(A) by striking ‘‘and’’ at the end of sub-
paragraph (B);
(B) by striking the period at the end of
subparagraph (C) and inserting ‘‘, and’’; and
(C) by adding at the end the following new
subparagraph:
‘‘(D) termination procedures consistent
with paragraph (7).’’; and
(2) by adding at the end the following new
paragraph:
‘‘(7) TIMELY
NOTICE
OF
PHYSICIAN
TERMI-
NATIONS.—Under an agreement described in para-
graph (1) between a Medicare+Choice organization
and a physician (or group of physicians)—
‘‘(A) the agreement shall be automatically
renewable between the parties unless there has
been notice by the physician or group to the
plan (or by the plan to the physician or group)
at least 120 days before the date the agreement
would otherwise expire; and
‘‘(B) in the case such an agreement is not
renewed, the physician or group of physicians
shall provide notice at least 90 days before such
expiration 
date 
to 
enrollees 
who 
are
Medicare+Choice enrollees and are current pa-
tients (as defined in regulations) of the physi-
cian or group at the time of the notice provided
under clause (i).’’.
(c) EFFECTIVE DATE.—The amendments made by
this section apply—
(1) to contracts between the Secretary and
Medicare+Choice organizations entered into more
than 6 months after the date of the enactment of
this Act; and
(2) to agreements between Medicare+Choice
organizations and physicians (and groups of physi-
cians) with respect to expirations of such agreements
occurring after the end of the 9-month period begin-
ning on the date of the enactment of this Act.
SEC. 
4. 
RESTRICTION 
ON 
TERMINATION 
OF
MEDICARE+CHOICE 
PLANS 
IN 
SELECTED
AREAS WITHIN A METROPOLITAN STATIS-
TICAL AREA.
(a) IN GENERAL.—Section 1857(c) of the Social Se-
curity Act (42 U.S.C. 1395w–27(c)) is amended by redes-
ignating paragraph (5) as paragraph (6) and by inserting
after paragraph (4) the following new paragraph:
‘‘(5) LIMITATION ON SELECTIVE TERMINATION
OF CONTRACTS.—
‘‘(A) IN GENERAL.—Except as provided in
subparagraph (B), if a Medicare+Choice orga-
nization offers a Medicare+Choice plan that
provides coverage in a metropolitan statistical
area (or a New England County Metropolitan
Area) in a State and terminates such coverage
for any part of such area (or Area) in the
State, the Secretary shall terminate any con-
tract with the organization for coverage of any
part of that area (or Area) in that State.
‘‘(B) EXCEPTION.—The Secretary may
waive the requirement of subparagraph (A) if
the Secretary finds that terminating contracts
for coverage in all parts of a metropolitan sta-
tistical area (or New England County Metro-
politan Area) in the State would pose an immi-
nent and serious risk to the health of individ-
uals enrolled with the organization under this
part in the area (or Area).’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) apply to terminations for which notice is
provided on or after the date of the enactment of this Act.
SEC. 5. CONTINUITY OF CARE IN CASE OF INVOLUNTARY
TERMINATION.
(a) IN GENERAL.—Section 1852(d) of the Social Se-
curity Act (42 U.S.C. 1395w–22(d)) is amended by adding
at the end the following new paragraph:
‘‘(5) CONTINUITY OF CARE.—
‘‘(A) IN GENERAL.—If—
‘‘(i) an individual’s enrollment with a
Medicare+Choice 
plan 
offered 
by 
a
Medicare+Choice organization under this
part is terminated by the organization
(other than for cause with respect to that
individual), and
‘‘(ii) on the effective date of such ter-
mination of enrollment the individual is in
a course of treatment for which coverage is
available under the plan and the individual
is not at that time covered under another
Medicare+Choice plan,
notwithstanding such termination the organiza-
tion shall continue to provide coverage for the
covered course of treatment for a period of 90
days after such effective date.
‘‘(B) PERMISSIBLE
TERMS
AND
CONDI-
TIONS.—The coverage provided under subpara-
graph (A) shall be under the same terms and
conditions (including applicable policies, proce-
dures, and quality assurance standards) as ex-
isted on the date before the effective date of the
termination.
‘‘(C) TERMINATE DEFINED.—In this para-
graph, the term ‘terminate’ includes the termi-
nation of a Medicare+Choice plan as a result
of the expiration or nonrenewal of a contract by
the organization under this part.
‘‘(D) CONSTRUCTION.—Nothing in this
paragraph shall be construed to require the cov-
erage of benefits which would not have been
covered on the effective date of the termination
involved.’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall apply to contracts entered into or re-
newed on or after the date of the enactment of this Act.
Æ