Administrative Relief and Accurate Medicare Payments Act of 2013

Administrative Relief and Accurate Medicare Payments Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to establish a maximum period of: (1) 2 years for submission of Medicare part B (Supplementary Medical Insurance) claims originally submitted by hospitals as Medicare part A (Hospital Insurance) claims, and (2) 60 days for certain such submissions for one-day stays.

Reduces from 4 to 3 fiscal years the maximum look-back period under the Medicare Integrity Program for the audit and recovery activities of recovery audit contractors.

[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2329 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 2329

   To amend title XVIII of the Social Security Act to provide for a 
  maximum period of 2 years for submissions of Medicare part B claims 
 originally submitted by hospitals as Medicare part A claims and of 60 
  days for certain such submissions for one-day stays; and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 12, 2013

   Mr. Smith of Nebraska (for himself, Mr. Sam Johnson of Texas, Mr. 
 Nunes, Mr. Tiberi, Mr. Roskam, Mr. Price of Georgia, Mr. Schock, Mrs. 
 Black, Mr. Reed, Mr. Young of Indiana, Mr. Kelly of Pennsylvania, Mr. 
  Benishek, and Ms. Jenkins) introduced the following bill; which was 
 referred to the Committee on Energy and Commerce, and in addition to 
   the Committee on Ways and Means, 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 provide for a 
  maximum period of 2 years for submissions of Medicare part B claims 
 originally submitted by hospitals as Medicare part A claims and of 60 
  days for certain such submissions for one-day stays; and for other 
                               purposes.

    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 ``Administrative Relief and Accurate 
Medicare Payments Act of 2013''.

SEC. 2. MAXIMUM PERIOD OF 2 YEARS FOR SUBMISSIONS OF MEDICARE PART B 
              CLAIMS ORIGINALLY SUBMITTED BY HOSPITALS AS MEDICARE PART 
              A CLAIMS AND OF 60 DAYS FOR CERTAIN SUCH SUBMISSIONS FOR 
              ONE-DAY STAYS.

    (a) Timely Submission as Condition for Provider Payment.--
            (1) In general.--Section 1835 of the Social Security Act 
        (42 U.S.C. 1395n) is amended--
                    (A) in subsection (a)(1), by inserting before the 
                semicolon the following: ``or, in the case of a claim 
                described in paragraph (1) or (2) of subsection (f), no 
                later than the close of the period described in such 
                respective paragraph''; and
                    (B) by adding at the end the following new 
                subsection:
    ``(f) For purposes of subsection (a)(1) and section 1842(b)(3)(B)--
            ``(1) in the case of a claim not described in paragraph (2) 
        for hospital services submitted under this part for which there 
        was a previous claim as inpatient hospital services under part 
        A that was denied as not reasonable and necessary pursuant to 
        section 1862(a)(1), the period described in this paragraph is 
        the period ending 2 calendar years after the date of service; 
        and
            ``(2) in the case of a claim for hospital services 
        submitted under this part for which there was a previous claim 
        as inpatient hospital services under part A for a length of 
        stay that does not include more than one midnight that was 
        denied as not reasonable and necessary by a qualified 
        independent contractor through a reconsideration conducted 
        under section 1869(c), the period described in this paragraph 
        is the period ending 60 days after the date of receipt of the 
        notice required under section 1869(c)(3)(C)(i) of the decision 
        for such denial with respect to such reconsideration.''.
            (2) Conforming amendment to exceptions authority.--Section 
        1835(a) of such Act (42 U.S.C. 1395n(a)) is amended in the last 
        sentence by inserting ``and the periods described in paragraphs 
        (1) and (2) of subsection (f)'' after ``1 calendar year period 
        specified in such paragraph''.
    (b) Application to Reasonable Charge Administrative Provision.--
            (1) In general.--Section 1842(b)(3)(B) of the Social 
        Security Act (42 U.S.C. 1395u(b)(3)(B)) is amended by inserting 
        ``or, in the case of a claim described in paragraph (1) or (2) 
        of section 1835(f), no later than the close of the period 
        described in such respective paragraph'' after ``date of 
        service''.
            (2) Conforming amendment to exceptions authority.--Section 
        1842(b)(3) of such Act (42 U.S.C. 1395u(b)(3)) is amended in 
        the last sentence by inserting ``and the periods described in 
        paragraphs (1) and (2) of section 1835(f)'' after ``1 calendar 
        year period specified in such paragraph''.
    (c) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after October 1, 2013.

SEC. 3. MAXIMUM LOOK-BACK PERIOD OF 3 YEARS FOR MEDICARE RECOVERY AUDIT 
              CONTRACTORS' AUDIT AND RECOVERY ACTIVITIES.

    (a) In General.--Section 1893(h)(4)(B) of the Social Security Act 
(42 U.S.C. 1395ddd(h)(4)(B)) is amended by striking ``4 fiscal years'' 
and inserting ``3 fiscal years''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to payments made for items and services furnished on 
or after October 1, 2013.
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