[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 3041 Introduced in Senate (IS)]







107th CONGRESS
  2d Session
                                S. 3041

  To require the Secretary of Health and Human Services to conduct a 
study and submit a report to Congress on new technology payments under 
    the medicare prospective payment system for hospital outpatient 
                          department services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 3, 2002

   Mr. Hatch introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To require the Secretary of Health and Human Services to conduct a 
study and submit a report to Congress on new technology payments under 
    the medicare prospective payment system for hospital outpatient 
                          department services.

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

SECTION 1. STUDY AND REPORT ON NEW TECHNOLOGY PAYMENTS UNDER THE 
              PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT 
              DEPARTMENT SERVICES.

    (a) Study.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this section referred to as the ``Secretary'') shall 
        conduct a study of the methods by which new medical devices, 
        new drugs, biologicals, and other new technologies are 
        recognized for payment under the hospital outpatient department 
        prospective payment system established under section 1833(t) of 
        the Social Security Act (42 U.S.C. 1395l(t)) and on possible 
        changes to those methods.
            (2) Issues examined.--The study conducted under paragraph 
        (1) shall examine the following:
                    (A) The experience to date of the transitional 
                pass-through payment mechanism for additional costs of 
                innovative medical devices, drugs, and biologicals 
                (provided under section 1833(t)(6) of the Social 
                Security Act (42 U.S.C. 1395l(t)(6))) and of the 
                provision for new technology ambulatory payment 
                classifications provided through regulations. In 
                particular, the study should examine the effect of such 
                payment mechanism on access of medicare beneficiaries 
                to orphan and single source drugs.
                    (B) The impact of transitional pass-through 
                payments of payment rates for procedures not using new 
                medical devices, drugs, biologicals, and other new 
                technologies.
                    (C) The impact of transitional pass-through 
                payments on various types of hospitals, including 
                teaching hospitals, rural hospitals, and small urban 
                hospitals.
                    (D) The extent to which additional payments are 
                necessary to facilitate access to improved treatments 
                by medicare beneficiaries.
            (3) Options considered.--In conducting the study under 
        paragraph (1), the Secretary shall consider the following 
        options:
                    (A) Statutory, regulatory, or administrative 
                changes that may be desirable to assure appropriate 
                recognition of the costs to hospitals of delivering 
                such services. In considering such changes, the 
                Secretary shall take into account the effect of such 
                changes on the payment for new technology services, on 
                payment for services that do not employ such technology 
                services, and on administrative resources of both the 
                Department of Health and Human Services and hospitals 
                that may be necessary to implement various changes in a 
                reliable fashion.
                    (B) Appropriate methods for assuring that decisions 
                concerning the eligibility of new technologies for 
                additional payment are made and implemented 
                expeditiously (including possible methods for 
                shortening the interval between approval of a 
                technology by the Food and Drug Administration and 
                commencement of additional payment in instances when a 
                new technology qualifies for such payment) and for 
                assuring that additional payments are directed to those 
                services that add value for medicare beneficiaries by 
                comparison to other technologies for which they may 
                substitute.
                    (C) Methods of setting additional payment rates 
                that may reasonably reflect hospital costs in 
                furnishing new technology services, including 
                alternatives to pricing new drugs based on average 
                wholesale price.
                    (D) Methods for appropriately reflecting the costs 
                of new technology services in payment rates under the 
                hospital outpatient department prospective payment 
                system after the period during which additional 
                payments are made.
    (b) Report.--Not later than July 1, 2003, the Secretary shall 
submit a report on the study conducted under paragraph (1) to the 
Committee on Ways and Means and the Committee on Energy and Commerce of 
the House of Representatives and the Committee on Finance of the Senate 
together with such recommendations for legislative and administrative 
action as the Secretary determines appropriate.
                                 <all>