US Congress House Bill 4227 (Prior Session Legislation)

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Spectrum: Partisan Bill (Democrat 1-0)
Status: Introduced on December 10 2015 - 25% progression, died in committee
Action: 2015-12-11 - Referred to the Subcommittee on Health.
Pending: House Subcommittee on Health Committee
Text: Latest bill text (Introduced) [PDF]

Medicare Advantage Bill of Rights Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to establish limits on the removal of Medicare Advantage (MA) providers by MA organizations. Within 60 days before the first day of the annual coordinated election period for an MA plan, an MA organization may remove a provider from the plan only if the provider is: (1) medically negligent, (2) in violation of a legal or contractual requirement, or (3) otherwise unfit to furnish items and services as required. An MA organization may remove a provider from an MA plan only after the completion of a fair notice and appeal process. Additionally, the MA organization must: (1) provide written notification of the removal to each enrollee receiving items or services from the provider, and (2) ensure that the removal satisfies certain continuity of care requirements. The bill also establishes network adequacy requirements. Specifically, when establishing a plan network, an MA organization shall consider specified factors related to provider availability and the timely provision of care. Furthermore, an MA organization must annually certify to the Centers for Medicare & Medicaid Services that providers in each of its plan networks are able to provide services and meet enrollees' needs as required. Sanctions for noncompliance with the bill's requirements apply.

Medicare Advantage Bill of Rights Act of 2015

Rep. Rosa DeLauro [D-CT]

Date	Chamber	Action
2015-12-11	House	Referred to the Subcommittee on Health.
2015-12-10	House	Referred to the Subcommittee on Health.
2015-12-10	House	Referred to House Energy and Commerce
2015-12-10	House	Referred to House Ways and Means
2015-12-10	House	Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
2015-12-10	House	Introduced in House

SB2392 (Same As) 2015-12-10 - Read twice and referred to the Committee on Finance.

Type	Source
Summary	https://www.congress.gov/bill/114th-congress/house-bill/4227/all-info
Text	https://www.congress.gov/114/bills/hr4227/BILLS-114hr4227ih.pdf