Medicare Expanded Choice Act

Medicare Expanded Choice Act - Amends title XVIII (Medicare) of the Social Security Act to provide for payments to employer based plans (EBP). Authorizes the Secretary of Health and Human Services to define a separate class or classes that include only members of that group who are enrolled, or who are eligible for enrollment, with an employment related group. Defines "employment related group" to mean the former employees of an employer or employers, and members of their families. Defines "eligible organization" to include an employer, or an employee organization, which provides health care services to individuals in the employment related group as well as a health maintenance organization (HMO) and a competitive medical plan (CMP). Limits the charges to individuals who are in a particular employment related group, or who are not in any employment related group. Exempts a trust fund described in provisions of the Labor Managmement Relations Act, 1947 from a requirement that eligible organizations have at least one-half of their membership consist of individuals who are not entitled to benefits under Medicare or Medicaid. Allows EBPs which contract with an HMO or a CMP to meet such requirement through the HMO or CMP with which they contract. Authorizes the Secretary to enter into a risk-sharing contract with respect to individuals in employment related groups. Authorizes the Secretary, in the case of a multi-year contract for payments to an HMO, CMP, or EBP, to: (1) determine the annual rates in advance of the entire term; and (2) discount those annual rates. Eliminates provisions relating to the charges for and the value of benefits provided in addition to those covered under Medicare. Removes provisions regulating an eligible organization's premium rates. Authorizes the organizations to provide rebates. Ends the requirement that eligible organizations which are not HMOs provide preventive services. Changes the criteria which must be met in order for the Secretary to enter into a reasonable cost reimbursement contract with an eligible organization. Limits cost reimbursement for organizations which provide health services on a prepayment basis to those organizations which received such reimbursement before 1988. Allows the organization to exercise through 1990 a right provided for in current law to set percentage of the reasonable cost of services in lieu of the same percentage of the reasonable charges for the services. Eliminates provisions relating to part B (Supplementary Medical Insurance) only enrollment. Limits the exclusion from enrollment of individuals with end-stage renal disease to those who are covered under a group health plan through their employment. Excludes from coverage those individuals who have elected Medicare coverage for hospice care. Prohibits the increase of premiums or decrease of benefits during a calendar year, subject to exception. Removes provisions relating to increase in premiums or decrease in benefits for 12 months after an individual's enrollment during a 30-day open enrollment period. Sets forth enrollment policies and procedures. Provides for civil monetary penalties against any eligible organization with a risk-sharing contract for certain prohibited actions. Authorizes the Secretary, in addition to, or instead of, imposing a monetary penalty, to provide for the suspension of enrollment of individuals or of payment to the organization. Eliminates provisions which allow a risk-sharing contract to provide that the Secretary will reimburse hospitals and skilled nursing facilities with respect to inpatient services funished to enrolled individuals. Requires providers of services, in order to participate in Medicare, to agree that they will accept as payment in full, for certain emergency services, the same amount for individuals enrolled in an eligible organization as would be accepted as payment in full for individuals not so enrolled. Provides for the preemption of any State law as it effects in certain ways the provision of health care services to individuals enrolled with an eligible organization. Requires an eligible organization to either: (1) limit benefits for services furnished other than through the organization to certain emergency services; or (2) authorize the Secretary to make payments for all covered services furnished to the individual other than through the organization. Prohibits an eligible organization's deductibles, coinsurance, and copayments charged, with respect to covered services furnished in a year, to any enrolled member from exceeding $2,000, to be increased or decreased according to a specified formula.