I

106TH CONGRESS

1ST SESSION H. R. 2030

To amend title XVIII of the Social Security Act to improve the process

by which the Secretary of Health and Human Services makes coverage

determinations for items and services furnished under the Medicare Program, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

JUNE 7, 1999

Mr. RAMSTAD 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 amend title XVIII of the Social Security Act to improve

the process by which the Secretary of Health and Human

Services makes coverage determinations for items and

services furnished 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; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Medicare Patient Access to Technology Act of 1999’’.
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1 (b) TABLE OF CONTENTS.—The table of contents of

2 this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Findings.

Sec. 3. Establishment of medicare advisory committees.

Sec. 4. Annual adjustments to medicare payment systems for changes in technology and medical practice.

Sec. 5. Process for making and implementing certain coding modifications.

Sec. 6. Retention of HCPCS level III codes.

3 SEC. 2. FINDINGS.

4 Congress makes the following findings:

5 (1) In order to assure genuine access of medi6 care beneficiaries to medical technologies, the Sec7 retary of Health and Human Services has an obliga8 tion to integrate and coordinate its medical tech9 nology coverage policy determination process with

10 agency policies and practices that govern assignment

11 of procedure codes, establishment and adjustment of

12 payment levels and groupings, and issuance of time13 ly instructions to contractors.

14 (2) The effectiveness of the medicare program

15 in meeting beneficiary needs is compromised if ac16 cess to state-of-the-art medical care is denied as a

17 result of ineffective agency performance in the cov18 erage, coding, or payment processes, or in the inef19 fective administrative execution of medical tech20 nology decisions.

21 (3) The Secretary of Health and Human Serv22 ices owes medicare beneficiaries the assurance that
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1 the various medicare payment systems (in both the

2 fee-for-service and managed care areas) are operated

3 in a way that reflects developments in, and improve4 ments upon, medical technology by properly setting

5 and adjusting payment levels and payment groups.

6 (4) Clear, predictable, and well-functioning cov7 erage, coding, and payment systems are particularly

8 critical to this country’s small medical technology

9 companies, which are the originators of most med10 ical product innovations.

11 (5) Unless medicare’s coverage, coding, and

12 payment systems review products promptly, apply

13 standards appropriate for medical technology, and

14 provide reasonable reimbursement levels, these com15 panies will experience difficulties in bringing the

16 benefits of medical innovation to medicare bene17 ficiaries.

18 SEC. 3. ESTABLISHMENT OF MEDICARE ADVISORY COMMIT19 TEES.

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

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

22 the end the following new section:

23 ‘‘MEDICARE ADVISORY COMMITTEES

24 ‘‘SEC. 1897. (a) ESTABLISHMENT OF MEDICARE AD25 VISORY COMMITTEES.—For the purpose of securing ad26 vice and recommendations on issues related to coverage,
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1 payment, and coding decisions, the Secretary shall estab2 lish, under section 9(a)(1) of the Federal Advisory Com3 mittee Act, the advisory committees described in this sec4 tion.

5 ‘‘(b) MEDICARE PAYMENT AND CODING ADVISORY

6 COMMITTEE.—

7 ‘‘(1) ESTABLISHMENT.—For the purpose of se8 curing advice and recommendations on payment and

9 coding issues under this title, not later than January

10 1, 2000, the Secretary shall establish the Medicare

11 Payment and Coding Advisory Committee (herein12 after in this subsection referred to as the ‘Com13 mittee’). The Secretary shall consult with the Com14 mittee, and may consult directly with any panel of

15 the Committee established pursuant to subsection

16 (d)(1).

17 ‘‘(2) DUTIES.—The Committee, and its panels,

18 shall provide advice and recommendations to the

19 Secretary on policies regarding payment and coding

20 issues under this title, including identification of—

21 ‘‘(A) policies and mechanisms to help en22 sure that payment and coding decisions are—

23 ‘‘(i) made in a way that encourages

24 access to high-quality medical care under

25 this title;
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1 ‘‘(ii) made through processes that

2 allow for significant public participation;

3 and

4 ‘‘(iii) made expeditiously, in accord5 ance with specified time frames for each

6 significant step in the process of making

7 such decisions;

8 ‘‘(B) an equitable mechanism for deter9 mining fee schedule payment amounts for items

10 and services (other than physicians’ services);

11 and

12 ‘‘(C) processes for reconsideration and ap13 peal of determinations of fee schedule payment

14 amounts.

