,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #gbdi  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,decemb] #aa1         
#bjah,mr4 ,re$ introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on ,ways & 
,means1 & 9 addition to ! ,committee on 
,en]gy & ,comm]ce1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
provide = c]ta9 prior au?orization      
notifications by ,m$ic>e ,advantage     
organizations4  #a4 ,%ort title ,?is    
,act may be cit$ z ! ,! ,bett] ,prior   
,au?orization ,notification ,act4  #b4  
,prior au?orization notifications       
requir$ to be made by ,m$ic>e ,advantage
 organizations  7a7 ,notification to    
provid]s & prescrib]s ,section #aheb7;j7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciew-#bb7;j77 is am5d$ by   
add+ at ! end ! foll[+3  7#h7 ,prior    
au?orization notification ,= ea* plan   

ye>1 beg9n+ ) plan ye> #bjba1 a ,m$ic>e 
,advantage organization (f]+ an ,,ma    
plan %all provide to physicians & o!r   
provid]s :o are prescrib]s :o h 9 effect
 = su* plan ye> an agreem5t (           
p>ticipation ) ! organization--  7,a7 at
 ! beg9n+ ( su* plan ye>1 in=mation 7su*
 z ?r\gh a public website1 mail1        
electronic communications1 or payor's   
web portal 7z def9$ by ! ,secret>y77 on 
items & s]vices 7:i* 9 ! case ( an      
,,ma-,,pd plan %all include cov]$ "p ,d 
drugs7 cov]$ "u ! plan t are subject to 
a prior au?orization2 &  7,b7 be=e      
implem5t+ any additional prior          
au?orization requirem5t "u ! plan dur+  
su* plan ye> applicable to su* items or 
s]vices1 notification ( su* additional  
requirem5t4  4  7b7 ,notification to    
b5efici>ies ,section #aheb7;c7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#bb7;c77 is am5d$ by add+ at !   
end ! foll[+ new p>agraph3  7#c7 ,prior 
au?orization in=mation  7,a7 ,9 g5]al ,=
 ea* plan ye>1 beg9n+ ) plan ye> #bjba1 

a ,m$ic>e ,advantage organization (f]+  
an ,,ma plan %all provide 7su* z ?r\gh a
 public website1 mail1 or electronic    
communication7 to ea* enrollee 9 su*    
plan1 be=e implem5t+ "u ! plan any new  
prior au?orization requirem5t applicable
 to an item or s]vice 7:i* 9 ! case ( an
 ,,ma-,,pd plan %all include cov]$ "p ,d
 drugs7 (f]$ "u ! plan t 0 utiliz$ by ! 
enrollee dur+ ! previ\s #ab-mon? p]iod  
7or su* o!r p]iod specifi$ by !         
,secret>y71 notification ( su*          
additional requirem5t & in=mation reg>d+
 an alt]native to su* item or s]vice1 if
 appropriate1 t is n subject to a prior 
au?orization requirem5t "u ! plan & t   
may h a l[] out-(-pocket co/ ?an ! item 
or s]vice subject to ! prior            
au?orization requirem5t4  7,b7 ,hotl9e  
,beg9n+ ) plan ye> #bjba1 a ,m$ic>e     
,advantage organization (f]+ an ,,ma    
plan %all ma9ta9 a hotl9e = enrollees 9 
su* plan to inquire ab\t & receive      
in=mation reg>d+ prior au?orization     
requirem5ts "u su* plan4  4