To amend title XVIII of the Social Security Act to assure access to services under the Medicare health maintenance organization program.

Summary

Amends title XVIII (Medicare) of the Social Security Act with regard to the Medicare health maintenance organization and competitive medical plans (organizations) program to require them to: (1) establish and maintain adequate arrangements with a sufficient number, mix, and distribution of health professionals in making services available and accessible under the program; and (2) provide for the full participation of all eligible physicians who graduated from either allopathic or osteopathic medical schools and have received training from programs approved by either the Accreditation Council for Graduate Medical Education or the American Osteopathic Association. Prohibits organizations from: (1) discriminating against a health physician or nonphysician health professional based solely on their certification or license, in participation in providing covered health services or reimbursement or indemnification for providing such services, if they may legally provide them in accordance with State law; or (2) excluding a nonphysician health professional from participation in its provider network based solely on the professional's certification or license or lack of affiliation with, or admitting privileges at, a hospital, if such lack of affiliation is due to the professional's type of license.

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3 official files

• Introduced in House (text)

  Introduced in House · EN · 13 March 1996

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• Introduced in House (PDF)

  Introduced in House · EN · 13 March 1996

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• Introduced in House

  summary · EN · 13 March 1996

  Open at official source

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