[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2476 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 2476

 To amend title XVIII of the Social Security Act to provide for common 
                 sense reforms of the Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 12, 1995

  Mr. Stupak introduced the following bill; which was referred to the 
   Committee on Ways and Means, and in addition to the Committees on 
Commerce, and the Judiciary, 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

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to provide for common 
                 sense reforms of the Medicare Program.

    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 ``Common Sense Medicare Reform Act of 
1995''.

                        TITLE I--FRAUD AND ABUSE

      Subtitle A--Provisions Relating to Durable Medical Equipment

SEC. 101. REVISION OF PAYMENT METHODOLOGY FOR DURABLE MEDICAL 
              EQUIPMENT.

    (a) In General.--Section 1834(a) of the Social Security Act (42 
U.S.C. 1395m(a)) is amended by adding at the end the following new 
paragraph:
            ``(19) Using competitive pricing to determine payment 
        amounts.--
                    ``(A) In general.--Notwithstanding any other 
                provision of this subsection, the Secretary shall 
                promulgate (on an interim basis pending notice and 
                opportunity for public comment) a fee schedule for 
                payment for covered items under this subsection based 
                on competitive prices and using the inherent 
                reasonableness authority contained in paragraph (10), 
                but without regard to section 1842(b)(9).
                    ``(B) Competitive bidding.--Notwithstanding any 
                other provision of law, for various areas of the 
                country, the Secretary may employ a competitive rate 
                setting process to establish payment rates for items of 
                durable medical equipment, prosthetics, orthotics, and 
                supplies under this part. The Secretary may restrict 
                payment for these benefits (i) to that supplier with 
                the lowest bid in such a process, or in those instances 
                where the Secretary concludes it is advantageous to 
                have more than one supplier, (ii) to that set of 
                suppliers whose bids are among the lowest, or (iii) to 
                those suppliers submitting bids who are willing to 
                accept the competitive rate as payment in full.
                    ``(C) Limitation on billing.--No supplier of 
                covered items under this subsection may balance bill 
                recipients for more than 15 percent of what is payable 
                to the supplier under this part (determined without 
                regard to deductibles or coinsurance).
                    ``(D) Improved monitoring of utilization of durable 
                medical equipment.--The Secretary shall take such steps 
                as may be necessary to improve the monitoring of the 
                utilization of covered items under this part.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply, pursuant to regulations of the Secretary, to durable medical 
equipment furnished on or after the date of the enactment of this Act.

SEC. 102. FREEZE IN UPDATES FOR 1996.

    (a) Covered Items.--Section 1834(a)(14) of the Social Security Act 
(42 U.S.C. 1395m(a)(14)) is amended--
            (1) by striking ``and'' at the end of subparagraph (A);
            (2) in subparagraph (B), by striking ``a subsequent year'' 
        and inserting ``1993, 1994, and 1995''; and
            (3) by adding at the end the following:
                    ``(C) for 1996 and each year thereafter, 0 
                percentage points.''.
    (b) Orthotics and Prosthetics.--Section 1834(h)(4)(A) of such Act 
(42 U.S.C. 1395m(h)(4)(A)) is amended--
            (1) by adding ``and'' at the end of clause (ii), and
            (2) in clause (iii), by striking ``and 1995'' and inserting 
        ``and each subsequent year'', and
            (3) by striking clause (iv).

                   Subtitle B--Anti-Fraud Provisions

SEC. 111. ILLEGAL REMUNERATION WITH RESPECT TO SPECIFIED HEALTH CARE 
              BENEFIT PROGRAMS.

