Page:United States Statutes at Large Volume 104 Part 2.djvu/545

This page needs to be proofread.


PUBLIC LAW 101-508 —NOV. 5, 1990 104 STAT. 1388-137 42 USC 1320C-3 note. 42 USC 139588 note. (2) Section 1882(b)(1) (42 U.S.C. 1395ss(b)(l)), as previously amended, is amended— (A) in subparagraph (A), by inserting ", except as otherwise provided by subparagraph (H)" before the semicolon; (B) by striking "and" at the end of subparagraph (F); (C) by inserting "and" at the end of subparagraph (G); and (D) by adding after subparagraph (G) the following: "(H) in the case of a policy that meets the standards under subparagraph (A) except that benefits under the policy are limited to items and services furnished by certain entities (or reduced benefits are provided when items or services are furnished by other entities), provides for the application of requirements equal to or more stringent than the requirements under subsection (t),". (3) The first sentence of section 1154(a)(4)(B) (42 U.S.C. 1320c- 3(a)(4)(B)) is amended by inserting "(or subject to review under section 1882(t))" after "section 1876". (c) EFFECTIVE DATE. —The amendments made by this section shall only apply in 15 States (as determined by the Secretary of Health and Human Services) and only during the 3-year period beginning with 1992. (d) EVALUATION.—The Secretary of Health and Human Services shall conduct an evaluation of the amendments made by this section and shall report to Congress on such evaluation by not later than January 1, 1995. SEC. 4359. HEALTH INSURANCE ADVISORY SERVICE FOR MEDICARE 42 USC 1395b-3. BENEFICIARIES. (a) IN GENERAL. —The Secretary of Health and Human Services shall establish a health insurance advisory service program (in this section referred to as the "beneficiary assistance program") to assist medicare-eligible individuals with the receipt of services under the medicare and medicaid programs and other health insurance programs. (b) OUTREACH ELEMENTS.— The beneficiary assistance program shall provide assistance— (1) through operation using local Federal offices that provide information on the medicare program, (2) using community outreach programs, and (3) using a toll-free telephone information service. (c) ASSISTANCE PROVIDED.—The beneficiary assistance program shall provide for information, counseling, and assistance for medicare-eligible individuals with respect to at least the following: (1) With respect to the medicare program— (A) eligibility, (B) benefits (both covered and not covered), (C) the process of payment for services, (D) rights and process for appeals of determinations, (E) other medicare-related entities (such as peer review organizations, fiscal intermediaries, and carriers), and (F) recent legislative and administrative changes in the medicare program. (2) With respect to the medicaid program— (A) eligibility, benefits, and the application process, (B) linkages between the medicaid and medicare programs, and 9-194O-91-18:QL3Part2