II 

111TH CONGRESS 

1ST SESSION S. 1380 

To amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment 

Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. 

IN THE SENATE OF THE UNITED STATES 

JUNE 25, 2009 

Mr. ROCKEFELLER 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 create 

a sensible infrastructure for delivery system reform by 

renaming the Medicare Payment Advisory Commission, 

making the Commission an executive branch agency, and 

providing the Commission new resources and authority 

to implement Medicare payment policy. 

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 ‘‘Medicare Payment Ad5 visory Commission (MedPAC) Reform Act of 2009’’. 


jbell on PROD1PC69 with BILLS
2 

•S 1380 IS

1 SEC. 2. RENAMING AND REFORMING THE MEDICARE PAY2 MENT ADVISORY COMMISSION. 

3 (a) AMENDMENT TO TITLE.— 

4 (1) IN GENERAL.—Section 1805 of the Social 

5 Security Act (42 U.S.C. 1395b–6) is amended— 

6 (A) in the heading, by striking ‘‘MEDI7 CARE PAYMENT ADVISORY COMMISSION’’ 

8 and inserting ‘‘MEDICARE PAYMENT AND

9 ACCESS COMMISSION’’; and 

10 (B) in subsection (a), by striking ‘‘Medi11 care Payment Advisory Commission’’ and in12 serting ‘‘Medicare Payment and Access Com13 mission (or ‘MedPAC’)’’. 

14 (2) REFERENCES.—Any reference to the Medi15 care Payment Advisory Commission shall be deemed 

16 a reference to the Medicare Payment and Access 

17 Commission. 

18 (b) ESTABLISHMENT AS EXECUTIVE AGENCY.—Sec19 tion 1805 of the Social Security Act (42 U.S.C. 1395b– 

20 6) is amended— 

21 (1) in subsection (a)— 

22 (A) by striking ‘‘ESTABLISHMENT.—There 

23 is’’ and inserting ‘‘ESTABLISHMENT.— 

24 ‘‘(i) IN GENERAL.—There is’’; 

25 (B) in clause (i), as added by subpara26 graph (A), by striking ‘‘agency of Congress’’ 


jbell on PROD1PC69 with BILLS
3 

•S 1380 IS

1 and inserting ‘‘independent establishment (as 

2 defined in section 104 of title 5, United States 

3 Code)’’; and 

4 (C) by adding at the end the following new 

5 clause: 

6 ‘‘(ii) PURPOSE.— 

7 ‘‘(I) IN GENERAL.—The purpose 

8 of the Commission is to act as the 

9 regulatory authority for payment and 

10 coverage policies under the program 

11 under this title and to implement poli12 cies that improve health outcomes, 

13 promote greater quality and efficiency, 

14 improve beneficiary access to nec15 essary and evidence-based items and 

16 services, maintain coverage afford17 ability, and improve the long-term sol18 vency of the program under this title. 

19 ‘‘(II) SPECIFIC RESPONSIBIL20 ITIES.—The specific responsibilities of 

21 the Commission fall into the following 

22 3 categories: 

23 ‘‘(aa) REIMBURSEMENT

24 POLICY.—The Commission shall 

25 determine payment policies, 


jbell on PROD1PC69 with BILLS
4 

•S 1380 IS

1 methodologies, and rates under 

2 this title, including units of pay3 ment and the amount of pay4 ment, so as to ensure maximum 

5 efficiency and quality and in a 

6 manner that is financially sus7 tainable. 

8 ‘‘(bb) COVERAGE POLICY.— 

9 The Commission shall determine 

10 coverage policies and methodolo11 gies, including national coverage 

12 determinations (as defined in sec13 tion 1869(f)(1)(B)), in a manner 

14 that provides stable premiums 

15 and maximum beneficiary access 

16 to medically necessary and appro17 priate care in the appropriate 

18 setting at the appropriate time. 

19 ‘‘(cc) FINANCIAL STA20 BILITY.—The Commission shall 

21 improve the overall financial sta22 bility of the program under this 

23 title, by using payment policies, 

24 methodologies, and rates and cov25 erage policies and methodologies 


jbell on PROD1PC69 with BILLS
5 

•S 1380 IS

1 to reasonably reduce the growth 

2 in expenditures under this title 

3 without sacrificing current or fu4 ture beneficiary access to medi5 cally necessary and appropriate 

6 care in the appropriate setting at 

7 the appropriate time. 

8 ‘‘(III) CARRYING OUT RESPON9 SIBILITIES.—In carrying out its re10 sponsibilities under this section, the 

11 Commission shall do so in a manner 

12 that serves the interests of current 

13 and future beneficiaries.’’; 

14 (2) in subsection (c)— 

15 (A) in paragraph (1)— 

16 (i) by striking ‘‘APPOINTMENT.—The 

17 Commission’’ and inserting ‘‘APPOINT18 MENT.— 

19 ‘‘(A) IN GENERAL.—The Commission’’; 

20 (ii) in subparagraph (A), as inserted 

21 by clause (i)— 

22 (I) by striking ‘‘17’’ and insert23 ing ‘‘11’’; 

24 (II) by inserting ‘‘the Secretary 

25 and the Administrator of the Centers 


jbell on PROD1PC69 with BILLS
6 

•S 1380 IS

1 for Medicare & Medicaid Services, 

2 who shall each serve as non-voting 

3 members of the Commission, and’’ 

4 after ‘‘composed of’’; and 

5 (III) by striking ‘‘Comptroller 

6 General’’ and inserting ‘‘President, by 

7 and with the advice and consent of 

8 the Senate’’; and 

9 (iii) by adding at the end the fol10 lowing new subparagraphs: 

11 ‘‘(B) LIMITATION ON NUMBER OF TERMS

12 SERVED.—An individual may not be appointed 

13 as a member of the Commission for more than 

14 2 consecutive terms. 

15 ‘‘(C) MEMBERS CURRENTLY APPOINTED.— 

16 ‘‘(i) IN GENERAL.—Any individual 

17 serving as a member of the Commission as 

18 of the date of enactment of the Medicare 

19 Payment Advisory Commission (MedPAC) 

20 Reform Act of 2009 may continue to serve 

21 as a member until the earlier of— 

22 ‘‘(I) the remainder of the term 

23 for which the member was appointed; 

24 or 

25 ‘‘(II) April 30, 2010. 


jbell on PROD1PC69 with BILLS
7 

•S 1380 IS

1 ‘‘(ii) CLARIFICATION REGARDING VA2 CANCIES.—Any vacancy in the Commission 

3 on or after such date of enactment shall be 

4 filled as provided in accordance with sub5 paragraph (A).’’; and 

6 (B) in paragraph (2), by striking subpara7 graph (D) and inserting the following new sub8 paragraph: 

9 ‘‘(D) ADDITIONAL QUALIFICATIONS.—In 

10 addition to the qualifications described in the 

11 succeeding provisions of this paragraph, the 

12 President shall consider the political balance of 

13 the membership of the Commission and the 

14 needs of individuals entitled to (or enrolled for) 

