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[DOCID: f:h2709ih.txt]






107th CONGRESS
  1st Session
                                H. R. 2709

 To amend title XVIII of the Social Security Act to improve access to 
   Medicare+Choice plans for special needs medicare beneficiaries by 
allowing plans to target enrollment to special needs beneficiaries and 
    by eliminating the beneficiary lock-in and other administrative 
                  barriers to serving this population.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 1, 2001

Mr. Ramstad (for himself and Mr. Cardin) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addition 
      to the Committee on Energy and Commerce, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to improve access to 
   Medicare+Choice plans for special needs medicare beneficiaries by 
allowing plans to target enrollment to special needs beneficiaries and 
    by eliminating the beneficiary lock-in and other administrative 
                  barriers to serving this population.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Improvements for Special 
Needs Beneficiaries Act of 2001''.

SEC. 2. SPECIALIZED MEDICARE+CHOICE PLANS FOR SPECIAL NEEDS 
              BENEFICIARIES.

    (a) Treatment as Coordinated Care Plan.--Section 1851(a)(2)(A) of 
the Social Security Act (42 U.S.C. 1395w-21(a)(2)(A)) is amended by 
adding at the end the following new sentence: ``Specialized 
Medicare+Choice plans for special needs beneficiaries (as defined in 
section 1859(b)(4)) may be any type of coordinated care plan.''.
    (b) Specialized Medicare+Choice Plan for Special Needs 
Beneficiaries Defined.--Section 1859(b) of such Act (42 U.S.C. 1395w-
29(b)) is amended by adding at the end the following new paragraph:
            ``(4) Specialized medicare+choice plans for special needs 
        beneficiaries.--
                    ``(A) In general.--The term `specialized 
                Medicare+Choice plan for special needs beneficiaries' 
                means a Medicare+Choice plan that exclusively serves 
                special needs beneficiaries (as defined in subparagraph 
                (B)).
                    ``(B) Special needs beneficiary.--The term `special 
                needs beneficiary' means a Medicare+Choice eligible 
                individual who--
                            ``(i) is institutionalized (as defined by 
                        the Secretary);
                            ``(ii) is entitled to medical assistance 
                        under a State plan under title XIX; or
                            ``(iii) meets such requirements as the 
                        Secretary may determine would benefit from 
                        enrollment in such a specialized 
                        Medicare+Choice plan described in subparagraph 
                        (A).''.
    (c) Restriction on Enrollment Permitted.--Section 1859 of such Act 
(42 U.S.C. 1395w-29) is amended by adding at the end the following new 
subsection:
    ``(f) Restriction on Enrollment for Specialized Medicare+Choice 
Plans for Special Needs Beneficiaries.--In the case of a specialized 
Medicare+Choice plan (as defined in subsection (b)(4)), notwithstanding 
any other provision of this part and in accordance with regulations of 
the Secretary, the plan may restrict the enrollment of individuals 
under the plan to individuals who are within one or more classes of 
special needs beneficiaries.''.
    (d) Continuous Open Enrollment Permitted.--Section 1851(e)(2)(D) of 
such Act (42 U.S.C. 1395w-21(e)(2)(D)) is amended to read as follows:
                    ``(D) Continuous open enrollment for special needs 
                beneficiaries.--At any time after 2001, in the case of 
                a special needs beneficiary (as defined in section 
                1859(b)(4)(B)), the beneficiary may change the election 
                under subsection (a)(1).''.
    (e) Waiver of Requirements Permitted.--Section 1857 of such Act (42 
U.S.C. 1395w-27) is amended by adding at the end the following new 
subsection:
    ``(j) Waiver of Requirements for Specialized Medicare+Choice 
Plans.--The Secretary is authorized to waive those requirements of this 
part which the Secretary finds to be impediments to a Medicare+Choice 
plan's ability to optimize the care being provided to individuals 
enrolled in a specialized Medicare+Choice plan for special needs 
beneficiaries (as defined in section 1859(b)(4)).''.
    (f) Effective Dates.--
            (1) In general.--The amendments made by this section take 
        effect upon the date of the enactment of this Act.
            (2) Deadline for issuance of requirements for special needs 
        beneficiaries; transition.--No later than September 1, 2002, 
        the Secretary of Health and Human Services shall issue final 
        regulations to establish requirements for special needs 
        beneficiaries under section 1859(b)(4)(B)(iii) of the Social 
        Security Act, as added by subsection (c).
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