WHAT THE LAW DOINCongress, in plain words

The law › Title 42, The Public Health and Welfare › Chapter 7

42 U.S.C. 1395w-28: Definitions; miscellaneous provisions

Created in 1997 by the Balanced Budget Act of 1997 (Public Law 105-33). Changed by 12 later laws. 1 bill in this Congress would change it.

This Congress

  • H.R. 1784 Medicare Fraud Detection and Deterrence Act of 2025 · introduced · would change (j)

How it got here

2018

  • Pub. L. 115–123, §50311(c)(2)(A), substituted "who—" for "who have", inserted "(I) before January 1, 2022, have" before "one or more comorbid and medically complex chronic conditions that are substantially disabling", and added subcl. (II). (Bipartisan Budget Act of 2018) Law text · (b)
  • Pub. L. 115–123, §50311(a), struck out "and for periods before January 1, 2019" after "the Secretary". (Bipartisan Budget Act of 2018) Law text · (f)
  • Pub. L. 115–123, §50311(b)(1)(A), added subpar. (F). (Bipartisan Budget Act of 2018) Law text · (f)
  • Pub. L. 115–123, §50311(c)(1), designated existing provisions as subpar. (A), inserted heading, substituted "Subject to subparagraph (B), the requirements" for "The requirements", redesignated former subpars. (A) and (B)(i) to (iii) as cls. (i) and (ii)(I) to (III), respectively, of… (Bipartisan Budget Act of 2018) Law text · (f)
  • Pub. L. 115–123, §50311(b)(1)(B), added par. (8). (Bipartisan Budget Act of 2018) Law text · (f)
  • Pub. L. 115–123, §50311(c)(2)(B), added par. (9). (Bipartisan Budget Act of 2018) Law text · (f)
  • Pub. L. 115–123, §50321, added subsec. (h). (Bipartisan Budget Act of 2018) Law text · (h)
  • Pub. L. 115–271 added subsec. (i). (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act" or the "SUPPORT for Patients and Communities Act) Law text · (i)

2016

  • Pub. L. 114–255 struck out "may waive application of section 1395w–21(a)(3)(B) of this title in the case of an individual described in clause (i), (ii), or (iii) of this subparagraph and" after "The Secretary" in concluding provisions. (21st Century Cures Act) Law text · (b)

2015

  • Pub. L. 114–10 substituted "2019" for "2017". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (f)

2014

  • Pub. L. 113–93 substituted "2017" for "2016". (Protecting Access to Medicare Act of 2014) Law text · (f)

2013

  • Pub. L. 113–67 substituted "2016" for "2015". Law text · (f)
  • Pub. L. 112–240 substituted "2015" for "2014". (American Taxpayer Relief Act of 2012) Law text · (f)

2010

  • Pub. L. 111–148, §3205(a), substituted "2014" for "2011". (Patient Protection and Affordable Care Act) Law text · (f)
  • Pub. L. 111–148, §3205(e)(1), added subpar. (C). (Patient Protection and Affordable Care Act) Law text · (f)
  • Pub. L. 111–148, §3205(e)(2), added subpar. (E). (Patient Protection and Affordable Care Act) Law text · (f)
  • Pub. L. 111–148, §3205(e)(3), added subpar. (C). (Patient Protection and Affordable Care Act) Law text · (f)
  • Pub. L. 111–148, §3205(g), struck out "described in subsection (b)(6)(B)(i)" after "individuals" in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (f)
  • Pub. L. 111–148, §3205(c), (e)(4), added pars. (6) and (7). (Patient Protection and Affordable Care Act) Law text · (f), (7)
  • Pub. L. 111–148, §3208(a), added subsec. (g). (Patient Protection and Affordable Care Act) Law text · (g)

2008

  • Pub. L. 110–275, §162(b), inserted concluding provisions. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (b)
  • Pub. L. 110–275, §164(c)(1)(A), inserted "and that, as of January 1, 2010, meets the applicable requirements of paragraph (2), (3), or (4) of subsection (f), as the case may be" before period at end. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (b)
  • Pub. L. 110–275, §164(e)(1), inserted "who have one or more comorbid and medically complex chronic conditions that are substantially disabling or life threatening, have a high risk of hospitalization or other significant adverse health outcomes, and require specialized deliv… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (b)
  • Pub. L. 110–275, §164(c)(1)(B)(ii), (iii), designated existing provisions as par. (1), inserted par. heading, and added pars. (2) to (4). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (f)
  • Pub. L. 110–275, §164(c)(1)(B)(i), amended heading generally. Prior to amendment, heading read "Restriction on enrollment for specialized MA plans for special needs individuals". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (f)
  • Pub. L. 110–275, §164(a), substituted "2011" for "2010". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (f)
  • Pub. L. 110–275, §164(d)(1), added par. (5). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (f)

2007

  • Pub. L. 110–173 substituted "2010" for "2009". (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (f)

2003

  • Pub. L. 108–173, §221(b)(1), added pars. (4) and (5). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (b), (5)
  • Pub. L. 108–173, §231(b), added par. (6). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (b)
  • Pub. L. 108–173, §221(d)(2), added par. (5). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (c)
  • Pub. L. 108–173, §231(c), added subsec. (f). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f)

1999

  • Pub. L. 106–113 substituted "section 1395w–21(a)(2) of this title" for "section 1395w–21(a)(2)(A) of this title" in introductory provisions. (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (e)

Text, outline and history from the official U.S. Code (2024 edition) on GovInfo, published by the Office of the Law Revision Counsel. Changes made after that edition appear under This Congress.