15 benefits under part A or enrolled under part B 

16 who are entitled to medical assistance under a 

17 State plan under title XIX.’’. 

18 (C) in paragraph (3)— 

19 (i) by amending subparagraph (A) to 

20 read as follows: 

21 ‘‘(A) IN GENERAL.—The terms of mem22 bers of the Commission shall be for 6 years ex23 cept that, of the members first appointed— 

24 ‘‘(i) four shall be appointed for terms 

25 of 5 years; 


jbell on PROD1PC69 with BILLS
8 

•S 1380 IS

1 ‘‘(ii) four shall be appointed for terms 

2 of 3 years; and 

3 ‘‘(iii) three shall be appointed for 

4 terms of 1 year.’’; and 

5 (ii) in subparagraph (B), in the third 

6 sentence, by striking ‘‘A vacancy’’ and in7 serting ‘‘Except as provided in paragraph 

8 (1)(C), a vacancy’’; 

9 (D) by amending paragraph (4) to read as 

10 follows: 

11 ‘‘(4) COMPENSATION.—Membership in the 

12 Commission shall be a full-time position. A member 

13 of the Commission shall be entitled to compensation 

14 at the rate payable for level IV of the Executive 

15 Schedule under section 5316 of title 5, United 

16 States Code. The Commission shall determine and 

17 prescribe the manner in which its obligations shall 

18 be incurred and its disbursements and expenses al19 lowed and paid and the salaries of its members and 

20 employees, whose employment, compensation, leave, 

21 and expenses shall be governed solely by the provi22 sions of this section and rules and regulations of the 

23 Commission not inconsistent therewith.’’; 

24 (E) by amending paragraph (5) to read as 

25 follows: 


jbell on PROD1PC69 with BILLS
9 

•S 1380 IS

1 ‘‘(5) CHAIRMAN; VICE CHAIRMAN.—The Presi2 dent shall designate a member of the Commission, at 

3 the time of appointment of the member by and with 

4 the advice and consent of the Senate, as Chairman 

5 and a member of the Commission, at the time of ap6 pointment of the member by and with the advice and 

7 consent of the Senate, as Vice Chairman, except that 

8 in the case where the Chairman or the Vice Chair9 man is not able to be present (including in the case 

10 of vacancy), a majority of the Commission may des11 ignate another member for the period of such ab12 sence.’’; and 

13 (F) by adding at the end the following new 

14 paragraph: 

15 ‘‘(7) NONAPPLICABILITY OF FEDERAL ADVI16 SORY COMMITTEE ACT.—The Federal Advisory Com17 mittee Act (5 U.S.C. App.) shall not apply to any 

18 advisory committee established or utilized by the 

19 Commission.’’; 

20 (3) in subsection (d), in the matter preceding 

21 paragraph (1), by striking ‘‘Subject to such review 

22 as the Comptroller General deems necessary to as23 sure the efficient administration of the Commission, 

24 the Commission’’ and inserting ‘‘The Commission’’; 


jbell on PROD1PC69 with BILLS
10 

•S 1380 IS

1 (4) by amending subsection (f) to read as fol2 lows: 

3 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated such sums as may be 

5 necessary to carry out the provisions of this section. Sixty 

6 percent of such appropriations shall be payable from the 

7 Federal Hospital Insurance Trust Fund, and 40 percent 

8 of such appropriation shall be payable from the Federal 

9 Supplementary Medical Insurance Trust Fund.’’; and 

10 (5) by adding at the end the following new sub11 section: 

12 ‘‘(g) REFERENCES.—Any reference to the Medicare 

13 Payment Advisory Commission or MedPAC shall be 

14 deemed a reference to the Medicare Payment and Access 

15 Commission.’’. 

16 (c) AUTHORITY TO DETERMINE PAYMENT AND COV17 ERAGE AND ROUTINE EVALUATION OF PAYMENT RATES

18 UNDER THE MEDICARE PROGRAM.— 

19 (1) IN GENERAL.—Section 1805(b) of the So20 cial Security Act (42 U.S.C. 1395b–6(b)) is amend21 ed— 

22 (A) in paragraph (1)(B), by inserting ‘‘, 

23 determine payment policies, methodologies, and 

24 rates under this title in accordance with para25 graph (9)(A), and determine coverage policies 


jbell on PROD1PC69 with BILLS
11 

•S 1380 IS

1 and methodologies under this title in accord2 ance with paragraph (9)(B)’’ before the semi3 colon at the end; and 

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

5 paragraphs: 

6 ‘‘(9) AUTHORITY TO DETERMINE PAYMENT AND

7 COVERAGE UNDER THIS TITLE.— 

8 ‘‘(A) DETERMINATION OF PAYMENT POLI9 CIES, METHODOLOGIES, AND RATES.— 

10 ‘‘(i) IN GENERAL.—Notwithstanding 

11 any other provision of law, subject to sub12 paragraph (C), the Commission shall de13 termine payment policies, methodologies, 

14 and rates for items and services, providers 

15 of services, and suppliers under this title. 

16 ‘‘(ii) TIMELINE FOR DETERMINATIONS

17 WITH RESPECT TO PAYMENT POLICIES, 

18 METHODOLOGIES, AND RATES FOR PHYSI19 CIANS AND HOSPITALS.—The Commission 

20 shall make a determination under this sub21 paragraph with respect to payment poli22 cies, methodologies, and rates— 

23 ‘‘(I) for physicians (as defined in 

24 section 1861(r)(1)), not later than 


jbell on PROD1PC69 with BILLS
12 

•S 1380 IS

1 December 1 of each year (beginning 

2 with 2012); and 

3 ‘‘(II) for hospitals, not later than 

4 March 1 of each year (beginning with 

5 2013). 

6 ‘‘(iii) IMPLEMENTATION OF PAYMENT

7 POLICIES, METHODOLOGIES, AND RATES.— 

8 ‘‘(I) AUTHORITY OF SEC9 RETARY.—Notwithstanding any other 

10 provision of law, the Secretary shall 

11 promulgate regulations to implement 

12 any payment policy, methodology, or 

13 rate determined by the Commission 

14 under this subparagraph. 

15 ‘‘(II) REGULATIONS CURRENTLY

16 IN EFFECT.—Any payment policies, 

17 methodologies, and rates for items 

18 and services, providers of services, or 

19 suppliers under this title as of the 

20 date of enactment of the Medicare 

21 Payment Advisory Commission 

22 (MedPAC) Reform Act of 2009 or 

23 regulation promulgated by the Sec24 retary relating to such payment poli25 cies, methodologies, and rates prior to 


jbell on PROD1PC69 with BILLS
13 

•S 1380 IS

1 such date of enactment shall remain 

2 in effect until the Secretary promul3 gates regulations under subclause (I) 

4 to implement a payment policy, meth5 odology, or rate determined by the 

6 Commission with respect to the item 

7 or service, provider of services, or sup8 plier. 

9 ‘‘(B) DETERMINATION OF COVERAGE POLI10 CIES AND METHODOLOGIES.— 

11 ‘‘(i) IN GENERAL.—Notwithstanding 

12 any other provision of law, subject to sub13 paragraph (C), the Commission shall de14 termine coverage policies and methodolo15 gies for items and services furnished under 

16 this title. 

