H.R. 280799th CongressHouse Bill

Medicare and Medicaid Second Opinion Act of 1985

Introduced in the HouseDead

This bill died when its Congress ended.

Bills don't carry over between Congresses. Without re-introduction in a new session, it cannot advance.

Medicare and Medicaid Second Opinion Act of 1985 - Amends title XVIII (Medicare) of the Social Security Act to prohibit payment for a surgical procedure listed by the Secretary of Health and Human Services unless a second opinion regarding such surgery is obtained. Provides that the second opinion need not agree with the first opinion in order for payment to be made. Directs the Secretary to establish a list of at least ten surgical procedures to which the second opinion requirement applies. Directs the Secretary to enter into contracts with utilization and quality control peer review organizations under which such organizations serve as referral centers for the second opinions required by this Act. Permits the patient to choose any qualified physician, except one affiliated with the initial physician, to provide the second opinion. Provides that a second opinion need not be obtained: (1) if to delay surgery would be a risk to the patient; (2) if no physician is available, within reasonable limits, to provide the second opinion; and (3) if the surgery is to be performed on a patient who is a member of a health maintenance organization or competitive medical plan having a risk sharing contract with the Secretary. Requires physicians, hospitals, and ambulatory surgical centers to notify patients of the second opinion requirement. Sets forth sanctions for noncompliance. Directs the Secretary to notify physicians, hospitals, ambulatory surgical centers, and Medicare beneficiaries of the requirements of this Act. Waives the deductible and copayments with respect to the second opinion. Amends title XIX (Medicaid) of the Act to require second opinions. Provides for the application of the Medicare second opinion requirements to Medicaid. Sets forth effective date, regulations, and study provisions.

Introduced Jun 19, 1985
1
Introduced

Filed in the House

2
Passed House
3
Passed Senate
4
Became Law

This house bill has been filed and is working its way through Congress. It will need to pass both the House and the Senate, then be signed by the President to become law.

Who introduced this

BK

Barbara Kennelly

Democrat

U.S. Representative · CT-1

2 cosponsors — mostly Republicans

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