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U.S. Code as of:
01/19/04
Section 1395b-2. Notice of medicare benefits; medicare and medigap information
(a) Notice of medicare benefits
The Secretary shall prepare (in consultation with groups
representing the elderly and with health insurers) and provide for
distribution of a notice containing -
(1) a clear, simple explanation of the benefits available under
this subchapter and the major categories of health care for which
benefits are not available under this subchapter,
(2) the limitations on payment (including deductibles and
coinsurance amounts) that are imposed under this subchapter, and
(3) a description of the limited benefits for long-term care
services available under this subchapter and generally available
under State plans approved under subchapter XIX of this chapter.
Such notice shall be mailed annually to individuals entitled to
benefits under part A or part B of this subchapter and when an
individual applies for benefits under part A of this subchapter or
enrolls under part B of this subchapter.
(b) Medicare and medigap information
The Secretary shall provide information via a toll-free telephone
number on the programs under this subchapter. The Secretary shall
provide, through the toll-free telephone number 1-800-MEDICARE, for
a means by which individuals seeking information about, or
assistance with, such programs who phone such toll-free number are
transferred (without charge) to appropriate entities for the
provision of such information or assistance. Such toll-free number
shall be the toll-free number listed for general information and
assistance in the annual notice under subsection (a) of this
section instead of the listing of numbers of individual
contractors.
(c) Contents of notice
The notice provided under subsection (a) of this section shall
include -
(1) a statement which indicates that because errors do occur
and because medicare fraud, waste, and abuse is a significant
problem, beneficiaries should carefully check any explanation of
benefits or itemized statement furnished pursuant to section
1395b-7 of this title for accuracy and report any errors or
questionable charges by calling the toll-free phone number
described in paragraph (4);
(2) a statement of the beneficiary's right to request an
itemized statement for medicare items and services (as provided
in section 1395b-7(b) of this title);
(3) a description of the program to collect information on
medicare fraud and abuse established under section 1395b-5(b) of
this title; and
(4) a toll-free telephone number maintained by the Inspector
General in the Department of Health and Human Services for the
receipt of complaints and information about waste, fraud, and
abuse in the provision or billing of services under this
subchapter.
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