I 

115TH CONGRESS 

1ST SESSION H. R. 4554 

To establish a smart card pilot program to combat fraud, waste, and abuse 

and to protect beneficiary identity under the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 5, 2017 

Mr. ROSKAM (for himself, Mr. BLUMENAUER, Mr. SHIMKUS, Mrs. DINGELL, 

Mr. MEEHAN, Mr. BRENDAN F. BOYLE of Pennsylvania, Mr. COSTELLO

of Pennsylvania, Mr. CONNOLLY, Mr. BUCHANAN, and Mr. DANNY K. 

DAVIS of Illinois) introduced the following bill; which was referred to the 

Committee on Ways and Means, and in addition to the Committee on Energy and 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 smart card pilot program to combat fraud, 

waste, and abuse and to protect beneficiary identity 

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 ‘‘Medicare Common Ac5 cess Card Act of 2017’’. 


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1 SEC. 2. MEDICARE SMART CARD PILOT PROGRAM. 

2 Part E of title XVIII of the Social Security Act is 

3 amended by inserting after section 1866E the following 

4 new section: 

5 ‘‘SEC. 1866F. SMART CARD PILOT PROGRAM. 

6 ‘‘(a) IMPLEMENTATION.— 

7 ‘‘(1) IN GENERAL.—Not later than 36 months 

8 after the date of the enactment of this section, the 

9 Secretary shall establish a pilot program (in this sec10 tion referred to as the ‘pilot program’) to dem11 onstrate the feasibility of using smart card tech12 nology under this title. 

13 ‘‘(2) SMART CARD TECHNOLOGY DEFINED.—In 

14 this section, the term ‘smart card technology’ means 

15 the following: 

16 ‘‘(A) BENEFICIARY SMART CARD.—A ma17 chine readable, fraud- and tamper-resistant 

18 card (in this section referred to as a ‘smart 

19 card’) that includes an embedded integrated cir20 cuit chip with a secure micro-controller that en21 ables the verification and secure, electronic au22 thentication of the identity of a Medicare bene23 ficiary at the point of service through a com24 bination of the smart card and a personal iden25 tification number known by or associated with 

26 such beneficiary. 


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1 ‘‘(B) CARD READER TECHNOLOGY.—Infor2 mation technology that enables a supplier and 

3 provider to authenticate the identity of a Medi4 care beneficiary through presentation of such a 

5 smart card and such components, with such au6 thentication to be reflected through the use of 

7 a modifier or in another appropriate manner, as 

8 determined by the Secretary, in the claims ad9 judication process. 

10 ‘‘(3) PROGRAM DESIGN ELEMENTS.—The pilot 

11 program shall be conducted for a period of 3 years 

12 consistent with the following: 

13 ‘‘(A) SELECTION OF AREA.—In consulta14 tion with the Inspector General of the Depart15 ment of Health and Human Services, the Sec16 retary shall select at least 3 geographic areas in 

17 which the pilot program will operate. 

18 ‘‘(B) SELECTION OF SUPPLIER AND PRO19 VIDER TYPES.—In consultation with the Inspec20 tor General of the Department of Health and 

21 Human Services, the Secretary shall select sup22 plier and provider types that will be required to 

23 participate in the pilot program (referred to in 

24 this section as ‘participating suppliers and proVerDate Sep 11 2014 23:42 Dec 11, 2017 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4554.IH H4554

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1 viders’). In selecting such supplier and provider 

2 types, the Secretary shall— 

3 ‘‘(i) take into account the risk of 

4 fraud, waste, and abuse (as described in 

5 section 1886(j)(2)(B) with respect to the 

6 category of provider or supplier) and other 

7 factors as determined appropriate by the 

8 Secretary; and 

9 ‘‘(ii) limit the pilot program to no 

10 more than 2,000 suppliers and providers. 

11 ‘‘(C) SUPPLIER AND PROVIDER HARDSHIP

12 EXEMPTIONS.—The Secretary shall exempt 

13 from participation in the pilot program a sup14 plier or provider that either— 

15 ‘‘(i) does not have access to card read16 er technology (as described in paragraph 

17 (2)(B)); 

18 ‘‘(ii) does not have sufficient internet 

19 access; or 

20 ‘‘(iii) has a low volume (as determined 

21 by the Secretary) of Medicare claims for 

22 which payment is made under this title. 

23 ‘‘(D) BENEFICIARY SMART CARD

24 ISSUANCE.—The Secretary shall provide for the 

25 issuance of beneficiary smart cards described in 


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1 paragraph (2)(A) to all Medicare beneficiaries 

2 residing in a geographic area in which the pilot 

3 program is conducted under subparagraph (A). 

4 Information that appears on Medicare cards 

5 used outside the pilot program may appear on 

6 the face of the beneficiary smart card. 

