Medicare Common Access Card Act of 2015
This bill establishes a pilot program under title XVIII (Medicare) of the Social Security Act for the purpose of utilizing smart card technology for Medicare beneficiary identification cards. A “smart card” is a secure, electronic, machine readable, fraud-resistant, tamper-resistant card that includes an embedded integrated circuit chip with a secure micro-controller.
The Centers for Medicare & Medicaid Services (CMS) must conduct the pilot program in at least three areas in which there is a high risk for waste and abuse, and must give priority in the provision of cards to Medicare beneficiaries who self-identify as individuals whose personal identity and health information has previously been compromised.
In designing the program, CMS must include, among other provisions: (1) regular monitoring and review of Medicare billings and records in order to identify and address inaccurate changes and instances of waste, fraud, or abuse; and (2) reporting mechanisms for measuring Medicare cost savings attributable to the pilot program.
CMS must report to Congress on issues and recommendations related the pilot program within two years of program implementation.
[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3220 Introduced in House (IH)]
114th CONGRESS
1st Session
H. R. 3220
To establish a smart card pilot program under the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 27, 2015
Mr. Roskam (for himself, Mr. Blumenauer, Mr. Dold, Mr. Brendan F. Boyle
of Pennsylvania, and Mr. Costello of Pennsylvania) 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
2015''.
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 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;
(C) reduce the potential for identity theft and
other unlawful use of Medicare beneficiary identifying
information; and
(D) reduce waste, fraud, and abuse in the Medicare
program.
(2) Site requirements.--
(A) In general.--The Secretary shall conduct the
pilot program in at least 3 areas in which the
Secretary determines there is a high risk for waste and
abuse.
(B) Priority in timing of distribution of cards.--
In each site selected by the Secretary under
subparagraph (A), the Secretary shall give priority in
the provision of the identification cards to Medicare
beneficiaries who self-identify as individuals whose
personal identity and health information has previously
been compromised.
(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. 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 have the Medicare identification number of
the beneficiary stored securely on the smart card chip
along with other information the Secretary deems
necessary.
(C) A process under which the cards issued under
subparagraph (B) are used by both Medicare
beneficiaries and Medicare providers to verify
eligibility, prevent fraud, and authorize transactions.
(D) 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.
(E) Reporting mechanisms for measuring the cost
savings to the Medicare program by reason of the pilot
program.
(F) Include provisions--
(i) to ensure that all devices and systems
utilized as part of the pilot program comply
with standards for identity credentials
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 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, and other equipment to
verify a Medicare beneficiary's identity and
eligibility for services;
(iv) to ensure that each Medicare
beneficiary 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
(III) 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 or other
means by which Medicare beneficiaries 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 requirements of
titles XI and XVIII of the Social Security Act as may be necessary to
carry out the purposes of the pilot program established under this
section.
(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) 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),
recommendations for such legislation and administrative actions
as the Secretary considers appropriate for implementation of
the program on a nationwide basis, and justifications for such
recommendations.
(e) 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.
<all>
Introduced in House
Introduced in House
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.
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.
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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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