17 ‘‘(ii) IMPLEMENTATION OF COVERAGE

18 POLICIES AND METHODOLOGIES.— 

19 ‘‘(I) AUTHORITY OF SEC20 RETARY.—Notwithstanding any other 

21 provision of law, the Secretary shall 

22 promulgate regulations to implement 

23 any coverage policies and methodolo24 gies determined by the Commission 

25 under this subparagraph. 


jbell on PROD1PC69 with BILLS
14 

•S 1380 IS

1 ‘‘(II) REGULATIONS CURRENTLY

2 IN EFFECT.—Any coverage policy or 

3 methodology for items and services 

4 furnished under this title as of the 

5 date of enactment of the Medicare 

6 Payment Advisory Commission 

7 (MedPAC) Reform Act of 2009 or 

8 regulation promulgated by the Sec9 retary relating to such coverage policy 

10 or methodology prior to such date of 

11 enactment shall remain in effect until 

12 the Secretary promulgates regulations 

13 under subclause (I) to implement a 

14 coverage policy or methodology deter15 mined by the Commission with respect 

16 to the item or service. 

17 ‘‘(C) USE OF AUTHORITY.— 

18 ‘‘(i) IN GENERAL.—In making a de19 termination under subparagraph (A) or 

20 (B), the Commission shall do so in a man21 ner that— 

22 ‘‘(I) is consistent with the provi23 sions of sections 1801 and 1802; 


jbell on PROD1PC69 with BILLS
15 

•S 1380 IS

1 ‘‘(II) is in the best interest of 

2 beneficiaries, including improving ben3 eficiary access to care; and 

4 ‘‘(III) improves the future viabil5 ity of the program under this title, in6 cluding protecting the short-term and 

7 long-term solvency of the program 

8 under this title. 

9 ‘‘(ii) LIMITATION.—A determination 

10 under subparagraph (A) or (B) shall not 

11 limit beneficiary access under this title to 

12 items and services that are medically nec13 essary. 

14 ‘‘(D) LIMITATION ON JUDICIAL REVIEW.— 

15 Any determination of the Commission under 

16 subparagraph (A) or (B) shall be a final agency 

17 action of the Commission and shall not be sub18 ject to judicial review. 

19 ‘‘(E) ANNUAL REPORT.—Not later than 

20 March 15 of each year (beginning with 2012), 

21 the Commission shall submit to Congress a re22 port on any determinations made under sub23 paragraph (A) or (B) during the preceding 

24 year, including the performance of the Sec25 retary in implementing such determinations by 


jbell on PROD1PC69 with BILLS
16 

•S 1380 IS

1 promulgating regulations under subparagraph 

2 (A)(iii) or (B)(ii) and any changes in coverage 

3 policies or methodologies, including any na4 tional coverage determinations (as defined in 

5 section 1869(f)(1)(B)) made during the pre6 ceding year. 

7 ‘‘(F) DEFINITIONS.— 

8 ‘‘(i) COVERAGE POLICIES AND METH9 ODOLOGIES.—In this section, the term 

10 ‘coverage policies and methodologies’ 

11 means the application of any requirements 

12 for coverage of items and services under 

13 this title, including the determination of 

14 the most appropriate way to provide and 

15 pay for such items and services consistent 

16 with the requirements of this title, the ap17 plication of any exclusion from coverage 

18 under this title (including whether an item 

19 or service is reasonable and necessary for 

20 purposes of section 1862(a)(1)(A)) and na21 tional coverage determinations (as defined 

22 in section 1869(f)(1)(B)). 

23 ‘‘(ii) PAYMENT POLICIES, METH24 ODOLOGIES, AND RATES.—In this section, 

25 the term ‘payment policies, methodologies, 


jbell on PROD1PC69 with BILLS
17 

•S 1380 IS

1 and rates’ means the application of any re2 quirements for payment for items and 

3 services furnished under this title, includ4 ing the amount of such payment and the 

5 methodology for determining such payment 

6 amount, including any annual updates to 

7 such payment under this title. 

8 ‘‘(G) CLARIFICATION.—Nothing in this 

9 paragraph shall affect any requirement under 

10 this title to cover an item or service. 

11 ‘‘(10) ROUTINE EVALUATION OF PAYMENT

12 POLICIES, METHODOLOGIES, AND RATES.—The 

13 Commission shall review the payment policies, meth14 odologies, and rates for each item and service, pro15 vider of services, and supplier under this title not 

16 less frequently than every 5 years in order to deter17 mine whether the Commission should make a deter18 mination under paragraph (9)(A) to update such 

19 payment policy, methodology, or rate.’’. 

20 (2) GAO STUDY AND ANNUAL REPORT ON DE21 TERMINATION AND IMPLEMENTATION OF PAYMENT

22 AND COVERAGE POLICIES UNDER THE MEDICARE

23 PROGRAM.— 

24 (A) STUDY.—The Comptroller General of 

25 the United States shall conduct a study on 


jbell on PROD1PC69 with BILLS
18 

•S 1380 IS

1 changes to payment policies, methodologies, and 

2 rates and coverage policies and methodologies 

3 under the Medicare Program under title XVIII 

4 of the Social Security Act as a result of the 

5 amendments made by this subsection, including 

6 an analysis of— 

7 (i) any determinations made by the 

8 Medicare Payment and Access Commission 

9 under subparagraph (A) or (B) of section 

10 1805(b)(9) of such Act, as added by para11 graph (1), during the preceding year; 

12 (ii) any regulations promulgated by 

13 the Secretary of Health and Human Serv14 ices under subparagraph (A)(iii) or (B)(ii) 

15 of such section during the preceding year; 

16 (iii) the process for— 

17 (I) making such determinations 

18 (including the evidence to support any 

19 such determination); 

20 (II) promulgating such regula21 tions (including the capacity of the 

22 Secretary of Health and Human Serv23 ices to promulgate such regulations); 

24 and 


jbell on PROD1PC69 with BILLS
19 

•S 1380 IS

1 (iv) the ability of the Centers for 

2 Medicare & Medicaid Services to fulfill its 

3 responsibilities in carrying out such regula4 tions. 

5 (B) REPORT.—Not later than December 

6 31 of each year (beginning with 2012), the 

7 Comptroller General shall submit to Congress a 

8 report containing the results of the study con9 ducted under subparagraph (A), together with 

10 recommendations for such legislation and ad11 ministrative action as the Secretary determines 

12 appropriate. 

13 (d) CONGRESSIONAL ACTION.—Section 1805 of the 

14 Social Security Act (42 U.S.C. 1395b–6), as amended by 

15 subsection (b), is amended— 

16 (1) by redesignating subsections (f) and (g), re17 spectively, as subsections (g) and (h); and 

18 (2) by inserting after subsection (e) the fol19 lowing new subsection: 

20 ‘‘(f) CONGRESSIONAL ACTION.— 

21 ‘‘(1) IN GENERAL.—Notwithstanding any other 

22 provision of law, it shall only be in order in the Sen23 ate or the House of Representatives to consider any 

24 measure that would overrule a determination of the 

25 Commission under subparagraph (A) or (B) of subVerDate Nov 24 2008 07:29 Jun 26, 2009 Jkt 079200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\S1380.IS S1380

jbell on PROD1PC69 with BILLS
20 

•S 1380 IS

section (d)(9) if 3 1 ⁄5 of the Members, duly chosen and 

2 sworn, of the Senate or the House of Representa3 tives agree to such consideration. 

