42 U.S.C. § 1395b–2 — Notice of medicare benefits; medicare and medigap information

(a) Notice of medicare benefits The Secretary must 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. Such notice must 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 or enrolls under part B. (b) Medicare and medigap information The Secretary must provide information via a toll-free telephone number on the programs under this subchapter. The Secretary must 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 must be the toll-free number listed for general information and assistance in the annual notice under subsection (a) instead of the listing of numbers of individual contractors. (c) Contents of notice The notice provided under subsection (a) must 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 under 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. (d) Medicare opioid safety education The notice provided under subsection (a) must include— (1) references to educational resources regarding opioid use and pain management; (2) a description of categories of alternative, non-opioid pain management treatments covered under this subchapter; and (3) a suggestion for the beneficiary to talk to a physician regarding opioid use and pain management. Terms that this section uses but does not define keep their quoted statutory meaning; this section does not define them.