    (a) In General.--Chapter 11 of title 18, United States Code, is 
amended by adding at the end the following:
``Sec. 227. Illegal remuneration with respect to specified health care 
              benefit programs
    ``(a) Whoever knowingly and willfully solicits or receives (or 
attempts to solicit or receive) any remuneration (including any 
kickback, bribe, or rebate) directly or indirectly, overtly or 
covertly, in cash or in kind--
            ``(1) in return for referring an individual to a person for 
        the furnishing or arranging for the furnishing of any item or 
        service for which payment may be made in whole or in part by 
        any specified health care benefit program, or
            ``(2) in return for purchasing, leasing, ordering, or 
        arranging for or recommending purchasing, leasing, or ordering 
        any good, facility, service, or item for which payment may be 
        made in whole or in part by any specified health care benefit 
        program,
shall be fined under this title or imprisoned for not more than five 
years, or both.
    ``(b) Whoever knowingly and willfully offers or pays (or attempts 
to offer or pay) any remuneration (including any kickback, bribe, or 
rebate) directly or indirectly, overtly or covertly, in cash or in 
kind--
            ``(1) to refer an individual to a person for the furnishing 
        or arranging for the furnishing of any item or service for 
        which payment may be made in whole or in part by any specified 
        health care benefit program, or
            ``(2) to purchase, lease, order, or arrange for or 
        recommending purchasing, leasing, or ordering any good, 
        facility, service, or item for which payment may be made in 
        whole or in part by any specified health care benefit program,
shall be fined under this title or imprisoned for not more than five 
years, or both.
    ``(c)(1) The Attorney General can bring an action in the district 
courts to impose upon any person who carries out any activity in 
violation of subsection (a) or (b) a civil penalty of not less than 
$25,000 and not more than $50,000 for each such violation, and that 
person shall be subject to damages of three times the total 
remuneration offered, paid, solicited, or received in violation of such 
subsection.
    ``(2) A violation exists under paragraph (1) of one or more 
purposes of the remuneration is unlawful, and the damages shall be the 
full amount of such remuneration.
    ``(3) The procedures for actions under this subsection with regard 
to subpoenas, statute of limitations, standard of proof, and collateral 
estoppel shall be governed by section 3731 of title 31, United States 
Code, and the Federal Rules of Civil Procedures shall apply to actions 
brought under this subsection.
    ``(4) This subsection shall not affect the availability of other 
criminal and civil remedies for violations of subsections (a) and (b).
    ``(d) Subsections (a) through (c) shall not apply to any of the 
following:
            ``(1) A discount or other reduction in price obtained by a 
        provider of services or other entity under a specified health 
        care benefit program if the reduction in price is properly 
        disclosed and appropriately reflected in the costs claimed or 
        charges made by the provider or entity under a specified health 
        care benefit program.
            ``(2) Any amount paid by an employer to an employee (which 
        has a bona fide employment relationship with such employer) for 
        employment in the provision of covered items or services if the 
        amount of the remuneration under the arrangement is consistent 
        with the fair market value of the services and is not 
        determined in a manner that takes into account (directly or 
        indirectly) the volume or value of any referrals.
            ``(3) Any amount paid by a vendor of goods or services to a 
        person authorized to act as a purchasing agent for a group of 
        individuals or entities who are furnishing services reimbursed 
        under a specified health care benefit program if--
                    ``(A) the person has a written contract with each 
                such individual or entity, which specifies the amount 
                to be paid the person, which amount may be a fixed 
                amount or a percentage of the value of the purchases 
                made by each such individual or entity under the 
                contract, and
                    ``(B) in the case of an entity that is a provider 
                of services (as defined in section 1861(u) of the 
                Social Security Act), the person discloses (in such 
                form and manner as the Secretary of Health and Human 
                Services requires) to the entity, and, upon request, to 
                the Secretary of Health and Human Services the amount 
                received from each such vendor with respect to chases 
                made by or on behalf of the entity.
            ``(4) A waiver of any coinsurance under part B of title 
        XVIII of the Social Security Act by a federally qualified 
        health care center with respect to an individual who qualifies 
        for subsidized services under a provision of the Public Health 
        Service Act.
            ``(5) Any payment practice specified by the Secretary of 
        Health and Human Services in regulations promulgated pursuant 
        to section 14(a) of the Medicare and Medicaid Patient and 
        Program Protection Act of 1987.
    ``(e) As used in this section, the term `specified health care 
benefit program' means any plan that provides health benefits, whether 
directly, through insurance, or otherwise, which is funded in whole or 
in part by the United States Government, or is a State health care 
program (as defined in section 1128(h) of the Social Security Act).''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end the following:

``227. Illegal remuneration with respect to specified health care 
                            benefit programs.''.

SEC. 112. GRAND JURY DISCLOSURE.