15 ‘‘(3) REPORT.—

16 ‘‘(A) ANNUAL REPORT TO THE SEC17 RETARY.—Not later than December 1 of each

18 of fiscal years 2000 through 2003, the Com19 mittee shall submit to the Secretary a report on

20 the progress of the Committee progress during

21 the preceding fiscal year, in carrying out the

22 duties under paragraph (2).

23 ‘‘(B) PUBLICATION OF REPORT.—Not later

24 than 60 days after receipt of the report under

25 subparagraph (A), the Secretary shall publish
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1 the report, together with any supplemental

2 views of the Secretary, on the Internet site of

3 the Department of Health and Human Services.

4 ‘‘(4) TERMINATION.—The Committee shall ter5 minate on September 30, 2003.

6 ‘‘(c) ADVISORY COMMITTEE ON MEDICARE ACCESS

7 TO TECHNOLOGY.—

8 ‘‘(1) ESTABLISHMENT.—Not later than July 1,

9 2003, the Secretary shall establish the Medicare Ac10 cess to Technology Advisory Committee (hereinafter

11 in this subsection referred to as the ‘Committee’).

12 The Secretary shall consult with the Committee, and

13 may consult directly with any panel of the Com14 mittee established pursuant to subsection (d)(1).

15 ‘‘(2) DUTIES.—The Committee, and its panels,

16 shall provide advice and recommendations to the

17 Secretary with respect to—

18 ‘‘(A) the issues referred to the Medicare

19 Coverage Advisory Committee (established by

20 the Secretary on November 24, 1998, notice of

21 which was printed in the Federal Register on

22 December 14, 1998, (63 FR 68780));

23 ‘‘(B) the issues referred to the Medicare

24 Payment and Coding Advisory Committee

25 under subsection (b); and
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1 ‘‘(C) integrating policies on coverage, pay2 ment, and coding under this title into a process

3 that helps to assure timely access to high-qual4 ity medical care.

5 ‘‘(3) REPORT.—

6 ‘‘(A) ANNUAL REPORT TO THE SEC7 RETARY.—Not later than December 1 of every

8 year beginning with 2004, the Committee shall

9 submit to the Secretary a report on the

10 progress of the Committee during the preceding

11 fiscal year, in accomplishing the duty described

12 in paragraph (2)(C).

13 ‘‘(B) PUBLICATION OF REPORT.—Not later

14 than 60 days after receipt of the report under

15 subparagraph (A), the Secretary shall publish

16 the report, together with any supplemental

17 views of the Secretary, on the Internet site of

18 the Department of Health and Human Services.

19 ‘‘(4) DURATION.—Section 14(a)(2)(B) of the

20 Federal Advisory Committee Act (5 U.S.C. App.; re21 lating to the termination of advisory committees)

22 shall not apply to the Committee.

23 ‘‘(d) ADVISORY COMMITTEE PROCEDURES.—In ad24 ministering each of the advisory committees under this

25 section, the Secretary shall—
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1 ‘‘(1) organize each advisory committee into pan2 els of experts according to types of items or services;

3 ‘‘(2) solicit nominations as needed from the

4 public by publishing a notice in the Federal Register

5 and on the Internet site of the Department of

6 Health and Human Services;

7 ‘‘(3) ensure participation on each advisory com8 mittee of persons who—

9 ‘‘(A) are experts in a variety of medical

10 specialties and fields of science, in specific areas

11 of medical technology (such as clinical and di12 agnostic tests and durable medical equipment),

13 in medical research generally (such as the study

14 of treatment outcomes), and in other areas rel15 evant to the duties assigned to the advisory

16 committee (taking into account, as appropriate,

17 any affiliations individuals may have with orga18 nizations possessing information, expertise, and

19 other resources that would contribute signifi20 cantly to the work of the advisory committee

21 and its panels);

22 ‘‘(B) are qualified by training and experi23 ence to evaluate the matters referred to the ad24 visory committee (including, on each panel, a

25 representative of consumer interests and a rep-
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1 resentative of the interests of manufacturers of

2 medical technology); and

3 ‘‘(C) have adequately diversified back4 grounds so that the advisory committee will

5 provide balanced advice and recommendations;

6 ‘‘(4) exclude from membership on each advisory

7 committee individuals who are in the full time em8 ploy of the United States and engaged in the admin9 istration of the program established under this title;

