
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-3]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
        SUBCHAPTER XVIII--HEALTH INSURANCE FOR AGED AND DISABLED
 
Sec. 1395b-3. Health insurance advisory service for medicare 
        beneficiaries
        

(a) In general

    The Secretary of Health and Human Services shall establish a health 
insurance advisory service program (in this section referred to as the 
``beneficiary assistance program'') to assist medicare-eligible 
individuals with the receipt of services under the medicare and medicaid 
programs and other health insurance programs.

(b) Outreach elements

    The beneficiary assistance program shall provide assistance--
        (1) through operation using local Federal offices that provide 
    information on the medicare program,
        (2) using community outreach programs, and
        (3) using a toll-free telephone information service.

(c) Assistance provided

    The beneficiary assistance program shall provide for information, 
counseling, and assistance for medicare-eligible individuals with 
respect to at least the following:
        (1) With respect to the medicare program--
            (A) eligibility,
            (B) benefits (both covered and not covered),
            (C) the process of payment for services,
            (D) rights and process for appeals of determinations,
            (E) other medicare-related entities (such as peer review 
        organizations, fiscal intermediaries, and carriers), and
            (F) recent legislative and administrative changes in the 
        medicare program.

        (2) With respect to the medicaid program--
            (A) eligibility, benefits, and the application process,
            (B) linkages between the medicaid and medicare programs, and
            (C) referral to appropriate State and local agencies 
        involved in the medicaid program.

        (3) With respect to medicare supplemental policies--
            (A) the program under section 1395ss of this title and 
        standards required under such program,
            (B) how to make informed decisions on whether to purchase 
        such policies and on what criteria to use in evaluating 
        different policies,
            (C) appropriate Federal, State, and private agencies that 
        provide information and assistance in obtaining benefits under 
        such policies, and
            (D) other issues deemed appropriate by the Secretary.

The beneficiary assistance program also shall provide such other 
services as the Secretary deems appropriate to increase beneficiary 
understanding of, and confidence in, the medicare program and to improve 
the relationship between beneficiaries and the program.

(d) Educational material

    The Secretary, through the Administrator of the Health Care 
Financing Administration, shall develop appropriate educational 
materials and other appropriate techniques to assist employees in 
carrying out this section.

(e) Notice to beneficiaries

    The Secretary shall take such steps as are necessary to assure that 
medicare-eligible beneficiaries and the general public are made aware of 
the beneficiary assistance program.

(f) Report

    The Secretary shall include, in an annual report transmitted to the 
Congress, a report on the beneficiary assistance program and on other 
health insurance informational and counseling services made available to 
medicare-eligible individuals. The Secretary shall include in the report 
recommendations for such changes as may be desirable to improve the 
relationship between the medicare program and medicare-eligible 
individuals.

(Pub. L. 101-508, title IV, Sec. 4359, Nov. 5, 1990, 104 Stat. 1388-
137.)

                          Codification

    Section was enacted as part of the Omnibus Budget Reconciliation Act 
of 1990, and not as part of the Social Security Act which comprises this 
chapter.


                 Qualified Medicare Beneficiary Outreach

    Pub. L. 103-432, title I, Sec. 154, Oct. 31, 1994, 108 Stat. 4437, 
provided that: ``Not later than 1 year after the date of the enactment 
of this Act [Oct. 31, 1994], the Secretary of Health and Human Services 
shall establish and implement a method for obtaining information from 
newly eligible medicare beneficiaries that may be used to determine 
whether such beneficiaries may be eligible for medical assistance for 
medicare cost-sharing under State medicaid plans as qualified medicare 
beneficiaries, and for transmitting such information to the State in 
which such a beneficiary resides.''
