GovTrack’s Bill Summary
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Library of Congress Summary
The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress.
Medigap Fraud and Abuse Prevention Act of 1990 - Amends title XVIII (Medicare) of the Social Security Act to penalize individuals who issue, sell, or renew Medicare supplemental policies which are in violation of this Act's standards or offer to sell a policy in a State that has not approved such policy. Requires that Medicare supplemental policy issuers: (1) cover a core group of basic benefits and, if they offer other benefits, issue a policy covering only such basic benefits; (2) provide prospective purchasers of a policy with a summary information sheet describing policy benefits and the amount of any premiums attributable to optional benefits; (3) guarantee the renewability of policies; (4) offer each group policyholder terminating their coverage or group membership the right to continued coverage under an individual policy (the policyholder ending his or her group membership may also opt for continued coverage under the group policy) or, if the old group policy is replaced by a new group policy, the right to coverage under a new group policy without exclusion for preexisting conditions; and (5) suspend policy benefits and premiums upon the policyholder's indication that he or she is entitled to Medicaid (title XIX of the Social Security Act) benefits. Requires the National Association of Insurance Commissioners (NAIC) or, upon the NAIC's default, the Secretary of Health and Human Services to promulgate simplification standards which set the core group of basic benefits policies must provide, limit the additional benefit packages that may be provided, and establish a uniform language and format to be used with respect to policy benefits. Prohibits the sale of policies which do not meet such standards, though permits approved waivers of such standards to test new or innovative benefits. Directs the Secretary to request the NAIC to educate Medicare beneficiaries on the simplification standards. Increases the civil monetary penalty for knowingly selling a policy which duplicates health benefits to which an individual is already entitled. Permits persons aggrieved by duplicative coverage to recover triple damages in a civil suit. Prohibits a policy issuer from selling a policy without: (1) obtaining a written statement of the buyer indicating any health policies of the same type or Medicaid coverage the buyer may have; and (2) notifying the buyer of the possibility and effect of their coverage under the Medicaid program and the address and telephone number of any State Medicare supplemental policy counseling program and the State Medicaid office. Prohibits the issuer from selling a policy to a person who indicates that he or she is covered by the Medicaid program or has duplicative health benefits. Penalizes individuals who sell a policy in violation of such requirements. Increases the percentage of premiums which must be returned to policyholders as benefits. Establishes a process whereby States must approve premium increases prior to their implementation. Requires public hearings for any premium increase request exceeding twice the percentage increase in the medical care component of the consumer price index. Limits Medicare supplemental policy sales commissions. Authorizes appropriations for a matching grant program to assist States in establishing counseling programs to aid Medicare-eligible individuals in choosing Medicare supplemental policies. Prohibits such policies from denying a claim for losses incurred more than six months from the effective date of coverage for a preexisting condition.
House Republican Conference Summary
The summary below was written by the House Republican Conference, which is the caucus of Republicans in the House of Representatives.
No summary available.
House Democratic Caucus Summary
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So, yes, we display the House Republican Conference’s summaries when available even if we do not have a Democratic summary available. That’s because we feel it is better to give you as much information as possible, even if we cannot provide every viewpoint.
We’ll be looking for a source of summaries from the other side in the meanwhile.