I 

118TH CONGRESS 

2D SESSION H. R. 8283 

To amend title XI of the Social Security Act to provide for a demonstration 

project to support automatic claim submissions under Medicare, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 7, 2024 

Mr. SCHWEIKERT 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 XI of the Social Security Act to provide 

for a demonstration project to support automatic claim 

submissions under Medicare, 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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Clean Commitment 

5 to Leveraging Artificial Intelligence to Improve Medicare 

6 Sustainability Act’’ or the ‘‘Clean CLAIMS Act’’. 


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1 SEC. 2. DEMONSTRATION PROJECT TO SUPPORT AUTO2 MATIC CLEAN CLAIM SUBMISSIONS UNDER 

3 MEDICARE. 

4 Section 1115 of the Social Security Act (42 U.S.C. 

5 1315) is amended by adding at the end following new sub6 section: 

7 ‘‘(g)(1) The Secretary shall enter into an agreement 

8 with a MAC submitting an application under the jurisdic9 tion of the MAC for the purpose of conducting a dem10 onstration project under this subsection. 

11 ‘‘(2) An agreement to conduct a demonstration 

12 project under this subsection shall— 

13 ‘‘(A) require the demonstration project to begin 

14 on the date that is the sooner of 1 year after the 

15 date of the enactment of this subsection or the first 

16 day on which the Secretary has sufficiently educated 

17 the physicians described in subparagraph (B), and 

18 end 3 years after the appropriate date; 

19 ‘‘(B) require the MAC to identify and contract 

20 with no less than 500 physicians (as defined in 

21 1861(r)) with National Provider Identifiers or Tax 

22 Identification Numbers to voluntarily participate in 

23 the demonstration project for the purpose of car24 rying out subparagraph (D); 

25 ‘‘(C) provide for the education and training of 

26 providers described in subparagraph (B) on how the 


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1 platform described in subparagraph (D) operates; 

2 and 

3 ‘‘(D) provide for a point of care clean claims 

4 processing platform for physicians that leverages ar5 tificially intelligent technologies that is capable of 

6 automatically— 

7 ‘‘(i) creating claims under part B of title 

8 XVIII after live audio recording a patient-phy9 sician encounter; 

10 ‘‘(ii) submitting claims described in clause 

11 (i) to the Secretary for reimbursement under 

12 such parts (as appropriate); 

13 ‘‘(iii) applying the appropriate payer guide14 lines; and 

15 ‘‘(iv) populates the required corresponding 

16 medical record documentation to support the 

17 items and services billed via the clean claim 

18 submitted pursuant to clause (ii). 

19 ‘‘(3) The Secretary shall, within 6 months after the 

20 date of the enactment of this subsection, publish a request 

21 for proposal for the purpose of contracting with an entity 

22 with a service platform with the capabilities to perform 

23 the activities for the demonstration described in paragraph 

24 (2)(D). 


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1 ‘‘(4) Notwithstanding title XVIII, an individual en2 rolled under part B of title XVIII who receives care for 

3 a claim which is submitted under this demonstration 

4 project may not be responsible for any cost sharing for 

5 items and services furnished by a physicians described in 

6 subparagraph (B) during the demonstration project for 

7 items and services billed incorrectly or not covered under 

8 part B. 

9 ‘‘(5) Any claim which is submitted under this dem10 onstration project shall be exempt from the Medicare Fee 

11 for Service Recovery Audit Program. 

12 ‘‘(6) Not later than 1 year after the date on which 

13 the demonstration project begins pursuant to paragraph 

14 (2)(A), the Secretary shall submit to Congress a report 

15 that— 

16 ‘‘(A) analyzes the data collected from the claims 

17 submitted pursuant to paragraph (2)(D); 

18 ‘‘(B) evaluates feedback submitted by physi19 cians described in paragraph (2)(B); 

20 ‘‘(C) recommends any improvements of the 

21 demonstration project with respect, including how to 

22 scale the project; and 

23 ‘‘(D) any other information the Secretary deter24 mines appropriate. 

25 ‘‘(7) In this subsection: 


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1 ‘‘(A) The term ‘jurisdiction’ means the defined 

2 geographic area in which a MAC processes claims 

3 submitted under part B of title XVIII. 

4 ‘‘(B) The term ‘MAC’ has the meaning given 

5 such term in section 1874A(a)(3).’’. 

Æ 


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