Medicare Common Access Card Act of 2015

Summary: 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 &ldquo;smart card&rdquo; 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 &amp; 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.

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 that their 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 Medicare 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 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) 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) a detailed description of issues related to the 
                expansion of the program under subsection (b);
                    (B) recommendations for such legislation and 
                administrative actions as the Secretary considers 
                appropriate for implementation of the program on a 
                nationwide basis; and
                    (C) a justification for each recommendation 
                described in subparagraph (B).
    (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.