II 

113TH CONGRESS 

2D SESSION S. 2005 

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

of certain hospital payment data under the Medicare program, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 6, 2014 

Mr. COBURN (for himself and Mrs. MCCASKILL) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to provide 

for the reporting of certain hospital payment data under 

the Medicare program, 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 ‘‘Consumer Learning 

5 through Electronically-Accessible and Reasonable Cost In6 formation Act of 2013’’ or the ‘‘CLEAR Cost Information 

7 Act of 2013’’. 


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1 SEC. 2. REPORTING OF CERTAIN HOSPITAL PAYMENT 

2 DATA. 

3 (a) IN GENERAL.—Section 1866 of the Social Secu4 rity Act (42 U.S.C. 1395cc) is amended— 

5 (1) in subsection (a)(1)— 

6 (A) in subparagraph (V), by striking 

7 ‘‘and’’ at the end; 

8 (B) in subparagraph (W), as added by sec9 tion 3005 of Public Law 111–148— 

10 (i) by moving such subparagraph 2 

11 ems to the left; and 

12 (ii) by striking the period at the end 

13 and inserting a comma; 

14 (C) in subparagraph (W), as added by sec15 tion 6406(b) of Public Law 111–148— 

16 (i) by moving such subparagraph 2 

17 ems to the left; 

18 (ii) by redesignating such subpara19 graph as subparagraph (X); and 

20 (iii) by striking the period at the end 

21 and inserting ‘‘, and’’; and 

22 (D) by inserting after subparagraph (X), 

23 as redesignated by subparagraph (C)(ii), the 

24 following new subparagraph: 

25 ‘‘(Y) in the case of a subsection (d) hospital (as 

26 defined in section 1886(d)(1)(B)), to report payment 


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1 data to the Secretary in accordance subsection (l).’’; 

2 and 

3 (2) by adding at the end the following new sub4 section: 

5 ‘‘(l) REPORTING OF CERTAIN HOSPITAL PAYMENT

6 DATA.— 

7 ‘‘(1) IN GENERAL.—A subsection (d) hospital 

8 (as defined in section 1886(d)(1)(B)) shall submit to 

9 the Secretary data on the actual amounts collected 

10 by the hospital from uninsured and insured patients 

11 over the preceding 2 years for each of the proce12 dures described in paragraph (2). 

13 ‘‘(2) PROCEDURES DESCRIBED.—The proce14 dures described in this paragraph are the 50 most 

15 common diagnosis-related groups and ambulatory 

16 payment classification groups for which payment is 

17 made under this title, as determined by the Sec18 retary based on claims data, in both the inpatient 

19 and outpatient settings. 

20 ‘‘(3) TRANSPARENCY.— 

21 ‘‘(A) IN GENERAL.—In order to be bene22 ficial to consumers, the reporting of data under 

23 this subsection shall be done in a manner that 

24 is transparent to the general public. 


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1 ‘‘(B) PUBLIC AVAILABILITY OF INFORMA2 TION.—The Secretary shall post data submitted 

3 under paragraph (1) on a publicly accessible 

4 and searchable Internet website in a form and 

5 manner that— 

6 ‘‘(i) allows for meaningful compari7 sons of hospital collections and related 

8 policies by zip code; and 

9 ‘‘(ii) is readily understandable by a 

10 typical consumer. 

11 ‘‘(C) LINKING OF DATA.—A subsection (d) 

12 hospital shall include a link to the data posted 

13 under subparagraph (B) on the home Internet 

14 website of the hospital.’’. 

15 (b) EFFECTIVE DATE.—The amendments made by 

16 this section shall apply to contracts entered into, or re17 newed, on or after the date of the enactment of this Act. 

18 SEC. 3. INCLUSION OF INFORMATION ON CHARITY CARE 

19 FURNISHED BY HOSPITALS IN MEDPAC’S AN20 NUAL REPORT. 

21 Each annual report submitted to Congress after the 

22 date of the enactment of this Act by the Medicare Pay23 ment Advisory Commission under section 1805 of the So24 cial Security Act (42 U.S.C. 1395b–6) shall contain infor25 mation on the percentage that charity care makes up of 


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1 the total care furnished by hospitals and critical access 

2 hospitals. 

3 SEC. 4. PUBLIC AVAILABILITY OF REPORT ON TRENDS IN 

4 LEVELS OF CHARITY CARE PROVIDED BY 

5 CERTAIN HOSPITALS. 

6 (a) POSTING OF DATA.—Section 9007(e)(2) of the 

7 Patient Protection and Affordable Care Act (Public Law 

8 111–148; 124 Stat. 858) is amended by adding at the end 

9 the following new subparagraph: 

10 ‘‘(C) PUBLIC AVAILABILITY.—The Sec11 retary of the Treasury, in consultation with the 

12 Secretary of Health and Human Services, shall 

13 post the data contained in the report under 

14 subparagraph (B) on a publicly accessible and 

15 searchable website that— 

16 ‘‘(i) allows for meaningful compari17 sons of the data by zip code; and 

18 ‘‘(ii) is readily understandable by a 

19 typical consumer.’’. 

20 (b) MEDICARE REQUIREMENT FOR HOSPITALS TO

21 PROVIDE A LINK TO THE DATA ON THE HOSPITAL’S

22 HOME WEBPAGE.— 

23 (1) IN GENERAL.—Section 1866(a)(1) of the 

24 Social Security Act (42 U.S.C. 1395cc(a)(1)), as 

25 amended by section 2, is amended— 


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1 (A) in subparagraph (X), by striking 

2 ‘‘and’’ at the end; 

3 (B) in subparagraph (Y), by striking the 

4 period at the end and inserting ‘‘, and’’; and 

5 (C) by inserting after subparagraph (Y) 

6 the following new subparagraph: 

7 ‘‘(Z) in the case of hospitals and critical 

8 access hospitals, to include a link on the home 

9 Internet website of the hospital or critical ac10 cess hospital to the data posted under section 

11 9007(e)(2)(C) of the Patient Protection and Af12 fordable Care Act.’’. 

13 (2) EFFECTIVE DATE.—The amendments made 

14 by paragraph (1) shall apply to contracts entered 

15 into, or renewed, on or after the date of the enact16 ment of this Act. 

Æ 


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