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H.R. 4998 (113th): Medicare Advantage Participant Bill of Rights Act of 2014

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The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress.

6/26/2014--Introduced. Medicare Advantage Participant Bill of Rights Act of 2014 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to require a Medicare Advantage (MA) organization to remove a service provider or a supplier from a plan network only for cause, subject to completion of a fair notice and appeals process.

Lists as cause for removal: (1) medical negligence, (2) violation of any legal or contractual requirement for the provider or supplier acting within the lawful scope of practice, or (3) unfitness to furnish items and services in accordance with Medicare requirements.

Requires an MA organization offering an MA plan to include information on the measures used to establish or modify the plan's provider network: (1) in the annual bid information submitted about the MA plan, and (2) on the plan's Internet Web.

Subjects to certain sanctions MA organizations with contracts which fail to meet these information requirements.

Directs the Secretary of Health and Human Services (HHS) to: (1) seek input from patient advocacy groups and others in applying network access adequacy standards, and (2) take necessary measures to ensure that the Medicare Advantage Compare Tool takes into account the preferences and utilization needs of such individuals.