I

106TH CONGRESS

1ST SESSION H. R. 1544

To require the Secretary of Health and Human Services to establish a

demonstration project to provide Medicare beneficiaries greater information with respect to various courses of treatment for certain diseases

or injuries to enable the beneficiaries to make more informed decisions

when selecting a course of treatment for the disease or injury.

IN THE HOUSE OF REPRESENTATIVES

APRIL 22, 1999

Mr. STARK introduced the following bill; which was referred to the Committee

on Ways and Means, and in addition to the Committee on 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 require the Secretary of Health and Human Services

to establish a demonstration project to provide Medicare

beneficiaries greater information with respect to various

courses of treatment for certain diseases or injuries to

enable the beneficiaries to make more informed decisions

when selecting a course of treatment for the disease

or injury.

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. DEMONSTRATION PROJECTS TO INCREASE

2 QUALITY OF INFORMATION PROVIDED TO

3 MEDICARE BENEFICIARIES WITH RESPECT

4 TO TREATMENT OPTIONS.

5 (a) ESTABLISHMENT OF PROJECT.—

6 (1) IN GENERAL.—Not later than January 1,

7 2001, the Secretary of Health and Human Services

8 shall establish demonstration projects (in this sec9 tion referred to as the ‘‘projects’’) under which the

10 Secretary shall furnish to providers of services and

11 physicians participating in the Medicare Program

12 under title XVIII of the Social Security Act informa13 tional videotapes (as described in subsection (b)) to

14 present to a Medicare beneficiary diagnosed with a

15 particular disease or injury (as identified by the Sec16 retary pursuant to subsection (c)) before the bene17 ficiary elects a course of treatment for that disease

18 or injury. The Secretary shall furnish such informa19 tional videotapes at no cost to such providers and

20 physicians.

21 (2) PROJECT AREAS.—The projects shall be

22 conducted in five separate counties of which 3 shall

23 be in urban areas and 2 shall be in rural areas.

24 (b) INFORMATIONAL VIDEOTAPE DESCRIBED.—

25 (1) IN GENERAL.—The Institute of Medicine, in

26 consultation with the National Institutes of Health
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1 and other medical experts (as determined by the

2 Secretary), shall develop a videotape presentation to

3 provide a Medicare beneficiary diagnosed as having

4 the disease or injury identified under subsection (c)

5 with the following information:

6 (A) A description of the disease or injury.

7 (B) The possible courses of treatment for

8 the disease or injury.

9 (C) The likely consequences of each such

10 course of treatment or of the decision not to

11 pursue any course of treatment.

12 (2) CONCLUDING STATEMENT.—Any such vid13 eotape presentation shall conclude with a statement

14 that the Medicare beneficiary may elect any course

15 of treatment or not to pursue any course of treat16 ment, that the Medicare beneficiary should consult

17 with a physician, and that the Medicare beneficiary

18 may seek a referral to a physician who furnishes

19 services consisting of the course of treatment that

20 the beneficiary elects.

21 (3) UPDATING OF VIDEOTAPE.—Any such vid22 eotape presentation shall be updated to reflect new

23 findings based on the best scientific evidence avail24 able, as determined by the Institute of Medicine, in

25 consultation with the National Institutes of Health
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1 and such other medical experts, about the disease or

2 injury, and various courses of treatment.

3 (c) SELECTION OF DISEASE OR INJURY.—

4 (1) IN GENERAL.—For purposes of selecting a

5 particular disease or injury for which a informa6 tional videotape shall be provided under the projects,

7 the Secretary shall identify diseases or injuries for

8 which there is a wide variation in treatment of that

9 disease throughout the United States.

10 (2) MANDATORY DESIGNATION OF PROSTATE

11 ENLARGEMENT FOR ONE PROJECT.—The disease or

12 injury for which a informational videotape is pro13 vided in one of the projects conducted under this

14 section shall be benign and malignant prostate en15 largement.

16 (d) PAYMENT.—(1) The Secretary shall establish a

17 payment amount to be made to a provider of services or

18 a physician under title XVIII of the Social Security Act

19 to reflect services consisting of the presentation of a infor20 mational videotape to and consultation with a Medicare

21 beneficiary after such presentation.

22 (2) For purposes of the payment amount under para23 graph (1), no payment may be made for the purchase or

24 rental of equipment or office space for purposes of making

25 such presentation.
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1 (e) WAIVER AUTHORITY.—The Secretary may waive

2 such requirements of title XVIII of such Act as may be

3 necessary for the purposes of carrying out the project.

4 (f) REPORTS.—Not later than June 1, 2004, the Sec5 retary shall submit to Congress a report on the following

6 matters:

7 (1) A description of courses of treatment for

8 the diseases or illnesses identified under subsection

9 (c) selected by Medicare beneficiaries during the

10 three year period ending on December 31, 2003.

11 (2) A comparison between courses of treatment

12 described in paragraph (1) and courses of treatment

13 selected by the Medicare beneficiaries participating

14 in the project.

15 (3) An analysis of the effect on costs to the

16 Medicare program due to any change in selection of

17 courses of treatment.

18 (g) DURATION.—A demonstration project under this

19 section shall be conducted for a 3-year period.

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