[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4216 Introduced in House (IH)]

103d CONGRESS
  2d Session
                                H. R. 4216

 To amend title XVIII of the Social Security Act to limit the amount a 
 provider may charge an individual for an outpatient hospital service 
  furnished under part B of the medicare program to 20 percent of the 
        reasonable cost of the service, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 14, 1994

Mr. Coyne introduced the following bill; which was referred jointly to 
        the Committees on Ways and Means and Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to limit the amount a 
 provider may charge an individual for an outpatient hospital service 
  furnished under part B of the medicare program to 20 percent of the 
        reasonable cost of the service, 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 ``Medicare Beneficiary Coinsurance 
Protection Act''.

SEC. 2. LIMITATION ON AMOUNT PROVIDER MAY CHARGE FOR OUTPATIENT 
              HOSPITAL SERVICES UNDER MEDICARE.

    (a) In General.--Section 1866(a)(2)(A)(ii) of the Social Security 
Act (42 U.S.C. 1395cc(a)(2)(A)(ii)) is amended by striking ``an amount 
equal to 20 per centum of the reasonable charges'' and all that follows 
through ``the Secretary)'' and inserting ``with respect to items and 
services for which payment is made under part B or which are durable 
medical equipment furnished as home health services, an amount equal to 
20 percent of the reasonable cost of the item or service (as determined 
under section 1861(v))''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to items and services furnished on or after January 1, 1995.

SEC. 3. ELIMINATION OF FORMULA-DRIVEN OVERPAYMENTS FOR CERTAIN 
              OUTPATIENT HOSPITAL SERVICES.

    (a) Ambulatory Surgical Center Procedures.--Section 
1833(i)(3)(B)(i)(II) of the Social Security Act (42 U.S.C. 
1395l(i)(3)(B)(i)(II)) is amended--
            (1) by striking ``of 80 percent''; and
            (2) by striking the period at the end and inserting the 
        following: ``, less the amount a provider may charge as 
        described in clause (ii) of section 1866(a)(2)(A).''.
    (b) Radiology Services and Diagnostic Procedures.--Section 
1833(n)(1)(B)(i)(II) of such Act (42 U.S.C. 1395l(n)(1)(B)(i)(II)) is 
amended--
            (1) by striking ``of 80 percent''; and
            (2) by striking the period at the end and inserting the 
        following: ``, less the amount a provider may charge as 
        described in clause (ii) of section 1866(a)(2)(A).''.
    (c) Effective Date.--The amendments made by this section shall 
apply to services furnished during portions of cost reporting periods 
occurring on or after January 1, 1995.

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