    Section 332 of title 18, United States Code, is amended--
            (1) by redesignating subsections (c) and (d) as subsections 
        (d) and (e), respectively, and
            (2) by inserting after subsection (b) the following new 
        subsection:
    ``(c) A person who is privy to grand jury information concerning a 
Federal health offense (as defined in section 982(a)(6)(D)) that is--
            ``(1) received in the course of duty as an attorney for the 
        Government, or
            ``(2) disclosed under rule 6(e)(3)(A)(ii) of the Federal 
        Rules of Criminal Procedure,
may disclose that information to an attorney for the Government to use 
in any investigation or civil proceeding relating to health care 
fraud.''.

SEC. 113. AUTHORIZED INVESTIGATIVE DEMAND PROCEDURES.

    (a) In General.--Chapter 233 of title 18, United States Code, is 
amended by inserting after section 3485 the following:
``Sec. 3486. Authorized investigative demand procedures
    ``(a) Authorization.--
            ``(1) In any investigation relating to functions set forth 
        in paragraph (2), the Attorney General (or designee of the 
        Attorney General) may issue in writing and cause to be served a 
        subpoena compelling production of any records (including any 
        books, papers, documents, electronic media, or other objects or 
        tangible things) which may be relevant to an authorized law 
        enforcement inquiry that a person or legal entity may possess 
        or have care, custody, or control. A custodian of records may 
        be required to give testimony concerning the production and 
        authentication of such records. The production of records may 
        be required from any place in any State or in any territory or 
        other place subject to the jurisdiction of the United States at 
        any designated place; except that such production shall not be 
        required more than 500 miles distant from the place where the 
        subpoena is served. Witnesses summoned under this paragraph 
        shall be paid the same fees and mileage that are paid witnesses 
        in the courts of the United States. A subpoena requiring the 
        production of records shall describe the objects required to be 
        produced and prescribe a return date within a reasonable period 
        of time within which the objects can be assembled and made 
        available.
            ``(2) Investigative demands utilizing an administrative 
        subpoena are authorized for any investigation with respect to 
        any act or activity constituting or involving health care 
        fraud. For purposes of this paragraph, the term `health care 
        fraud' means a scheme or artifice (A) to defraud any health 
        plan or other person, in connection with the delivery of or 
        payment for health care benefits, items, or services, or (B) to 
        obtain, by means of false or fraudulent pretenses, 
        representations, or promises, any of the money or property 
        owned by, or under the custody or control of, any health plan, 
        or person in connection with the delivery of or payment for 
        health care benefits, items, or services.
    ``(b) Services.--A subpoena issued under this section may be served 
by any person designated in the subpoena to serve it. Service upon a 
natural person may be made by personal delivery of the subpoena to the 
person. Service may be made upon a domestic or foreign association 
which is subject to suit under a common name, by delivering the 
subpoena to an officer, to a managing or general agent, or to any other 
agent authorized by appointment or by law to receive service of 
process. The affidavit of the person serving the subpoena entered on a 
true copy thereof by the person serving it shall be proof of service.
    ``(c) Enforcement.--In the case of contumacy by or refusal to obey 
a subpoena issued to any person, the Attorney General may invoke the 
aid of any court of the United States within the jurisdiction of which 
the investigation is carried on or of which the subpoenaed person is an 
inhabitant, or in which he carries on business or may be found, to 
compel compliance with the subpoena. The court may issue an order 
requiring the subpoenaed person to appear before the Attorney General 
to produce records, if so ordered, or to give testimony touching the 
matter under investigation. Any failure to obey the order of the court 
may be punished by the court as a contempt thereof. All process in any 
such case may be served in any judicial district in which such person 
may be found.
    ``(d) Immunity From Civil Liability.--Notwithstanding any Federal, 
State, or local law, any person, including officers, agents, and 
employees, receiving a subpoena under this section, who complies in 
good faith with the subpoena and thus produces the materials sought, 
shall not be liable in any court of any State or the United States to 
any customer or other person for such production or for nondisclosure 
of that production to the customer.
    ``(e) Use in Action Against Individuals.--
            ``(1) Health information about an individual that is 
        disclosed under this section may not be used in, or disclosed 
        to any person for use in, any administrative, civil, or 
        criminal action or investigation directed against the 
        individual who is the subject of the information unless the 
        action or investigation arises out of and is directly related 
        to receipt of health care or payment for health care or an 
        action involving a fraudulent claim related to health; or if 
        authorized by an appropriate order of a court of competent 
        jurisdiction, granted after application showing good cause 
        therefor.
            ``(2) In assessing good cause under paragraph (1), the 
        court shall weigh the public interest and the need for 
        disclosure against the injury to the patient, to the physician-
        patient relationship, and to the treatment services.
            ``(3) Upon granting of such order, the court, in 
        determining the extent to which any disclosure of all or any 
        part of any record is necessary, shall impose appropriate 
        safeguards against unauthorized disclosure.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
3485 the following new item:

