[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5730 Introduced in House (IH)]

112th CONGRESS
  2d Session
                                H. R. 5730

   To amend title XVIII of the Social Security Act to make publicly 
available on the official Medicare Internet site medicare payment rates 
   for frequently reimbursed hospital inpatient procedures, hospital 
            outpatient procedures, and physicians' services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 10, 2012

   Mr. Huizenga of Michigan 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 amend title XVIII of the Social Security Act to make publicly 
available on the official Medicare Internet site medicare payment rates 
   for frequently reimbursed hospital inpatient procedures, hospital 
            outpatient procedures, and physicians' services.

    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 Payment Rate Disclosure Act 
of 2012''.

SEC. 2. PUBLIC INTERNET AVAILABILITY OF MEDICARE PAYMENT RATES FOR 
              FREQUENTLY REIMBURSED PROCEDURES AND SERVICES.

    Title XVIII of the Social Security Act is amended by adding at the 
end the following new section:

``SEC. 1899B. PUBLIC INTERNET AVAILABILITY OF MEDICARE PAYMENT RATES 
              FOR FREQUENTLY REIMBURSED PROCEDURES AND SERVICES.

    ``(a) In General.--
            ``(1) Initial posting.--During the initial period beginning 
        on a date not later than 120 days after the date of the 
        enactment of this section and ending on the date that is 240 
        days after such starting date, the Secretary shall make 
        publicly available on the official Medicare Internet site the 
        following:
                    ``(A) Payment rates for hospital inpatient 
                procedures.--For each procedure selected under 
                subsection (b)(1)(A)(i) and for each Metropolitan 
                Statistical Area or other payment area used for 
                purposes of section 1886(d), the average rate of 
                payment under such section for the procedure, 
                determined without regard to the application of any 
                deduction or coinsurance amount or any adjustment under 
                subparagraph (B), (D), (F), or (G) of paragraph (5) of 
                such section.
                    ``(B) Payment rates for hospital outpatient 
                procedures.--For each procedure selected under 
                subsection (b)(1)(A)(ii) and for each county or other 
                payment area used for purposes of section 1833(t), the 
                average rate of payment under such section for the 
                procedure, determined without regard to the application 
                of any deductible or coinsurance.
                    ``(C) Physician payment rates for physicians' 
                services.--For each physicians' service selected under 
                subsection (b)(1)(A)(iii) and for each fee schedule 
                area under section 1848, the average payment amount 
                determined under the fee schedule under such section 
                for the service, determined without regard to the 
                application of any deductible or coinsurance.
                    ``(D) Period for which payment rates are 
                applicable.--A description of the period for which each 
                payment rate or amount under subparagraph (A), (B), or 
                (C) is applicable.
                    ``(E) Services included in procedures.--A 
                description of the items and services included in each 
                procedure selected under clauses (i) and (ii) of 
                subsection (b)(1)(A).
                    ``(F) Notice.--A statement that the average payment 
                rates and average payment amounts described in 
                subparagraphs (A) through (C) are only applicable to 
                the Medicare program under this title and may not be 
                available for an individual who is not purchasing such 
                a procedure or service under such program.
            ``(2) Posting of expanded selection.--During the period 
        beginning on the date that is one day after the last day of the 
        initial period described in paragraph (1), the Secretary shall 
        make publicly available on the official Medicare Internet site 
        the following:
                    ``(A) Payment rates for hospital inpatient 
                procedures.--For each procedure selected under 
                subsection (b)(1)(B)(i) and for each Metropolitan 
                Statistical Area or other payment area used for 
                purposes of section 1886(d), the average rate of 
                payment described in paragraph (1)(A) for the 
                procedure.
                    ``(B) Payment rates for hospital outpatient 
                procedures.--For each procedure selected under 
                subsection (b)(1)(B)(ii) and for each county or other 
                payment area used for purposes of section 1833(t), the 
                average rate of payment described in paragraph (1)(B) 
                for the procedure.
                    ``(C) Physician payment rates for physicians' 
                services.--For each physicians' service selected under 
                subsection (b)(1)(B)(iii) and for each fee schedule 
                area under section 1848, the average payment amount 
                described in paragraph (1)(C) for the physicians' 
                service.
                    ``(D) Period for which payment rates are 
                applicable.--A description of the period for which each 
                payment rate or amount under subparagraph (A), (B), or 
                (C) is applicable.
                    ``(E) Services included in procedures.--A 
                description of the items and services included in each 
                procedure selected under clauses (i) and (ii) of 
                subsection (b)(1)(B).
                    ``(F) Notice.--A statement that the average payment 
                rates and average payment amounts described in 
                subparagraphs (A) through (C) are only applicable to 
                the Medicare program under this title and may not be 
                available for an individual who is not purchasing such 
                a procedure or service under such program.
    ``(b) Selection of Procedures and Services.--
            ``(1) In general.--
                    ``(A) Initial selection.--For purposes of 
                subsection (a)(1) and based on the most recent national 
                data available, the Secretary shall select the 
                following:
                            ``(i) At least the 30 hospital inpatient 
                        procedures for which payment is most frequently 
                        provided under section 1886(d).
                            ``(ii) At least the 30 hospital outpatient 
                        procedures for which payment is most frequently 
                        provided under section 1833(t).
                            ``(iii) At least the 30 physicians' 
                        services (as defined in section 1861(q)) for 
                        which payment is most frequently provided under 
                        section 1848.
                    ``(B) Expanded selection.--For purposes of 
                subsection (a)(2) and based on the most recent national 
                data available, the Secretary shall select the 
                following:
                            ``(i) At least the 100 hospital inpatient 
                        procedures for which payment is most frequently 
                        provided under section 1886(d).
                            ``(ii) At least the 100 hospital outpatient 
                        procedures for which payment is most frequently 
                        provided under section 1833(t).
                            ``(iii) At least the 100 physicians' 
                        services (as defined in section 1861(q)) for 
                        which payment is most frequently provided under 
                        section 1848.
            ``(2) Updating expanded selection.--The Secretary shall 
        periodically update the procedures and services selected under 
        paragraph (1)(B).
            ``(3) Further expansion of selection.--The Secretary shall 
        expand the number of procedures and services selected under 
        paragraph (1)(B) to include as many procedures and services as 
        may be useful for an individual not entitled to benefits under 
        part A or enrolled under part B in the purchase of such 
        procedures and services.
    ``(c) Authority To Post Additional Information.--The Secretary may 
make publicly available on the official Medicare website such 
information on the payment rate or payment amount under this title for 
a procedure, item, or service not selected under subsection (b) as may 
be useful for an individual not entitled to benefits under part A or 
enrolled under part B in the purchase of the procedure, item, or 
service. To the extent practicable, such information shall be provided 
for each payment area involved.
    ``(d) Administrative Provisions.--
            ``(1) Use of most recent national data.--The information 
        described in paragraph (1) of subsection (b) and subsection (c) 
        shall be based on the most recent national data available.
            ``(2) Accessibility by zip code.--Such information for an 
        applicable payment area shall be accessible by any zip code 
        included in such area.''.
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