I
107TH CONGRESS
1ST SESSION
H. R. 3267
To amend part C of title XVIII of the Social Security Act to provide
for continuous open enrollment and disenrollment in Medicare+Choice
plans, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
NOVEMBER 8, 2001
Mr. STARK (for himself, Mr. GEPHARDT, Mr. RANGEL, Mr. DINGELL, Mr.
BROWN of Ohio, Mr. WAXMAN, Mr. KLECZKA, Mrs. THURMAN, Mr.
CARDIN, and Mr. TIERNEY) introduced the following bill; which was re-
ferred to the Committee on Ways and Means, and in addition to the
Committee on Energy and Commerce, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions
as fall within the jurisdiction of the committee concerned
A BILL
To amend part C of title XVIII of the Social Security Act
to 
provide 
for 
continuous 
open 
enrollment 
and
disenrollment in Medicare+Choice plans, and for other
purposes.
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+Choice Con-
sumer Protection Act of 2001’’.
(2) PERMITTING
ENROLLMENT
IN
MEDIGAP
WHEN
M+C
PLANS
REDUCE
BENEFITS
OR
WHEN
PROVIDER LEAVES AN M+C PLAN.—
(A) IN GENERAL.—Clause (ii) of section
1882(s)(3)(B) 
of 
such 
Act 
(42 
U.S.C.
1395ss(s)(3)(B)) is amended—
(i) by inserting ‘‘(I)’’ after ‘‘(ii)’’;
(ii) by striking ‘‘under the first sen-
tence of’’ each place it appears and insert-
ing ‘‘during a special election period pro-
vided for under’’;
(iii) by inserting ‘‘the circumstances
described in subclause (II) are present or’’
before ‘‘there are circumstances’’; and
(iv) by adding at the end the following
new subclause:
‘‘(II) The circumstances described in this sub-
clause are, with respect to an individual enrolled in
a Medicare+Choice plan, a reduction in benefits (in-
cluding an increase in cost-sharing) offered under
the Medicare+Choice plan from the previous year or
a provider of services or physician who serves the in-
dividual no longer participating in the plan (other
than because of good cause relating to quality of
care under the plan).’’.
(B) CONFORMING
AMENDMENT.—Clause
(iii) of such section is amended—
(i) by inserting ‘‘the circumstances de-
scribed in clause (ii)(II) are met or’’ after
‘‘policy described in subsection (t), and’’;
and
(ii) by striking ‘‘under the first sen-
tence of’’ and inserting ‘‘during a special
election period provided for under’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall take effect on January 1, 2002, and shall
apply to reductions in benefits and changes in provider
participation occurring on or after such date.
SEC. 3. LIMITATION ON MEDICARE+CHOICE COST-SHARING.
(a) IN
GENERAL.—Section 1852(a) (42 U.S.C.
1395w–22(a)) is amended by adding at the end the fol-
lowing new paragraph:
‘‘(6) LIMITATION ON COST-SHARING.—
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), in no case shall the cost-sharing
with respect to an item or service under a
Medicare+Choice plan exceed the cost-sharing
otherwise applicable under parts A and B to an
individual 
who 
is 
not 
enrolled 
in 
a
Medicare+Choice plan under this part.
‘‘(B) PERMITTING
FLAT
COPAYMENTS.—
Subparagraph (A) shall not be construed as
preventing the application of flat dollar copay-
ment amounts (in place of a percentage coin-
surance), such as a fixed copayment for a doc-
tor’s visit, so long as such amounts are reason-
able and appropriate and do not adversely af-
fect access to items and services (as determined
by the Secretary).’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall apply as of January 1, 2003.
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