I 

112TH CONGRESS 

1ST SESSION H. R. 560 

To amend titles XVIII and XIX of the Social Security Act to ensure proportional representation of rural interests on the Medicare Payment Advisory 

Commission and the Medicaid and CHIP Payment and Access Commission, and to provide for greater transparency in proceedings of those 

Commissions. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 8, 2011 

Mr. WALDEN (for himself, Mr. THOMPSON of California, Mr. ROSS of Arkansas, Mrs. MCMORRIS RODGERS, and Mr. MATHESON) 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 titles XVIII and XIX of the Social Security Act 

to ensure proportional representation of rural interests 

on the Medicare Payment Advisory Commission and the 

Medicaid and CHIP Payment and Access Commission, 

and to provide for greater transparency in proceedings 

of those Commissions. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Rural Representation 

3 and Transparency Improvement Act’’. 

4 SEC. 2. ENSURING PROPORTIONAL REPRESENTATION OF 

5 INTERESTS OF RURAL AREAS ON THE MEDI6 CARE PAYMENT ADVISORY COMMISSION 

7 (MEDPAC) AND GREATER TRANSPARENCY OF 

8 MEDPAC PROCEEDINGS. 

9 (a) RURAL REPRESENTATION.—Paragraph (2) of 

10 section 1805(c) of the Social Security Act (42 U.S.C. 

11 1395b–6(c)) is amended— 

12 (1) in subparagraph (A), by inserting ‘‘con13 sistent with subparagraph (E)’’ after ‘‘rural rep14 resentatives’’; and 

15 (2) by adding at the end the following new sub16 paragraph: 

17 ‘‘(E) PROPORTIONAL REPRESENTATION OF

18 INTERESTS OF RURAL AREAS.—In order to pro19 vide a balance between urban and rural rep20 resentatives under subparagraph (A), the pro21 portion of members of the Commission who rep22 resent the interests of health care providers and 

23 Medicare beneficiaries located in rural areas 

24 shall be no less than the proportion of the total 

25 number of Medicare beneficiaries who reside in 

26 rural areas.’’. 


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1 (b) GREATER TRANSPARENCY OF PROCEEDINGS.— 

2 Such section is further amended by adding at the end the 

3 following new paragraph: 

4 ‘‘(7) GREATER TRANSPARENCY OF PRO5 CEEDINGS.—The Commission shall provide through 

6 the Internet or such easy public access to and full 

7 and timely public disclosure of its proceedings, such 

8 as through the posting of audio or video coverage of 

9 its proceedings and of transcripts of its proceedings, 

10 as may be practicable within the resources available 

11 to the Commission.’’. 

12 (c) EFFECTIVE DATE.—The amendments made by 

13 subsection (a) shall apply to appointments to the Medicare 

14 Payment Advisory Commission made after the date of en15 actment of this Act and the amendment made by sub16 section (b) shall apply to proceedings occurring on or after 

17 the date that is 6 months after the date of the enactment 

18 of this Act. 


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1 SEC. 3. ENSURING PROPORTIONAL REPRESENTATION OF 

2 INTERESTS OF RURAL AREAS ON THE MED3 ICAID AND CHIP PAYMENT AND ACCESS COM4 MISSION (MACPAC) AND GREATER TRANS5 PARENCY OF MACPAC PROCEEDINGS. 

6 (a) RURAL REPRESENTATION.—Paragraph (2) of 

7 section 1900(c) of the Social Security Act (42 U.S.C. 

8 1396(c)) is amended— 

9 (1) in subparagraph (A), by inserting ‘‘con10 sistent with subparagraph (E)’’ after ‘‘rural rep11 resentation’’; and 

12 (2) by adding at the end the following new sub13 paragraph: 

14 ‘‘(E) PROPORTIONAL REPRESENTATION OF

15 INTERESTS OF RURAL AREAS.—In order to pro16 vide a balance between urban and rural rep17 resentation under subparagraph (A), the pro18 portion of members of MACPAC who represent 

19 the interests of health care providers and Med20 icaid beneficiaries located in rural areas shall be 

21 no less than the proportion of the total number 

22 of Medicaid beneficiaries who reside in rural 

23 areas.’’. 

24 (b) GREATER TRANSPARENCY OF PROCEEDINGS.— 

25 Such section is further amended by adding at the end the 

26 following new paragraph: 


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1 ‘‘(7) GREATER TRANSPARENCY OF PRO2 CEEDINGS.—The MACPAC shall provide through 

3 the Internet for such easy public access to and full 

4 and timely public disclosure of its proceedings, such 

5 as through the posting of audio or video coverage of 

6 its proceedings and of transcripts of its proceedings, 

7 as may be practicable within the resources available 

8 to MACPAC.’’. 

9 (c) EFFECTIVE DATE.—The amendments made by 

10 subsection (a) shall apply to appointments to the Medicaid 

11 and CHIP Payment and Access Commission made after 

12 the date of enactment of this Act and the amendment 

13 made by subsection (b) shall apply to proceedings occur14 ring on or after the date that is 6 months after the date 

15 of the enactment of this Act. 

Æ 


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