PlainBillCongress, translated.Legislation. Context. Public interest.Sponsor introductory remarks on measure. (CR S12837)
Congressional Research Service
Version 00 · Introduced in House · Mar 14, 1995
Long-Term Care Insurance Consumer Protection Act of 1995 - Amends the Public Health Service Act to prohibit the sale of long-term care insurance unless this Act is complied with. Imposes civil money penalties. Requires application of standards meeting the requirements of this Act, allowing State standards providing greater policyholder protection. Imposes a duty of good faith and fair dealing. Prohibits: (1) twisting, high pressure tactics, and cold lead advertising; (2) knowingly selling a policy to an individual eligible for assistance under title XIX (Medicaid) of the Social Security Act; (3) selling a service-benefit policy duplicating existing coverage; and (4) selling a policy to an organization's member without disclosing a financial arrangement between the seller and the organization. Imposes civil money penalties and applies Social Security Act provisions regarding civil money penalties. Requires issuers to return premiums if a policy is denied or returned, explain denials, and use pre-issuance medical assessments of applicants 75 years old or older, and limit agent sales compensation. Imposes civil money penalties and applies Social Security Act provisions regarding civil money penalties. Prohibits cancellation or nonrenewal except for nonpayment of premium or material misrepresentation. Regulates continuation and conversion rights. Requires policies to use uniform language and format and contain certain disclosures. Prohibits conditioning or limiting benefits in specified ways or placing certain limits or requirements on home health care services, if covered. Mandates a minimum coverage period. Prohibits treating benefits differently for individuals with certain dementias or mental illness differently from individuals with other conditions. Restricts preexisting condition limits. Requires policies to determine benefits based on a functional assessment. Requires policies to provide for annual increases in payment levels and the maximum payment limit and limits on annual premium increases. Requires policies to provide that, if a policy lapses after being in effect for a minimum period, the policy will provide certain benefits without additional premiums. Prohibits policy cancellation or claim denial based on issuance fraud or misrepresentation unless notice is provided within six months of issuance. Allows applicants to return a policy within 30 days and have the premium refunded. (Sec. 3) Amends Medicaid provisions to require each State Medicaid plan to establish a regulatory program to enforce the standards issued under this Act. Prohibits Medicaid payments to a State for nursing facility services if the State fails to establish a regulatory program. (Sec. 5) Authorizes appropriations for information, counseling, and assistance regarding the procurement of adequate and appropriate long-term care insurance.
People & committees
Rep. Wyden, Ron [D-OR-3] · D–OR
Legislative record
A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.
Sponsor introductory remarks on measure. (CR S12837)
Referred to the Subcommittee on Health and Environment.
Referred to the House Committee on Commerce.
Introduced in House
Introduced in House
Primary sources
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Source last updated: Jun 3, 2026. Consult Congress.gov for the current record.
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