10 ‘‘(5) limit the number of members of each advi11 sory committee who are otherwise in the full-time

12 employ of the United States to not more than 10

13 percent of the total membership of the advisory com14 mittee;

15 ‘‘(6) impose appropriate term limits for mem16 bers of each advisory committee;

17 ‘‘(7) designate one of the members of each

18 panel to serve as the chair thereof and appoint an

19 executive subcommittee comprised of the chairs of

20 each panel to advise the Secretary regarding—

21 ‘‘(A) establishing priorities; and

22 ‘‘(B) referring issues to appropriate panels;

23 ‘‘(8) permit each panel to independently advise

24 the Secretary with regard to matters referred to the
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1 panel, without the need to obtain the concurrence

2 of the full advisory committee;

3 ‘‘(9) provide for appropriate consultation with

4 outside experts by each advisory committee and its

5 panels;

6 ‘‘(10) provide for—

7 ‘‘(A) full public participation, to the extent

8 required or permitted under law, in any meet9 ing of each advisory committee or its panels;

10 ‘‘(B) at least 60 days’ advance notice on

11 the Internet site of the Department of Health

12 and Human Services of any such meeting, in13 cluding a statement of the issues to be consid14 ered by the advisory committee or panel, a de15 scription of the specific information that is rel16 evant to such issues, and the text of any pro17 posals the Secretary will ask the advisory com18 mittee or panel to consider;

19 ‘‘(C) consideration by each advisory com20 mittee or panel of relevant information or testi21 mony that is submitted by the public; and

22 ‘‘(D) public access in a central repository

23 to the information described in subparagraph

24 (C) at least 20 days before the meeting;
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1 ‘‘(11) furnish each advisory committee and its

2 panels with adequate clerical and other necessary as3 sistance;

4 ‘‘(12) provide for the compensation of members

5 of each advisory committee and its panels (other

6 than those in the full time employ of the United

7 States)—

8 ‘‘(A) while attending meetings or otherwise

9 engaged in official business at rates to be fixed

10 by the Secretary, but not at rates exceeding the

11 daily equivalent of the rate in effect for level IV

12 of the Executive Schedule for each day so en13 gaged, including travel time; and

14 ‘‘(B) while serving away from their homes

15 or regular places of business, of travel expenses

16 (including per diem in lieu of subsistence) as

17 authorized by section 5703 of Title 5, United

18 States Code, for persons in the Government

19 service employed intermittently;

20 ‘‘(13) provide for the panels to meet at least

21 once every 3 months unless there is no business to

22 conduct;

23 ‘‘(14) require each advisory committee and its

24 panels to provide, with any recommendation, a sum25 mary of the reasons for the recommendation and a
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1 summary of the data upon which the recommenda2 tion is based;

3 ‘‘(15) make a verbatim transcript of each advi4 sory committee and panel proceedings (other than

5 those portions that are closed to the public in ac6 cordance with law) available to the public within 14

7 days on an official Internet site of the Department

8 of Health and Human Services; and

9 ‘‘(16) prescribe in regulations the procedures to

10 be followed by each advisory committee and its pan11 els in making their reviews and recommendations.

12 ‘‘(e) DEFINITIONS.—For purposes of this section—

13 ‘‘(1) the term ‘coding’ means the assignment of

14 identification codes for medical equipment and sup15 plies, items, services, and other benefits under this

16 title; and

17 ‘‘(2) the term ‘payment’ means the determina18 tion of appropriate payment amounts for medical

19 equipment and supplies, items, services, and other

20 benefits under this title.’’.

21 (b) TRANSITION, CONTINUING RESPONSIBILITY FOR

22 UNFINISHED DUTIES.—

23 (1) Effective on the date the Medicare Access

24 to Technology Advisory Committee is established,

25 the Secretary of Health and Human Services shall
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1 provide for the transfer to such committee of any as2 sets and staff of the Medicare Coverage Advisory

3 Committee and the Medicare Payment and Coding

4 Advisory Committee, without any loss of benefits or

5 seniority by virtue of such transfers. Fund balances

6 available to the Medicare Coverage Advisory Com7 mittee or the Medicare Payment and Coding Advi8 sory Committee for any period shall be available to

9 the Medicare Access to Technology Advisory Com10 mittee for such period for like purposes.

