nual notice of change for the MA plan for 
the upcoming plan year. 
‘‘(iii) CONTINUITY OF CARE.—In any 
case in which a provider of services or sup-
plier is removed from a network of an MA 
plan, such plan shall ensure that the re-
moval satisfies the continuity of care re-
quirements under paragraph (1)(A) with 
respect to each individual enrolled in such 
plan receiving items or services from the 
provider or supplier during the plan year 
in effect on the date of removal or during 
the previous plan year. 
‘‘(F) RULE OF CONSTRUCTION.—Nothing 
in this paragraph shall be construed as affect-
ing the ability of a provider of services or sup-
plier to decline to participate in a network of an 
MA plan. 
‘‘(8) TRANSPARENCY IN MEASURES USED BY 
MA ORGANIZATIONS TO ESTABLISH OR MODIFY PRO-
VIDER NETWORKS.— 
‘‘(A) IN GENERAL.—Beginning with plan 
year 2017, an MA organization offering an MA 
plan shall include the information described in 
subparagraph (B)— 
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‘‘(i) in the annual bid information 
submitted by the MA organization with re-
spect to the MA plan under section 1854; 
and 
‘‘(ii) on the Internet Web Site for the 
MA plan. 
‘‘(B) INFORMATION DESCRIBED.—The in-
formation described in this subparagraph is the 
following: 
‘‘(i) Information regarding the meas-
ures used by the MA organization to estab-
lish or modify the provider network of the 
MA plan, including measures of the quality 
and efficiency of providers. Such informa-
tion shall include the specifications, meth-
odology, and sample size of such measures. 
‘‘(ii) Other information related to the 
establishment or modification of such pro-
vider network that the Secretary deter-
mines appropriate. 
‘‘(C) LIMITATION.—The information de-
scribed in subparagraph (B) shall not include 
any individually identifiable information of any 
provider or supplier of services.’’. 
(b) ENFORCEMENT.— 
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(1) SANCTIONS FOR NONCOMPLIANCE.—Section 
1857(g)(1) of the Social Security Act (42 U.S.C. 
1395w–27(g)(1)) is amended— 
(A) in subparagraph (J), by striking ‘‘or’’; 
(B) by redesignating subparagraph (K) as 
subparagraph (L); 
(C) by inserting after subparagraph (J) 
the following new subparagraph: 
‘‘(K) 
fails 
to 
comply 
with 
sections 
1852(d)(7) or 1852(d)(8); or’’; and 
(D) in subparagraph (L) (as so redesig-
nated), by striking ‘‘through (J)’’ and inserting 
‘‘through (K)’’. 
(2) SANCTIONS NOT APPLICABLE TO PART D.— 
Title XVIII of the Social Security Act is amended— 
(A) in section 1860D–12(b)(3)(E) (42 
U.S.C. 
1395w–112(b)(3)(E)), 
by 
striking 
‘‘paragraph (1)(F)’’ and inserting ‘‘paragraphs 
(1)(F) and (1)(K)’’; and 
(B) in section 1894(e)(6)(B) (42 U.S.C. 
1395eee(e)(6)(B)), by inserting ‘‘(other than 
paragraph (1)(K) of such section)’’ after 
‘‘1857(g)(1)’’. 
(c) MEDICARE ADVANTAGE PLAN COMPARE TOOL.— 
Not later than one year after the date of enactment of 
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this Act, the Secretary of Health and Human Services 
shall take such measures as are necessary to ensure that 
the Medicare Advantage Compare Tool takes into account 
the preferences and utilization needs of such individuals. 
SEC. 3. NETWORK ADEQUACY. 
(a) IN GENERAL.—Section 1852(d) of the Social Se-
curity Act (42 U.S.C. 1395w–22(d)), as amended by sec-
tion 2, is amended by adding at the end the following: 
‘‘(9) NETWORK
ADEQUACY
REQUIREMENTS.— 
Beginning in plan year 2017, notwithstanding any 
other provision of law, the following shall apply: 
‘‘(A) PROVIDER AVAILABILITY.—When es-
tablishing a plan network, a Medicare Advan-
tage organization offering an MA plan shall, 
among other factors determined by the Sec-
retary, consider the following: 
‘‘(i) The anticipated enrollment in the 
plan. 
‘‘(ii) The expected types of services 
provided and utilization of services by en-
rollees under the plan. 
‘‘(iii) The number and types of pro-
viders needed to provide such services. 
‘‘(iv) The number of network pro-
viders who are not accepting new patients. 
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‘‘(v) The location of providers and en-
rollees. 
‘‘(vi) The full-time equivalent avail-
ability of a provider to provide such serv-
ices. 
‘‘(B) PROVISION
OF
CARE
IN
A
TIMELY 
MANNER.—A Medicare Advantage organization 
offering an MA plan shall ensure that providers 
are able to provide services in a timely manner, 
as defined by the Secretary, under the plan. 
‘‘(C) APPLICATION OF NETWORK ACCESS 
ADEQUACY STANDARDS.—In applying the net-
work access adequacy standards pursuant to 
paragraph (1), the Secretary shall seek input 
from patient advocacy groups, providers of serv-
ices and suppliers, and MA plans under this 
part. 
‘‘(D) CERTIFICATION.—Each plan year, a 
Medicare Advantage organization shall certify 
to the Secretary, with respect to each MA plan 
offered by the organization, that the providers, 
including specialists and subspecialists, in the 
plan network are able to provide the services re-
quired under the organization’s contract with 
the Secretary under section 1857 with respect 
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to the offering of such plan and to meet the 
needs of the enrollees within the plan service 
area during the year. 
‘‘(E) ANNUAL
REPORTING.—Each plan 
year, a Medicare Advantage organization shall 
report to the Secretary the following with re-
spect to each MA plan offered by the organiza-
tion: 
‘‘(i) AVERAGE WAIT TIME.—The aver-
age wait time for primary and specialty 
care for enrollees under the plan. 
‘‘(ii) UTILIZATION OF OUT OF NET-
WORK PROVIDERS.—The utilization of out- 
of-network providers under the plan. 
‘‘(iii) AVERAGE COST PER PATIENT.— 
The average annual spending per patient 
for primary and specialty care for enrollees 
under the plan. 
‘‘(F) CERTIFICATION.—In advance of the 
annual, coordinated election period under sec-
tion 1851(e)(3), a Medicare Advantage organi-
zation shall certify to the Secretary the accu-
racy of provider directories for each plan of-
fered by the organization. 
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