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Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>
2026-07-06 10:51:44 -04:00

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LegalText 42 U.S.C. § 1395w154 Improved Medicare prescription drug plan and MAPD plan complaint system us united_states_code code_section 42 THE PUBLIC HEALTH AND WELFARE 7 SOCIAL SECURITY 1395w154 42 U.S.C. § 1395w154 current 119-100 2026-06-26 official https://uscode.house.gov/download/releasepoints/us/pl/119/100/xml_usc42@119-100.zip /us/usc/t42/s1395w154 data/legal/raw/us/code/title-42/usc42.xml 479753e5c98b3b796301d627477f7f7e698c0521db3bfefb1014bf3a9b98d89a 644321055a08eb1f260a6a3e31ac157fa024756abf612a9fd6857e7e400cf24e a186de2fec67cb1edeaf5afad93bd1b4a38a39d5d81d26f8cb33fa3eef050c5e 2026-07-04 official
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42 U.S.C. § 1395w154 - Improved Medicare prescription drug plan and MAPD plan complaint system

Text

(a) In general The Secretary shall develop and maintain a complaint system, that is widely known and easy to use, to collect and maintain information on MAPD plan and prescription drug plan complaints that are received (including by telephone, letter, e-mail, or any other means) by the Secretary (including by a regional office of the Department of Health and Human Services, the Medicare Beneficiary Ombudsman, a subcontractor, a carrier, a fiscal intermediary, and a Medicare administrative contractor under section 1395kk1 of this title) through the date on which the complaint is resolved. The system shall be able to report and initiate appropriate interventions and monitoring based on substantial complaints and to guide quality improvement.

(b) Model electronic complaint form The Secretary shall develop a model electronic complaint form to be used for reporting plan complaints under the system. Such form shall be prominently displayed on the front page of the Medicare.gov Internet website and on the Internet website of the Medicare Beneficiary Ombudsman.

(c) Annual reports by the Secretary The Secretary shall submit to Congress annual reports on the system. Such reports shall include an analysis of the number and types of complaints reported in the system, geographic variations in such complaints, the timeliness of agency or plan responses to such complaints, and the resolution of such complaints.

(d) Definitions In this section:

(1) MAPD plan The term “MAPD plan” has the meaning given such term in section 1395w151(a)(9) of this title.

(2) Prescription drug plan The term “prescription drug plan” has the meaning given such term in section 1395w151(a)(14) of this title.

(3) Secretary The term “Secretary” means the Secretary of Health and Human Services.

(4) System The term “system” means the plan complaint system developed and maintained under subsection (a).

(Pub. L. 111148, title III, § 3311, Mar. 23, 2010, 124 Stat. 475.)

Notes

Editorial Notes

Codification Section was enacted as part of the Patient Protection and Affordable Care Act, and not as part of the Social Security Act which comprises this chapter.