Page:United States Statutes at Large Volume 124.djvu/502

 124 STAT. 476 PUBLIC LAW 111–148—MAR. 23, 2010 collect and maintain information on MA–PD plan and prescription drug plan complaints that are received (including by telephone, letter, e-mail, or any other means) by the Secretary (including by a regional office of the Department of Health and Human Serv- ices, the Medicare Beneficiary Ombudsman, a subcontractor, a car- rier, a fiscal intermediary, and a Medicare administrative contractor under section 1874A of the Social Security Act (42 U.S.C. 1395kk)) through the date on which the complaint is resolved. The system shall be able to report and initiate appropriate interventions and monitoring based on substantial complaints and to guide quality improvement. (b) MODEL ELECTRONIC COMPLAINT FORM.—The Secretary shall develop a model electronic complaint form to be used for reporting plan complaints under the system. Such form shall be prominently displayed on the front page of the Medicare.gov Internet website and on the Internet website of the Medicare Beneficiary Ombuds- man. (c) ANNUAL REPORTS BY THE SECRETARY.—The Secretary shall submit to Congress annual reports on the system. Such reports shall include an analysis of the number and types of complaints reported in the system, geographic variations in such complaints, the timeliness of agency or plan responses to such complaints, and the resolution of such complaints. (d) DEFINITIONS.—In this section: (1) MA–PD PLAN.—The term ‘‘MA–PD plan’’ has the meaning given such term in section 1860D–41(a)(9) of such Act (42 U.S.C. 1395w–151(a)(9)). (2) PRESCRIPTION DRUG PLAN.—The term ‘‘prescription drug plan’’ has the meaning given such term in section 1860D– 41(a)(14) of such Act (42 U.S.C. 1395w–151(a)(14)). (3) SECRETARY.—The term ‘‘Secretary’’ means the Secretary of Health and Human Services. (4) SYSTEM.—The term ‘‘system’’ means the plan complaint system developed and maintained under subsection (a). SEC. 3312. UNIFORM EXCEPTIONS AND APPEALS PROCESS FOR PRESCRIPTION DRUG PLANS AND MA–PD PLANS. (a) IN GENERAL.—Section 1860D–4(b)(3) of the Social Security Act (42 U.S.C. 1395w–104(b)(3)) is amended by adding at the end the following new subparagraph: ‘‘(H) USE OF SINGLE, UNIFORM EXCEPTIONS AND APPEALS PROCESS.—Notwithstanding any other provision of this part, each PDP sponsor of a prescription drug plan shall— ‘‘(i) use a single, uniform exceptions and appeals process (including, to the extent the Secretary deter- mines feasible, a single, uniform model form for use under such process) with respect to the determination of prescription drug coverage for an enrollee under the plan; and ‘‘(ii) provide instant access to such process by enrollees through a toll-free telephone number and an Internet website.’’. (b) EFFECTIVE DATE.—The amendment made by subsection (a) shall apply to exceptions and appeals on or after January 1, 2012. 42 USC 1395w–104 note.