Page:United States Statutes at Large Volume 111 Part 1.djvu/312

 Ill STAT. 288 PUBLIC LAW 105-33 —AUG. 5, 1997 in the announcement made at the beginning of such period, then, unless otherwise required by law— "(A) such determination shall not apply to contracts under this part until the first contract year that begins after the end of such period, and "(B) if such coverage determination provides for coverage of additional benefits or coverage under additional circumstances, section 1851(i)(l) shall not apply to payment for such additional benefits or benefits provided under such additional circumstances until the first contract year that begins after the end of such period. "(b) ANTIDISCRIMINATION.— "(1) BENEFICIARIES. — " (A) IN GENERAL. — A Medicare+Choice organization may not deny, limit, or condition the coverage or provision of benefits under this part, for individuals permitted to be enrolled with the organization under this part, based on any health status-related factor described in section 2702(a)(1) of the Public Health Service Act. " (B) CONSTRUCTION. —Subparagraph (A) shall not be construed as requiring a Medicare+Choice organization to enroll individuals who are determined to have end-stage renal disease, except as provided under section 1851(a)(3)(B). "(2) PROVIDERS. —A Medicare+Choice organization shall not discriminate with respect to participation, reimbursement, or indemnification as to any provider who is acting within the scope of the provider's license or certification under applicable State law, solely on the basis of such license or certification. This paragraph shall not be construed to prohibit a plan from including providers only to the extent necessary to meet the needs of the plan's enrollees or from establishing any measure designed to maintain quality and control costs consistent with the responsibilities of the plan. "(c) DISCLOSURE REQUIREMENTS. — "(1) DETAILED DESCRIPTION OF PLAN PROVISIONS. — A Medicare+Choice organization shall disclose, in clear, accurate, and standardized form to each enrollee with a Medicare+Choice plan offered by the organization under this part at the time of enrollment and at least annually thereafter, the following information regarding such plan: "(A) SERVICE AREA.—The plan's service area. "(B) BENEFITS. —Benefits offered under the plan, including information described in section 1851(d)(3)(A) and exclusions from coverage and, if it is an MSA plan, a comparison of benefits under such a plan with benefits under other Medicare+Choice plans. "(C) ACCESS. — The number, mix, and distribution of plan providers, out-of-network coverage (if any) provided by the plan, and any point-of-service option (including the supplemental premium for such option). "(D) OUT-OF-AREA COVERAGE. —Out-of-area coverage provided by the plan. "(E) EMERGENCY COVERAGE.— Coverage of emergency services, including— "(i) the appropriate use of emergency services, including use of the 911 telephone system or its local

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