11 (2) The Medicare Access to Technology Advi12 sory Committee shall be responsible for the prepara13 tion and submission of reports and recommendations

14 not yet submitted to the Secretary by the Medicare

15 Coverage Advisory Committee or the Medicare Pay16 ment and Coding Advisory Committee upon the expi17 ration of those committees.

18 (c) REPORTING REQUIREMENTS.—

19 (1) Not later than April 1, 2000, the Secretary

20 of Health and Human Services shall submit to Con21 gress a report certifying that the committee and

22 panels required to be established by section 1897(b),

23 as added by subsection (a), are operational.

24 (2) Not later than September 1, 2003, the Sec25 retary of Health and Human Services shall submit
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1 to Congress a report certifying that the committee

2 and panels required to be established by section

3 1897(c), as added by subsection (a), are operational.

4 (3) Not later than December 1 of each year be5 ginning with 2000, the Secretary of Health and

6 Human Services shall submit to Congress a report

7 describing the timeliness of the Secretary’s national

8 coverage policy decision making during the preceding

9 fiscal year measured by the time frames the Sec10 retary has published for the national coverage policy

11 determination process, and such report shall include

12 the actual time periods that were necessary to com13 plete and fully implement national coverage policy

14 determinations and each significant step in the proc15 ess.

16 (4) Not later than July 1, 2000, the Secretary

17 of Health and Human Services shall submit to Con18 gress a report, on the nature of the coverage policy

19 determination processes used by Medicare+Choice

20 organizations, under part C of title XVIII of the So21 cial Security Act, including a detailed explanation of

22 any steps taken to ensure that the coverage policy

23 determination processes under the Medicare+Choice

24 program—
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1 (A) produce results consistent with the

2 coverage policy determinations reached under

3 parts A and B of such title; and

4 (B) treat any medical device being inves5 tigated under section 520(g) of the Federal

6 Food, Drug, and Cosmetic Act (42 U.S.C.

7 360j(g)), in a manner consistent with the treat8 ment afforded such medical device under such

9 parts.

10 SEC. 4. ANNUAL ADJUSTMENTS TO MEDICARE PAYMENT

11 SYSTEMS FOR CHANGES IN TECHNOLOGY

12 AND MEDICAL PRACTICE.

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

14 Act (42 U.S.C. 1395 et seq.) is amended by inserting after

15 section 1888 the following new section:

16 ‘‘ANNUAL ADJUSTMENTS TO MEDICARE PAYMENT SYS17 TEMS FOR CHANGES IN TECHNOLOGY AND MEDICAL

18 PRACTICE

19 ‘‘SEC. 1889. (a) IN GENERAL.—Notwithstanding any

20 other provision of this title, the Secretary shall adjust the

21 appropriate elements of the payment systems established

22 under sections 1833(i)(2)(A), 1833(t), 1848, and 1886(d),

23 and the payment systems referred to in subsection (f), (in24 cluding relative payment weights, relative value units, and

25 weighting factors) at least annually to ensure that pay26 ments under such systems—
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1 ‘‘(1) appropriately reflect changes in medical

2 technology and medical practice affecting the items

3 and services for which payment may be made under

4 such systems; and

5 ‘‘(2) promote the efficient and effective delivery

6 of high-quality health care.

7 ‘‘(b) RULES FOR DETERMINING ADJUSTMENTS.—

8 Except as provided in subsection (c), the provisions of sec9 tion 1833(i)(2)(A), section 1833(t)(6), section

10 1848(c)(2)(B), and section 1886(d)(4)(C), and the appro11 priate provisions of the payments systems referred to in

12 subsection (f), shall apply to the annual adjustments re13 quired by this section in the same manner and to the same

14 extent as they apply to the periodic adjustments of relative

15 payment weights, relative value units, and weighting fac16 tors, respectively, that are authorized or required by such

17 sections.

18 ‘‘(c) USE OF INTERNAL DATA COLLECTED BY THE

19 SECRETARY.—

20 ‘‘(1) IN GENERAL.—In determining the adjust21 ments required by this subsection, the Secretary

22 may not—

23 ‘‘(A) decline to make an adjustment that is

24 based on data collected by the Secretary in the

25 administration of the program established
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1 under this title if the data reflect a representa2 tive sample of cases that is statistically valid;

3 and

4 ‘‘(B) establish a uniform period of time

5 (such as one year) from which such data must

6 be drawn.

