the period for advanced
notice under such subparagraph) in the case of
circumstances beyond the control of the
Medicare+Choice organization and in such
other cases as the Secretary deems appro-
priate.’’.
(b) APPLICATION TO ELIGIBLE ORGANIZATIONS.—
Section 
1876(k)(4) 
of 
such 
Act 
(42 
U.S.C.
1395mm(k)(4)) is amended by adding at the end the fol-
lowing new subparagraph:
‘‘(E) Advance notice of termination of hospital
participation under section 1852(c)(3).’’.
(c) EFFECTIVE DATE.—
(1) IN GENERAL.—Subject to paragraph (2),
the amendments made by this section apply to ter-
minations of participation occurring on or after the
date of the enactment of this Act.
(2) TRANSITION.—In no case shall notice of a
termination of participation be required under such
amendments earlier than 30 days after the date of
the enactment of this Act.
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