,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #cibj  ,,in ,,the ,,house ,,of  
,,representatives  ,october #c1         
#bjag,mrs4 ,walorski introduced the     
following bill2 which was referred to   
the ,committee on ,ways and ,means1 and 
in addition to the ,committee on ,energy
 and ,commerce1 for a period to be      
subsequently determined by the ,speaker1
 in each case for consideration of such 
provisions as fall within the           
jurisdiction of the committee concerned 
,a ,,bill  ,to establish a ,medicare    
demonstration program on the use of     
third-party interest-free payment       
arrangements to reduce ,medicare        
hospital part ,a bad debt claims4  #a4  
,medicare demonstration program on the  
use of third-party interest-free payment
 arrangements to reduce ,medicare       
hospital part ,a bad debt claims  7a7   
,in general ,the ,secretary of ,health  
and ,human ,services 7in this section   
referred to as the ,secretary7 shall    
establish a #c-year demonstration       

program 7in this section referred to as 
the demonstration program7 in #e ,states
 to determine the impact on patient     
engagement and satisfaction1 health     
outcomes1 and claims for ,medicare      
hospital part ,a bad debt 7as defined in
 subsection 7d77#b77 of hospitals'      
implementing third-party interest-free  
payment arrangements 7as defined in     
subsection 7b774  7b7 ,third-,party     
interest-,free payment arrangement      
defined ,in this section1 the term      
third-party interest-free payment       
arrangement means1 with respect to a    
hospital and individuals who are        
receiving inpatient hospital services   
for which payment may be made under part
 ,a of title ,,xviii of the ,social     
,security ,act1 an arrangement between  
the hospital1 a third-party1 and such   
individuals under which--  7#a7 the     
hospital offers to all such individuals 
the option of making payment of         
,medicare part ,a cost-sharing under    
such an arrangement for such services   

rather than through the routine billing 
process for such cost-sharing2  7#b7 in 
the case of any such individual who     
agrees to such offer1 the hospital      
assigns to the third party the rights of
 collection for such ,medicare part ,a  
cost-sharing from such individual and   
efforts for such collection by the third
 party pursuant to this section shall be
 treated as reasonable collection       
efforts by the hospital for purposes of 
section #dac4hi7;e7 of title #db of the 
,code of ,federal ,regulations 7or any  
successor regulation72  7#c7 in the case
 of any such individual who does not    
agree to such offer1 the hospital       
payment of ,medicare part ,a            
cost-sharing for such services shall    
continue to be made through the routine 
billing process for such cost-sharing   
7including with respect to claims for   
,medicare hospital part ,a bad debt72   
and  7#d7 the third party-- 7,a7        
participates in a level of financial    
engagement and education with all such  

individuals who agree to such offer to  
ensure such individuals are able to     
afford such cost-sharing payments2  7,b7
 in collecting the amounts so owed1     
permits all such individuals who agree  
to such offer to make payment over time 
through a payment plan that does not    
charge interest with respect to the     
balance of the amount so owed2 and  7,c7
 pays the hospital the amount so        
collected under the arrangement less a  
fee that does not exceed #ae percent of 
the amount so collected4  7c7 ,payment  
incentive ,the demonstration program    
shall provide that a hospital that      
participates in such a third-party      
interest free payment arrangement under 
the program and demonstrates improved   
patient engagement and satisfaction1    
improved health outcomes1 and a         
reduction in the number of claims for   
,medicare hospital part ,a bad debt that
 are reported to the ,secretary is paid 
an amount equal to #aj percent of the   
original amount owed in ,medicare part  

,a cost-sharing that is collected under 
the arrangement4 ,such amount shall be  
paid from funds appropriated 7under     
subsection 7f77#a7 of section #aaae;,a  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acae;a77 for activities to   
carry out such section4  7d7 ,report to 
,congress ,after the completion of the  
demonstration program1 the ,secretary   
shall submit a report on the            
demonstration program to the ,committee 
on ,ways and ,means of the ,house of    
,representatives and the ,committee on  
,finance of the ,senate4 ,the report    
shall include an analysis of whether the
 demonstration program reduced the      
number and amount of ,medicare hospital 
part ,a bad debt claims and if there    
were improved health outcomes for       
,medicare beneficiaries who did not     
forgo medical care due to their         
inability to pay for ,medicare part ,a  
cost-sharing4  7e7 ,other definitions   
,in this section3 7#a7 ,medicare part ,a
 cost-sharing ,the term ,medicare part  

,a cost-sharing means1 with respect to a
 hospital1 amounts owed to the hospital 
that are derived from deductibles and   
coinsurance imposed under part ,a of    
title ,,xviii of the ,social ,security  
,act 7#db ,u4,s4,c4 #acie;c et seq474   
7#b7 ,medicare hospital part ,a bad debt
 ,the term ,medicare hospital part ,a   
bad debt means bad debt of a hospital   
that is attributable to the inability of
 the hospital to collect ,medicare part 
,a cost-sharing1 taking into account    
collections made under third-party      
interest-free payment arrangements made 
under the demonstration program4