4 ‘‘(2) RULES OF THE SENATE AND HOUSE OF

5 REPRESENTATIVES.—This subsection is enacted by 

6 Congress— 

7 ‘‘(A) as an exercise of the rulemaking 

8 power of the Senate and House of Representa9 tives, respectively, and is deemed to be part of 

10 the rules of each House, respectively, but appli11 cable only with respect to the procedure to be 

12 followed in that House in the case of a measure 

13 described in paragraph (1), and it supersedes 

14 other rules only to the extent that it is incon15 sistent with such rules; and 

16 ‘‘(B) with full recognition of the constitu17 tional right of either House to change the rules 

18 (so far as they relate to the procedure of that 

19 House) at any time, in the same manner, and 

20 to the same extent as in the case of any other 

21 rule of that House.’’. 

22 (e) RESEARCH AND INFORMATION ACCESS.—Section 

23 1805(e) of the Social Security Act (42 U.S.C. 1395b–6(e)) 

24 is amended by adding at the end the following new para25 graphs: 


jbell on PROD1PC69 with BILLS
21 

•S 1380 IS

1 ‘‘(5) AUTHORITY TO INFORM RESEARCH PRIOR2 ITIES FOR DATA COLLECTION.—The Commission 

3 may advise the Secretary (through the Director of 

4 the Agency for Healthcare Research and Quality and 

5 the Director of the National Institutes of Health) on 

6 priorities for health services research, particularly as 

7 such priorities pertain to necessary changes and 

8 issues regarding payment reforms under this title. 

9 ‘‘(6) EXPANDED AUTHORITY TO ACCESS FED10 ERAL DATA AND REPORTS.—In addition to data ob11 tained under paragraph (1), the Commission shall 

12 have priority access to all raw data and research 

13 conducted or funded by the Federal Government, in14 cluding data and research produced by the Centers 

15 for Medicare & Medicaid Services, the National In16 stitutes of Health, and the Agency for Healthcare 

17 Research and Quality. 

18 ‘‘(7) ELECTRONIC ACCESS.—The National Di19 rector for Health Information Technology, in coordi20 nation with the Secretary, the Administrator of the 

21 Centers for Medicare & Medicaid Services, and the 

22 Commission, shall establish a direct electronic link 

23 for raw data, including claims data under this title, 

24 to be accessed by the Commission for the purposes 

25 of evaluating and determining recommendations 


jbell on PROD1PC69 with BILLS
22 

•S 1380 IS

1 under this title, in accordance with applicable pri2 vacy laws and data use agreements. 

3 ‘‘(8) ACCESS TO BIANNUAL REPORTS.—Not less 

4 frequently than on a biannual basis, the National In5 stitutes of Health and the Agency for Healthcare 

6 Research and Quality shall submit to the Commis7 sion a report containing information on any research 

8 conducted by the National Institutes of Health and 

9 the Agency for Healthcare Research and Quality, re10 spectively, which has relevance for the determina11 tions and recommendations being considered by the 

12 Commission. Such information shall be provided to 

13 the Commission in electronic form.’’. 

14 (f) ADDITIONAL RESOURCES TO CARRY OUT DU15 TIES.— 

16 (1) IN GENERAL.—Section 1805(d) of the So17 cial Security Act (42 U.S.C. 1395b–6(d)) is amend18 ed— 

19 (A) in paragraph (1), by inserting ‘‘(in20 cluding an attorney)’’ after ‘‘such other per21 sonnel’’; and 

22 (B) in paragraph (5), by striking ‘‘and’’ at 

23 the end; 

24 (C) in paragraph (6), by striking the pe25 riod at the end and inserting ‘‘; and’’; and 


jbell on PROD1PC69 with BILLS
23 

•S 1380 IS

1 (D) by adding at the end the following new 

2 paragraph: 

3 ‘‘(7) establish a public affairs office.’’. 

4 (2) OFFICE OF THE OMBUDSMAN.—Section 

5 1805(e) of the Social Security Act (42 U.S.C. 

6 1395b–6(e)), as amended by subsection (e), is 

7 amended by adding at the end the following new 

8 paragraph: 

9 ‘‘(10) OFFICE OF THE OMBUDSMAN.— 

10 ‘‘(A) IN GENERAL.—The Commission shall 

11 establish an office of the ombudsman to handle 

12 complaints regarding the implementation of 

13 regulations under subsection (a)(9)(B). 

14 ‘‘(B) DUTIES.—The office of the ombuds15 man shall— 

16 ‘‘(i) act as a liaison between the Com17 mission and any entity or individual af18 fected by the implementation of such a 

19 regulation; and 

20 ‘‘(ii) ensure that the Commission has 

21 established safeguards— 

22 ‘‘(I) to encourage such entities 

23 and individuals to submit complaints 

24 to the office of the ombudsman; and 


jbell on PROD1PC69 with BILLS
24 

•S 1380 IS

1 ‘‘(II) to protect the confiden2 tiality of any entity or individual who 

3 submits such a complaint.’’. 

4 (g) MACPAC TECHNICAL AMENDMENTS.—Section 

5 1900(b) of the Social Security Act (42 U.S.C. 1396) is 

6 amended— 

7 (1) in paragraph (1)(D), by striking ‘‘June 1’’ 

8 and inserting ‘‘June 15’’; and 

9 (2) by adding at the end the following: 

10 ‘‘(10) CONSULTATION WITH MEDPAC.— 

11 MACPAC shall regularly consult with the Medicare 

12 Payment and Access Commission (in this paragraph 

13 referred to as ‘MedPAC’) established under section 

14 1805 in carrying out its duties under this section.’’. 

15 (h) LOBBYING COOLING-OFF PERIOD FOR MEMBERS

16 OF THE MEDICARE PAYMENT ADVISORY COMMISSION.— 

17 Section 207(c) of title 18, United States Code, is amended 

18 by inserting at the end the following: 

19 ‘‘(3) MEMBERS OF THE MEDICARE PAYMENT

20 ADVISORY COMMISSION.— 

21 ‘‘(A) IN GENERAL.—Paragraph (1) shall 

22 apply to a member of the Medicare Payment 

23 Advisory Commission who was appointed to 

24 such Commission as of the date of enactment of 


jbell on PROD1PC69 with BILLS
25 

•S 1380 IS

1 the Medicare Payment Advisory Commission 

2 (MedPAC) Reform Act of 2009. 

3 ‘‘(B) AGENCIES AND CONGRESS.—For pur4 poses of paragraph (1), the agency in which the 

5 individual described in subparagraph (A) served 

6 shall be considered to be the Medicare Payment 

7 and Access Commission established under sec8 tion 1805 of the Social Security Act, the De9 partment of Health and Human Services, and 

10 the relevant committees of jurisdiction of Con11 gress.’’. 

