H.R. 6113: To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program.

This bill seeks to amend the Social Security Act by introducing specific limitations on contracts with Medicare Advantage (MA) organizations. The key changes proposed are as follows:

Limits on Number of Plans Offered

The legislation would limit the number of Medicare Advantage plans that an organization can offer. Specifically:

• After the bill is enacted, the Secretary of Health and Human Services would not be allowed to enter into or renew contracts with any organization offering more than three MA plans in any given plan year.
• If an organization wishes to offer more than one MA plan, each plan must vary significantly in terms of premiums, benefits, or cost-sharing structures. The Secretary would determine what constitutes "significantly different."

Effective Date

The new rules would take effect one year after the bill becomes law, allowing time for organizations to adjust to the new limitations.

Objective

The intention behind these modifications is to streamline the options available to Medicare beneficiaries and potentially reduce confusion regarding the available plans. This could help in improving the clarity and comprehensibility of the choices presented to seniors regarding their healthcare options under Medicare Advantage.

Oversight and Implementation

The bill places responsibility on the Secretary of Health and Human Services to oversee the application of these rules, ensuring that contracts align with the established criteria.

Relevant Companies

• HUM - Humana Inc. may be affected as it offers Medicare Advantage plans and would need to adapt to the new constraints regarding the number of plans it can offer.
• ANTM - Anthem, Inc. also provides Medicare Advantage plans and would have to modify its offerings in response to the limitations set forth by this bill.
• CNC - Centene Corporation, which operates multiple Medicare Advantage plans, would face restrictions on the number of plans it could manage under the proposed regulations.