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United States · Bill · HR

H.R. 1221 (104th)

Long-Term Care Insurance Consumer Protection Act of 1995

openUnited States· United States Congress· EN

Introduced

14 March 1995

Last action

7 September 1995 · Introduced

Status

Sponsor introductory remarks on measure. (CR S12837)

Sponsors

Sen. Wyden, Ron [D-OR], Rep. Morella, Constance A. [R-MD-8], Rep. Kennedy, Joseph P., II [D-MA-8], Rep. Regula, Ralph [R-OH-16], Rep. Evans, Lane [D-IL-17], JOSE SERRANO, ALCEE HASTINGS, Rep. Frost, Martin [D-TX-24], Rep. Holden, Tim [D-PA-17], Rep. Olver, John W. [D-MA-1], Sen. Durbin, Richard J. [D-IL], Rep. McDermott, Jim [D-WA-7], Rep. Reynolds, Mel [D-IL-2], Rep. Frank, Barney [D-MA-4], Rep. Ackerman, Gary L. [D-NY-7], Rep. Rangel, Charles B. [D-NY-19], Rep. Dellums, Ronald V. [D-CA-8], Rep. Miller, George [D-CA-7], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Fattah, Chaka [D-PA-2], Rep. Hinchey, Maurice D. [D-NY-22], Rep. Moran, James P. [D-VA-8], Rep. Horn, Stephen [R-CA-38], Zoe Lofgren, Rep. Foglietta, Thomas M. [D-PA-1]

Subjects

Healthcare

Source updated

3 June 2026

Healthcare

Official sourceDownload fileView documentsShare

Summary

Long-Term Care Insurance Consumer Protection Act of 1995 - Amends the Public Health Service Act to prohibit the sale of long-term care insurance unless this Act is complied with. Imposes civil money penalties. Requires application of standards meeting the requirements of this Act, allowing State standards providing greater policyholder protection. Imposes a duty of good faith and fair dealing. Prohibits: (1) twisting, high pressure tactics, and cold lead advertising; (2) knowingly selling a policy to an individual eligible for assistance under title XIX (Medicaid) of the Social Security Act; (3) selling a service-benefit policy duplicating existing coverage; and (4) selling a policy to an organization's member without disclosing a financial arrangement between the seller and the organization. Imposes civil money penalties and applies Social Security Act provisions regarding civil money penalties. Requires issuers to return premiums if a policy is denied or returned, explain denials, and use pre-issuance medical assessments of applicants 75 years old or older, and limit agent sales compensation. Imposes civil money penalties and applies Social Security Act provisions regarding civil money penalties. Prohibits cancellation or nonrenewal except for nonpayment of premium or material misrepresentation. Regulates continuation and conversion rights. Requires policies to use uniform language and format and contain certain disclosures. Prohibits conditioning or limiting benefits in specified ways or placing certain limits or requirements on home health care services, if covered. Mandates a minimum coverage period. Prohibits treating benefits differently for individuals with certain dementias or mental illness differently from individuals with other conditions. Restricts preexisting condition limits. Requires policies to determine benefits based on a functional assessment. Requires policies to provide for annual increases in payment levels and the maximum payment limit and limits on annual premium increases. Requires policies to provide that, if a policy lapses after being in effect for a minimum period, the policy will provide certain benefits without additional premiums. Prohibits policy cancellation or claim denial based on issuance fraud or misrepresentation unless notice is provided within six months of issuance. Allows applicants to return a policy within 30 days and have the premium refunded. (Sec. 3) Amends Medicaid provisions to require each State Medicaid plan to establish a regulatory program to enforce the standards issued under this Act. Prohibits Medicaid payments to a State for nursing facility services if the State fails to establish a regulatory program. (Sec. 5) Authorizes appropriations for information, counseling, and assistance regarding the procurement of adequate and appropriate long-term care insurance.

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

  1. 14 March 1995

    Introduced

    Referred to the House Committee on Commerce.

    Source: IntroReferral

  2. 14 March 1995

    Introduced

    Introduced in House

    Source: IntroReferral

  3. 14 March 1995

    Introduced

    Introduced in House

    Source: IntroReferral

  4. 20 March 1995

    Referred

    Referred to the Subcommittee on Health and Environment.

    Source: Committee

  5. 7 September 1995

    Introduced

    Sponsor introductory remarks on measure. (CR S12837)

    Source: IntroReferral

Votes

No vote records are attached yet.

Versions

Documents

3 official files

Introduced in House (text)

View fileDownload file

Sponsors

Related records

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Sources

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