[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 421 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 421

  To direct the Secretary of Health and Human Services to reduce the 
amount of coinsurance payable in conjunction with outpatient department 
 services furnished under the Medicare Program, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 19, 1999

  Mr. Stark introduced the following bill; which was referred to the 
  Committee on Commerce, and in addition to the Committee on Ways and 
 Means, 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 direct the Secretary of Health and Human Services to reduce the 
amount of coinsurance payable in conjunction with outpatient department 
 services furnished under the Medicare Program, 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 Hospital Outpatient 
Coinsurance Assistance Act of 1999''.

SEC. 2. REDUCTION IN RATE OF COINSURANCE PAYABLE FOR OUTPATIENT 
              DEPARTMENT SERVICES FURNISHED UNDER MEDICARE.

    (a) Reduction in Rate of Coinsurance.--
            (1) In general.--For services furnished under the medicare 
        program during the period described in paragraph (2), the 
        Secretary of Health and Human Services shall provide for a 
        reduction in the OPD coinsurance payment by a percentage that 
        the Secretary determines would result in an amount of aggregate 
        savings to effected medicare beneficiaries equal to 
        $460,000,000, adjusted proportionally in the manner provided in 
        paragraph (3).
            (2) Period described.--For purposes of paragraph (1), the 
        period described in this paragraph is the period beginning on 
        the date of the enactment of this Act ending on the date of the 
        implementation of the prospective payment system for hospital 
        outpatient department services under section 1833(t) of the 
        Social Security Act (42 U.S.C. 1395l(t)).
            (3) Proportional adjustment.--In determining the reduction 
        under paragraph (1), the Secretary shall make a proportional 
        adjustment to the reduction such that the reduction applies 
        such aggregate savings over the period of 1999 that follows the 
        date of the enactment of this Act.
    (b) Medicare Payment Rate.--For purposes of payment to providers of 
services (as defined in section 1861(u) of such Act (42 U.S.C. 
1395x(u)) under the sections described in subparagraphs (A) through (C) 
of subsection (c)(1), the Secretary of Health and Human Services shall 
make payments to such providers for items and services furnished 
without regard to the application of under subsection (a).
    (c) Definitions.--As used in this section:
            (1) OPD coinsurance payment.--The term ``OPD coinsurance 
        payment'' means the coinsurance payment imposed under section 
        1866(a)(2)(A)(ii) of the Social Security Act (42 U.S.C. 
        1395cc(a)(2)(A)(ii)) with respect to items and services 
        furnished under the following sections of such Act:
                    (A) Section 1833(a)(2)(B) (42 U.S.C. 
                1395l(a)(2)(B)).
                    (B) Section 1833(i)(2)(A) (42 U.S.C. 
                1395l(i)(2)(A)).
                    (C) Section 1833(n) (42 U.S.C. 1395l(n)).
            (2) Effected medicare beneficiaries.--The term ``effected 
        medicare beneficiaries'' means individuals enrolled under part 
        B of the medicare program under title XVIII of such Act who are 
        required to make OPD coinsurance payments for items and 
        services furnished under such program during 1999.
    (d) Prompt Implementation.--
            (1) In general.--The Secretary of Health and Human Services 
        shall promptly issue (without regard to chapter 8 of title 5, 
        United States Code) program memoranda as may be necessary to 
        provide for the reduction under subsection (a) for services 
        furnished on or after January 1, 1999.
            (2) Judicial review.--There shall be no administrative or 
        judicial review under section 1869 of the Social Security Act 
        (42 U.S.C. 1395ff), 1878 of such Act (42 U.S.C. 1395ff), or 
        under any other provision of law of any action by the Secretary 
        in determining the reduction under subsection (a).
                                 <all>