S. 5117 — Introduced in Senate

II 117th CONGRESS 2d Session S. 5117 IN THE SENATE OF THE UNITED STATES November 17, 2022Mr. Marshall (for himself and Ms. Hassan) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to require the inclusion of information on prior authorization requirements and other utilization management techniques, and other information, in the Medicare & You annual notice. 1. Short title This Act may be cited as the Medicare & You Handbook Improvement Act of 2022. 2. Requiring the inclusion of information on prior authorization requirements and other utilization management techniques, and other information, in the Medicare & You annual notice (a) In general Section 1804(c) of the Social Security Act (42 U.S.C. 1395b–2(c)) is amended— (1) in paragraph (3), by striking and at the end; and (2) by adding at the end the following new paragraphs: (5) a description of the types of prior authorization requirements and any other utilization management techniques that may apply under this title, including information on how an individual may find out which such requirements and techniques (if any) apply under a Medicare Advantage plan or a prescription drug plan; (6) a description of the network sizes of Medicare Advantage plans relative to the number of providers of services and suppliers who accept the original Medicare fee-for-service program under parts A and B; and (7) an illustrative example clarifying that a beneficiary switching from a Medicare Advantage plan to the original Medicare fee-for-service program under parts A and B may be prohibited from purchasing a medicare supplemental policy under section 1882 or have to pay significantly higher premiums for such a policy. . (b) Effective date The amendments made by subsection (a) shall apply to notices distributed on or after January 1, 2023.