SEC. 
2. 
ASSURING 
ACCESS 
TO 
OBSTETRICIAN-GYNE-
COLOGISTS.
Section 1852(d) of the Social Security Act (42 U.S.C.
1395w–22(d)) is amended—
(1) by striking ‘‘A Medicare+Choice organiza-
tion’’ and inserting ‘‘Subject to paragraph (5), a
Medicare+Choice organization’’, and
(2) by adding at the end the following new
paragraph:
‘‘(5) ASSURING ACCESS TO OBSTETRICAL AND
GYNECOLOGICAL CARE.—
‘‘(A) IN GENERAL.—If a Medicare+Choice
organization requires or provides for an enrollee
to designate a participating primary care pro-
vider—
‘‘(i) the organization shall permit such
an individual to designate a participating
physician who specializes in obstetrics and
gynecology as the individual’s primary care
provider; and
‘‘(ii) if such an individual has not des-
ignated such a provider as a primary care
provider, the organization—
‘‘(I) may not require authoriza-
tion or a referral by the individual’s
primary care provider or otherwise for
coverage of routine gynecological care
(such as preventive women’s health
examinations) and pregnancy-related
services provided by a participating
health care professional who special-
izes in obstetrics and gynecology to
the extent such care is otherwise cov-
ered, and
‘‘(II) may treat the ordering of
other gynecological care by such a
participating physician as the author-
ization of the primary care provider
with respect to such care under the
Medicare+Choice plan.
‘‘(B) CONSTRUCTION.—Nothing in sub-
paragraph (A)(ii)(II) shall waive any require-
ments of coverage relating to medical necessity
or appropriateness with respect to coverage of
gynecological care so ordered.’’.
SEC. 3. ASSURING CONTINUITY OF CARE.
Section 1852 of the Social Security Act (42 U.S.C.
1395w–22) is amended by adding at the end the following
new subsection:
‘‘(l) ASSURING CONTINUITY OF CARE.—
‘‘(1) IN GENERAL.—
‘‘(A) TERMINATION
OF
PROVIDER.—If a
contract between a Medicare+Choice organiza-
tion and a health care provider is terminated
(as defined in subparagraph (B)), or benefits or
coverage provided by a health care provider are
terminated because of a change in the terms of
provider participation in a Medicare+Choice
plan, and an individual who is an enrollee in the
plan is undergoing a course of treatment from
the provider at the time of such termination,
the organization shall—
‘‘(i) notify the individual on a timely
basis of such termination, and
‘‘(ii) subject to paragraph (3), permit
the individual to continue or be covered
with respect to the course of treatment
with the provider during a transitional pe-
riod (provided under paragraph (2)).
‘‘(B) TERMINATION.—In this subsection,
the term ‘terminated’ includes, with respect to
a contract, the expiration or nonrenewal of the
contract, but does not include a termination of
the contract by the organization for failure to
meet applicable quality standards or for fraud.
‘‘(2) TRANSITIONAL PERIOD.—
‘‘(A) IN GENERAL.—Except as provided in
subparagraphs (B) through (D), the transi-
tional period under this paragraph shall extend
for at least 90 days from the date of the notice
described in paragraph (1)(A)(i) of the provid-
er’s termination.
‘‘(B) INSTITUTIONAL
CARE.—The transi-
tional period under this paragraph for institu-
tional or inpatient care from a provider shall
extend until the discharge or termination of the
period of institutionalization and also shall in-
clude institutional care provided within a rea-
sonable time of the date of termination of the
provider status if the care was scheduled before
the date of the announcement of the termi-
nation of the provider status under paragraph
(1))(A)(i) or if the individual on such date was
on an established waiting list or otherwise
scheduled to have such care.
‘‘(C) PREGNANCY.—If—
‘‘(i) an enrollee has entered the sec-
ond trimester of pregnancy at the time of
a provider’s termination of participation,
and