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II
113th CONGRESS
2d Session
S. 2586
IN THE SENATE OF THE UNITED STATES
July 10, 2014
Mr. Kirk (for himself and Mr. Rubio) introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To establish a smart card pilot program under the Medicare program.
1.
Short
title
This Act may be cited as
the Medicare Common Access Card Act of 2014.
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 and provider 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
furnished by Medicare providers;
(C)
reduce the
potential for identity theft and other unlawful use of Medicare
beneficiary and
provider identifying information; and
(D)
reduce waste,
fraud, and abuse in the Medicare program.
(2)
Site
requirements
The Secretary shall conduct the pilot program in at
least 5 geographic areas in which the Secretary determines there is a high
risk
for waste, fraud, or abuse.
(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 and Medicare providers. 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 not have the Social Security number printed on the front
but,
instead shall have such number stored securely on the smart card chip
along
with other information the Secretary deems necessary.
(C)
Issuance of a new
provider card to all Medicare providers participating in the pilot
program.
Such card shall include a photograph of the provider and shall not have
the
Medicare provider number printed on the front of the card but, instead
shall
have such number stored securely on the smart card chip along with other
information the Secretary deems necessary.
(D)
A process for
enrollment of all Medicare providers that includes—
(i)
identity and
certification verification; and
(ii)
utilization of
biometric data, such as fingerprints, for provider identification and
authentication.
(E)
A process under
which the cards issued under subparagraphs (B) and (C) are used by both
Medicare beneficiaries and Medicare providers to verify eligibility,
prevent
fraud, and authorize transactions.
(F)
Distribution of
necessary equipment, including cards, card readers, kiosks, biometric
readers,
and other materials or documents to Medicare beneficiaries and providers
at no
cost to them.
(G)
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.
(H)
Reporting
mechanisms for measuring the cost savings to the Medicare program by
reason of
the pilot program.
(I)
Include
provisions—
(i)
to
ensure that all devices and systems utilized as part of the pilot program
comply with standards for identity credentials and biometric data
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 and provider’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, biometric data and readers, and other equipment to
verify
a Medicare beneficiary’s identity and eligibility for services;
(iv)
to
ensure that each Medicare beneficiary and provider 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, with
respect to
providers, their biometric data;
(III)
the manner in
which the biometric data for providers will be used; and
(IV)
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, Web site, or other means by which Medicare beneficiaries and
providers 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 provisions of titles XI
and XVIII of the Social Security Act as the Secretary determines to be
appropriate for the conduct of the pilot program.
(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)
Interim
report
Not later than 1 year after the pilot program is first
implemented, the Secretary shall conduct an evaluation of the pilot
program and
submit an interim report to Congress. Such an evaluation shall include an
initial analysis of the deployment of the program, the usability of the
card
system, and the measures taken to protect beneficiary and provider
information.
(3)
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) and
recommendations for such legislation and administrative actions as the
Secretary considers appropriate for implementation of the program on a
nationwide basis.
(e)
Funding
There
are appropriated, from amounts in the Treasury not otherwise appropriated,
$29,000,000 for the design, implementation, and evaluation of the pilot
program. Amounts appropriated under the preceding sentence shall remain
available until expended.
(f)
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.
3.
Revision of funding for the Center for Medicare and Medicaid Innovation
Section 1115A(f) of the Social Security Act (42 U.S.C. 1315a(f)) is amended—
(1) In paragraph (1)—
(A) in subparagraph (B), by striking and at the end;
(B) by redesignating subparagraph (C) as subparagraph (D);
(C) by inserting after subparagraph (B) the following new subparagraph:
(C) $8,900,000,000 for the activities initiated under this section for the period of fiscal years 2020
through 2029; and
; and
(D) in subparagraph (D), as redesignated by subparagraph (B) of this paragraph, by striking 2020 and inserting 2030; and
(2) in paragraph (2), by striking and (C) and inserting , (C), and (D).