Summary: H.R.4047 — 104th Congress (1995-1996)All Information (Except Text)

There is one summary for H.R.4047. Bill summaries are authored by CRS.

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Introduced in House (09/11/1996)

Medigap Amendments of 1996 - Amends title XVIII (Medicare) of the Social Security Act with respect to certification of Medicare supplemental health insurance policies, particularly coverage for pre-existing conditions, providing for additional consumer protections for certain individuals whose enrollment with an eligible organization ceases for one or more specified reasons. Prohibits a Medicare supplemental policy issuer from denying or conditioning a policy to such an individual, from imposing preexisting condition exclusions, and from discriminating in pricing because of the individual's health, claims experience, or disability in the case of such an individual who has had continuous coverage (with no break longer than 63 days), if the policy in which the individual wishes to enroll has a comparable or less generous benefits package.

Revises the prohibition against an insurer's excluding benefits based on a pre-existing condition during the initial six-month enrollment period after an individual first becomes eligible for Medicare. Extends the six-month initial enrollment period to non-elderly Medicare beneficiaries.

Authorizes the Secretary of Health and Human Services to provide grants to private, independent, nonprofit consumer organizations and State agencies applying to conduct programs to prepare and make available to Medicare beneficiaries comprehensive and understandable information on enrollment in health plans with a Medicare managed care contract and in Medicare supplemental policies in which they are eligible to enroll. Requires any eligible organization with a Medicare managed care contract or any issuer of a Medicare supplemental policy to: (1) conduct a consumer satisfaction survey of the enrollees under such contract or such policy; and (2) make the survey results available to the Secretary and the State Insurance Commissioner of the State in which the enrollees are so enrolled. Requires each organization which provides a Medicare managed care contract or issues a Medicare supplemental policy to pay to the Secretary its pro rata share of the estimated costs to be incurred by the Secretary in providing the grants. Makes necessary appropriations.