I

106TH CONGRESS

2D SESSION H. R. 5334

To establish a Patients Before Paperwork Medicare Red Tape Reduction

Commission to study the proliferation of paperwork under the medicare

program.

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 28, 2000

Mr. DICKEY introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Commerce, 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 establish a Patients Before Paperwork Medicare Red

Tape Reduction Commission to study the proliferation

of paperwork under the medicare program.

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

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Patients Before Paper5 work Medicare Red Tape Reduction Act of 2000’’.

6 SEC. 2. FINDINGS.

7 Congress makes the following findings:
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1 (1) Regulations promulgated by the Health

2 Care Financing Administration to administer the

3 medicare program under title XVIII of the Social

4 Security Act are 3 times as long as the regulations

5 relating to the Internal Revenue Code of 1986.

6 (2) According to American Medical Association

7 Immediate Past President Dr. Nancy W. Dickey, for

8 most doctors, ‘‘the biggest challenge is getting

9 through mountains of medicare paperwork’’.

10 (3) The Health Care Financing Administration

11 uses 23 different forms in the administration of the

12 medicare program.

13 (4) In 1998, the average processing time for

14 appeals of claims denied under part A of the medi15 care program was 310 days and the average appeal

16 time was 524 days under part B of such program.

17 SEC. 3. PATIENTS BEFORE PAPERWORK MEDICARE RED

18 TAPE REDUCTION COMMISSION.

19 (a) ESTABLISHMENT.—There is established a com20 mission to be known as the Patients Before Paperwork

21 Medicare Red Tape Reduction Commission (in this section

22 referred to as the ‘‘Commission’’).

23 (b) DUTIES OF THE COMMISSION.—The Commission

24 shall—
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1 (1) review existing paperwork burdens and re2 lated regulations under the medicare program under

3 title XVIII of the Social Security Act (42 U.S.C.

4 1395 et seq.), with the goal of reducing the paper5 work burdens under such program;

6 (2) analyze whether existing and proposed pa7 perwork requirements and related regulations have

8 proven benefits, including a positive health benefit

9 for medicare beneficiaries;

10 (3) make recommendations regarding methods

11 to streamline and to simplify the coding method for

12 items and services for which reimbursement is pro13 vided under the medicare program;

14 (4) make recommendations regarding the facili15 tation of electronic filing of claims for reimburse16 ment and the elimination of paperwork under the

17 medicare program;

18 (5) develop a standard form that will minimize

19 any duplication of data and that facilitates the cre20 ation of an electronic system that relies on less pa21 perwork than the current system;

22 (6) determine the effect of the paperwork re23 quirements under the medicare program on relation24 ships between doctors and patients; and
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1 (7) review and analyze such other matters relat2 ing to paperwork reduction under the medicare pro3 gram as the Commission deems appropriate.

4 (c) MEMBERSHIP.—

5 (1) COMPOSITION.—The Commission shall be

6 composed of 10 voting members appointed in accord7 ance with paragraph (2) and one ex officio voting

8 member designated under paragraph (3).

9 (2) IN GENERAL.—Not later than 60 days after

10 the date of the enactment of this Act, members of

11 the Commission shall be appointed as follows:

12 (A) The President shall appoint 3 mem13 bers, of whom not more than 2 shall be of the

14 same political party.

15 (B) The majority leader of the Senate,

16 after consultation with the minority leader of

17 the Senate, shall appoint 3 members, of whom

18 not more than 2 shall be of the same political

19 party.

20 (C) The Speaker of the House of Rep21 resentatives, after consultation with the minor22 ity leader of the House of Representatives, shall

23 appoint 3 members, of whom not more than 2

24 shall be of the same political party.
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1 (D) The President, majority leader of the

2 Senate, and the Speaker of the House of Rep3 resentatives shall jointly appoint 1 member,

4 who shall serve as Chairperson of the Commis5 sion.

6 (3) EX OFFICIO MEMBER.—The Secretary of

7 Health and Human Services (or the Secretary’s des8 ignee) shall serve as an ex officio member of the

9 Commission.

10 (4) QUALIFICATIONS.—

11 (A) IN GENERAL.—Subject to subpara12 graph (B), each member appointed under para13 graph (2) shall be a health care provider, in14 surer, an individual with expertise in the medi15 care program, or a medicare beneficiary.

16 (B) INCLUSION OF PRACTICING PHYSI17 CIANS.—At least 1 member appointed under

18 paragraph (2) shall be a practicing physician.

19 (5) TERMS OF APPOINTMENT.—The term of

20 any appointment under paragraph (1) to the Com21 mission shall be for the life of the Commission.

22 (6) MEETINGS.—The Commission shall meet at

23 the call of its Chairperson or a majority of its mem24 bers.
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1 (7) QUORUM.—A quorum shall consist of a ma2 jority of the members of the Commission, except

3 that 3 members may conduct a hearing under sub4 section (e)(1).

5 (8) VACANCIES.—A vacancy on the Commission

6 shall be filled in the same manner in which the origi7 nal appointment was made not later than 30 days

8 after the Commission is given notice of the vacancy

9 and shall not affect the power of the remaining

10 members to execute the duties of the Commission.

