Medicare Catastrophic Illness Coverage Act of 1987

Summary

Medicare Catastrophic Illness Coverage Act of 1987 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to cover: (1) inpatient hospital services which are not covered under part A (Hospital Insurance) of the Medicare program due to durational limitations on such coverage; (2) the second and any subsequent deductible imposed for inpatient hospital services furnished within a calendar year; (3) coinsurance amounts imposed for inpatient hospital services and post-hospital extended care services; (4) the deductible imposed for the first two units of blood furnished to an individual as part of inpatient hospital services; and (5) a part B Medicare beneficiary's out-of-pocket medical expenses in excess of $1,800 in 1988, with adjustments to such ceiling thereafter reflecting changes in the cost-of-living. Excludes from the computation of a beneficiary's out-of-pocket expenses amounts above the full part B payment to physicians and others who do not accept assignment. Includes in the computation of the part B premium an amount equal to the Secretary of Health and Human Services' estimate of a part B enrollee's share of the benefits and administrative costs which result from this Act's catastrophic care coverage and beneficiary expense ceiling. Covers as home health services, daily nursing care and home health aide services furnished for up to 21 days with a physician's certification of the need for such daily care. (Currently such care must be provided on a part-time or intermittent basis.) Directs the Secretary to request the Institute of Medicine to perform a study to determine which prescription drugs should have their costs counted toward the part B beneficiary's out-of-pocket expenses limit. Requires the Institute to submit an interim report within six months and a final report within one year of this Act's enactment to the Secretary and the Congress regarding such study. Requires State regulatory standards for Medicare supplemental health insurance policies to be equal to or more stringent than the National Association of Insurance Commissioners (NAIC) Model Standards, amended within 90 days of this Act's enactment to reflect changes made by this Act. Provides that if the NAIC Model Standards are not amended, Federal model standards shall be established and serve as the basis for evaluating State regulatory standards for Medicare supplemental health insurance policies. Excludes any day on which an individual is an inpatient of a skilled nursing facility but does not need the degree of care provided by such facility from a Medicare beneficiary's "spell of illness."

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1 official file

• Introduced in Senate

  summary · EN · 17 March 1987

  Open at official source

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