Sec. 1001. Protecting Medicare fee-for-service beneficiaries from high out-of-pocket costs
420 words·~2 min read·
/bill/118/s/1655/is/section-1001A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ) is amended by adding at the end the following new section: Notwithstanding any other provision of this title, in the case of an individual entitled to, or enrolled for, benefits under part A or enrolled in part B, if the amount of the out-of-pocket cost-sharing of such individual for a year (effective the year beginning January 1 of the year following the date of enactment of the Medicare for All Act ) equals or exceeds $1,500, the individual shall not be responsible for additional out-of-pocket cost-sharing that occurred during that year. Subject to paragraphs
(2)and (3), in this section, the term out-of-pocket cost-sharing means, with respect to an individual, the amount of the expenses incurred by the individual that are attributable to— coinsurance and copayments applicable under part A or B; or for items and services that would have otherwise been covered under part A or B but for the exhaustion of those benefits. Expenses incurred for items and services which are not included (or treated as being included) under part A or B shall not be considered incurred expenses for purposes of determining out-of-pocket cost-sharing under paragraph (1). If an item or service is furnished to an individual under this title and is not furnished on an assignment-related basis, any additional expenses the individual incurs above the amount the individual would have incurred if the item or service was furnished on an assignment-related basis shall not be considered incurred expenses for purposes of determining out-of-pocket cost-sharing under paragraph (1). For purposes of paragraph (1), the Secretary shall consider expenses to be incurred by the individual without regard to whether the individual or another person, including a State program or other third-party coverage, has paid for such expenses. . Section 1813(b) of the Social Security Act ( 42 U.S.C. 1395e(b) ) is amended by adding at the end the following new paragraph: For each year (beginning January 1 of the year following the date of enactment of the Medicare for All Act ), the inpatient hospital deductible for the year shall be $0. . Section 1833(b) of the Social Security Act ( 42 U.S.C. 1395l(b) ) is amended, in the first sentence— by striking and for a subsequent year and inserting for each of 2006 through the year that includes the date of enactment of the ; and Medicare for All Act by inserting , and $0 for each year subsequent year after $1) .
Connectionstraces to 3
Traces to 3 documents
Citation graph
cites case law
Sec. 1001
Protecting Medicare fee-for-service beneficiaries from high out-of-pocket costs
Cites 3Cited by 0 across 0 sources