A bill to amend title XVIII of the Social Security Act to assist medicare beneficiaries in understanding their enrollment in health maintenance organizations and competitive medical plans.

Summary

Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to prepare a brochure that describes clearly what enrollment in a health maintenance organization (HMO) or competitive medical plan (CMP) entails. Requires HMOs and CMPs to distribute copies of such brochures to their enrollees. Directs HMOs and CMPs to give their enrollees at least 60 days advance notice of any change in the premium charged for enrollment. Provides that if there is a cancellation of the contract between an HMO or CMP and a hospital or clinic through which such organization provides services, or an interruption in such services during contract negotiations the organization shall notify its enrollees of such cancellation or interruption within the period prescribed by State law for providing notice to physicians or, in the absence of such law, within seven days after such cancellation or interruption. Requires that such notice include an explanation of alternative hospitals or clinics through which enrollees will receive covered services.

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1 official file

• Introduced in House

  summary · EN · 29 June 1987

  Open at official source

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