
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC1395b-2]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
        SUBCHAPTER XVIII--HEALTH INSURANCE FOR AGED AND DISABLED
 
Sec. 1395b-2. Notice of medicare benefits; medicare and medigap 
        information
        

(a) Notice of medicare benefits

    The Secretary shall prepare (in consultation with groups 
representing the elderly and with health insurers) and provide for 
distribution of a notice containing--
        (1) a clear, simple explanation of the benefits available under 
    this subchapter and the major categories of health care for which 
    benefits are not available under this subchapter,
        (2) the limitations on payment (including deductibles and 
    coinsurance amounts) that are imposed under this subchapter, and
        (3) a description of the limited benefits for long-term care 
    services available under this subchapter and generally available 
    under State plans approved under subchapter XIX of this chapter.

Such notice shall be mailed annually to individuals entitled to benefits 
under part A or part B of this subchapter and when an individual applies 
for benefits under part A of this subchapter or enrolls under part B of 
this subchapter.

(b) Medicare and medigap information

    The Secretary shall provide information via a toll-free telephone 
number on the programs under this subchapter.

(c) Contents of notice

    The notice provided under subsection (a) of this section shall 
include--
        (1) a statement which indicates that because errors do occur and 
    because medicare fraud, waste, and abuse is a significant problem, 
    beneficiaries should carefully check any explanation of benefits or 
    itemized statement furnished pursuant to section 1395b-7 of this 
    title for accuracy and report any errors or questionable charges by 
    calling the toll-free phone number described in paragraph (4);
        (2) a statement of the beneficiary's right to request an 
    itemized statement for medicare items and services (as provided in 
    section 1395b-7(b) of this title);
        (3) a description of the program to collect information on 
    medicare fraud and abuse established under section 1395b-5(b) of 
    this title; and
        (4) a toll-free telephone number maintained by the Inspector 
    General in the Department of Health and Human Services for the 
    receipt of complaints and information about waste, fraud, and abuse 
    in the provision or billing of services under this subchapter.

(Aug. 14, 1935, ch. 531, title XVIII, Sec. 1804, as added Pub. L. 100-
360, title II, Sec. 223(a), July 1, 1988, 102 Stat. 747; amended Pub. L. 
103-432, title I, Sec. 171(j)(1), Oct. 31, 1994, 108 Stat. 4450; Pub. L. 
105-33, title IV, Sec. 4311(a)(1), Aug. 5, 1997, 111 Stat. 384.)

                       References in Text

    Parts A and B of this subchapter, referred to in subsec. (a), are 
classified to sections 1395c et seq. and 1395j et seq., respectively, of 
this title.


                               Amendments

    1997--Subsec. (c). Pub. L. 105-33 added subsec. (c).
    1994--Pub. L. 103-432 inserted ``; medicare and medigap 
information'' in section catchline, designated existing provisions as 
subsec. (a), and added subsec. (b).


                    Effective Date of 1997 Amendment

    Section 4311(a)(2) of Pub. L. 105-33 provided that: ``The amendment 
made by this subsection [amending this section] shall apply to notices 
provided on or after January 1, 1998.''


                    Effective Date of 1994 Amendment

    Amendment by Pub. L. 103-432 effective as if included in the 
enactment of Pub. L. 101-508, see section 171(l) of Pub. L. 103-432, set 
out as a note under section 1395ss of this title.


                             Effective Date

    Section 223(d)(1) of Pub. L. 100-360 provided that: ``The Secretary 
of Health and Human Services shall first distribute the notice required 
by the amendment made by subsection (a) [enacting this section] not 
later than January 31, 1989.''


                        State Regulatory Programs

    For provisions relating to changes required to conform State 
regulatory programs to amendments by section 171 of Pub. L. 103-432, see 
section 171(m) of Pub. L. 103-432, set out as a note under section 
1395ss of this title.


                         Demonstration Projects

    Section 4361(b) of Pub. L. 101-508 provided that: ``The Secretary of 
Health and Human Services is authorized to conduct demonstration 
projects in up to 5 States for the purpose of establishing statewide 
toll-free telephone numbers for providing information on medicare 
benefits, medicare supplemental policies available in the State, and 
benefits under the State medicaid program.''


    Notice of Changes Under Repeal of Medicare Catastrophic Coverage

    Pub. L. 101-234, title II, Sec. 203(c), Dec. 13, 1989, 103 Stat. 
1984, provided that: ``The Secretary of Health and Human Services shall 
provide, in the notice of medicare benefits provided under section 1804 
of the Social Security Act [this section] for 1990, for a description of 
the changes in benefits under title XVIII of such Act [this subchapter] 
made by the amendments made by this Act [see Tables for 
classification].''


  Benefits Counseling and Assistance Demonstration Project for Certain 
                   Medicare and Medicaid Beneficiaries

    Section 424 of Pub. L. 100-360, which directed Secretary of Health 
and Human Services to establish a demonstration project to demonstrate 
that its volunteers were adequately trained and competent to render 
effective benefits counseling and assistance to the elderly, was 
repealed by Pub. L. 101-234, title III, Sec. 301(a), Dec. 13, 1989, 103 
Stat. 1985.

                  Section Referred to in Other Sections

    This section is referred to in section 1395w-21 of this title.
