[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2925 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 2925

  To establish a smart card pilot program under the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 14, 2011

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

_______________________________________________________________________

                                 A BILL


 
  To establish a smart card pilot program 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. SHORT TITLE.

    This Act may be cited as the ``Medicare Common Access Card Act of 
2011''.

SEC. 2. SECURE MEDICARE CARD PILOT PROGRAM.

    (a) Pilot Program Implementation (Phase I).--
            (1) In general.--Not later than 18 months after the date of 
        the enactment of this Act, the Secretary shall conduct a pilot 
        program under title XVIII of the Social Security Act for the 
        purpose of utilizing smart card technology for Medicare 
        beneficiary and provider identification cards in order to--
                    (A) increase the quality of care furnished to 
                Medicare beneficiaries;
                    (B) improve the accuracy and efficiency in the 
                billing for Medicare items and services furnished by 
                Medicare providers;
                    (C) reduce the potential for identity theft and 
                other unlawful use of Medicare beneficiary and provider 
                identifying information; and
                    (D) reduce waste, fraud, and abuse in the Medicare 
                program.
            (2) Site requirements.--The Secretary shall conduct the 
        pilot program in at least 5 geographic areas in which the 
        Secretary determines there is a high risk for waste, fraud, or 
        abuse.
            (3) Design of pilot program.--In designing the pilot 
        program, the Secretary shall provide for the following:
                    (A) Implementation of a system that utilizes a 
                smart card as a Medicare identification card for 
                Medicare beneficiaries and Medicare providers. Such a 
                card shall contain appropriate security features and 
                protect personal privacy.
                    (B) Issuance of a new smart card to all Medicare 
                beneficiaries participating in the pilot program. Such 
                card shall not have the Social Security number printed 
                on the front but, instead shall have such number stored 
                securely on the smart card chip along with other 
                information the Secretary deems necessary.
                    (C) Issuance of a new provider card to all Medicare 
                providers participating in the pilot program. Such card 
                shall include a photograph of the provider and shall 
                not have the Medicare provider number printed on the 
                front of the card but, instead shall have such number 
                stored securely on the smart card chip along with other 
                information the Secretary deems necessary.
                    (D) A process for enrollment of all Medicare 
                providers that includes--
                            (i) identity and certification 
                        verification; and
                            (ii) utilization of biometric data, such as 
                        fingerprints, for provider identification and 
                        authentication.
                    (E) A process under which the cards issued under 
                subparagraphs (B) and (C) are used by both Medicare 
                beneficiaries and Medicare providers to verify 
                eligibility, prevent fraud, and authorize transactions.
                    (F) Distribution of necessary equipment, including 
                cards, card readers, kiosks, biometric readers, and 
                other materials or documents to Medicare beneficiaries 
                and providers at no cost to them.
                    (G) Regular monitoring and review by the Secretary 
                of Medicare providers' Medicare billings and Medicare 
                beneficiaries' Medicare records in order to identify 
                and address inaccurate charges and instances of waste, 
                fraud, or abuse.
                    (H) Reporting mechanisms for measuring the cost 
                savings to the Medicare program by reason of the pilot 
                program.
                    (I) Including provisions--
                            (i) to ensure that all devices and systems 
                        utilized as part of the pilot program comply 
                        with standards for identity credentials and 
                        biometric data developed by the American 
                        National Standards Institute and the National 
                        Institute of Standards and Technology and 
                        Federal requirements relating to 
                        interoperability and information security, 
                        including all requirements under the Health 
                        Insurance Portability and Accountability Act of 
                        1996;
                            (ii) to ensure that a Medicare 
                        beneficiary's and provider's personal 
                        identifying, health, and other information is 
                        protected from unauthorized access or 
                        disclosure through the use of at least two-
                        factor authentication;
                            (iii) for the development of procedures and 
                        guidelines for the use of identification cards, 
                        card readers, kiosks, biometric data and 
                        readers, and other equipment to verify a 
                        Medicare beneficiary's identity and eligibility 
