1.This Act may be cited as the
Medicare Common Access Card Act of
2011
.
2.Secure Medicare
card pilot program
(a)Pilot program
implementation (Phase I)
(1)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)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)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)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)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)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)
(1)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)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)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)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)In
this section:
(1)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)The term Medicare program means the health
benefits program under title XVIII of the Social Security Act.
(3)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)The term pilot program means the pilot
program conducted under this section.
(5)The
term Secretary means the Secretary of Health and Human
Services.
(6)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 FundSection 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).