Source: http://www.law.cornell.edu/uscode/text/42/1395b-2?quicktabs_8=1
Timestamp: 2013-12-10 13:05:43
Document Index: 108930882

Matched Legal Cases: ['§ 1395', '§ 1395', '§ 1395', '§ 1804', '§ 223', '§ 171', '§ 4311', '§ 923', '§ 923', '§ 203', '§ 301']

42 USC § 1395b–2 - Notice of medicare benefits; medicare and medigap information | Title 42 - The Public Health and Welfare | U.S. Code | LII / Legal Information Institute
USC › Title 42 › Chapter 7 › Subchapter XVIII › § 1395b–2	prevnext
42 USC § 1395b–2 - Notice of medicare benefits; medicare and medigap information
Notice of medicare benefits The Secretary shall prepare (in consultation with groups representing the elderly and with health insurers) and provide for distribution of a notice containing—
a clear, simple explanation of the benefits available under this subchapter and the major categories of health care for which benefits are not available under this subchapter,
the limitations on payment (including deductibles and coinsurance amounts) that are imposed under this subchapter, and
a description of the limited benefits for long-term care services available under this subchapter and generally available under State plans approved under subchapter XIX of this chapter.
Such notice shall be mailed annually to individuals entitled to benefits under part A or part B of this subchapter and when an individual applies for benefits under part A of this subchapter or enrolls under part B of this subchapter.
Medicare and medigap information The Secretary shall provide information via a toll-free telephone number on the programs under this subchapter. The Secretary shall provide, through the toll-free telephone number 1–800–MEDICARE, for a means by which individuals seeking information about, or assistance with, such programs who phone such toll-free number are transferred (without charge) to appropriate entities for the provision of such information or assistance. Such toll-free number shall be the toll-free number listed for general information and assistance in the annual notice under subsection (a) of this section instead of the listing of numbers of individual contractors.
Contents of notice The notice provided under subsection (a) of this section shall include—
a statement which indicates that because errors do occur and because medicare fraud, waste, and abuse is a significant problem, beneficiaries should carefully check any explanation of benefits or itemized statement furnished pursuant to section 1395b–7 of this title for accuracy and report any errors or questionable charges by calling the toll-free phone number described in paragraph (4);
a statement of the beneficiary’s right to request an itemized statement for medicare items and services (as provided in section 1395b–7
a description of the program to collect information on medicare fraud and abuse established under section 1395b–5
a toll-free telephone number maintained by the Inspector General in the Department of Health and Human Services for the receipt of complaints and information about waste, fraud, and abuse in the provision or billing of services under this subchapter.
(Aug. 14, 1935, ch. 531, title XVIII, § 1804, as added Pub. L. 100–360, title II, § 223(a),July 1, 1988, 102 Stat. 747; amended Pub. L. 103–432, title I, § 171(j)(1),Oct. 31, 1994, 108 Stat. 4450; Pub. L. 105–33, title IV, § 4311(a)(1),Aug. 5, 1997, 111 Stat. 384; Pub. L. 108–173, title IX, § 923(d)(1),Dec. 8, 2003, 117 Stat. 2394.)
2003—Subsec. (b). Pub. L. 108–173inserted at end “The Secretary shall provide, through the toll-free telephone number 1–800–MEDICARE, for a means by which individuals seeking information about, or assistance with, such programs who phone such toll-free number are transferred (without charge) to appropriate entities for the provision of such information or assistance. Such toll-free number shall be the toll-free number listed for general information and assistance in the annual notice under subsection (a) of this section instead of the listing of numbers of individual contractors.”
1997—Subsec. (c). Pub. L. 105–33added subsec. (c).
1994—Pub. L. 103–432inserted “; medicare and medigap information” in section catchline, designated existing provisions as subsec. (a), and added subsec. (b).
Section 4311(a)(2) ofPub. L. 105–33provided that: “The amendment made by this subsection [amending this section] shall apply to notices provided on or after January 1, 1998.”
Section 223(d)(1) ofPub. L. 100–360provided that: “The Secretary of Health and Human Services shall first distribute the notice required by the amendment made by subsection (a) [enacting this section] not later than January 31, 1989.”
Pub. L. 108–173, title IX, § 923(d)(2),Dec. 8, 2003, 117 Stat. 2395, provided that:
“(A) Study.—The Comptroller General of the United States shall conduct a study to monitor the accuracy and consistency of information provided to individuals entitled to benefits under part A [probably means part A of title XVIII of the Social Security Act which is classified to part A of this subchapter] or enrolled under part B [probably means part B of title XVIII of the Social Security Act which is classified to part B of this subchapter], or both, through the toll-free telephone number 1–800–MEDICARE, including an assessment of whether the information provided is sufficient to answer questions of such individuals. In conducting the study, the Comptroller General shall examine the education and training of the individuals providing information through such number.
“(B) Report.—Not later than 1 year after the date of the enactment of this Act [Dec. 8, 2003], the Comptroller General shall submit to Congress a report on the study conducted under subparagraph (A).”
Section 4361(b) ofPub. L. 101–508provided that: “The Secretary of Health and Human Services is authorized to conduct demonstration projects in up to 5 States for the purpose of establishing statewide toll-free telephone numbers for providing information on medicare benefits, medicare supplemental policies available in the State, and benefits under the State medicaid program.”
Notice of Changes Under Repeal of Medicare Catastrophic Coverage
Pub. L. 101–234, title II, § 203(c),Dec. 13, 1989, 103 Stat. 1984, provided that: “The Secretary of Health and Human Services shall provide, in the notice of medicare benefits provided under section 1804 of the Social Security Act [this section] for 1990, for a description of the changes in benefits under title XVIII of such Act [this subchapter] made by the amendments made by this Act [see Tables for classification].”
Benefits Counseling and Assistance Demonstration Project for Certain Medicare and Medicaid Beneficiaries
Section 424 ofPub. L. 100–360, which directed Secretary of Health and Human Services to establish a demonstration project to demonstrate that its volunteers were adequately trained and competent to render effective benefits counseling and assistance to the elderly, was repealed by Pub. L. 101–234, title III, § 301(a),Dec. 13, 1989, 103 Stat. 1985.