H.R. 5400: Medicare PPO Fairness Act of 2004
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H.R. 5400: Medicare PPO Fairness Act of 2004
108th Congress · introduced 2004-11-19 · Health · Latest: Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman.
federal
Follow this bill, step by step
- Where it came from: introduced 2004-11-19 · official record
- Who proposed it: Rep. Cardin, Benjamin L. [D-MD-3] · what a sponsor is
- What happened next: no floor votes in our records yet. Why?
- Where it stands now: Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman. Not final yet: this can still change. We check for updates every day.
- If it becomes law and spends money: follow the money to money laws, then agencies and contracts and grants.
Official title
Medicare PPO Fairness Act of 2004
Plain summary
Medicare PPO Fairness Act of 2004 - Directs the Secretary of Health and Human Services to provide written notice to each individual who is, or has been, enrolled in the Medicare PPO Demonstration Project of the following: (1) the fact that the enrollees are, and have been, eligible for coverage of services whether the services were provided by in-network or out-of-network providers; and (2) there is a procedure for reimbursement for claims for services that should be (or have been) covered but were not covered because of their provision by an out-of-network provider. Directs the Secretary to: (1) establish a procedure for reimbursement of enrollees under the Medicare PPO Demonstration Project for claims for services furnished before January 1, 2005, that should be (or have been) covered but were not covered because of their provision by an out-of-network provider; and (2) provide for an adjustment in the capitation rates for plans under the project for months in 2005 so as to reduce payment under such rates, in the aggregate, by the aggregate amount of payments the Secretary estimates will be paid under such procedure.
Congressional Research Service summary (Introduced in House), quoted unchanged (nonpartisan). Read the source.
What a vote does
A “Yea” vote
If it passes both chambers and is signed, it becomes law.
A “Nay” vote
If it is not passed, current law stays as it is.
PSI Sci description of the legislative step (not an opinion).
What does this mean? (plain words)
Official text
Medicare PPO Fairness Act of 2004
Source: Congressional Research Service summary (Introduced in House)
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Alternatives
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How did my representative vote? · This bill's floor votes
Officials and money
Sponsor: Rep. Cardin, Benjamin L. [D-MD-3] · 0 cosponsors
Cost estimate: No cost estimate published yet.
No linked floor roll calls in our collected records yet. This does not mean the bill has never had a vote. Check the official bill history.
Sources
- Congressional Research Service summary (Introduced in House)
- Congress.gov
- Data: GovInfo BILLSTATUS bulk data (Library of Congress), BILLSTATUS-108hr5400.xml <https://www.govinfo.gov/bulkdata/BILLSTATUS/108/hr>
Record fed-us-cong108-hr5400 · catalog fed-us-congress-bills-cong108 · updated 2026-11-15 by psicol fed-bills-cong108