42 U.S.C. § 1395b-3 : US Code - Section 1395B-3: Health insurance advisory service for medicare beneficiaries

Search 42 U.S.C. § 1395b-3 : US Code - Section 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 Centers for
Medicare&Medicaid Services, 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.