Page:United States Statutes at Large Volume 111 Part 1.djvu/304

From Wikisource
Jump to navigation Jump to search
This page needs to be proofread.

Ill STAT. 280 PUBLIC LAW 105-33 —AUG. 5, 1997 relating to medicare select policies described in section 1882(t). "(E) POTENTIAL FOR CONTRACT TERMINATION.—The fact that a Medicare+Choice organization may terminate its contract, refuse to renew its contract, or reduce the service area included in its contract, under this part, and the effect of such a termination, nonrenewal, or service area reduction may have on individuals enrolled with the Medicare+Choice plan under this part. " (4) INFORMATION COMPARING PLAN OPTIONS.— Information under this paragraph, with respect to a Medicare+Choice plan for a year, shall include the following: "(A) BENEFITS. — The benefits covered under the plan, including the following: "(i) Covered items and services beyond those provided under the original medicare fee-for-service program. "(ii) Any beneficiary cost sharing, "(iii) Any maximum limitations on out-of-pocket expenses. "(iv) In the case of an MSA plan, differences in cost sharing, premiums, and balance billing under such a plan compared to under other Medicare+Choice plans. "(v) In the case of a Medicare+Choice private feefor-service plan, differences in cost sharing, premiums, and balance billing under such a plan compared to under other Medicare+Choice plans. "(vi) The extent to which an enrollee may obtain benefits through out-of-network health care providers. "(vii) The extent to which an enrollee may select among in-network providers and the types of providers participating in the plan's network. "(viii) The organization's coverage of emergency and urgently needed care. "(B) PREMIUMS. —The Medicare+Choice monthly basic beneficiary premium and Medicare+Choice monthly supplemental beneficiary premium, if any, for the plan or, in the case of an MSA plan, the Medicare+Choice monthly MSA premium. "(C) SERVICE AREA.— The service area of the plan. "(D) QUALITY AND PERFORMANCE. —TO the extent available, plan quality and performance indicators for the benefits under the plan (and how they compare to such indicators under the original medicare fee-for-service program under parts A and B in the area involved), including— "(i) disenrollment rates for medicare enrollees electing to receive benefits through the plan for the previous 2 years (excluding disenrollment due to death or moving outside the plsin's service area), "(ii) information on medicare enrollee satisfaction, "(iii) information on health outcomes, and "(iv) the recent record regarding compliance of the plan with requirements of this part (as determined by the Secretary). " (E) SUPPLEMENTAL BENEFITS. —Whether the organization offering the plan includes mandatory supplemental