``3486. Authorized investigative demand procedures.''.
    (c) Conforming Amendment.--Section 1510(b)(3)(B) of title 18, 
United States Code, is amended by inserting ``or a Department of 
Justice subpoena issued under section 3486 of this title'' after 
``subpoena''.

              Subtitle C--Health Care Fraud Abuse Account

SEC. 121. FRAUD AND ABUSE CONTROL FUND.

    (a) In General.--Part A of title XI of the Social Security Act is 
amended by adding at the end the following new section:

                     ``fraud and abuse control fund

    ``Sec. 1145. (a) The Secretary shall, directly or through 
contractual or other arrangements and with appropriate coordination 
with the States, take all steps necessary to assure the accuracy of 
payments from the trust funds established under title XVIII (referred 
to herein as the `Medicare Trust Funds') and the appropriation for 
payments to States to carry out title XIX (referred to herein as the 
`Medicaid appropriation') and otherwise assure the appropriateness of 
expenditures from such Funds and such appropriation. To carry out this 
responsibility, the Secretary shall place particular emphasis on the 
development of and experimentation with innovative or rigorous 
techniques and approaches to identifying, investigating, and 
eliminating fraudulent or abusive practices that burden the Medicare 
Trust Funds or the Medicaid appropriation.
    ``(b) To provide a reliable source of funding to support the 
Secretary's activities under subsection (a) and encourage cost-
effective innovation, there is established in the Treasury of the 
United States a fund to be known as the `HHS Fraud and Abuse Control 
Fund' (referred to herein as the `Fund').
    ``(c) There shall be deposited in the Fund--
            ``(1) that portion of amounts recovered in relation to 
        section 1128A arising out of a claim under title XIX or title 
        XVIII as remains after application of subsection (f)(1) 
        (pertaining to reimbursement of a State's share of recoveries 
        relating to title XIX) or subsection (f)(2) (relating to 
        repayment of the Medicare Trust Funds) of that section, as may 
        be applicable,
            ``(2) payments made pursuant to a court or administrative 
        order or voluntary settlement agreement to reimburse for all or 
        part of the costs of investigations, audits, and monitoring of 
        compliance plans, conducted by the Department of Health and 
        Human Services that relate to the programs under title XVIII or 
        XIX, and
            ``(3) penalties and damages imposed (other than funds 
        awarded to a relator or for restitution) under sections 3729 
        through 3732 of title 31, United States Code (pertaining to 
        false claims) in cases involving claims relating to programs 
        under title XVIII or XIX (to the extent the amounts deposited 
        in the Fund under paragraphs (1) and (2) in a fiscal year are 
        less than $2,000,000).
    ``(d) Amounts deposited in the Fund shall be available to the 
Secretary (without the necessity for any provision therefor in 
appropriations Acts) until expended for payment of expenses incurred in 
carrying out subsection (a).
    ``(e) No more than $2,000,000 may be deposited in the Fund in any 
fiscal year.''.
    (b) Initial Deposit in HHS Fraud and Abuse Control Fund.--There is 
authorized to be appropriated for fiscal year 1996 an amount (to be 
deposited in the HHS Fraud and Abuse Control Fund established by 
section 1145(b) of the Social Security Act) for the initial 
implementation of activities under section 1145(a) of that Act (subject 
to section 1145(e) of that Act).
    (c) Conforming Amendment.--Section 1128A(f) of the Social Security 
Act (42 U.S.C. 1320a-7a(f)) is amended--
            (1) by renumbering paragraph (3) as paragraph (4), and
            (2) by inserting after paragraph (2) the following:
    ``(3) Additional amounts (subject to section 1145(e)) shall be 
deposited in the HHS Fraud and Abuse Control Fund established by 
section 1145(b).''.
    (d) Effective Date.--Sections 1145(c) and 1128A(f)(3) of the Social 
Security Act (as enacted and amended by subsections (a) and (c) of this 
section) apply to amounts recovered, payments made, and penalties and 
damages imposed, after fiscal year 1995.

