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[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2375 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 2375

To delay for at least 6 months the implementation of round 1 recompete 
and round 2 of the Medicare durable medical equipment (DME) competitive 
  bidding program and of the national mail order program for diabetic 
   testing supplies to permit Congress an opportunity to reform the 
   competitive bidding program, to provide for an evaluation of that 
       program by an auction expert team, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             June 14, 2013

   Mr. Thompson of Pennsylvania (for himself and Mr. Braley of Iowa) 
 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 delay for at least 6 months the implementation of round 1 recompete 
and round 2 of the Medicare durable medical equipment (DME) competitive 
  bidding program and of the national mail order program for diabetic 
   testing supplies to permit Congress an opportunity to reform the 
   competitive bidding program, to provide for an evaluation of that 
       program by an auction expert team, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Transparency and Accountability in 
Medicare Bidding Act of 2013''.

SEC. 2. DELAY IN IMPLEMENTING THE MEDICARE DME COMPETITIVE BIDDING 
              PROGRAM AND THE NATIONAL MAIL ORDER PROGRAM FOR DIABETIC 
              TESTING SUPPLIES.

    (a) In General.--Notwithstanding any other provision of law, the 
Secretary of Health and Human Services shall delay from July 1, 2013, 
to a date that is no earlier than December 31, 2013, the dates of 
implementation of--
            (1) round 2 of the DMEPOS competitive bidding program under 
        section 1847 of the Social Security Act (42 U.S.C. 1395w-3); 
        and
            (2) the single payment amounts under the national mail 
        order competition for diabetic supplies under such section.
    (b) Round 1 Recompete Delay.--Notwithstanding any other provision 
of law, the Secretary of Health and Human Services shall delay the 
start of round 1 recompete of such DMEPOS competitive bidding program 
from January 1, 2014, to a date that is no earlier than 6 months after 
the date of initial implementation of round 2 of such program.

SEC. 3. EVALUATION OF DMEPOS COMPETITIVE BIDDING PROGRAM BY AUCTION 
              EXPERT TEAM.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary''), not later than 3 months 
after the date of the enactment of this Act and acting through the 
Office of the Assistant Secretary for Planning and Evaluation, shall 
contract 3 auction experts, a health economist, and an econometrician 
to work as a team (in this section collectively referred to as the 
``auction expert team''), led by the auction experts, to independently 
review and assess all aspects of round 1 re-bid and round 2 of the 
DMEPOS competitive bidding program under section 1847 of the Social 
Security Act (42 U.S.C. 1395w-3), including the design, development, 
implementation, adequacy of support for Medicare beneficiaries with 
chronic illness or disabilities, market fairness, sustainability, and 
functioning of such program.
    (b) Selection of Auction Expert Team.--
            (1) In general.--The selection of the experts on the 
        auction expert team under subsection (a) shall be undertaken 
        through a competitive process.
            (2) Disqualifications.--An individual shall not be selected 
        for the auction expert team if such individual--
                    (A) is a current or former employee of the Centers 
                for Medicare & Medicaid Services;
                    (B) is a current or former contractor for the 
                Centers for Medicare & Medicaid Services that 
                participated in the design or implementation of the 
                DMEPOS competitive bidding program;
                    (C) does not have significant experience in 
                implementing auctions of similar complexity in 
                government programs; and
                    (D) does not have appropriate educational 
                credentials.
    (c) Access to Information.--The Secretary shall make available to 
the auction expert team all applicable information (including 
confidential information) on the DMEPOS competitive bidding program in 
its entirety (including information on its design and the bidding under 
round 1, round 1 re-bid, and round 2).
    (d) Report to Secretary and Congress.--
            (1) In general.--Not later than 4 months after the date the 
        Secretary enters into the contract with the experts under 
        subsection (a), the auction expert team shall submit a report 
        to the Secretary and to the Congress on its assessment and 
        review under subsection (a).
            (2) Items to be included in report.--Such report shall 
        include the following and shall identify all potential problems 
        with the DMEPOS competitive bidding program:
                    (A) A review and assessment of the appropriateness 
                of HCPCS codes selected for auctions.
                    (B) An evaluation and assessment of the ability of 
                individuals eligible for the DMEPOS items subject to 
                the program to obtain these items and services, 
                including an assessment of utilization patterns.
                    (C) An analysis of any current or future adverse 
                effects on beneficiaries' health outcomes related to 
                the program and related costs to the Medicare trust 
                fund, including an analysis of those beneficiaries in 
                each competitively bid area who did not continue to 
                receive such items and the effect on their Medicare 
                claims under parts A, B, and D.
                    (D) An identification and report on the cause of 
                any material deterioration in the quality of items and 
                services provided to an individual eligible for DMEPOS 
                benefits under the program.
                    (E) An evaluation of the costs of any preventable 
                or prolonged hospitalizations due to lack of timely 
                access to items and related services subject to the 
                program.
                    (F) An identification, for each product category 
                and competitive bid area in the round 1 re-bid, of the 
                following:
                            (i) The original winning bidders which 
                        signed contracts and the number of allowed 
                        unique Medicare beneficiaries each contracting 
                        supplier fulfilled annually for the calendar 
                        years 2010, 2011 and 2012 in the competitive 
                        bidding areas.
                            (ii) How many contracting suppliers failed 
                        to submit beneficiary product claims for more 
                        than 60 consecutive days.
                            (iii) An identification of DMEPOS suppliers 
                        added after January 1, 2011, and the number of 
                        allowed unique Medicare beneficiaries each such 
                        added supplier served annually for the calendar 
                        years 2010, 2011 and 2012 in the competitive 
                        bidding areas.
                    (G) An identification, for each product category 
                and each competitive bidding area in the round 1 re-bid 
                and in round 2, of the following:
                            (i) The number of winning suppliers.
                            (ii) The number of such winning suppliers 
                        which have not previously supplied the DMEPOS 
                        products bid for in the competitive bidding 
                        area.
                            (iii) The total actual unique Medicare 
                        beneficiaries served by such winning suppliers, 
                        for 2010 with the round 1 re-bid and 2012 for 
                        round 2.
                            (iv) The total capacity, measured by unique 
                        Medicare beneficiaries to be served by such 
                        winning suppliers, as estimated by Secretary to 
                        meet the needs of seniors during the 
                        contracting period.
                            (v) Such total capacity as bid by the 
                        winning bidders.
                            (vi) The total capacity attributed by the 
                        Secretary to the winning bidders.
            (3) Recommendations.--Such report shall also include such 
        recommendations for changes in such program as the auction 
        expert team determines appropriate, including recommendations 
        that respond to all the potential problems identified under 
        paragraph (2).
                                 <all>
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