[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2991 Introduced in House (IH)]

103d CONGRESS
  1st Session
                                H. R. 2991

   To establish a Uniform Claim Commission, to require the use of a 
 universal claim form to submit claims under certain Federal programs 
   that provide for payments for health care services, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 6, 1993

 Mr. Ramstad introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To establish a Uniform Claim Commission, to require the use of a 
 universal claim form to submit claims under certain Federal programs 
   that provide for payments for health care services, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care Administrative 
Simplification Act of 1993''.

SEC. 2. ESTABLISHMENT.

    There is established a commission to be known as the Uniform Claim 
Commission.

SEC. 3. DUTY.

    The Commission shall develop a universal paper claims processing 
form containing standard data elements for use by all health service 
providers that furnish services for which a claim may be submitted 
under a Federal program that provides for payments for health care 
services. The Commission shall develop such form in a manner that will 
permit the form to serve as a model for claims processing forms used in 
the private sector.

SEC. 4. MEMBERSHIP.

    (a) Number and Appointment.--The Commission shall be composed of 17 
members appointed by the director of the Office of Technology 
Assessment not later than 120 days after the date of the enactment of 
this Act. The members of the Commission shall be appointed from among 
individuals with expertise in health care claims administration, 
enrollment and eligibility administration, health care financial 
management, health care reimbursement, and other related fields. The 
Commission shall include individuals from various geographic areas of 
the United States, representatives from public and private health 
benefit plans involved in payment under such plans, administrators of 
such plans, and health service providers.
    (b) Terms.--Each member shall be appointed for the life of the 
Commission.
    (c) Vacancies.--A vacancy in the Commission shall be filled not 
later than 30 days after the date of the creation of the vacancy in the 
manner in which the original appointment was made.
    (d) Compensation.--
            (1) Rates of pay.--Except as provided in paragraph (2), 
        members of the Commission shall serve without pay.
            (2) Travel expenses.--Each member of the Commission shall 
        receive travel expenses, including per diem in lieu of 
        subsistence, in accordance with sections 5702 and 5703 of title 
        5, United States Code.
    (e) Quorum.--11 members of the Commission shall constitute a 
quorum, but a lesser number may hold hearings, take testimony, or 
receive evidence.
    (f) Chairperson.--The chairperson of the Commission shall be 
elected by a majority vote of the members of the Commission.
    (g) Meetings.--The Commission shall meet at the call of the 
chairperson of the Commission.

SEC. 5. STAFF AND SUPPORT SERVICES.

    (a) Director.--The Commission shall have a director appointed by 
the Commission and paid at a rate not to exceed the maximum rate of 
basic pay payable for GS-9 of the General Schedule.
    (b) Staff.--The Commission may appoint and fix the pay of 
additional personnel as it considers appropriate, except that--
            (1) not more than 2 individuals may be appointed under this 
        subsection; and
            (2) an individual so appointed may not receive pay in 
        excess of the maximum rate of basic pay payable for GS-7 of the 
        General Schedule.
    (c) Applicability of Certain Civil Service Laws.--The director and 
staff of the Commission may be appointed without regard to the 
provisions of title 5, United States Code, governing appointments in 
the competitive service, and may be paid without regard to the 
provisions of chapter 51 and subchapter III of chapter 53 of that title 
relating to classification and General Schedule pay rates, except as 
provided in subsections (a) and (b).
    (d) Staff of Federal Agencies.--Upon request of the Commission, the 
head of any Federal agency may detail, on a nonreimbursable basis, any 
of the personnel of the agency to the Commission to assist it in 
carrying out its duties under this Act.
    (e) Experts and Consultants.--The Commission may procure temporary 
and intermittent services under section 3109(b) of title 5, United 
States Code, but at rates for individuals not to exceed the daily 
equivalent of the maximum annual rate of basic pay payable for GS-12 of 
the General Schedule.
    (f) Administrative Support Services.--The Administrator of General 
Services shall provide to the Commission on a reimbursable basis such 
administrative support services necessary for the Commission to carry 
out its responsibilities under this Act.

SEC. 6. POWERS.

