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106th CONGRESS
2d Session
H. R. 5622
To establish a commission to create a comprehensive strategy for an
integrated, advanced informational infrastructure for the medicare
program, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 2, 2000
Mr. Horn (for himself and Mr. Calvert) introduced the following bill;
which was referred to the Committee on Ways and Means, and in addition
to the Committee on 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 commission to create a comprehensive strategy for an
integrated, advanced informational infrastructure for the medicare
program, 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; PURPOSE.
(a) Short Title.--This Act may be cited as the ``Medicare Program
Infrastructure Investment Act of 2000''.
(b) Purpose.--The purpose of this Act is to design a strategy for
the implementation of an advanced informational infrastructure for the
administration of parts A and B of the medicare program in coordination
with the Administrator of the Health Care Financing Administration and
the Chief Information Office of the Health Care Financing
Administration.
SEC. 2. ESTABLISHMENT OF THE HEALTH CARE INFRASTRUCTURE COMMISSION.
(a) Establishment.--There is established within the Department of
Health and Human Services a Health Care Infrastructure Advisory
Commission (in this section referred to as the ``Commission'').
(b) Duties.--The Commission shall carry out the following duties:
(1) In conjunction with the Administrator and Chief
Information Officer of the Health Care Financing
Administration, the Commission shall develop a strategy to
create an advanced informational infrastructure for the
administration of the medicare program under parts A and B of
title XVIII of the Social Security Act, including claims
processing by medicare carriers and fiscal intermediaries and
beneficiary information functions.
(2) 18 months after the date all of the members of the
Commission are appointed under subsection (c)(2), the
Commission shall submit to Congress (and publish in the Federal
Register) an initial report that describes a strategic plan to
implement an advanced information structure for parts A and B
of the medicare program, including a cost estimate and schedule
for the plan, that--
(A) complies with all existing Federal financial
management and information technology laws;
(B) provides immediate, point-of-service
information on covered items and services under the
program to each beneficiary, provider of services,
physician, and supplier;
(C) ensures that strict security measures are
integral to and designed into the system that--
(i) protect the privacy of patients and the
confidentiality of personally identifiable
health insurance data used or maintained under
the system in a manner consistent with privacy
regulations promulgated by the Secretary under
the Health Insurance Portability and
Accountability Act of 1996;
(ii) guard system integrity in a manner
consistent with security regulations
promulgated by the Secretary under such Act;
and
(iii) apply to any network service provider
used in connection with the system;
(D) immediately notifies each provider of services,
physician, or supplier of any incomplete or invalid
claim, including--
(i) the identification of any missing
information;
(ii) the identification of any coding
errors; and
(iii) information detailing how the
provider of services, physician, or supplier
may develop a claim under such system;
(E) allows for proper completion and resubmission
of each claim identified as incomplete or invalid under
subparagraph (D);
(F) allows for immediate automatic processing of
clean claims and subsequent payment in accordance with
the provisions of sections 1816(c)(2)(B)(i) and
1842(c)(2)(B)(i) of the Social Security Act (42 U.S.C.
1395h(c)(2)(B)(i) and 1395u(c)(2)(B)(i)) so that a
provider of services, physician, or supplier may
immediately provide the beneficiary with a written
explanation of medical benefits, including an
explanation of costs and coverage to any beneficiary
under parts A and B at the point of care;
(G) allows for electronic payment of claims to each
provider of services, physician, and supplier,
including payment through electronic funds transfer,
for each claim for which payment is not made on a
periodic interim payment basis under section 1815(e)(2)
of such Act (42 U.S.C. 1395g(e)(2)) for items and
services furnished under part A;
(H) complies with all applicable transactions
standards adopted by the Secretary under the Health
Insurance Portability and Accountability Act of 1996;
(I) provides for system specifications that are
flexible, modular in nature, scalable, and performance-
based; and
(J) is designed to be used, or easily adapted for
use, in other health insurance programs administered by
a department or agency of the United States.
(3) Not later than one year after the date the Commission
submits the initial report under paragraph (2), the Commission
shall submit to Congress (and shall publish in the Federal
Register) a final report on the Secretary's progress in
developing an advanced informational system.
(4) Each report required under this subsection--
(A) shall include those recommendations, findings,
and conclusions of the Commission that receive the
approval of at least a majority of the members of the
Commission; and
(B) shall include dissenting or additional views of
members of the Commission with respect to the subject
matter of the report.
(c) Membership.--
(1) Composition.--The Commission shall be composed of 13
voting members appointed in accordance with paragraph (2) and
two ex officio voting members designated under paragraph (3).
(2) In general.--Not later than 90 days after the date of
the enactment of this Act, members of the Commission shall be
appointed as follows:
(A) The Director of the Defense Advanced Research
Projects Agency shall appoint one member.
(B) The Director of the National Science Foundation
shall appoint one member.
