PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman.
Congressional Research Service
Version 00 · Introduced in House · Nov 19, 2004
Medicare PPO Fairness Act of 2004 - Directs the Secretary of Health and Human Services to provide written notice to each individual who is, or has been, enrolled in the Medicare PPO Demonstration Project of the following: (1) the fact that the enrollees are, and have been, eligible for coverage of services whether the services were provided by in-network or out-of-network providers; and (2) there is a procedure for reimbursement for claims for services that should be (or have been) covered but were not covered because of their provision by an out-of-network provider.
Directs the Secretary to: (1) establish a procedure for reimbursement of enrollees under the Medicare PPO Demonstration Project for claims for services furnished before January 1, 2005, that should be (or have been) covered but were not covered because of their provision by an out-of-network provider; and (2) provide for an adjustment in the capitation rates for plans under the project for months in 2005 so as to reduce payment under such rates, in the aggregate, by the aggregate amount of payments the Secretary estimates will be paid under such procedure.
People & committees
Rep. Cardin, Benjamin L. [D-MD-3] · D–MD
Legislative record
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Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman.
Referred to the Subcommittee on Health.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sponsor introductory remarks on measure. (CR 11/20/2004 E2115)
Introduced in House
Introduced in House
Primary sources
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Source last updated: Aug 18, 2025. Consult Congress.gov for the current record.
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