[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4554 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 4554

  To establish a smart card pilot program to combat fraud, waste, and 
 abuse and to protect beneficiary identity under the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            December 5, 2017

Mr. Roskam (for himself, Mr. Blumenauer, Mr. Shimkus, Mrs. Dingell, Mr. 
     Meehan, Mr. Brendan F. Boyle of Pennsylvania, Mr. Costello of 
  Pennsylvania, Mr. Connolly, Mr. Buchanan, and Mr. Danny K. Davis of 
  Illinois) 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 to combat fraud, waste, and 
 abuse and to protect beneficiary identity 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 
2017''.

SEC. 2. MEDICARE SMART CARD PILOT PROGRAM.

    Part E of title XVIII of the Social Security Act is amended by 
inserting after section 1866E the following new section:

``SEC. 1866F. SMART CARD PILOT PROGRAM.

    ``(a) Implementation.--
            ``(1) In general.--Not later than 36 months after the date 
        of the enactment of this section, the Secretary shall establish 
        a pilot program (in this section referred to as the `pilot 
        program') to demonstrate the feasibility of using smart card 
        technology under this title.
            ``(2) Smart card technology defined.--In this section, the 
        term `smart card technology' means the following:
                    ``(A) Beneficiary smart card.--A machine readable, 
                fraud- and tamper-resistant card (in this section 
                referred to as a `smart card') that includes an 
                embedded integrated circuit chip with a secure micro-
                controller that enables the verification and secure, 
                electronic authentication of the identity of a Medicare 
                beneficiary at the point of service through a 
                combination of the smart card and a personal 
                identification number known by or associated with such 
                beneficiary.
                    ``(B) Card reader technology.--Information 
                technology that enables a supplier and provider to 
                authenticate the identity of a Medicare beneficiary 
                through presentation of such a smart card and such 
                components, with such authentication to be reflected 
                through the use of a modifier or in another appropriate 
                manner, as determined by the Secretary, in the claims 
                adjudication process.
            ``(3) Program design elements.--The pilot program shall be 
        conducted for a period of 3 years consistent with the 
        following:
                    ``(A) Selection of area.--In consultation with the 
                Inspector General of the Department of Health and Human 
                Services, the Secretary shall select at least 3 
                geographic areas in which the pilot program will 
                operate.
                    ``(B) Selection of supplier and provider types.--In 
                consultation with the Inspector General of the 
                Department of Health and Human Services, the Secretary 
                shall select supplier and provider types that will be 
                required to participate in the pilot program (referred 
                to in this section as `participating suppliers and 
                providers'). In selecting such supplier and provider 
                types, the Secretary shall--
                            ``(i) take into account the risk of fraud, 
                        waste, and abuse (as described in section 
                        1886(j)(2)(B) with respect to the category of 
                        provider or supplier) and other factors as 
                        determined appropriate by the Secretary; and
                            ``(ii) limit the pilot program to no more 
                        than 2,000 suppliers and providers.
                    ``(C) Supplier and provider hardship exemptions.--
                The Secretary shall exempt from participation in the 
                pilot program a supplier or provider that either--
                            ``(i) does not have access to card reader 
                        technology (as described in paragraph (2)(B));
                            ``(ii) does not have sufficient internet 
                        access; or
                            ``(iii) has a low volume (as determined by 
                        the Secretary) of Medicare claims for which 
                        payment is made under this title.
                    ``(D) Beneficiary smart card issuance.--The 
                Secretary shall provide for the issuance of beneficiary 
                smart cards described in paragraph (2)(A) to all 
                Medicare beneficiaries residing in a geographic area in 
                which the pilot program is conducted under subparagraph 
                (A). Information that appears on Medicare cards used 
                outside the pilot program may appear on the face of the 
                beneficiary smart card.
                    ``(E) Information on operation of pilot program.--
                The Secretary shall provide participating suppliers and 
                providers and Medicare beneficiaries who are furnished 
                items and services by such suppliers and providers, 
                with information on the operation of the pilot program, 
                including privacy protections described in subparagraph 
                (H).
                    ``(F) Access to services outside the pilot 
                program.--
                            ``(i) Beneficiaries.--Medicare 
                        beneficiaries who receive beneficiary smart 
                        cards may receive items and services care from 
                        suppliers and providers not participating in 
                        the pilot program.
                            ``(ii) Suppliers and providers.--Suppliers 
                        and providers not participating in the pilot 
                        program may submit claims under this title for 
                        items and services furnished without use of 
                        smart card technology to Medicare beneficiaries 
                        who receive beneficiary smart cards.
                    ``(G) Private sector implementation.--The Secretary 
                shall select, by using a competitive procurement, a 
                private sector contractor to implement and operate the 
                pilot program.
                    ``(H) Privacy protections.--The Secretary shall 
                ensure that the pilot program complies with applicable 
                Federal laws, including regulations, concerning 
                individually identifiable health information, including 
                the Privacy Act of 1974 and regulations promulgated 
                under section 264(c) of the Health Insurance 
                Portability and Accountability Act of 1996 and such 
                individually identifiable information shall be exempt 
                from disclosure under section 552(b)(3) of title 5, 
                United States Code.
                    ``(I) Mandatory participation.--Subject to 
                subparagraph (C), in the case of services furnished by 
                a provider or supplier included in a supplier or 
                provider type selected under subparagraph (B) in a 
                geographic area selected under subparagraph (A), 
                payment may only be made under this title for such 
                services during the period of the pilot program if the 
                provider or supplier is participating in the pilot 
                program.
            ``(4) Definitions.--In this section:
                    ``(A) The terms `supplier' and `provider' have the 
                meanings given the terms `supplier' and `provider of 
                services' in subsections (d) and (u), respectively, of 
                section 1861.
                    ``(B) The term `Medicare beneficiary' means an 
                individual who is enrolled in the original Medicare 
                fee-for-service program under parts A and B and is not 
                enrolled in an MA plan under part C, an eligible 
                organization under section 1876, or a PACE program 
                under section 1894.
                    ``(C) The term `Medicare claim' means a claim for 
                an item or service for which payment is made under this 
                title.
    ``(b) Reports to Congress.--
            ``(1) In general.--The Secretary shall submit to Congress 
        the following reports:
                    ``(A) Initial design report.--Not later than 2 
                years after the date of the enactment of this section, 
                a report that outlines the plan for implementation of 
                the pilot program.
                    ``(B) Implementation report.--After implementation 
                of the pilot program, a report on the initial 
                implementation of the pilot program, including 
                parameters for operation of such program.
                    ``(C) Interim performance report.--Not later than 2 
                years after the date the pilot program is implemented, 
                an interim report on the performance of such program.
                    ``(D) Final performance report.--Not later than 18 
                months after the date of the completion of the pilot 
                program, a final report on the performance of such 
                program.
            ``(2) Contents of certain reports.--The reports under 
        subparagraphs (C) and (D) of paragraph (1) shall include 
        information on the performance of the pilot program in 
        achieving its objectives and such recommendations regarding 
        expanding the duration and scope of such program as the 
        Secretary determines appropriate.
    ``(c) Funding.--For purposes of conducting the pilot program, the 
Secretary shall provide for the transfer, from the Supplemental Medical 
Insurance Trust Fund under section 1841, to the Centers for Medicare & 
Medicaid Program Management Account, of $150,000,000, to be available 
until expended.''.
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