    (a) Hearings and Sessions.--The Commission may, for the purpose of 
carrying out this Act, hold hearings, sit and act at times and places, 
take testimony, and receive evidence as the Commission considers 
appropriate. The Commission may administer oaths or affirmations to 
witnesses appearing before it.
    (b) Delegation of Authority.--Any member or agent of the Commission 
may, if authorized by the Commission, take any action that the 
Commission is authorized to take by this section.
    (c) Information.--
            (1) In general.--The Commission may secure directly from 
        any Federal agency information necessary to enable it to carry 
        out this Act. Upon request of the Commission, the head of the 
        Federal agency shall furnish the information to the Commission.
            (2) Exception.--Paragraph (1) shall not apply to any 
        information that the Commission is prohibited to secure or 
        request by another law.
    (d) Mails.--The Commission may use the United States mails in the 
same manner and under the same conditions as other Federal agencies.
    (e) Contract Authority.--The Commission may contract with and 
compensate government and private agencies or persons for supplies or 
services without regard to section 3709 of the Revised Statutes (41 
U.S.C. 5).
    (f) Publication in Federal Register.--The Commission may publish a 
notice and request for comments in the Federal Register in the same 
manner as a Federal agency.

SEC. 7. PROMULGATION OF UNIFORM CLAIMS PROCESSING FORM.

    (a) Development of Preliminary Form.--The Commission shall develop 
a preliminary version of the form required to be developed under 
section 3 not later than the expiration of the 6-month period beginning 
on the date of the appointment of the last member of the Commission to 
be appointed under section 4(a).
    (b) Publication.--The Commission shall publish a copy of the 
preliminary version of the form required to be developed under 
subsection (a) in the Federal Register, along with a notice of the 
comment period established in subsection (c) and a request for 
comments, promptly after the date on which such preliminary version is 
completed.
    (c) Comment Period.--The Commission may receive comments concerning 
the preliminary version of the form required to be developed under 
subsection (a) during the 30-day period beginning on the date the 
preliminary version appears in the Federal Register.
    (d) Revision of Form and Final Report.--Not later than the 
expiration of the 30-day period beginning on the date following the 
closing date of the comment period under subsection (c), the Commission 
shall--
            (1) revise the preliminary version of the form required to 
        be developed under subsection (a), taking into consideration 
        any comments received pursuant to subsection (c);
            (2) develop a final version of the form required to be 
        developed under section 3; and
            (3) submit to the Congress, the Secretary of Health and 
        Human Services, the Secretary of Defense, and the Secretary of 
        Veterans Affairs a report containing--
                    (A) a copy of the final version of the form;
                    (B) a summary of the activities of the Commission; 
                and
                    (C) any other findings, conclusions, or 
                recommendations that the Commission determines to be 
                appropriate.

SEC. 8. TERMINATION.

    The Commission shall terminate not later than the expiration of the 
30-day period beginning on the date on which the Commission submits its 
report under section 7.

SEC. 9. PROMULGATION OF REGULATIONS CONCERNING UNIFORM CLAIMS 
              PROCESSING FORM.

    (a) Notice of Regulations.--Promptly upon receipt of the report 
submitted under section 7(d), the Secretary of Health and Human 
Services, the Secretary of Defense, and the Secretary of Veterans 
Affairs each shall publish in the Federal Register a notice of 
rulemaking in which the Secretary announces the promulgation of a 
regulation that will--
            (1) take effect 90 days after the date of the publication 
        of the notice; and
            (2) require all health service providers that furnish 
        health care services for which a claim for payment may be 
        submitted under a Federal program within the jurisdiction of 
        the Secretary to submit any such claim using the universal 
        paper claims processing form developed by the Commission under 
        section 3.
    (b) Promulation and Implementation of Regulations.--The Secretary 
of Health and Human Services, the Secretary of Defense, and the 
Secretary of Veterans Affairs each shall promulgate and implement a 
regulation described in subsection (a).

SEC. 10. FUNDING.

    From funds appropriated for salaries and expenses with respect to 
the Department of Health and Human Services for fiscal year 1995, the 
Secretary of Health and Human Services shall expend such amounts as may 
be necessary to ensure that the Commission is able to carry out its 
duties under this Act, except that such amounts shall not exceed 
$500,000.

SEC. 11. DEFINITIONS.

    For purposes of this Act:
            (1) Commission.--The term ``Commission'' means the Uniform 
        Claims Commission established by section 2.
            (2) Health service provider.--The term ``health service 
        provider'' includes a provider of services (as defined in 
        section 1861(u) of the Social Security Act), physician, 
        supplier, and other person furnishing health care services but 
        does not include a Federal program that provides directly for 
        the provision of health care services to beneficiaries.

SEC. 12. BUDGET COMPLIANCE.

    Any spending authority (as defined in subparagraphs (A) and (C) of 
section 401(c)(2) of the Congressional Budget Act of 1974 (2 U.S.C. 
651(c)(2)(A))) authorized by this Act shall be effective only to such 
extent or in such amounts as are provided in appropriation Acts.

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