11 (9) COMPENSATION.—Members of the Commis12 sion shall receive no additional pay, allowances, or

13 benefits by reason of their service on the Commis14 sion.

15 (10) EXPENSES.—Each member of the Com16 mission shall receive travel expenses and per diem in

17 lieu of subsistence in accordance with sections 5702

18 and 5703 of title 5, United States Code.

19 (d) STAFF AND SUPPORT SERVICES.—

20 (1) EXECUTIVE DIRECTOR.—

21 (A) APPOINTMENT.—The Chairperson

22 shall appoint an executive director of the Com23 mission.

24 (B) COMPENSATION.—The executive direc25 tor shall be paid the rate of basic pay for level
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1 V of the Executive Schedule under section 5316

2 of title 5, United States Code.

3 (2) STAFF.—With the approval of the Commis4 sion, the executive director may appoint such per5 sonnel as the executive director considers appro6 priate.

7 (3) APPLICABILITY OF CIVIL SERVICE LAWS.—

8 The staff of the Commission shall be appointed with9 out regard to the provisions of title 5, United States

10 Code, governing appointments in the competitive

11 service, and shall be paid without regard to the pro12 visions of chapter 51 and subchapter III of chapter

13 53 of such title (relating to classification and Gen14 eral Schedule pay rates).

15 (4) EXPERTS AND CONSULTANTS.—With the

16 approval of the Commission, the executive director

17 may procure temporary and intermittent services

18 under section 3109(b) of title 5, United States Code.

19 (5) PHYSICAL FACILITIES.—The Administrator

20 of General Services shall locate suitable office space

21 for the operation of the Commission. The facilities

22 shall serve as the headquarters of the Commission

23 and shall include all necessary equipment and

24 incidentals required for the proper functioning of the

25 Commission.
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1 (e) POWERS OF COMMISSION.—

2 (1) HEARINGS AND OTHER ACTIVITIES.—For

3 the purpose of carrying out its duties, the Commis4 sion may hold such hearings and undertake such

5 other activities as the Commission determines to be

6 necessary to carry out its duties.

7 (2) STUDIES BY GAO.—Upon the request of the

8 Commission, the Comptroller General of the United

9 States shall conduct such studies or investigations as

10 the Commission determines to be necessary to carry

11 out its duties.

12 (3) COST ESTIMATES BY CONGRESSIONAL

13 BUDGET OFFICE AND OFFICE OF THE CHIEF ACTU14 ARY OF HCFA.—

15 (A) The Director of the Congressional

16 Budget Office or the Chief Actuary of the

17 Health Care Financing Administration shall

18 provide to the Commission, upon the request of

19 the Commission, such cost estimates as the

20 Commission determines to be necessary to carry

21 out its duties.

22 (B) The Commission shall reimburse the

23 Director of the Congressional Budget Office for

24 expenses relating to the employment in the of25 fice of the Director of such additional staff as
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1 may be necessary for the Director to comply

2 with requests by the Commission under sub3 paragraph (A).

4 (4) DETAIL OF FEDERAL EMPLOYEES.—Upon

5 the request of the Commission, the head of any Fed6 eral agency is authorized to detail, without reim7 bursement, any of the personnel of such agency to

8 the Commission to assist the Commission in car9 rying out its duties. Any such detail shall not inter10 rupt or otherwise affect the civil service status or

11 privileges of the Federal employee.

12 (5) TECHNICAL ASSISTANCE.—Upon the re13 quest of the Commission, the head of a Federal

14 agency shall provide such technical assistance to the

15 Commission as the Commission determines to be

16 necessary to carry out its duties.

17 (6) USE OF MAILS.—The Commission may use

18 the United States mails in the same manner and

19 under the same conditions as Federal agencies and

20 shall, for purposes of the frank, be considered a

21 commission of Congress as described in section 3215

22 of title 39, United States Code.

23 (7) OBTAINING INFORMATION.—The Commis24 sion may secure directly from any Federal agency

25 information necessary to enable it to carry out its
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1 duties, if the information may be disclosed under

2 section 552 of title 5, United States Code. Upon re3 quest of the Chairperson of the Commission, the

4 head of such agency shall furnish such information

5 to the Commission.

6 (8) ADMINISTRATIVE SUPPORT SERVICES.—

7 Upon the request of the Commission, the Adminis8 trator of General Services shall provide to the Com9 mission on a reimbursable basis such administrative

10 support services as the Commission may request.

11 (9) PRINTING.—For purposes of costs relating

12 to printing and binding, including the cost of per13 sonnel detailed from the Government Printing Of14 fice, the Commission shall be deemed to be a com15 mittee of Congress.

16 (f) REPORT.—Not later than 1 year after the date

17 on which the final member of the Commission is appointed

18 under subsection (c), the Commission shall submit to the

19 President and Congress a report which shall contain a de20 tailed statement of only those recommendations, findings,

21 and conclusions of the Commission that receive the ap22 proval of at least a majority of the members of the Com23 mission.
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1 (g) TERMINATION.—The Commission shall terminate

2 30 days after the date of submission of the report required

3 under subsection (f).

4 (h) AUTHORIZATION OF APPROPRIATIONS.—There

5 are authorized to be appropriated $500,000 to carry out

6 this section.

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