Title: Medicare & You Handbook Improvement Act of 2022
Policy area: Health

Summary:
Medicare & You Handbook Improvement Act of 2022
This bill specifically requires the Centers for Medicare & Medicaid Services to describe the types of prior authorization requirements and other utilization management requirements that may apply under Medicare in the Medicare & You handbook, including how to inquire about requirements under Medicare Advantage (MA) or prescription drug plans. It also requires the handbook to include a description of the network sizes of MA plans and an illustrative example showing the impact of switching from an MA plan to Medicare on the ability to purchase Medigap supplemental policies.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 5117 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  2d Session
                                S. 5117

    To amend title XVIII of the Social Security Act to require the 
inclusion of information on prior authorization requirements and other 
   utilization management techniques, and other information, in the 
                     Medicare & You annual notice.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           November 17, 2022

  Mr. Marshall (for himself and Ms. Hassan) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
    To amend title XVIII of the Social Security Act to require the 
inclusion of information on prior authorization requirements and other 
   utilization management techniques, and other information, in the 
                     Medicare & You annual notice.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare & You Handbook Improvement 
Act of 2022''.

SEC. 2. REQUIRING THE INCLUSION OF INFORMATION ON PRIOR AUTHORIZATION 
              REQUIREMENTS AND OTHER UTILIZATION MANAGEMENT TECHNIQUES, 
              AND OTHER INFORMATION, IN THE MEDICARE & YOU ANNUAL 
              NOTICE.

    (a) In General.--Section 1804(c) of the Social Security Act (42 
U.S.C. 1395b-2(c)) is amended--
            (1) in paragraph (3), by striking ``and'' at the end; and
            (2) by adding at the end the following new paragraphs:
            ``(5) a description of the types of prior authorization 
        requirements and any other utilization management techniques 
        that may apply under this title, including information on how 
        an individual may find out which such requirements and 
        techniques (if any) apply under a Medicare Advantage plan or a 
        prescription drug plan;
            ``(6) a description of the network sizes of Medicare 
        Advantage plans relative to the number of providers of services 
        and suppliers who accept the original Medicare fee-for-service 
        program under parts A and B; and
            ``(7) an illustrative example clarifying that a beneficiary 
        switching from a Medicare Advantage plan to the original 
        Medicare fee-for-service program under parts A and B may be 
        prohibited from purchasing a medicare supplemental policy under 
        section 1882 or have to pay significantly higher premiums for 
        such a policy.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to notices distributed on or after January 1, 2023.
                                 <all>