Page:United States Statutes at Large Volume 102 Part 1.djvu/785

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PUBLIC LAW 100-000—MMMM. DD, 1988

PUBLIC LAW 100-360—JULY 1, 1988

102 STAT. 747

1972, for portions of contract years occurring after December 31, 1988, so as to apply to such organizations and contracts the requirements imposed by the amendments made by this Act upon a n organization with a risk-sharing contract under section 1876 of the Social Security Act. SEC. 223. MAILING OF NOTICE OF MEDICARE BENEFITS AND INFORMATION DESCRIBING PARTICIPATING PHYSICIAN PROGRAM.

(a) DISTRIBUTION OF NOTICES.—Title XVin is amended by inserting after section 1803 the following new section: "NOTICE OF MEDICARE BENEFITS

"SEC. 1804. The Secretary shall prepare (in consultation with 42 USC l395b-2. groups representing the elderly and with health insurers) and provide for d^tribution of a notice containing— "(1) a clear, simple explanation of the benefits available under this title and the major categories of health care for which benefits are not available under this title, "(2) the limitations on payment (including deductibles and coinsurance amounts) that are imposed under this title, and "(3) a description of the limited benefits for long-term care services available under this title and generally available under State plans approved under title XIX. Such notice shall be mailed annually to individuals entitled to benefits under part A or part B of this title and when an individual applies for benefits under part A or enrolls under part B.". (b) DISTRIBUTION OF INFORMATION DESCRIBING PARTICIPATING PHYSICIAN PROGRAM.—Section 1842(h)(5) (42 U.S.C. 1395u(h)(5)) is

amended— (1) by inserting "through an annual mailing" after "under this part", (2) by striking the last sentence, (3) by inserting "(A)" after "(5)", and (4) by adding at the end the following new subparagraph: "(B) The annual notice provided under subparagraph (A) shall include— "(i) a description of the participation program, "(ii) an explanation of the advantages to beneficiaries of obtaining covered services through a psuticipating physician or supplier, (iii) an explanation of the assistance offered by carriers in obtaining the names of participating physicians and suppliers, and "(iv) the toll-free telephone number under paragraph (2)(A) for inquiries concerning the program and for requests for free copies of appropriate directories.'. (c) REVISION OF EXPLANATION OF MEDICARE BENEFITS.—Section

1842(h)(7) (42 U.S.C. 1395u(h)(7)) is amended— (1) in subparagraph (A)— (A) by inserting "prominent" before "reminder", and (B) by striking), and" and inserting "and a clear statement of any amounts charged for the particular items or services on the claim involved above the amount recognized under this part),"; (2) in subparagraph (B), by striking the period at the end and inserting ", and '; and