article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Medicare HMO Protection Act of 1998''. SEC. 2. AUTHORITY TO EVALUATE AND ALTER TERMINATION DECISIONS. Section 1851(g)(3) of the Social Security Act (42 U.S.C. 1395w- 21(g)(3)) is amended by adding at the end the following: ``(E) Authority to delay termination date.-- ``(i) In general.--If a Medicare+Choice organization terminates a plan under subparagraph (B)(iii), the Secretary may delay the effectiveness of such termination if the Secretary determines that-- ``(I) the termination would cause an imminent and serious risk to the health of individuals enrolled under the plan under this part; ``(II) the termination would result in a significant reduction in the Medicare+Choice plans that are available in the area affected by the termination; or ``(III) the organization terminating coverage is offering Medicare+Choice plans in contract areas that are in close proximity to the area affected by the termination without suffering considerable financial losses. In making the determination described in subclause (III), the Secretary may audit and inspect any books or records of the organization pursuant to the authority provided to the Secretary under section 1857(d). ``(ii) End of delay.--The Secretary may end a delay under clause (i), prior to the end of the period established by the Secretary under such clause, if the Secretary determines that an adequate provider network has been established which will provide at least an equal level of insurance coverage as existed in the area affected by the termination on the date the Medicare+Choice organization informed the Secretary of its intention to terminate the contract. ``(F) Authority to renegotiate contract.--If the Secretary delays the effectiveness of a termination for a period pursuant to subparagraph (E), the Secretary and the Medicare+Choice organization terminating coverage pursuant to subparagraph (B)(iii) may negotiate during such period for a new contract under section 1857 which will enable such organization to continue such coverage. In negotiating such contract, the Secretary shall ensure that beneficiaries are not adversely affected by such contract.''. SEC. 3. EXTENSION OF INITIAL MEDICARE+CHOICE CONTRACT PERIOD TO 3 YEARS. (a) In General.--Section 1857(c)(1) of the Social Security Act (42 U.S.C. 1395w-27(c)(1)) is amended by striking ``a term of at least 1 year'' and inserting ``a term of at least 3 years''. (b) Effective Date.--The amendment made by subsection (a) applies to contracts entered into on or after the date of enactment of this Act. SEC. 4. NOTICE OF TERMINATION. (a) In General.--Section 1857(d)(3) of the Social Security Act (42 U.S.C. 1395w-27(d)(3)) is amended to read as follows: ``(3) Enrollee notice at time of termination.-- ``(A) In general.--Each contract under this section shall require the organization to provide (and pay for) written notice at least 120 days prior to the contract's termination, as well as a description of alternatives for obtaining benefits under this title, to each individual enrolled with the organization under this part. ``(B) Description.--The description of alternatives referred to in subparagraph (A) shall include a description of-- ``(i) all Medicare+Choice plans and medicare supplemental policies available in the area where the contract that is being terminated is serving beneficiaries and the costs of such plans and policies; and ``(ii) the telephone number of local social service agencies providing assistance to medicare beneficiaries in such area.''. (b) Effective Date.--The amendment made by subsection (a) applies to any notice of termination which is provided on or after the date of enactment of this Act.
summary: Medicare HMO Protection Act of 1998 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to authorize the Secretary of Health and Human Services to delay the effectiveness of a Medicare+Choice organization's termination of its plan with respect to all individuals in an area, if: (1) the termination would cause an imminent and serious health risk to enrollees; (2) the termination would result in a significant reduction in the Medicare+Choice plans available in the area affected; or (3) the organization terminating coverage is offering Medicare+Choice plans in contract areas close to the area affected without suffering considerable financial losses. Amends Medicare part C with regard to contracts with Medicare+Choice organizations to provide for extension of the initial Medicare+Choice contract period from one year to three years and to revise certain requirements for notification of enrollees at the time of contract termination.