                 TITLE II--MEDICARE PLUS PILOT PROGRAM

SEC. 201. ESTABLISHMENT OF PILOT PROGRAM.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a pilot program (in this section referred to as the ``pilot 
program'') under which additional health plans (including health plans 
of the type described in subsection (b)) may qualify to be offered 
under section 1876 of the Social Security Act.
    (b) Types of Organizations Described.--The types of organizations 
described in this subsection are the following:
            (1) Provider-sponsored networks.--A health plan offered by 
        a group of affiliated providers that provides a substantial 
        proportion of medicare covered items and services directly 
        through the affiliated group of providers.
            (2) Taft-hartley plans.--A group health plan that is 
        established or maintained by two or more employers or jointly 
        by one or more employers and one or more employee 
        organizations.
            (3) Association plans.--A health plan offered through an 
        association, religious fraternal organization, or other 
        organization (which may be a trade, industry, or professional 
        association, a chamber of commerce, or a public entity 
        association) that--
                    (A) has been formed for purposes other than the 
                sale of any health insurance and does not restrict 
                membership based on the health status, claims 
                experience, receipt of health care, medical history, or 
                lack of evidence of insurability, of an individual,
                    (B) does not exist solely or principally for the 
                purpose of selling insurance, and
                    (C) has at least 1,000 individual members or 200 
                employer members.
            (4) High deductible health plans with contribution to 
        medical savings accounts.--
                    (A) In general.--A benefit package consisting of--
                            (i) a high deductible health plan described 
                        in subparagraph (B), and
                            (ii) a contribution to a medical savings 
                        account (of the excess of the medicare payment 
                        amount over the premium for such high 
                        deductible health plan).
                    (B) High deductible health plan described.--A high 
                deductible health plan described in this subparagraph 
                is a health plan that--
                            (i) provides reimbursement for at least 
                        items and services covered under the medicare 
                        program in a year but only after the enrollee 
                        incurs countable expenses (as specified under 
                        the plan) equal to the amount of a deductible 
                        (in an amount that does not exceed $10,000);
                            (ii) counts as such expenses (for purposes 
                        of such deductible) at least all amounts that 
                        would have been payable under parts A and B of 
                        the medicare program or by the enrollee if the 
                        enrollee had elected to receive benefits 
                        through the provisions of such parts (rather 
                        than through the plan); and
                            (iii) provides, after such deductible is 
                        met for a year and for all subsequent expenses 
                        for benefits referred to in clause (i) in the 
                        year, for a level of reimbursement that is not 
                        less than--
                                    (I) 100 percent of such expenses, 
                                or
                                    (II) 100 percent of the amounts 
                                that would have been paid (without 
                                regard to any deductibles or 
                                coinsurance) under parts A and B of the 
                                medicare program with respect to such 
                                expenses,
                        whichever is less.
    (c) Program Dates.--
            (1) Applications.--Under the pilot program the Secretary 
        shall provide for receipt of applications by October 1, 1996.
            (2) Initial operation.--Operation of the pilot program 
        under approved application shall commence on January 1, 1997.
            (3) Termination date.--
                    (A) In general.--The pilot program under this 
                section shall terminate on December 31, 2001, unless 
                extended by the Congress.
                    (B) Early termination.--The Secretary may terminate 
                any project under the pilot program on an earlier date 
                if the Secretary determines that the continued 
                operation of the project will endanger the medicare 
                trust funds.
    (d) Study of Application.--In the case of the high deductible 
health plans with contribution to medical savings accounts described in 
subsection (b)(4), the Secretary shall conduct a study of the extent to 
which enrollees represent a cross-section by age and income of medicare 
beneficiaries.
    (e) Study and Report.--The Secretary shall conduct a study of the 
operation of the pilot program and shall submit to Congress, not later 
than March 1, 2001, on such operation and whether the program should be 
continued beyond the termination date specified in subsection 
(c)(3)(A).