12 SEC. 3. ESTABLISHMENT OF COUNCIL OF HEALTH AND 

13 ECONOMIC ADVISERS, CONSUMER ADVISORY 

14 COUNCIL, AND FEDERAL HEALTH ADVISORY 

15 COUNCIL. 

16 Section 1805(b) of the Social Security Act (42 U.S.C. 

17 1395b–6(b)), as amended by section 2(c), is amended by 

18 adding at the end the following new paragraph: 

19 ‘‘(11) COUNCIL OF HEALTH AND ECONOMIC AD20 VISERS, CONSUMER ADVISORY COUNCIL, AND FED21 ERAL HEALTH ADVISORY COUNCIL.— 

22 ‘‘(A) COUNCIL OF HEALTH AND ECONOMIC

23 ADVISERS.— 

24 ‘‘(i) IN GENERAL.—The Commission 

25 shall establish a council of health and ecoVerDate Nov 24 2008 07:29 Jun 26, 2009 Jkt 079200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S1380.IS S1380

jbell on PROD1PC69 with BILLS
26 

•S 1380 IS

1 nomic advisers to advise the Commission 

2 on its development, analyses, and imple3 mentation of payment policies under this 

4 title. 

5 ‘‘(ii) MEMBERSHIP.— 

6 ‘‘(I) IN GENERAL.—The council 

7 of health and economic advisers shall 

8 be composed of acknowledged experts 

9 in health care and economics selected 

10 by the Commission. 

11 ‘‘(II) INITIAL INCLUSION OF

12 FORMER MEMBERS OF MEDICARE PAY13 MENT ADVISORY COMMISSION.—The 

14 members initially selected for the 

15 council of health and economic advis16 ers under subclause (I) shall include 

17 those individuals who were members 

18 of the Medicare Payment Advisory 

19 Commission as of the day before the 

20 date of enactment of the Medicare 

21 Payment Advisory Commission 

22 (MedPAC) Reform Act of 2009. 

23 ‘‘(B) CONSUMER ADVISORY COUNCIL.— 

24 ‘‘(i) IN GENERAL.—There is estab25 lished a consumer advisory council to adVerDate Nov 24 2008 07:29 Jun 26, 2009 Jkt 079200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\S1380.IS S1380

jbell on PROD1PC69 with BILLS
27 

•S 1380 IS

1 vise the Commission on the impact of pay2 ment policies under this title on con3 sumers. 

4 ‘‘(ii) MEMBERSHIP.— 

5 ‘‘(I) NUMBER AND APPOINT6 MENT.—The consumer advisory coun7 cil shall be composed of 10 consumer 

8 representatives appointed by the 

9 Comptroller General of the United 

10 States, 1 from among each of the 10 

11 regions established by the Secretary 

12 as of the date of enactment of the 

13 Medicare Payment Advisory Commis14 sion (MedPAC) Reform Act of 2009. 

15 ‘‘(II) QUALIFICATIONS.—The 

16 membership of the council shall rep17 resent the interests of consumers and 

18 particular communities. 

19 ‘‘(iii) DUTIES.—The consumer advi20 sory council shall, subject to the call of the 

21 Commission, meet not less frequently than 

22 2 times each year in the District of Colum23 bia. 


jbell on PROD1PC69 with BILLS
28 

•S 1380 IS

1 ‘‘(iv) OPEN MEETINGS.—Meetings of 

2 the consumer advisory council shall be 

3 open to the public. 

4 ‘‘(v) ELECTION OF OFFICERS.—Mem5 bers of the consumer advisory council shall 

6 elect their own officers. 

7 ‘‘(C) FEDERAL HEALTH ADVISORY COUN8 CIL.— 

9 ‘‘(i) IN GENERAL.—There is estab10 lished a Federal health advisory council to 

11 consult with and provide advice to the 

12 Commission on all matters within the ju13 risdiction of the Commission. 

14 ‘‘(ii) MEMBERSHIP.—The Federal 

15 health advisory council shall be composed 

16 of 10 representatives from the health care 

17 industry appointed by the Comptroller 

18 General of the United States, 1 from 

19 among each of the 10 regions established 

20 by the Secretary as of the date of enact21 ment of the Medicare Payment Advisory 

22 Commission (MedPAC) Reform Act of 

23 2009. 

24 ‘‘(iii) TERMS.— 


jbell on PROD1PC69 with BILLS
29 

•S 1380 IS

1 ‘‘(I) IN GENERAL.—The terms of 

2 members of the Federal health advi3 sory council shall be for 1 year. 

4 ‘‘(II) LIMITATION ON NUMBER

5 OF TERMS SERVED.—An individual 

6 may not be appointed as a member of 

7 the Federal health advisory council for 

8 more than 3 terms. 

9 ‘‘(iv) DUTIES.—The Federal health 

10 advisory council shall, subject to the call of 

11 the Commission, meet not less frequently 

12 than 2 times each year in the District of 

13 Columbia. 

14 ‘‘(v) OPEN MEETINGS.—Meetings of 

15 the Federal health advisory council shall be 

16 open to the public. 

17 ‘‘(vi) ELECTION OF OFFICERS.—Mem18 bers of the Federal health advisory council 

19 shall elect their own officers. 

20 ‘‘(D) LIMITATION ON FUNDING.—Out of 

21 amounts appropriated under subsection (g), the 

22 Commission may use not more than $300,000 

23 each fiscal year to carry out this paragraph.’’. 


jbell on PROD1PC69 with BILLS
30 

•S 1380 IS

1 SEC. 4. COST CONTAINMENT IN MEDICARE. 

2 Section 1805(b) of the Social Security Act (42 U.S.C. 

3 1395b–6(b)), as amended by section 3, is amended by add4 ing at the end the following new paragraph: 

5 ‘‘(12) SPENDING REDUCTIONS.— 

6 ‘‘(A) IN GENERAL.— 

7 ‘‘(i) IMPLEMENTATION BY THE COM8 MISSION.—Notwithstanding any other pro9 vision of law, effective beginning on Janu10 ary 1, 2012, subject to clause (ii) and the 

11 succeeding provisions of this paragraph, 

12 the Commission shall implement payment 

13 policies, methodologies, and rates and cov14 erage policies and methodologies which are 

15 estimated to reduce expenditures under 

16 this title by not less than 1.5 percent an17 nually. 

18 ‘‘(ii) FAIL SAFE MECHANISM.—Not19 withstanding any other provision of law, 

20 effective beginning on January 1, 2013, 

21 subject to the succeeding provisions of this 

22 paragraph, in the case where the Chief Ac23 tuary of the Centers for Medicare & Med24 icaid Services finds that the payment poli25 cies, methodologies, and rates and coverage 

26 policies and methodologies implemented 


jbell on PROD1PC69 with BILLS
31 

•S 1380 IS

1 under clause (i) for a given year will not 

2 reduce annual expenditures under this title 

3 by not less than 1.5 percent, the Secretary 

4 shall implement an automatic reduction in 

5 reimbursement for providers of services 

6 and suppliers under the original Medicare 

7 fee-for-service program under parts A and 

8 B in order to achieve such 1.5 percent re9 duction. Such reduction shall be cumu10 lative, may vary depending on the provider 

11 of services or supplier involved, and may 

12 be zero based on initiatives implemented by 

13 the Secretary for including no reduction. 

