Managed Care Integrity Act of 2000

Summary

Managed Care Integrity Act of 2000 - Requires health benefits plans offered by managed care entities to ensure that, with respect to a contract year, the actuarial value of the aggregate plan benefits is at least 85 percent of the aggregate amount of payments received from, or on behalf of, plan enrollees. Waives such requirement for a limited period if an entity's solvency is in jeopardy or compliance would cause the entity to fail to meet solvency requirements for licensure in a State. Excludes plan management and operation costs for purposes of determining actuarial value of aggregate benefits. Includes Medicaid managed care organizations and managed care entities providing health care coverage for Federal employees and members of the armed forces within the definition of "managed care entity." Requires the Secretary of Health and Human Services to develop formal investigation and compliance procedures with respect to complaints concerning failures of health benefits plans to comply with this Act. Amends title XVIII (Medicare) of the Social Security Act to apply the requirements of the Managed Care Integrity Act of 2000 to Medicare+Choice organizations. Sets forth remedies with respect to failures to comply with this Act, including monetary penalties, and, with respect to Medicare+Choice organizations, suspension of enrollment of individuals or payments.

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3 official files

• Introduced in Senate (text)

  Introduced in Senate · EN · 27 July 2000

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• Introduced in Senate (PDF)

  Introduced in Senate · EN · 27 July 2000

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• Introduced in Senate

  summary · EN · 27 July 2000

  Open at official source

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