I 
107TH CONGRESS 
2D SESSION 
H. R. 5727
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. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 13, 2002
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.
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 2002’’.
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) for individuals with severe 
or disabling chronic conditions.’’. 
(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 and for peri-
ods before January 1, 2008, the plan may restrict the en-
rollment of individuals under the plan to individuals who 
are within one or more classes of special needs bene-
ficiaries.’’. 
(d) REPORT TO CONGRESS.—Not later than Decem-
ber 31, 2006, the Secretary of Health and Human Serv-
ices shall submit to Congress a report that assesses the