14 ‘‘(B) REQUIREMENTS.—In carrying out 

15 subparagraph (A), the following requirements 

16 shall apply: 

17 ‘‘(i) Any reductions in reimbursement 

18 for items and services furnished under this 

19 title which are subject to a competitive bid20 ding process shall apply in the year fol21 lowing the year in which the Commission 

22 or the Secretary determines that such re23 duction shall be implemented. 

24 ‘‘(ii) Any reductions in reimbursement 

25 to a Medicare Advantage organization ofVerDate Nov 24 2008 07:29 Jun 26, 2009 Jkt 079200 PO 00000 Frm 00031 Fmt 6652 Sfmt 6201 E:\BILLS\S1380.IS S1380

jbell on PROD1PC69 with BILLS
32 

•S 1380 IS

1 fering a Medicare Advantage plan under 

2 part C shall be reflected in the MA area3 specific non-drug monthly benchmark 

4 amount computed under section 1853(j) 

5 for months in the year following the year 

6 in which the Commission or the Secretary 

7 determines that such reduction shall be im8 plemented. 

9 ‘‘(iii) The amount of a reduction in 

10 reimbursement to a provider of services or 

11 a supplier under this title during a year 

12 shall not be greater than 5 percent of the 

13 amount of payment that would otherwise 

14 apply under this title. 

15 ‘‘(iv) In the case where the amount of 

16 any savings to the program under this title 

17 during a year as a result of the provisions 

18 of subparagraph (A) exceeds 1.5 percent of 

19 the amount of expenditures that would 

20 otherwise be made under this title, the 

21 amount of such excess shall be deposited, 

22 in such proportion as the Commission de23 termines appropriate, in the Federal Hos24 pital Insurance Trust Fund established 

25 under section 1817 and the Federal SupVerDate Nov 24 2008 07:29 Jun 26, 2009 Jkt 079200 PO 00000 Frm 00032 Fmt 6652 Sfmt 6201 E:\BILLS\S1380.IS S1380

jbell on PROD1PC69 with BILLS
33 

•S 1380 IS

1 plementary Medical Insurance Trust Fund 

2 established under section 1841. 

3 ‘‘(C) ANALYSIS.—The Chief Actuary of the 

4 Centers for Medicare & Medicaid Services 

5 shall— 

6 ‘‘(i) analyze such payment polices, 

7 methodologies, and rates and coverage poli8 cies and methodologies prospectively, in 

9 order to determine the amount of such es10 timated reduction in expenditures for a 

11 year; and 

12 ‘‘(ii) include such analysis in the an13 nual report of the Boards of Trustees of 

14 the Federal Hospital Insurance Trust 

15 Fund and Federal Supplementary Medical 

16 Insurance Trust Funds for the year. 

17 ‘‘(D) THIRD PARTY VERIFICATION.—The 

18 analysis under subparagraph (C) shall be 

19 verified by an independent, third party actuary. 

20 ‘‘(E) GAO AUDIT AND ANNUAL REPORT.— 

21 ‘‘(i) AUDIT.—The Comptroller Gen22 eral of the United States shall audit the 

23 procedures used to determine such esti24 mated reduction in expenditures. 


jbell on PROD1PC69 with BILLS
34 

•S 1380 IS

1 ‘‘(ii) ANNUAL REPORT.—The Comp2 troller General shall submit to Congress an 

3 annual report containing the results of the 

4 audit conducted under clause (i). 

5 ‘‘(F) INCLUSION OF INTERIM PAYMENT

6 AND COVERAGE POLICIES.—Any savings or ad7 ditional expenditures as a result of payment 

8 policies, methodologies, and rates and coverage 

9 policies and methodologies under any health re10 form legislation enacted on or after the date of 

11 enactment of the Medicare Payment Advisory 

12 Commission (MedPAC) Reform Act of 2009 

13 shall be included in the determination of wheth14 er expenditures under this title have been re15 duced by not less than 1.5 percent for a year. 

16 ‘‘(G) NON-APPLICATION DURING YEARS

17 WHEN SOLVENCY HAS BEEN DETERMINED.— 

18 This paragraph shall not apply for a year in the 

19 case where the Chief Actuary of the Centers for 

20 Medicare & Medicaid Services determines, as 

21 part of the annual report of the Boards of 

22 Trustees of the Federal Hospital Insurance 

23 Trust Fund and Federal Supplementary Med24 ical Insurance Trust Funds for the preceding 

25 year, that the program under this title is solVerDate Nov 24 2008 07:29 Jun 26, 2009 Jkt 079200 PO 00000 Frm 00034 Fmt 6652 Sfmt 6201 E:\BILLS\S1380.IS S1380

jbell on PROD1PC69 with BILLS
35 

•S 1380 IS

1 vent, according to the short range test for fi2 nancial adequacy of the Chief Actuary of the 

3 Centers for Medicare & Medicaid Services.’’. 

4 SEC. 5. ESTABLISHMENT OF JOINT COMMITTEE ON MEDI5 CARE. 

6 (a) IN GENERAL.—There is hereby established the 

7 Joint Committee on Medicare (in this section referred to 

8 as the ‘‘Joint Committee’’). 

9 (b) MEMBERSHIP.—The Joint Committee shall be 

10 composed of 11 members appointed as follows: 

11 (1) 5 members shall be appointed by the Presi12 dent pro tempore of the Senate, on the recommenda13 tion of the majority and minority leaders of the Sen14 ate, from among the members of the Committee on 

15 Finance of the Senate, 3 of whom shall be from the 

16 majority on the Committee and 2 of whom shall be 

17 from the minority on the Committee; and 

18 (2) 6 members shall be appointed by the Speak19 er of the House of Representatives, in consultation 

20 with the minority leader of the House of Representa21 tives— 

22 (A) 3 from among the members of the 

23 Committee on Ways and Means of the House of 

24 Representatives, 2 of whom shall be from the 


jbell on PROD1PC69 with BILLS
36 

•S 1380 IS

1 majority on the Committee and 1 of whom shall 

2 be from the minority on the Committee; and 

3 (B) 3 from among the members of the 

4 Committee on Energy and Commerce of the 

5 House of Representatives, 2 of whom shall be 

6 from the majority on the Committee and 1 of 

7 whom shall be from the minority on the Com8 mittee. 

9 (c) DUTIES.—The Joint Committee shall— 

10 (1) study the operation and effects of any 

11 changes proposed by Congress to the Medicare Pro12 gram under title XVIII of the Social Security Act, 

13 and other matters relating to the Medicare Program 

14 that the Joint Committee determines appropriate; 

15 (2) submit reports to the Committee on Fi16 nance of the Senate and the Committee on Ways 

17 and Means and the Committee on Energy and Com18 merce of the House of Representatives containing 

19 the results of any studies conducted under para20 graph (1), including recommendations for such legis21 lation and administrative action as the Joint Com22 mittee determines appropriate; 

23 (3) prepare pamphlets for hearings conducted 

24 by such Committees, reports of such Committees, 

25 and conference reports accompanying any legislation 


jbell on PROD1PC69 with BILLS
37 

•S 1380 IS

1 enacted by Congress relating to the Medicare Pro2 gram; 

3 (4) assist members of Congress in drafting leg4 islative language relating to the Medicare Program; 

5 (5) assist members of Congress with the devel6 opment and analysis of proposed legislation relating 

7 to the Medicare Program; and 

8 (6) prepare impact estimates of all legislation 

9 relating to the Medicare Program that is considered 

10 by Congress. 