7 ‘‘(2) DEADLINE FOR SUPPLYING INTERNAL

8 DATA.—The Secretary shall establish a reasonable

9 deadline for the submission of data collected by the

10 Secretary to be used in making the adjustments re11 quired by this section. In no event may the deadline

12 established under this paragraph be more than 7

13 months before the first day of the provider payment

14 update period for which the adjustment or adjust15 ments to which the data relates would be effective.

16 ‘‘(d) USE OF EXTERNAL DATA.—

17 ‘‘(1) IN GENERAL.—Subject to paragraph (2),

18 in determining the adjustments required by this sec19 tion, the Secretary shall utilize data other than data

20 collected by the Secretary in the administration of

21 the program established under this title if—

22 ‘‘(A) data collected by the Secretary in the

23 administration of such program are not avail24 able at the time such adjustments are being de25 termined; and
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1 ‘‘(B) such other data are reliable and

2 verifiable.

3 ‘‘(2) EXTERNAL DATA FACILITATING THE USE

4 OF INTERNAL DATA.—In determining the adjust5 ments required by this section, the Secretary may

6 not—

7 ‘‘(A) decline to use data other than data

8 collected by the Secretary if such other data—

9 ‘‘(i) enable the Secretary to identify or

10 refine data collected by the Secretary for

11 use in making such an adjustment; and

12 ‘‘(ii) are based on a representative

13 sample of cases that is statistically valid;

14 or

15 ‘‘(B) establish a uniform period of time

16 (such as one year) from which such data must

17 be drawn.

18 ‘‘(3) ALTERNATIVE SOURCES OF DATA.—In de19 termining the adjustments required by this section,

20 the Secretary shall use data, that otherwise meets

21 the requirements of this subsection, collected by (or

22 on behalf of)—

23 ‘‘(A) private payers;

24 ‘‘(B) manufacturers of medical tech25 nologies;
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1 ‘‘(C) suppliers;

2 ‘‘(D) groups representing physicians and

3 other health care professionals;

4 ‘‘(E) groups representing providers;

5 ‘‘(F) clinical trials; and

6 ‘‘(G) such other sources as the Secretary

7 determines to be appropriate.

8 ‘‘(4) CLARIFICATION.—Nothing in this title

9 shall be construed as—

10 ‘‘(A) requiring the Secretary to identify all

11 claims submitted under a payment system es12 tablished under section 1833(i)(2)(A), section

13 1833(t), section 1848, or section 1886(d), or

14 under the payment systems referred to in sub15 section (f), involving the use of a medical tech16 nology before the Secretary may make the ad17 justments under this section (or under section

18 1833(i)(2)(A), section 1833(t), section 1848, or

19 section 1886(d), or under the appropriate sec20 tions with respect to the payment systems re21 ferred to in subsection (f)) with respect to such

22 technology; or

23 ‘‘(B) authorizing the Secretary to defer ac24 tion on such an adjustment until all such claims

25 are identifiable.
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1 ‘‘(5) DEADLINE FOR SUPPLYING EXTERNAL

2 DATA.—The Secretary shall establish a reasonable

3 deadline for the submission of data other than data

4 collected by the Secretary to be used in making the

5 adjustments required by this section. In no event

6 may the deadline established under this paragraph

7 be more than 9 months before the first day of the

8 provider payment update period for which the ad9 justment or adjustments to which the data relates

10 would be effective.

11 ‘‘(e) TIMING OF ADJUSTMENTS.—

12 ‘‘(1) IN GENERAL.—The annual adjustments

13 required by this section shall—

14 ‘‘(A) apply to provider payment update pe15 riods beginning on or after October 1, 2000;

16 and

17 ‘‘(B) be described in the proposed and

18 final rules published by the Secretary with re19 spect to changes to a payment system estab20 lished under section 1833(i)(2)(A), 1833(t),

21 1848, or 1886(d), or a payment system referred

22 to in subsection (f), for the provider payment

23 update period to which they relate, together

24 with a description of the data on which such

25 adjustments are based.
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1 ‘‘(2) DEFINITION.—For purposes of this sec2 tion, the term ‘provider payment update period’

3 means—

4 ‘‘(A) in the case of the payment systems

5 established under section 1833(t) and section

6 1848, a calendar year;

7 ‘‘(B) in the case the payment systems es8 tablished under section 1833(i)(2)(A) and sec9 tion 1886(d), a fiscal year beginning on October

10 1; and

11 ‘‘(C) in the case of a payment system re12 ferred to in subsection (f), such calendar year

13 or such fiscal year, as determined by the Sec14 retary.

