[104th Congress Public Law 18]
[From the U.S. Government Printing Office]

[DOCID: f:publ18.104]

[[Page 109 STAT. 192]]

Public Law 104-18
104th Congress

                                 An Act

    To amend the Omnibus Budget Reconciliation Act of 1990 to permit 
 medicare select policies to be offered in all States. <<NOTE: July 7, 
                          1995 -  [H.R. 483]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,


      Section 4358(c) of the Omnibus Budget Reconciliation Act of 1990, 
as amended by section 172(a) of the Social Security Act Amendments of 
1994, <<NOTE: 42 USC 1320c-3 note.>>  is amended to read as follows:
      ``(c) Effective Date.--(1) The amendments made by this section 
shall only apply--
            ``(A) in 15 States (as determined by the Secretary of Health 
        and Human Services) and such other States as elect such 
        amendments to apply to them, and
            ``(B) subject to paragraph (2), during the 6\1/2\-year 
        period beginning with 1992.

For purposes of this paragraph, the term `State' has the meaning given 
such term by section 210(h) of the Social Security Act (42 U.S.C. 
      ``(2)(A) The Secretary of Health and Human Services shall conduct 
a study that compares the health care costs, quality of care, and access 
to services under medicare select policies with that under other 
medicare supplemental policies. The study shall be based on surveys of 
appropriate age-adjusted sample populations. The study shall be 
completed by June 30, 1997.
      ``(B) Not later than December 31, 1997, the Secretary shall 
determine, based on the results of the study under subparagraph (A), if 
any of the following findings are true:
            ``(i) The amendments made by this section have not resulted 
        in savings of premium costs to those enrolled in medicare select 
        policies (in comparison to their enrollment in medicare 
        supplemental policies that are not medicare select policies and 
        that provide comparable coverage).
            ``(ii) There have been significant additional expenditures 
        under the medicare program as a result of such amendments.
            ``(iii) Access to and quality of care has been significantly 
        diminished as a result of such amendments.
      ``(C) The amendments made by this section shall remain in effect 
beyond the 6\1/2\-year period described in paragraph (1)(B) unless the 
Secretary determines that any of the findings described in clause (i), 
(ii), or (iii) of subparagraph (B) are true.
      ``(3) The Comptroller General shall conduct a study to determine 
the extent to which individuals who are continuously covered under

[[Page 109 STAT. 193]]

a medicare supplemental policy are subject to medical underwriting if 
they change the policy under which they are covered, and to identify 
options, if necessary, for modifying the medicare supplemental insurance 
market to make sure that continuously insured beneficiaries are able to 
switch plans without medical underwriting. By not later than June 30, 
1996, the Comptroller General <<NOTE: Reports.>>  shall submit to the 
Congress a report on the study. The report shall include a description 
of the potential impact on the cost and availability of medicare 
supplemental policies of each option identified in the study.''.

    Approved July 7, 1995.


HOUSE REPORTS: Nos. 104-79, Pt. 1 (Comm. on Ways and Means) and Pt. 2 
(Comm. on Commerce), and 104-157 (Comm. of Conference).
            Apr. 6, considered and passed House.
            May 17, considered and passed Senate, amended.
            June 26, Senate agreed to conference report.
            June 30, House agreed to conference report.