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HR 2807 99th Congress House Social Welfare Health Health facilities Hospitals Medicaid Medical personnel Medicare Peer review organizations (Medicine) Physicians Surgery Unnecessary surgery

Medicare and Medicaid Second Opinion Act of 1985

Introduced: June 19, 1985 See on congress.gov
 Everywhere this bill has been 6 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Aug 1, 1985
For Further Action See H.R.3101.
Jun 24, 1985
Referred to Subcommittee on Health.
Jun 24, 1985
Referred to Subcommittee on Health and the Environment.
Jun 19, 1985
Referred to House Committee on Ways and Means.
Jun 19, 1985
Referred to House Committee on Energy and Commerce.
Jun 19, 1985
Introduced in House
 Plain-English summary Congressional Research Service

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.

What's happening now August 1, 1985

For Further Action See H.R.3101.

 Committees of jurisdiction 4