15 ‘‘(f) ANNUAL UPDATES FOR OTHER MEDICARE PAY16 MENT SYSTEMS.—The provisions of subsection (a) shall

17 apply to payment systems established under this title

18 (other than those specified in subsection (a)) in the same

19 manner as they apply to the payment systems specified

20 in such subsection.’’.

21 (b) CONFORMING AMENDMENTS.—

22 (1) AMBULATORY SURGICAL CENTERS.—Section

23 1833(i)(2)(A) of the Social Security Act (42 U.S.C.

24 1395l(i)(2)(A)) is amended by striking ‘‘Each’’ in
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1 the second sentence thereof and inserting ‘‘Subject

2 to section 1889, each’’.

3 (2) OUTPATIENT HOSPITAL PROSPECTIVE PAY4 MENT SYSTEM.—Section 1833(t)(6)(A) of such Act

5 (42 U.S.C. 1395l(t)(6)(A)) is amended by striking

6 ‘‘The’’ and inserting ‘‘Subject to section 1889, the’’.

7 (3) PHYSICIAN PAYMENT.—Section

8 1848(c)(2)(B)(i) of such Act (42 U.S.C. 1395w9 4(c)(2)(B)(i)) is amended by striking ‘‘The’’ and in10 serting ‘‘Subject to section 1889, the’’.

11 (4) INPATIENT HOSPITAL PROSPECTIVE PAY12 MENT SYSTEM.—Section 1886(d)(4)(C)(i) of such

13 Act (42 U.S.C. 1395ww(d)(4)(C)(i)) is amended by

14 striking ‘‘The’’ and inserting ‘‘Subject to section

15 1889, the’’.

16 SEC. 5. PROCESS FOR MAKING AND IMPLEMENTING CER17 TAIN CODING MODIFICATIONS.

18 (a) IN GENERAL.—Notwithstanding any other provi19 sion of title XVIII of the Social Security Act (42 U.S.C.

20 1395 et seq.), the Secretary of Health and Human Serv21 ices shall—

22 (1) accept recommendations for HCPCS level II

23 code modifications from the public throughout the

24 year;
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1 (2) cause determinations on recommendations

2 received during the three months immediately pre3 ceding the last month of a calendar quarter to be

4 made not later than the first day of the following

5 calendar quarter; and

6 (3) incorporate approved modifications to

7 HCPCS level II codes into the payment systems es8 tablished under such title (including the medicare

9 fee schedule data base) not later than 180 days after

10 the date on which the determination approving a

11 modification was made.

12 (b) ELIMINATION OF REQUIREMENT FOR MAR13 KETING EXPERIENCE.—Notwithstanding any other provi14 sion of title XVIII of the Social Security Act, the Sec15 retary of Health and Human Services may not require a

16 minimum period of marketing experience with respect to

17 a drug or device as a condition of consideration or ap18 proval of a recommendation for a HCPCS level II modi19 fication for such drug or device.

20 (c) DEFINITION.—For purposes of this section, the

21 term ‘‘HCPCS level II code modification’’ means any

22 change to the alpha-numeric codes for items not included

23 in level I or level III of the Health Care Financing Admin24 istration Common Procedure Coding System (HCPCS).
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1 (d) REPORT.—Not later than 180 days after the date

2 of the enactment of this Act, the Secretary of Health and

3 Human Services shall submit to Congress a report on the

4 feasibility and desirability of opening meetings of the

5 Alpha-Numeric Editorial Panel of the Department of

6 Health and Human Services to the public. If the Secretary

7 determines that opening such meetings to the public is not

8 feasible or desirable, the Secretary shall include in the re9 port a detailed explanation of the reasons for such deter10 mination.

11 (e) EFFECTIVE DATE.—The provisions of this section

12 take effect on January 1, 2000.

13 SEC. 6. RETENTION OF HCPCS LEVEL III CODES.

14 (a) IN GENERAL.—The Secretary of Health and

15 Human Services shall maintain and continue the use of

16 HCPCS level III codes (as in effect on June 1, 1999),

17 and shall make such codes available to the public.

18 (b) DEFINITION.—For purposes of this section, the

19 term ‘‘HCPCS Level III codes’’ means the alpha-numeric

20 codes for local use under the Health Care Financing Ad21 ministration Common Procedure Coding System

22 (HCPCS).

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