11 (d) HEARINGS.— 

12 (1) IN GENERAL.—The Joint Committee or, at 

13 the direction of the Joint Committee, any sub14 committee or member of the Joint Committee, may, 

15 for the purpose of carrying out this Act— 

16 (A) hold such hearings, meet and act at 

17 such times and places, take such testimony, re18 ceive such evidence, and administer such oaths; 

19 and 

20 (B) require, by subpoena or otherwise, the 

21 attendance and testimony of such witnesses and 

22 the production of such books, records, cor23 respondence, memoranda, papers, documents, 

24 tapes, and materials; 


jbell on PROD1PC69 with BILLS
38 

•S 1380 IS

1 as the Joint Committee or such subcommittee or 

2 member considers advisable. 

3 (2) ISSUANCE AND ENFORCEMENT OF SUB4 POENAS.— 

5 (A) ISSUANCE.—A subpoena issued under 

6 paragraph (1) shall— 

7 (i) bear the signature of the Chair8 person of the Joint Committee; and 

9 (ii) be served by any person or class 

10 of persons designated by the Chairperson 

11 for that purpose. 

12 (B) ENFORCEMENT.—In the case of contu13 macy or failure to obey a subpoena issued 

14 under paragraph (1)(B), the United States dis15 trict court for the district in which the subpoe16 naed person resides, is served, or may be found 

17 may issue an order requiring the person to ap18 pear at any designated place to testify or to 

19 produce documentary or other evidence. 

20 (C) NONCOMPLIANCE.—Any failure to 

21 obey the order of the court may be punished by 

22 the court as a contempt of court. 

23 (3) WITNESS ALLOWANCES AND FEES.— 

24 (A) IN GENERAL.—Section 1821 of title 

25 28, United States Code, shall apply to a witness 


jbell on PROD1PC69 with BILLS
39 

•S 1380 IS

1 requested or subpoenaed to appear at a hearing 

2 of the Joint Committee. 

3 (B) EXPENSES.—The per diem and mile4 age allowances for a witness shall be paid from 

5 funds available to pay the expenses of the Joint 

6 Committee. 

7 (e) INFORMATION FROM FEDERAL AGENCIES.— 

8 (1) IN GENERAL.—The Joint Committee may 

9 secure directly from a Federal agency such informa10 tion as the Joint Committee considers necessary to 

11 carry out this Act, including any data relating to the 

12 Medicare Program (including Medicare claims data). 

13 (2) PROVISION OF INFORMATION.—On request 

14 of the Joint Committee, the head of the agency shall 

15 provide the information to the Joint Committee. 

16 (f) POSTAL SERVICES.—The Joint Committee may 

17 use the United States mails in the same manner and 

18 under the same conditions as other agencies of the Federal 

19 Government. 

20 (g) PRINTING AND BINDING, OTHER NECESSARY

21 EXPENDITURES.—The Joint Committee may make nec22 essary expenditures, including the procurement of printing 

23 and binding services, as the Joint Committee determines 

24 appropriate. 

25 (h) JOINT COMMITTEE PERSONNEL MATTERS.— 


jbell on PROD1PC69 with BILLS
40 

•S 1380 IS

1 (1) COMPENSATION OF MEMBERS.—A member 

2 of the Joint Committee shall serve without com3 pensation in addition to the compensation received 

4 for the services of the member as an officer or em5 ployee of the Federal Government. 

6 (2) TRAVEL EXPENSES.—A member of the 

7 Joint Committee shall be allowed travel expenses, in8 cluding per diem in lieu of subsistence, at rates au9 thorized for an employee of an agency under sub10 chapter I of chapter 57 of title 5, United States 

11 Code, while away from the home or regular place of 

12 business of the member in the performance of the 

13 duties of the Joint Committee. 

14 (3) STAFF.— 

15 (A) IN GENERAL.—The Chairperson of the 

16 Joint Committee may, without regard to the 

17 civil service laws (including regulations), ap18 point and terminate an executive director and 

19 such other additional personnel as are necessary 

20 to enable the Joint Committee to perform the 

21 duties of the Joint Committee. 

22 (B) CONFIRMATION OF EXECUTIVE DIREC23 TOR.—The employment of an executive director 

24 shall be subject to confirmation by the Joint 

25 Committee. 


jbell on PROD1PC69 with BILLS
41 

•S 1380 IS

1 (C) COMPENSATION.— 

2 (i) IN GENERAL.—Except as provided 

3 in subparagraph (B), the Chairperson of 

4 the Joint Committee may fix the com5 pensation of the executive director and 

6 other personnel without regard to the pro7 visions of chapter 51 and subchapter III of 

8 chapter 53 of title 5, United States Code, 

9 relating to classification of positions and 

10 General Schedule pay rates. 

11 (ii) MAXIMUM RATE OF PAY.—The 

12 rate of pay for the executive director and 

13 other personnel shall not exceed the rate 

14 payable for level V of the Executive Sched15 ule under section 5316 of title 5, United 

16 States Code. 

17 (4) DETAIL OF FEDERAL GOVERNMENT EM18 PLOYEES.— 

19 (A) IN GENERAL.—An employee of the 

20 Federal Government may be detailed to the 

21 Joint Committee without reimbursement. 

22 (B) CIVIL SERVICE STATUS.—The detail of 

23 the employee shall be without interruption or 

24 loss of civil service status or privilege. 


jbell on PROD1PC69 with BILLS
42 

•S 1380 IS

1 (5) PROCUREMENT OF TEMPORARY AND INTER2 MITTENT SERVICES.—The Chairperson of the Joint 

3 Committee may procure temporary and intermittent 

4 services in accordance with section 3109(b) of title 

5 5, United States Code, at rates for individuals that 

6 do not exceed the daily equivalent of the annual rate 

7 of basic pay prescribed for level V of the Executive 

8 Schedule under section 5316 of that title. 

9 (6) NONPARTISAN STAFF.—Personnel of the 

10 Joint Committee shall provide objective and con11 fidential technical analysis and assistance on legisla12 tion relating to the Medicare Program. Such per13 sonnel— 

14 (A) shall not operate as personnel solely 

15 for the majority or the minority in Congress; 

16 (B) shall not be responsible for rep17 resenting a particular point of view on any 

18 issue relating to the Medicare Program; and 

19 (C) shall examine critically policies under 

20 the Medicare Program, including the long-range 

21 effects of such policies. 


jbell on PROD1PC69 with BILLS
43 

•S 1380 IS

1 SEC. 6. REVISIONS TO PROCESS FOR CONDUCT OF DEM2 ONSTRATION PROJECTS. 

3 (a) IN GENERAL.—Title XVIII of the Social Security 

4 Act (42 U.S.C. 1395 et seq.) is amended by adding at 

5 the end the following new section: 

6 ‘‘SEC. 1899. CONDUCT OF DEMONSTRATION PROJECTS. 

