Notice of medicare benefits; medicare and medigap information
(a)
Notice of medicare benefits
The Secretary shall prepare (in consultation with groups representing the elderly and with health insurers) and provide for distribution of a notice containing—
(1)
a clear, simple explanation of the benefits available under this subchapter and the major categories of health care for which benefits are not available under this subchapter,
(2)
the limitations on payment (including deductibles and coinsurance amounts) that are imposed under this subchapter, and
(3)
a description of the limited benefits for long-term care services available under this subchapter and generally available under State plans approved under subchapter XIX.
Such notice shall be mailed annually to individuals entitled to benefits under part A or part B of this subchapter and when an individual applies for benefits under part A or enrolls under part B.
(b)
Medicare and medigap information
The Secretary shall provide information via a toll-free telephone number on the programs under this subchapter. The Secretary shall provide, through the toll-free telephone number 1–800–MEDICARE, for a means by which individuals seeking information about, or assistance with, such programs who phone such toll-free number are transferred (without charge) to appropriate entities for the provision of such information or assistance. Such toll-free number shall be the toll-free number listed for general information and assistance in the annual notice under subsection (a) instead of the listing of numbers of individual contractors.
(c)
Contents of notice
The notice provided under subsection (a) shall include—
(1)
section 1395b–7 of this title a statement which indicates that because errors do occur and because medicare fraud, waste, and abuse is a significant problem, beneficiaries should carefully check any explanation of benefits or itemized statement furnished pursuant to for accuracy and report any errors or questionable charges by calling the toll-free phone number described in paragraph (4);
(2)
section 1395b–7(b) of this title a statement of the beneficiary’s right to request an itemized statement for medicare items and services (as provided in );
(3)
section 1395b–5(b) of this title a description of the program to collect information on medicare fraud and abuse established under ; and
(4)
a toll-free telephone number maintained by the Inspector General in the Department of Health and Human Services for the receipt of complaints and information about waste, fraud, and abuse in the provision or billing of services under this subchapter.
(d)
Medicare opioid safety education
The notice provided under subsection (a) shall include—
(1)
references to educational resources regarding opioid use and pain management;
(2)
a description of categories of alternative, non-opioid pain management treatments covered under this subchapter; and
(3)
a suggestion for the beneficiary to talk to a physician regarding opioid use and pain management.
Pub. L. 108–1732003—Subsec. (b). inserted at end “The Secretary shall provide, through the toll-free telephone number 1–800–MEDICARE, for a means by which individuals seeking information about, or assistance with, such programs who phone such toll-free number are transferred (without charge) to appropriate entities for the provision of such information or assistance. Such toll-free number shall be the toll-free number listed for general information and assistance in the annual notice under subsection (a) instead of the listing of numbers of individual contractors.”
Pub. L. 103–4321994— inserted “; medicare and medigap information” in section catchline, designated existing provisions as subsec. (a), and added subsec. (b).
“The amendment made by subsection (a) [amending this section] shall apply to notices distributed prior to each Medicare open enrollment period beginning after .”
“The Secretary of Health and Human Services shall first distribute the notice required by the amendment made by subsection (a) [enacting this section] not later than .”
42 U.S.C. 1395jThe Comptroller General of the United States shall conduct a study to monitor the accuracy and consistency of information provided to individuals entitled to benefits under part A [probably means part A of title XVIII of the Social Security Act which is classified to part A of this subchapter] or enrolled under part B [probably means part B of title XVIII of the Social Security Act, et seq.], or both, through the toll-free telephone number 1–800–MEDICARE, including an assessment of whether the information provided is sufficient to answer questions of such individuals. In conducting the study, the Comptroller General shall examine the education and training of the individuals providing information through such number.
“(B)
Report .—
Not later than 1 year after the date of the enactment of this Act [], the Comptroller General shall submit to Congress a report on the study conducted under subparagraph (A).”
“The Secretary of Health and Human Services is authorized to conduct demonstration projects in up to 5 States for the purpose of establishing statewide toll-free telephone numbers for providing information on medicare benefits, medicare supplemental policies available in the State, and benefits under the State medicaid program.”
, , , provided that:
Notice of Changes Under Repeal of Medicare Catastrophic Coverage
42 U.S.C. 1395b–242 U.S.C. 1395“The Secretary of Health and Human Services shall provide, in the notice of medicare benefits provided under section 1804 of the Social Security Act [] for 1990, for a description of the changes in benefits under title XVIII of such Act [ et seq.] made by the amendments made by this Act [see Tables for classification].”
, , , provided that:
Benefits Counseling and Assistance Demonstration Project for Certain Medicare and Medicaid Beneficiaries