Medicare Modernization Act of 2000

Summary

Medicare Modernization Act of 2000 - Title I: Making Medicare More Competitive and Efficient - Part A: Competitive Defined Benefit - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSA) with regard to: (1) payments to Medicare+Choice organizations based on risk-adjusted bids; (2) Medicare premium reduction and monthly excess premium for Medicare+Choice plan enrollment; (3) Medicare+Choice plan inclusion of cost-sharing reduction in its basic benefits; and (4) provision of supplemental health care benefits by Medicare+Choice organizations subject to the approval of the Secretary of Health and Human Services. Part B: Private Sector Purchasing and Quality Improvement Tools for Original Medicare - Amends SSA title XVIII to provide for: (1) care coordination services, including their coverage as Medicare part B (Supplementary Medical Insurance) medical services; (2) disease management services, including their coverage as Medicare part B medical services; (3) competitive acquisition of items and services; (4) provider and physician collaborations; (5) preferred participants; (6) centers of excellence; (7) demonstration projects to test and, if proven effective, expand the use of incentives (bonus payments) to certain health care groups participating in Medicare; and (8) administration of certain private sector purchasing and quality improvement programs. (Sec. 120) Amends SSA title XVIII to revise requirements for contracting for Medicare claims processing. (Sec. 121) Outlines special provisions for funding of activities related to certain overpayment recoveries and provider enrollment and reverification of eligibility. Title II: Modernizing Medicare Benefits - Part A: Prescription Drug Benefit - Amends title XVIII (Medicare) of the Social Security Act (SSA) to add a new part D (Prescription Drug Benefit for the Aged and Disabled) outlining the following program components: (1) establishment of a voluntary insurance program to provide prescription drug benefits for individuals who are aged or disabled or have end-stage renal disease and who elect to enroll under such program, to be financed from enrollee premium payments together with contributions from Federal appropriations; (2) scope of benefits; (3) payment of benefits and benefit limits; (4) eligibility and enrollment; (5) monthly premium rates; (6) creation within the Federal Supplementary Medical Insurance Trust Fund under Medicare part B (Supplementary Medical Insurance) of the Prescription Drug Insurance Account for payments;(7) administration of benefits through benefit managers; (8) authorization for the Employer Incentive Program to encourage employers to provide adequate prescription drug benefits to retired individuals and to maintain such existing benefit programs by subsidizing, in part, the sponsor's cost of providing coverage under qualifying plans; and (9) authorization of appropriations to the Account to cover Government contributions. (Sec. 201) Directs the Secretary of Health and Human Services to study and report on the feasibility and advisability of establishing an annual open enrollment period under the new part D program. (Sec. 202) Amends SSA title XIX (Medicaid) to: (1) provide for coverage for certain low-income individuals of part D premiums;(2) require State Medicaid plans to provide that in the case of any individual whose eligibility for medical assistance is not limited to Medicare or Medicare drug cost-sharing, and for whom the State elects to pay monthly premiums under part D, the State will purchase all prescription drugs, without regard to whether the benefit limit for such individual has been reached; (3) require Government payment of Medicare drug cost-sharing for qualified Medicare beneficiaries and for Medicare-eligible individuals with incomes between 100 and 150 percent of the Federal poverty line; and (4) make provisions on payment for covered outpatient drugs inapplicable to prescription drugs purchased under part D pursuant to an agreement with the Secretary under the special eligibility, enrollment, and copayment rules below for low-income individuals. Amends SSA title XVIII part D to outline special eligibility, enrollment, and copayment rules for low-income individuals, which include options for continuation of Medicaid coverage or enrollment under such part. Part B: Improving Preventive Benefits and Eliminating Cost Sharing - Amends SSA title XVIII to eliminate deductibles and coinsurance for certain preventive health care items and services. (Sec. 222) Directs the Secretary to carry out: (1) a nationwide education campaign to promote preventive health awareness among older Americans and people with disabilities; and (2) a demonstration project testing a variety of smoking cessation services for Medicare beneficiaries for the purpose of identifying the most successful and cost-effective approaches. Provides for funding. Part C: Rationalizing Cost Sharing and Medigap - Amends SSA title XVIII with regard to: (1) deductibles and coinsurance for clinical laboratory services, indexing the deductible for inflation; and (2) Medicare supplemental health insurance (Medigap) policies, authorizing establishment of new Medigap plan. (Sec. 234) Directs the Secretary to report to Congress on policy options for improving Medigap coverage. (Sec. 235) Amends SSA title XVIII to: (1) apply Medigap protections to disabled and end stage renal disease (ESRD) Medicare beneficiaries; (2) add a special Medigap enrollment antidiscrimination requirement for certain beneficiaries; (3) add a one-time additional special open enrollment for beneficiaries losing access to Medicare+Choice plans; (4) provide guaranteed access for certain Medicare beneficiaries to all Medigap policies; and (5) provide for increased civil money penalties for enrollment period violations. (Sec. 236) Amends SSA title XVIII to remove the sunset date for cost-sharing in Medicare part B premiums for certain qualifying individuals. Repeals the mandate for State coverage of Medicare cost-sharing for additional low-income Medicare beneficiaries. Title III: Protecting and Extending Medicare Solvency - Amends SSA title XVIII to make additional appropriations to the Federal Hospital Insurance Trust Fund (Trust Fund) under Medicare part A (Hospital Insurance) for FY 2001 through FY 2015. (Sec. 302) Establishes the Catastrophic Prescription Drug Coverage Reserve (Reserve), defined under the Congressional Budget Act of 1974 for FY 2006 through 2010. Provides that beginning with September 30, 2006, any balance remaining in the Reserve on the last day of a fiscal year is appropriated to the Trust Fund. (Sec. 303) Creates the Medicare Solvency Debt Reduction Reserve comprising hospital insurance employment taxes imposed under the Federal Insurance Contributions Act as well as amounts in the Reserve. Amends the Congressional Budget Act of 1974 to: (1) make it out of order in either House of Congress to consider any budget resolution that would allocate funds from or assume a reduction of the Medicare Solvency Debt Reduction Reserve; and (2) require a supermajority vote for waiver of related points of order. (Sec. 304) Provides that: (1) any provision of legislation that would reduce, repeal, or reverse the additional appropriations made by this Act to the Trust Fund, or the amount of the Reserve, shall not be counted on the pay-as-you-go scorecard, and shall not be included in any pay-as-you-go estimates made by the Congressional Budget Office or the Office of Management and Budget; and (2) certain transfers under this Act to the Medicare Solvency Debt Reduction Reserve shall be treated for purposes of the President's budget, the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman- Hollings Act), and the Congressional Budget Act of 1974 as reductions to the on-budget surplus (or increases in the on-budget deficit).

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3 official files

• Introduced in Senate (text)

  Introduced in Senate · EN · 4 April 2000

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• Introduced in Senate (PDF)

  Introduced in Senate · EN · 4 April 2000

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• Introduced in Senate

  summary · EN · 4 April 2000

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