7 ‘‘(a) IN GENERAL.— 

8 ‘‘(1) RENAMING AND TRANSFER OF OFFICE OF

9 RESEARCH, DEVELOPMENT AND INFORMATION.—Ef10 fective beginning January 1, 2011, the Office of Re11 search, Development and Information shall be— 

12 ‘‘(A) transferred from the Administrator of 

13 the Centers for Medicare & Medicaid Services 

14 to the Assistant Secretary for Planning and 

15 Evaluation of the Department of Health and 

16 Human Services; and 

17 ‘‘(B) renamed the Office of Research, De18 velopment and Information of the Department 

19 of Health and Human Services. 

20 ‘‘(2) AUTHORITY TO DESIGN AND EVALUATE

21 DEMONSTRATION PROJECTS.—The Office of Re22 search, Development and Information of the Depart23 ment of Health and Human Services (in this section 

24 referred to as the ‘Office’) shall have sole authority 

25 to design and evaluate demonstration projects under 

26 this title, including demonstration projects to test 


jbell on PROD1PC69 with BILLS
44 

•S 1380 IS

1 new and innovative methods of reimbursement under 

2 the Medicare program to improve the quality and ef3 ficiency of health care and reduce costs under the 

4 Medicare program. 

5 ‘‘(3) IMPLEMENTATION.—The Secretary of 

6 Health and Human Services (in this section referred 

7 to as the ‘Secretary’) shall maintain all responsibility 

8 for implementing demonstration projects under this 

9 title, including for implementing the process through 

10 which providers of services and suppliers are reim11 bursed for items and services furnished under the 

12 demonstration projects. 

13 ‘‘(4) AUTHORITY TO EXPAND SUCCESSFUL

14 DEMONSTRATION PROJECTS.— 

15 ‘‘(A) EXPANSION.—Notwithstanding any 

16 other provision of law, the Secretary may ex17 pand the duration and scope of a demonstration 

18 project under this title, to an extent determined 

19 appropriate by the Secretary, if the Secretary 

20 determines that such expansion is appropriate. 

21 ‘‘(B) AUDITS AND REPORTS.— 

22 ‘‘(i) AUDITS.—The Inspector General 

23 of the Department of Health and Human 

24 Services shall conduct an annual audit of 

25 any expansion under subparagraph (A) to 


jbell on PROD1PC69 with BILLS
45 

•S 1380 IS

1 determine whether the funding of and 

2 process for such expansion is consistent 

3 with Congressional intent and serves the 

4 best interest of beneficiaries. 

5 ‘‘(ii) REPORTS.—The Inspector Gen6 eral shall submit to Congress an annual re7 port containing the results of any audits 

8 conducted under clause (i), together with 

9 recommendations for such legislation and 

10 administrative action as the Inspector Gen11 eral determines appropriate. 

12 ‘‘(C) WEBSITE.—The Office shall establish 

13 a publicly available Internet website that con14 tains current information regarding demonstra15 tion projects under this title, including a de16 scription of the demonstration projects and the 

17 status, location, points of contact, and any mid18 term or final evaluation of the demonstration 

19 projects. 

20 ‘‘(b) ADVISORY COMMITTEE.— 

21 ‘‘(1) ESTABLISHMENT.—There is hereby estab22 lished an advisory committee to consult with the Of23 fice on existing and proposed demonstration projects 

24 under this title. 


jbell on PROD1PC69 with BILLS
46 

•S 1380 IS

1 ‘‘(2) MEMBERSHIP.—The advisory committee 

2 shall be composed of the following members: 

3 ‘‘(A) The Chairman of the Medicare Pay4 ment and Access Commission established under 

5 section 1805. 

6 ‘‘(B) The Director of the Agency for 

7 Healthcare Research and Quality. 

8 ‘‘(C) The Administrator of the Centers for 

9 Medicare & Medicaid Services. 

10 ‘‘(D) The National Coordinator for Health 

11 Information Technology. 

12 ‘‘(E) The Director of the Office of Man13 agement and Budget. 

14 ‘‘(3) DUTIES.—Not less frequently than 2 times 

15 each year, the advisory committee shall meet with 

16 the Office to consult on demonstration projects 

17 under this title. 

18 ‘‘(c) ELIMINATION OF BUDGET NEUTRAL IMPLE19 MENTATION REQUIREMENT FOR DEMONSTRATION

20 PROJECTS.—Notwithstanding any other provision of law, 

21 the Secretary, in conducting a demonstration project 

22 under this title, shall not be required to ensure that the 

23 aggregate payments made by the Secretary under this title 

24 do not exceed the amount which the Secretary would have 


jbell on PROD1PC69 with BILLS
47 

•S 1380 IS

1 paid under this title if the demonstration project was not 

2 implemented. 

3 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated such sums as may be 

5 necessary to carry out the provisions of this section. Sixty 

6 percent of such appropriation shall be payable from the 

7 Federal Hospital Insurance Trust Fund established under 

8 section 1817 of the Social Security Act (42 U.S.C. 1395i), 

9 and 40 percent of such appropriation shall be payable 

10 from the Federal Supplementary Medical Insurance Trust 

11 Fund established under section 1841 of such Act (42 

12 U.S.C. 1395t). Out of amounts appropriated under the 

13 preceding sentence, the Secretary may use not more than 

14 $500,000,000 each fiscal year to conduct demonstration 

15 projects to test new and innovative methods of reimburse16 ment under the Medicare program that seek to improve 

17 quality and efficiency of health care reduce costs under 

18 the Medicare program.’’. 

19 (b) BIANNUAL COMMUNICATIONS BY MEDPAC TO

20 THE SECRETARY AND CONGRESS.—Section 1805(b) of the 

21 Social Security Act (42 U.S.C. 1395b–6(b)), as amended 

22 by section 4, is amended by adding at the end the fol23 lowing new paragraph: 

24 ‘‘(13) Not later than 30 days after each meet25 ing of the advisory committee established under secVerDate Nov 24 2008 07:29 Jun 26, 2009 Jkt 079200 PO 00000 Frm 00047 Fmt 6652 Sfmt 6201 E:\BILLS\S1380.IS S1380

jbell on PROD1PC69 with BILLS
48 

•S 1380 IS

1 tion 1899(b), the Commission shall send a detailed 

2 letter to the Secretary and to Congress providing 

3 feedback on the following: 

4 ‘‘(A) Recommendations for demonstration 

5 projects being conducted under this title as of 

6 the date of such biannual meeting that should 

7 be expanded on a program-wide basis. 

8 ‘‘(B) Recommendations for such dem9 onstration projects that should be eliminated. 

10 ‘‘(C) Recommendations for potential 

11 changes to improve, expand, or otherwise alter 

12 such demonstration projects. 

13 ‘‘(D) Recommendations for new ideas to 

14 test through demonstration projects conducted 

15 under this title.’’. 

Æ 


jbell on PROD1PC69 with BILLS