(C) The Director of the Office of Science and
Technology Policy shall appoint one member.
(D) The Secretary shall appoint one member who
represents each of the following:
(i) Physicians and other health care
practitioners.
(ii) Hospitals.
(iii) Skilled nursing facilities.
(iv) Home health agencies.
(v) Suppliers of durable medical equipment.
(vi) Fiscal intermediaries and carriers.
(E) The Secretary shall appoint two members who
represent information technology providers, one who
represents medicare information technology providers
and one who represent health industry information
technology providers.
(F) The Secretary shall appoint two members who
represent medicare beneficiaries.
(3) Ex officio members.--The following shall serve as ex
officio members of the Commission:
(A) The Secretary, who shall be the chairperson of
the Commission.
(B) The Chief Financial Officer of the Health Care
Financing Administration.
(4) Qualifications.--Each of the members appointed under
paragraph (2) shall be knowledgeable in advanced information
technology, financial management, or electronic billing
procedures associated with health care benefit programs. One of
the members appointed under paragraph (2)(F) shall have
expertise in health information privacy.
(d) Meetings.--
(1) In general.--The Commission shall meet at the call of
the chairperson, except that it shall meet--
(A) not less than four times each year; or
(B) on the written request of a majority of its
members.
(2) Quorum.--A majority of the members of the Commission
shall constitute a quorum, but a lesser number of members may
hold hearings.
(e) Compensation.--Each member of the Commission who is a full-time
officer or employee of the United States may not receive additional
pay, allowances, or benefits by reason of their service on the
Commission. Each member of the Commission shall receive travel
expenses and per diem in lieu of subsistence in accordance with
sections 5702 and 5703 of title 5, United States Code.
(f) Staff.--
(1) In general.--The chairperson of the Commission may,
without regard to the civil service laws and regulations,
appoint an executive director and such other additional
personnel as may be necessary to enable the Commission to
perform its duties.
(2) Compensation.--The chairperson of the Commission may
fix the compensation of the executive director and other
personnel without regard to the provisions of chapter 51 and
subchapter III of chapter 53 of title 5, United States Code,
relating to classification of positions and General Schedule
pay rates, except that the rate of pay for the executive
director and other personnel may not exceed the rate payable
for level V of the Executive Schedule under section 5316 of
such title.
(3) Detail of government employees.--Upon request of the
chairperson, the head of any Federal department or agency may
detail to the Commission, without reimbursement, basis, any of
the personnel of that department or agency to the Commission to
assist it in carrying out its duties under this Act. Such
detail shall be without interruption or loss of civil service
status or privilege.
(g) Procurement of Temporary and Intermittent Services.--The
chairperson of the Commission may procure temporary and intermittent
services under section 3109(b) of title 5, United States Code, at rates
for individuals which do not exceed the daily equivalent of the annual
rate of basic pay prescribed for level V of the Executive Schedule
under section 5316 of such title.
(h) Termination.--The Commission shall terminate on the date that
is 60 days after the date the Commission submits to Congress the final
report under subsection (b)(3).
(i) Authorization of Appropriations.--
(1) In general.--There are authorized to be appropriated
out of any funds in the Treasury not otherwise appropriated,
such sums as may be necessary for the Commission to carry out
its duties under this section.
(2) Availability.--Any sums appropriated under paragraph
(1) shall remain available until the termination of the
Commission under subsection (h).
(j) Definitions.--In this section:
(1) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(2) Administrator.--The term ``Administrator'' means the
Administrator of the Health Care Financing Administration.
(k) Applicability of FACA.--The provisions of the Federal Advisory
Committee Act (5 U.S.C. App.) shall apply to the Commission.
SEC. 3. IMPLEMENTATION OF SYSTEM.
(a) Annual Reports on Implementation.--Not later than 6 months
after the Commission publishes in the Federal Register the final report
required under section 2(b)(3) and annually thereafter until the date
of final implementation under subsection (b), the Secretary shall
submit to Congress a report on the progress of the Health Care
Financing Administration on implementing a modernized advanced,
integrated informational infrastructure for the administration of parts
A and B of the medicare program.
(b) Final Implementation.--Not later than 10 years after the date
of the enactment of this Act, the Secretary shall fully implement a
modernized advanced, integrated informational infrastructure for the
administration of parts A and B of the medicare program.
SEC. 4. ADMINISTRATIVE SIMPLIFICATION.
Section 1173(a) of the Social Security Act (42 U.S.C. 1320d-2(a))
is amended by adding at the end the following new paragraph:
``(4) Interactive transactions.--If the Secretary adopts a
batch standard for a transaction under paragraph (1) that
involves a health care provider, not later than 24 months after
the adoption of the batch standard, the Secretary shall also
adopt an interactive standard that is compatible with the batch
standard so that the provider may immediately complete the
transaction at the point of service.''.
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