3.0.0 4077 2023-01-11T13:29:21Z 2023-01-11T13:29:21Z House HR 2015-11-18 114 [Congressional Record Volume 161, Number 170 (Wednesday, November 18, 2015)]From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]By Mr. WILLIAMS:H.R. 4077.Congress has the power to enact this legislation pursuantto the following:Article 1, Section 8, Clause 1 of the United StatesConstitution.[Page H8361]]]> hsif00 Energy and Commerce Committee House Standing hsif14 Health Subcommittee Referred to 2015-11-20T14:09:12Z Referred to 2015-11-18T15:03:05Z hswm00 Ways and Means Committee House Standing hswm02 Health Subcommittee Referred to 2015-11-18T20:21:43Z Referred to 2015-11-18T15:03:00Z 2015-11-20 hsif14 Health Subcommittee 1 House committee actions Referred to the Subcommittee on Health. Committee 2015-11-18 hswm02 Health Subcommittee 1 House committee actions Referred to the Subcommittee on Health. Committee 2015-11-18 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. IntroReferral H11100 2 House floor actions hsif00 Energy and Commerce Committee 2015-11-18 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. IntroReferral H11100-A 9 Library of Congress 2015-11-18 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. IntroReferral H11100 2 House floor actions hswm00 Ways and Means Committee 2015-11-18 Introduced in House IntroReferral Intro-H 9 Library of Congress 2015-11-18 Introduced in House IntroReferral 1000 9 Library of Congress W000816 Rep. Williams, Roger [R-TX-25] Roger Williams R TX 25 N F000461 Rep. Flores, Bill [R-TX-17] Bill Flores R TX 17 2015-11-18 True G000377 Rep. Granger, Kay [R-TX-12] KAY GRANGER R TX 12 2015-11-18 True T000238 Rep. Thornberry, Mac [R-TX-13] WILLIAM THORNBERRY R TX M. 13 2015-11-18 True N000182 Rep. Neugebauer, Randy [R-TX-19] Randy Neugebauer R TX 19 2015-11-18 True O000168 Rep. Olson, Pete [R-TX-22] Pete Olson R TX 22 2015-11-18 True S001189 Rep. Scott, Austin [R-GA-8] Austin Scott R GA 8 2015-11-18 True Health Administrative law and regulatory procedures Business records Department of Health and Human Services Health information and medical records Licensing and registrations Medicare Health 00 2015-11-18 Introduced in House 2016-09-15T21:35:02Z Medicare Established Provider Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to direct the Department of Health and Human Services (HHS) to develop a system for designating providers that represent a low risk of submitting fraudulent Medicare claims as "established providers" for purposes of applying for special treatment in the claim review process.

To qualify as an established provider, a provider must demonstrate that, within a specified timeframe: (1) at least 90% of Medicare claims submitted by the provider were determined to be eligible for full or partial payment, and (2) the provider appealed at least 90% of all Medicare claims that were not initially determined to be eligible for payment.

HHS may withhold payment for a Medicare claim made by an established provider only if a final determination has been made that the claim is ineligible for payment. If such a final determination is made, the provider shall repay such payment electronically and within a specified timeframe.

]]> Medicare Established Provider Act of 2015 Display Title Medicare Established Provider Act of 2015 Official Title as Introduced To amend title XVIII of the Social Security Act to provide for a Medicare established provider system under which providers of services and suppliers representing a low risk for submitting fraudulent Medicare claims are provided certain claim review protections. Introduced in House IH Short Titles as Introduced Medicare Established Provider Act of 2015 Introduced in House 2015-11-18T05:00:00Z https://www.govinfo.gov/content/pkg/BILLS-114hr4077ih/xml/BILLS-114hr4077ih.xml 2015-11-20 Referred to the Subcommittee on Health. text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Congressional Research Service, Library of Congress This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.