There is within the Centers for Medicare & Medicaid Services a center to carry out the duties described in paragraph (3).
Such center shall be headed by a director who shall report directly to the Administrator of the Centers for Medicare & Medicaid Services.
The duties described in this paragraph are the following:
The Secretary shall ensure that the center is carrying out the duties described in paragraph (3) by not later than January 1, 2008.
The Secretary may employ, within the Centers for Medicare & Medicaid Services, such individuals as management staff as the Secretary determines to be appropriate. With respect to the administration of parts C and D, such individuals shall include individuals with private sector expertise in negotiations with health benefits plans.
To be eligible for employment under paragraph (1) an individual shall be required to have demonstrated, by their education and experience (either in the public or private sector), superior expertise in at least one of the following areas:
Subject to subparagraph (B), the Secretary shall establish the rate of pay for an individual employed under paragraph (1). Such rate shall take into account expertise, experience, and performance.
In no case may the rate of compensation determined under subparagraph (A) exceed the highest rate of basic pay for the Senior Executive Service under sectionof title 5.
The Secretary shall appoint within the Department of Health and Human Services a Medicare Beneficiary Ombudsman who shall have expertise and experience in the fields of health care and education of (and assistance to) individuals entitled to benefits under this subchapter.
The Medicare Beneficiary Ombudsman shall-
The Ombudsman shall not serve as an advocate for any increases in payments or new coverage of services, but may identify issues and problems in payment or coverage policies.
To the extent possible, the Ombudsman shall work with health insurance counseling programs (receiving funding under sectionof this title) to facilitate the provision of information to individuals entitled to benefits under part A or enrolled under part B, or both regarding MA plans and changes to those plans. Nothing in this paragraph shall preclude further collaboration between the Ombudsman and such programs.
Not later than 12 months after December 13, 2016, the Secretary shall provide for a pharmaceutical and technology ombudsman within the Centers for Medicare & Medicaid Services who shall receive and respond to complaints, grievances, and requests that-
The second sentence of subsection (c)(2) shall apply to the ombudsman under subparagraph (A) in the same manner as such sentence applies to the Medicare Beneficiary Ombudsman under subsection (c).
1 So in original. A closing parenthesis probably should precede the semicolon.
42 U.S.C. § 1395b-9
AMENDMENTS2016-Subsec. (d). Pub. L. 114-255 added subsec. (d). 2003-Subsec. (b). Pub. L. 108-173, §900(b), added subsec. (b).Subsec. (c). Pub. L. 108-173, §923(a), added subsec. (c).
DEADLINE FOR APPOINTMENT Pub. L. 108-173, title IX, §923(b), Dec. 8, 2003, 117 Stat. 2394, provided that: "By not later than 1 year after the date of the enactment of this Act [Dec. 8, 2003], the Secretary [of Health and Human Services] shall appoint the Medicare Beneficiary Ombudsman under section 1808(c) of the Social Security Act [ 42 U.S.C. 1395b-9(c) ], as added by subsection (a)."
- The term "Administrator" means the Administrator of General Services.
- The term "Secretary" means the Secretary of Housing and Urban Development.1 See References in Text note below.