I 

113TH CONGRESS 

1ST SESSION H. R. 2329 

To amend title XVIII of the Social Security Act to provide for a maximum 

period of 2 years for submissions of Medicare part B claims originally 

submitted by hospitals as Medicare part A claims and of 60 days for 

certain such submissions for one-day stays; and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 12, 2013 

Mr. SMITH of Nebraska (for himself, Mr. SAM JOHNSON of Texas, Mr. 

NUNES, Mr. TIBERI, Mr. ROSKAM, Mr. PRICE of Georgia, Mr. SCHOCK, 

Mrs. BLACK, Mr. REED, Mr. YOUNG of Indiana, Mr. KELLY of Pennsylvania, Mr. BENISHEK, and Ms. JENKINS) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committee on Ways and Means, 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 amend title XVIII of the Social Security Act to provide 

for a maximum period of 2 years for submissions of 

Medicare part B claims originally submitted by hospitals 

as Medicare part A claims and of 60 days for certain 

such submissions for one-day stays; and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Administrative Relief 

3 and Accurate Medicare Payments Act of 2013’’. 

4 SEC. 2. MAXIMUM PERIOD OF 2 YEARS FOR SUBMISSIONS 

5 OF MEDICARE PART B CLAIMS ORIGINALLY 

6 SUBMITTED BY HOSPITALS AS MEDICARE 

7 PART A CLAIMS AND OF 60 DAYS FOR CER8 TAIN SUCH SUBMISSIONS FOR ONE-DAY 

9 STAYS. 

10 (a) TIMELY SUBMISSION AS CONDITION FOR PRO11 VIDER PAYMENT.— 

12 (1) IN GENERAL.—Section 1835 of the Social 

13 Security Act (42 U.S.C. 1395n) is amended— 

14 (A) in subsection (a)(1), by inserting be15 fore the semicolon the following: ‘‘or, in the 

16 case of a claim described in paragraph (1) or 

17 (2) of subsection (f), no later than the close of 

18 the period described in such respective para19 graph’’; and 

20 (B) by adding at the end the following new 

21 subsection: 

22 ‘‘(f) For purposes of subsection (a)(1) and section 

23 1842(b)(3)(B)— 

24 ‘‘(1) in the case of a claim not described in 

25 paragraph (2) for hospital services submitted under 

26 this part for which there was a previous claim as inmstockstill on DSK4VPTVN1PROD with BILLS

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1 patient hospital services under part A that was de2 nied as not reasonable and necessary pursuant to 

3 section 1862(a)(1), the period described in this para4 graph is the period ending 2 calendar years after the 

5 date of service; and 

6 ‘‘(2) in the case of a claim for hospital services 

7 submitted under this part for which there was a pre8 vious claim as inpatient hospital services under part 

9 A for a length of stay that does not include more 

10 than one midnight that was denied as not reasonable 

11 and necessary by a qualified independent contractor 

12 through a reconsideration conducted under section 

13 1869(c), the period described in this paragraph is 

14 the period ending 60 days after the date of receipt 

15 of the notice required under section 1869(c)(3)(C)(i) 

16 of the decision for such denial with respect to such 

17 reconsideration.’’. 

18 (2) CONFORMING AMENDMENT TO EXCEPTIONS

19 AUTHORITY.—Section 1835(a) of such Act (42 

20 U.S.C. 1395n(a)) is amended in the last sentence by 

21 inserting ‘‘and the periods described in paragraphs 

22 (1) and (2) of subsection (f)’’ after ‘‘1 calendar year 

23 period specified in such paragraph’’. 

24 (b) APPLICATION TO REASONABLE CHARGE ADMIN25 ISTRATIVE PROVISION.— 

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1 (1) IN GENERAL.—Section 1842(b)(3)(B) of 

2 the Social Security Act (42 U.S.C. 1395u(b)(3)(B)) 

3 is amended by inserting ‘‘or, in the case of a claim 

4 described in paragraph (1) or (2) of section 1835(f), 

5 no later than the close of the period described in 

6 such respective paragraph’’ after ‘‘date of service’’. 

7 (2) CONFORMING AMENDMENT TO EXCEPTIONS

8 AUTHORITY.—Section 1842(b)(3) of such Act (42 

9 U.S.C. 1395u(b)(3)) is amended in the last sentence 

10 by inserting ‘‘and the periods described in para11 graphs (1) and (2) of section 1835(f)’’ after ‘‘1 cal12 endar year period specified in such paragraph’’. 

13 (c) EFFECTIVE DATE.—The amendments made by 

14 this section shall apply to services furnished on or after 

15 October 1, 2013. 

16 SEC. 3. MAXIMUM LOOK-BACK PERIOD OF 3 YEARS FOR 

17 MEDICARE RECOVERY AUDIT CONTRACTORS’ 

18 AUDIT AND RECOVERY ACTIVITIES. 

19 (a) IN GENERAL.—Section 1893(h)(4)(B) of the So20 cial Security Act (42 U.S.C. 1395ddd(h)(4)(B)) is amend21 ed by striking ‘‘4 fiscal years’’ and inserting ‘‘3 fiscal 

22 years’’. 

23 (b) EFFECTIVE DATE.—The amendment made by 

24 subsection (a) shall apply with respect to payments made 

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1 for items and services furnished on or after October 1, 

2 2013. 

Æ 

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