TITLE III--COMMISSION ON THE EFFECT OF THE BABY BOOM GENERATION ON THE 
                            MEDICARE PROGRAM

SEC. 301. COMMISSION ON THE EFFECT OF THE BABY BOOM GENERATION ON THE 
              MEDICARE PROGRAM.

    (a) Establishment.--There is established a commission to be known 
as the Commission on the Effect of the Baby Boom Generation on the 
Medicare Program (in this section referred to as the ``Commission'').
    (b) Duties.--
            (1) In general.--The Commission shall--
                    (A) examine the financial impact on the medicare 
                program of the significant increase in the number of 
                medicare eligible individuals which will occur 
                beginning approximately during 2010 and lasting for 
                approximately 25 years, and
                    (B) make specific recommendations to the Congress 
                respecting a comprehensive approach to preserve the 
                medicare program for the period during which such 
                individuals are eligible for medicare.
            (2) Considerations in making recommendations.--In making 
        its recommendations, the Commission shall consider the 
        following:
                    (A) The amount and sources of Federal funds to 
                finance the medicare program, including the potential 
                use of innovative financing methods.
                    (B) The most efficient and effective manner of 
                administering the program.
                    (C) Methods used by other nations to respond to 
                comparable demographic patterns in eligibility for 
                health care benefits for elderly and disabled 
                individuals.
                    (D) Trends in employment-related health care for 
                retirees, including the use of medical savings accounts 
                and similar financing devices.
                    (E) The needs of medicare beneficiaries and 
                providers located in diverse geographic locations, 
                including urban and rural areas.
            (3) Consultation with medicare trustees.--The Commission 
        shall conduct its activities in consultation with the trustees 
        of the Federal Supplementary Medical Insurance Trust Fund.
    (c) Membership.--
            (1) Appointment.--The Commission shall be composed of 15 
        members appointed as follows:
                    (A) The President shall appoint 3 members.
                    (B) The Majority Leader of the Senate shall 
                appoint, after consultation with the minority leader of 
                the Senate, 6 members, of whom not more than 4 may be 
                of the same political party.
                    (C) The Speaker of the House of Representatives 
                shall appoint, after consultation with the minority 
                leader of the House of Representatives, 6 members, of 
                whom not more than 4 may be of the same political 
                party.
            (2) Chairman and vice chairman.--The Commission shall elect 
        a Chairman and Vice Chairman from among its members.
            (3) Vacancies.--Any vacancy in the membership of the 
        Commission shall be filled in the manner in which the original 
        appointment was made and shall not affect the power of the 
        remaining members to execute the duties of the Commission.
            (4) Quorum.--A quorum shall consist of 8 members of the 
        Commission, except that 4 members may conduct a hearing under 
        subsection (e).
            (5) Meetings.--The Commission shall meet at the call of its 
        Chairman or a majority of its members. The Commission shall 
        hold hearings in different areas throughout the country in 
        order to obtain information and suggestions from a diverse 
        group of individuals.
            (6) Compensation and reimbursement of expenses.--Members of 
        the Commission are not entitled to receive compensation for 
        service on the Commission. Members may be reimbursed for 
        travel, subsistence, and other necessary expenses incurred in 
        carrying out the duties of the Commission.
    (d) Staff and Consultants.--
            (1) Staff.--The Commission may appoint and determine the 
        compensation of such staff as may be necessary to carry out the 
        duties of the Commission. Such appointments and compensation 
        may be made without regard to the provisions of title 5, United 
        States Code, that govern appointments in the competitive 
        services, and the provisions of chapter 51 and subchapter III 
        of chapter 53 of such title that relate to classifications and 
        the General Schedule pay rates.
            (2) Consultants.--The Commission may procure such temporary 
        and intermittent services of consultants under section 3109(b) 
        of title 5, United States Code, as the Commission determines to 
        be necessary to carry out the duties of the Commission.
    (e) Powers.--
            (1) Hearings and other activities.--For the purpose of 
        carrying out its duties, the Commission may hold such hearings 
