One Hundred Percent (100%) of the Medi-
care Part B Excess Charges (as defined in
section 8C(5) of such Regulation); or
‘‘(II) the benefits required under the
Standardized Medicare supplement benefit
plan ‘J’ (as specified in section 9E(10) of
such Regulation).
‘‘(B) The issuer of the policy (in relation to the
policy) meets the same requirements under section
1876 that would apply to an eligible organization
with a risk-sharing contract under that section (in-
cluding community rating of premiums and prior ap-
proval of marketing materials, but not including pro-
vision of benefits).’’.
SEC. 205. ARRANGEMENTS FOR OUT-OF-AREA DIALYSIS
SERVICES.
Section 1876(c) of the Social Security Act (42 U.S.C.
1395mm(c)) is amended by adding at the end the follow-
ing new paragraph:
‘‘(9) Each eligible organization shall assure that en-
rollees requiring renal dialysis services who are tempo-
rarily outside of the organization’s service area (within the
United States) have reasonable access to such services
by—
‘‘(A) making such arrangements with providers
of services or renal dialysis facilities outside the
service area for the coverage of and payment for
such services furnished to enrollees as the Secretary
determines necessary to assure reasonable access; or
‘‘(B) providing for the reimbursement of any
provider of services or renal dialysis facility outside
the service area for the furnishing of such services
to enrollees.’’.
SEC. 206. COORDINATION OF MEDICARE ENROLLMENT.
(a) UNIFORM OPEN ENROLLMENT PERIODS.—
(1) FOR MEDIGAP PLANS.—Section 1882(s) of
such Act (42 U.S.C. 1395ss(s)), as amended by sec-
tions 202(a) and 203(a), is amended—
(A) by redesignating paragraph (5) as
paragraph (6), and
(B) by inserting after paragraph (4) the
following new paragraph:
‘‘(5) Each issuer of a Medicare supplemental policy
shall have an open enrollment period (which shall be the
period 
specified 
by 
the 
Secretary 
under 
section
1876(c)(3)(A)(i)), of at least 30 days duration every year,
during which the issuer may not deny or condition the is-
suance or effectiveness of a Medicare supplemental policy,
or discriminate in the pricing of the policy, because of age,
health status, claims experience, receipt of health care, or
medical condition. The policy may not provide any time
period applicable to pre-existing conditions, waiting peri-
ods, elimination periods, and probationary periods (except
as provided by paragraph (2)(B)). The Secretary may re-
quire enrollment through a third party designated under
section 1876(c)(3)(B).’’.
(2) FOR MEDICARE SELECT POLICIES.—Section
1882(t)(5) of such Act (42 U.S.C. 1395ss(t)(5)), as
added by section 204(6), is amended by adding at
the end the following new subparagraph:
‘‘(C) The periods for enrollment applicable for
the policy are the same periods applicable to a Medi-
care supplemental policy under section 1882(s)(4).’’.
(b) ENROLLMENTS
FOR NEW MEDICARE BENE-
FICIARIES
AND
THOSE
WHO
MOVE.—Section
1876(c)(3)(A) of such Act (42 U.S.C. 1395mm(c)(3)(A))
is amended—
(1) in clause (i), by striking ‘‘clause (ii)’’ and
inserting ‘‘clauses (ii) through (iv)’’, and
(2) by adding at the end the following:
‘‘(iii) Each eligible organization shall have an open
enrollment period for each individual eligible to enroll
under subsection (d) during any enrollment period speci-
fied by section 1837 that applies to that individual. Enroll-
ment under this clause shall be effective as specified by
section 1838.
‘‘(iv) Each eligible organization shall have an open
enrollment period for each individual eligible to enroll
under subsection (d) who has previously resided outside
the geographic area which the organization serves. The en-
rollment period shall begin with the beginning of the
month that precedes the month in which the individual
becomes a resident of that geographic area and shall end
at the end of the following month. Enrollment under this
clause shall be effective as of the first of the month follow-
ing the month in which the individual enrolls.’’.
(c) PROVISION BY SECRETARY OF ENROLLMENT IN-
FORMATION AND OTHER INFORMATION ON ELIGIBLE OR-
GANIZATIONS
AND
MEDICARE
SUPPLEMENTAL
POLI-
CIES.—
(1) IN GENERAL.—Section 1804(b) of such Act
(42 U.S.C. 1395b–2(b)) is amended to read as fol-
lows:
‘‘(b) The Secretary shall provide information upon re-
quest (including through the mails and via a toll-free tele-
phone number) to any individual entitled to benefits under
this title on the programs under this title, including—
‘‘(1) information to assist individuals in enroll-
ing with eligible organizations under section 1876
and in selecting among such organizations for enroll-
ment, including information on the premiums
charged by such organizations for enrollment; and
‘‘(2) information on Medicare supplemental
policies under section 1882, including the relation-
ship of State programs under title XIX to such poli-
cies and the premiums charged by such policies for
enrollment (to the extent information on such pre-
miums is available to the Secretary).’’.
(2) 
CONFORMING
AMENDMENT.—Section
1882(f) of such Act (42 U.S.C. 1395ss(f)) is re-
pealed.
(d) EFFECTIVE DATE.—The amendments made by
this section apply to enrollments occurring after 1997 (but
only after the Secretary of Health and Human Services
has prescribed the relevant annual period), except that the
amendments made by subsection (b)(2) apply to enroll-
ments for a Medicare supplemental policy made after
1997.
TITLE III—MEDICAID
SEC. 301. PROHIBITION ON PAYMENTS UNDER MEDICAID
UNTIL COMPLETION OF ORIENTATION, MEDI-
CAL PROFILE, AND IMMUNIZATION.
(a) REQUIREMENT FOR ORIENTATION AND MEDICAL
PROFILE.—
(1) IN GENERAL.—Notwithstanding any other
provision of law, no payment shall be made to a
State under title XIX of the Social Security Act with
respect to expenditures incurred by it for payment
(determined under a prepaid capitation basis or
under any other risk basis) for services provided by
any entity (including a health insuring organization)
for an individual enrolled with the entity until the
entity certifies to the Secretary of Health and
Human Services that—
(A) the entity has provided the enrollee
with such orientation as the Secretary of
Health and Human Services specifies, which
orientation shall include the explanation of
rights described in paragraph (2) and the expla-
nation of access to care described in paragraph
(3);
(B) the entity has a medical profile de-
scribed in section 1876(c)(3)(G)(iii) of the So-
cial Security Act (as added by section 201(a))
with respect to the enrollee; and
(C) if the entity is responsible for the pro-
vision (directly or through arrangements with
providers of services) of immunizations for an
enrollee who is a child—