[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2726 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 2726

To amend title XVIII of the Social Security Act to direct the Secretary 
of Health and Human Services to contract with certain hospitals for the 
provision of certain surgical procedures and related services under the 
                           Medicare Program.


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                    IN THE HOUSE OF REPRESENTATIVES

                            October 23, 1997

Mr. Stark (for himself and Mr. Becerra) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addition 
     to the Committee on 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

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                                 A BILL


 
To amend title XVIII of the Social Security Act to direct the Secretary 
of Health and Human Services to contract with certain hospitals for the 
provision of certain surgical procedures and related services under the 
                           Medicare Program.

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

SECTION. 1. PROVISION FOR NEGOTIATED ALL-INCLUSIVE RATES.

    (a) In General.--Title XVIII of the Social Security Act is amended 
by inserting after section 1888 the following:

                    ``negotiated all-inclusive rates

    ``Sec. 1889. (a) In General.--The Secretary shall use a competitive 
process to contract with specific hospitals or other entities for 
furnishing services related to surgical procedures, and for furnishing 
services (unrelated to surgical procedures) to hospital inpatients that 
the Secretary determines to be appropriate. The services may include 
any services covered under this title that the Secretary determines to 
be appropriate, including post-hospital services.
    ``(b) Quality Standards.--Only entities that meet quality standards 
established by the Secretary shall be eligible to contract under this 
section. In considering quality, the Secretary shall take into account 
the quality, experience, and quantity of services of providers who 
provide services in more than one entity. Contracting entities shall 
implement a quality improvement plan approved by the Secretary.
    ``(c) Payment.--Payment under this section shall be made on the 
basis of negotiated all-inclusive rates. The amount of payment made by 
the Secretary to an entity under this title for services covered under 
a contract shall be less than the aggregate amount of the payments that 
the Secretary would have otherwise made for the services.
    ``(d) Contract Period.--A contract period shall be 3 years (subject 
to renewal), so long as the entity continues to meet quality and other 
contractual standards.
    ``(e) Incentives for Use of Contracting Entities.--Entities under a 
contract under this section may furnish additional services (at no cost 
to an individual entitled to benefits under this title) or waive cost-
sharing, subject to the approval of the Secretary.
    ``(f) Limit on Number of Contracting Entities.--The Secretary shall 
limit the number of contracting entities in a geographic area to the 
number needed to meet projected demand for contracted services.''.
    (b) Effective Date.--The amendment made by subsection (a) applies 
to services furnished on or after October 1, 1997.
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