        and undertake such other activities as the Commission 
        determines to be necessary to carry out its duties.
            (2) Studies by gao.--Upon the request of the Commission, 
        the Comptroller General shall conduct such studies or 
        investigations as the Commission determines to be necessary to 
        carry out its duties.
            (3) Cost estimates by congressional budget office.--
                    (A) Upon the request of the Commission, the 
                Director of the Congressional Budget Office shall 
                provide to the Commission such cost estimates as the 
                Commission determines to be necessary to carry out its 
                duties.
                    (B) The Commission shall reimburse the Director of 
                the Congressional Budget Office for expenses relating 
                to the employment in the office of the Director of such 
                additional staff as may be necessary for the Director 
                to comply with requests by the Commission under 
subparagraph (A).
            (4) Detail of federal employees.--Upon the request of the 
        Commission, the head of any Federal agency is authorized to 
        detail, without reimbursement, any of the personnel of such 
        agency to the Commission to assist the Commission in carrying 
        out its duties. Any such detail shall not interrupt or 
        otherwise affect the civil service status or privileges of the 
        Federal employee.
            (5) Technical assistance.--Upon the request of the 
        Commission, the head of a Federal agency shall provide such 
        technical assistance to the Commission as the Commission 
        determines to be necessary to carry out its duties.
            (6) Use of mails.--The Commission may use the United States 
        mails in the same manner and under the same conditions as 
        Federal agencies and shall, for purposes of the frank, be 
        considered a commission of Congress as described in section 
        3215 of title 39, United States Code.
            (7) Obtaining information.--The Commission may secure 
        directly from any Federal agency information necessary to 
        enable it to carry out its duties, if the information may be 
        disclosed under section 552 of title 5, United States Code. 
        Upon request of the Chairman of the Commission, the head of 
        such agency shall furnish such information to the Commission.
            (8) Administrative support services.--Upon the request of 
        the Commission, the Administrator of General Services shall 
        provide to the Commission on a reimbursable basis such 
        administrative support services as the Commission may request.
            (9) Acceptance of donations.--The Commission may accept, 
        use, and dispose of gifts or donations of services or property.
            (10) Printing.--For purposes of costs relating to printing 
        and binding, including the cost of personnel detailed from the 
        Government Printing Office, the Commission shall be deemed to 
        be a committee of the Congress.
    (f) Report.--Not later than January 1, 2001, the Commission shall 
submit to Congress a report containing its findings and recommendations 
regarding how to protect and preserve the medicare program in a 
financially solvent manner until 2030 (or, if later, throughout the 
period of projected solvency of the Federal Old-Age and Survivors 
Insurance Trust Fund). The report shall include detailed 
recommendations for appropriate legislative initiatives respecting how 
to accomplish this objective.
    (g) Termination.--The Commission shall terminate 60 days after the 
date of submission of the report required in subsection (f).
    (h) Authorization of Appropriations.--There are authorized to be 
appropriated $1,500,000 to carry out this section. Amounts appropriated 
to carry out this section shall remain available until expended.

     TITLE IV--DEVELOPMENT OF SINGLE MEDICARE ADMINISTRATIVE SYSTEM

SEC. 401. IMPROVED ADMINISTRATIVE EFFICIENCIES.

    (a) In General.--The Secretary of Health and Human Services shall 
take such steps as may be required to provide for improved efficiency 
in the medicare program through--
            (1) establishment of a common payment form (as part of a 
        medicare transaction system) for all medicare payments, and
            (2) consolidation of the administrative system for parts A 
        and B of the medicare program.
    (b) Report.--The Secretary shall submit to Congress a report on 
steps taken under subsection (a) and in such legislation as may be 
required to further carry out subsection (a) and to provide for further 
administrative efficiencies under the medicare program.

                      TITLE V--LOCK-BOX PROVISION

SEC. 501. LIMITATION ON USE OF SAVINGS.

    Notwithstanding any other provision of law, all savings resulting 
from the enactment of this Act shall be transferred to the credit of 
the Federal Hospital Insurance Trust Fund and may not be used to offset 
revenue losses from a tax cut.
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HR 2476 IH----2