7 ‘‘(E) INFORMATION ON OPERATION OF

8 PILOT PROGRAM.—The Secretary shall provide 

9 participating suppliers and providers and Medi10 care beneficiaries who are furnished items and 

11 services by such suppliers and providers, with 

12 information on the operation of the pilot pro13 gram, including privacy protections described in 

14 subparagraph (H). 

15 ‘‘(F) ACCESS TO SERVICES OUTSIDE THE

16 PILOT PROGRAM.— 

17 ‘‘(i) BENEFICIARIES.—Medicare bene18 ficiaries who receive beneficiary smart 

19 cards may receive items and services care 

20 from suppliers and providers not partici21 pating in the pilot program. 

22 ‘‘(ii) SUPPLIERS AND PROVIDERS.— 

23 Suppliers and providers not participating 

24 in the pilot program may submit claims 

25 under this title for items and services furVerDate Sep 11 2014 23:42 Dec 11, 2017 Jkt 079200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4554.IH H4554

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1 nished without use of smart card tech2 nology to Medicare beneficiaries who re3 ceive beneficiary smart cards. 

4 ‘‘(G) PRIVATE SECTOR IMPLEMENTA5 TION.—The Secretary shall select, by using a 

6 competitive procurement, a private sector con7 tractor to implement and operate the pilot pro8 gram. 

9 ‘‘(H) PRIVACY PROTECTIONS.—The Sec10 retary shall ensure that the pilot program com11 plies with applicable Federal laws, including 

12 regulations, concerning individually identifiable 

13 health information, including the Privacy Act of 

14 1974 and regulations promulgated under sec15 tion 264(c) of the Health Insurance Portability 

16 and Accountability Act of 1996 and such indi17 vidually identifiable information shall be exempt 

18 from disclosure under section 552(b)(3) of title 

19 5, United States Code. 

20 ‘‘(I) MANDATORY PARTICIPATION.—Sub21 ject to subparagraph (C), in the case of services 

22 furnished by a provider or supplier included in 

23 a supplier or provider type selected under sub24 paragraph (B) in a geographic area selected 

25 under subparagraph (A), payment may only be 


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1 made under this title for such services during 

2 the period of the pilot program if the provider 

3 or supplier is participating in the pilot program. 

4 ‘‘(4) DEFINITIONS.—In this section: 

5 ‘‘(A) The terms ‘supplier’ and ‘provider’ 

6 have the meanings given the terms ‘supplier’ 

7 and ‘provider of services’ in subsections (d) and 

8 (u), respectively, of section 1861. 

9 ‘‘(B) The term ‘Medicare beneficiary’ 

10 means an individual who is enrolled in the origi11 nal Medicare fee-for-service program under 

12 parts A and B and is not enrolled in an MA 

13 plan under part C, an eligible organization 

14 under section 1876, or a PACE program under 

15 section 1894. 

16 ‘‘(C) The term ‘Medicare claim’ means a 

17 claim for an item or service for which payment 

18 is made under this title. 

19 ‘‘(b) REPORTS TO CONGRESS.— 

20 ‘‘(1) IN GENERAL.—The Secretary shall submit 

21 to Congress the following reports: 

22 ‘‘(A) INITIAL DESIGN REPORT.—Not later 

23 than 2 years after the date of the enactment of 

24 this section, a report that outlines the plan for 

25 implementation of the pilot program. 


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1 ‘‘(B) IMPLEMENTATION REPORT.—After 

2 implementation of the pilot program, a report 

3 on the initial implementation of the pilot pro4 gram, including parameters for operation of 

5 such program. 

6 ‘‘(C) INTERIM PERFORMANCE REPORT.— 

7 Not later than 2 years after the date the pilot 

8 program is implemented, an interim report on 

9 the performance of such program. 

10 ‘‘(D) FINAL PERFORMANCE REPORT.—Not 

11 later than 18 months after the date of the com12 pletion of the pilot program, a final report on 

13 the performance of such program. 

14 ‘‘(2) CONTENTS OF CERTAIN REPORTS.—The 

15 reports under subparagraphs (C) and (D) of para16 graph (1) shall include information on the perform17 ance of the pilot program in achieving its objectives 

18 and such recommendations regarding expanding the 

19 duration and scope of such program as the Secretary 

20 determines appropriate. 

21 ‘‘(c) FUNDING.—For purposes of conducting the pilot 

22 program, the Secretary shall provide for the transfer, from 

23 the Supplemental Medical Insurance Trust Fund under 

24 section 1841, to the Centers for Medicare & Medicaid ProVerDate Sep 11 2014 23:42 Dec 11, 2017 Jkt 079200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H4554.IH H4554

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1 gram Management Account, of $150,000,000, to be avail2 able until expended.’’. 

Æ 


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