                        for services;
                            (iv) to ensure that each Medicare 
                        beneficiary and provider participating in the 
                        pilot program is informed of--
                                    (I) the purpose of the program;
                                    (II) the processes for capturing, 
                                enrolling, and verifying their 
                                eligibility and, with respect to 
                                providers, their biometric data;
                                    (III) the manner in which the 
                                biometric data for providers will be 
                                used; and
                                    (IV) the steps that will be taken 
                                to protect personal identifying, 
                                health, and other information from 
                                unauthorized access and disclosure;
                            (v) for addressing problems related to the 
                        loss, theft, or malfunction of or damage to 
                        equipment and any identifying documents or 
                        materials provided by the Secretary;
                            (vi) for development of a hotline, Web 
                        site, or other means by which Medicare 
                        beneficiaries and providers can contact the 
                        Secretary for assistance; and
                            (vii) for addressing problems related to 
                        accessing care outside the pilot area and cases 
                        where the individual faces issues related to 
                        physical or other capacity limitations.
            (4) Privacy.--Information on the smart card shall only be 
        disclosed if the disclosure of such information is permitted 
        under the Federal regulations (concerning the privacy of 
        individually identifiable health information) promulgated under 
        section 264(c) of the Health Insurance Portability and 
        Accountability Act of 1996.
            (5) Disclosure exemption.--Information on the smart card 
        shall be exempt from disclosure under section 552(b)(3) of 
        title 5, United States Code.
    (b) Expanded Implementation (Phase II).--Taking into account the 
interim report under subsection (d)(2), the Secretary shall, through 
rulemaking, expand the duration and the scope of the pilot program, to 
the extent determined appropriate by the Secretary.
    (c) Waiver Authority.--The Secretary may waive such provisions of 
titles XI and XVIII of the Social Security Act as the Secretary 
determines to be appropriate for the conduct of the pilot program.
    (d) Reports to Congress.--
            (1) Plan.--Not later than 6 months after the date of the 
        enactment of this Act, the Secretary shall submit to Congress a 
        report that contains a description of the design and 
        development of the pilot program, including the Secretary's 
        plan for implementation.
            (2) Interim report.--Not later than 1 year after the date 
        that the pilot program is first implemented, the Secretary 
        shall conduct an evaluation of the pilot program and submit an 
        interim report to Congress. Such an evaluation shall include an 
        initial analysis of the deployment of the program, the 
        usability of the card system, and the measures taken to protect 
        beneficiary and provider information.
            (3) Additional report.--Not later than 2 years after the 
        date that the pilot program is first implemented, the Secretary 
        shall submit to Congress a report on the pilot program. Such 
        report shall contain a detailed description of issues related 
        to the expansion of the program under subsection (b) and 
        recommendations for such legislation and administrative actions 
        as the Secretary considers appropriate for implementation of 
        the program on a nationwide basis.
    (e) Funding.--There are appropriated, from amounts in the Treasury 
not otherwise appropriated, $29,000,000 for the design, implementation, 
and evaluation of the pilot program. Amounts appropriated under the 
preceding sentence shall remain available until expended.
    (f) Definitions.--In this section:
            (1) Medicare beneficiary.--The term ``Medicare 
        beneficiary'' means an individual entitled to, or enrolled for, 
        benefits under part A of title XVIII of the Social Security Act 
        or enrolled for benefits under part B of such title.
            (2) Medicare program.--The term ``Medicare program'' means 
        the health benefits program under title XVIII of the Social 
        Security Act.
            (3) Medicare provider.--The term ``Medicare provider'' 
        means a provider of services (as defined in subsection (u) of 
        section 1861 of the Social Security Act (42 U.S.C. 1395x)) and 
        a supplier (as defined in subsection (d) of such section), 
        including a supplier of durable medical equipment and supplies.
            (4) Pilot program.--The term ``pilot program'' means the 
        pilot program conducted under this section.
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (6) Smart card.--The term ``smart card'' means a secure, 
        electronic, machine readable, fraud-resistant, tamper-resistant 
        card that includes an embedded integrated circuit chip with a 
        secure micro-controller.
    (g) Revision of Medicare Improvement Fund.--Section 1898(b)(1) of 
the Social Security Act (42 U.S.C. 1395iii(b)(1)) is amended--
            (1) by striking subparagraphs (A) and (B) and inserting the 
        following subparagraph:
                    ``(A) fiscal year 2015, $246,000,000; and''; and
            (2) by redesignating subparagraph (C) as subparagraph (B).
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