,i  #aaith ,,congress  #b;d ,session    
,h4 ,r4 #hhjd  ,,in ,,the ,,house ,,of  
,,representatives  ,may #ac1 #bjbf,mr4  
,smucker 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     
amend title ,,xviii of the ,social      
,security ,act to authorize the         
,secretary of ,health and ,human        
,services to enter into contracts with  
recovery audit contractors to perform   
prepayment reviews under the ,medicare  
program4  #a4 ,short title ,this ,act   
may be cited as the ,medicare ,payment  
,integrity ,enhancement ,act of #bjbf4  
#b4 ,authorizing recovery auditor       
contractors to conduct prepayment       
reviews under ,medicare  7a7 ,in general
 ,section #ahic7;h7 of the ,social      

,security ,act 7#db ,u4,s4,c4           
#acie;ddd7h77 is amended--  7#a7 in     
paragraph 7#a7-- 7,a7 in matter         
preceding subparagraph 7,a7--  7i7 by   
striking and recouping and inserting 1  
recouping2 and  7ii7 by striking title4 
and inserting title1 and conducting     
prepayment review of claims for payment 
under this title42  7,b7 in subparagraph
 7,a71 by inserting except in the case  
of prepayment review of claims for      
payment under this title1 before payment
 shall be made2  7,c7 in subparagraph   
7,b7-- 7i7 by inserting except in the   
case of prepayment review of claims for 
payment under this title1 before from   
such amounts2 and  7ii7 in clause 7ii71 
by striking and at the end2  7,d7 in    
subparagraph 7,c71 by striking the      
period at the end and inserting 2 and2  
and  7,e7 by inserting after            
subparagraph 7,c7 the following new     
subparagraph3  7,d7 payment to such a   
contractor for prepayment review of     
claims for payment under this title     

shall be made in amounts determined     
under a methodology established by the  
,secretary that--  7i7 takes into       
account the amount of improper payment  
that such contractor prevented from     
being paid under this title2 and  7ii7  
incentivizes the timely and accurate    
prevention of such improper payments1   
without a disproportionate focus on     
particular types of claims4  2  7#b7 in 
paragraph 7#c71 by inserting 1 and not  
later than #a year after the date of the
 enactment of the ,medicare ,payment    
,integrity ,enhancement ,act of #bjbf1  
in the case of contracts relating to the
 prepayment review of claims for payment
 under this title after under part ,c or
 ,d2  7#c7 in paragraph 7#g7--  7,a7 by 
inserting or the prevention of part or  
all of a payment under this title based 
on a prepayment review of a claim for   
payment after individual or entity2 and 
7,b7 by inserting or prepayment review  
after such overpayment2  7#d7 in        
paragraph 7#h71 by inserting 7and1 to   

the extent that contracts under this    
subsection require prepayment review of 
claims for payment under this title1 on 
the performance of such contractors with
 respect to such prepayment reviews7    
after recouping overpayments2 and  7#e7 
by adding at the end the following new  
paragraph3  7#aa7 ,funding for          
prepayment review ,for purposes of      
making payment to recovery audit        
contractors for prepayment review of    
claims for payment under this title1 as 
described in paragraph 7#a77;,d71 the   
,secretary shall provide for the        
transfer1 from the ,federal ,hospital   
,insurance ,trust ,fund under section   
#ahag and the ,federal ,supplementary   
,medical ,insurance ,trust ,fund under  
section #ahda1 in such proportion as the
 ,secretary determines appropriate based
 upon the relative amount of improper   
payments that such contractors prevented
 from being paid under parts ,a and ,b1 
of such sums as the ,secretary          
determines necessary1 to the ,centers   

for ,medicare  ,medicaid ,services      
,program ,management ,account4  4  7b7  
,regulations ,not later than #a year    
after the date of the enactment of this 
section1 the ,secretary of ,health and  
,human ,services shall issue such rules 
as are necessary to implement the       
amendments made by subsection 7a74 ,such
 rules shall include--  7#a7 a          
description of the methodology that the 
,secretary shall use as the basis for   
making payment to recovery audit        
contractors for the prepayment review of
 claims for payment under title ,,xviii 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acie et seq472 and  7#b7 a   
description of the methodology that the 
,secretary shall use to calculate       
savings to the ,medicare program under  
such title ,,xviii generated by such    
prepayment reviews4