[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 5117 Introduced in Senate (IS)]
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117th CONGRESS
2d Session
S. 5117
To amend title XVIII of the Social Security Act to require the
inclusion of information on prior authorization requirements and other
utilization management techniques, and other information, in the
Medicare & You annual notice.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 17, 2022
Mr. Marshall (for himself and Ms. Hassan) introduced the following
bill; which was read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to require the
inclusion of information on prior authorization requirements and other
utilization management techniques, and other information, in the
Medicare & You annual notice.
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 & You Handbook Improvement
Act of 2022''.
SEC. 2. REQUIRING THE INCLUSION OF INFORMATION ON PRIOR AUTHORIZATION
REQUIREMENTS AND OTHER UTILIZATION MANAGEMENT TECHNIQUES,
AND OTHER INFORMATION, IN THE MEDICARE & YOU ANNUAL
NOTICE.
(a) In General.--Section 1804(c) of the Social Security Act (42
U.S.C. 1395b-2(c)) is amended--
(1) in paragraph (3), by striking ``and'' at the end; and
(2) by adding at the end the following new paragraphs:
``(5) a description of the types of prior authorization
requirements and any other utilization management techniques
that may apply under this title, including information on how
an individual may find out which such requirements and
techniques (if any) apply under a Medicare Advantage plan or a
prescription drug plan;
``(6) a description of the network sizes of Medicare
Advantage plans relative to the number of providers of services
and suppliers who accept the original Medicare fee-for-service
program under parts A and B; and
``(7) an illustrative example clarifying that a beneficiary
switching from a Medicare Advantage plan to the original
Medicare fee-for-service program under parts A and B may be
prohibited from purchasing a medicare supplemental policy under
section 1882 or have to pay significantly higher premiums for
such a policy.''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to notices distributed on or after January 1, 2023.
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