II

106TH CONGRESS

1ST SESSION S. 256

To amend title XVIII of the Social Security Act to promote the use of

universal product numbers on claims forms submitted for reimbursement

under the medicare program.

IN THE SENATE OF THE UNITED STATES

JANUARY 20, 1999

Mr. GRASSLEY (for himself, Mr. BREAUX, and Mr. CONRAD) 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 promote

the use of universal product numbers on claims forms

submitted for reimbursement 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 Universal

5 Product Number Act of 1999’’.
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1 SEC. 2. UNIVERSAL PRODUCT NUMBERS ON CLAIMS FORMS

2 FOR REIMBURSEMENT UNDER THE MEDI3 CARE PROGRAM.

4 (a) ACCOMMODATION OF UPNS ON MEDICARE

5 CLAIMS FORMS.—Not later than February 1, 2001, all

6 claims forms developed or used by the Secretary of Health

7 and Human Services for reimbursement under the medi8 care program under title XVIII of the Social Security Act

9 (42 U.S.C. 1395 et seq.) shall accommodate the use of

10 universal product numbers for a UPN covered item.

11 (b) REQUIREMENT FOR PAYMENT OF CLAIMS.—Title

12 XVIII of the Social Security Act (42 U.S.C. 1395 et seq.)

13 is amended by adding at the end the following:

14 ‘‘USE OF UNIVERSAL PRODUCT NUMBERS

15 ‘‘SEC. 1897. (a) IN GENERAL.—No payment shall be

16 made under this title for any claim for reimbursement for

17 any UPN covered item unless the claim contains the uni18 versal product number of the UPN covered item.

19 ‘‘(b) DEFINITIONS.—In this section:

20 ‘‘(1) UPN COVERED ITEM.—

21 ‘‘(A) IN GENERAL.—Except as provided in

22 subparagraph (B), the term ‘UPN covered

23 item’ means—

24 ‘‘(i) a covered item as that term is de25 fined in section 1834(a)(13);
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1 ‘‘(ii) an item described in paragraph

2 (8) or (9) of section 1861(s);

3 ‘‘(iii) an item described in paragraph

4 (5) of section 1861(s); and

5 ‘‘(iv) any other item for which pay6 ment is made under this title that the Sec7 retary determines to be appropriate.

8 ‘‘(B) EXCLUSION.—The term ‘UPN cov9 ered item’ does not include a customized item

10 for which payment is made under this title.

11 ‘‘(2) UNIVERSAL PRODUCT NUMBER.—The

12 term ‘universal product number’ means a number

13 that is—

14 ‘‘(A) affixed by the manufacturer to each

15 individual UPN covered item that uniquely

16 identifies the item at each packaging level; and

17 ‘‘(B) based on commercially acceptable

18 identification standards such as, but not limited

19 to, standards established by the Uniform Code

20 Council–International Article Numbering Sys21 tem or the Health Industry Business Commu22 nication Council.’’.

23 (c) DEVELOPMENT AND IMPLEMENTATION OF PRO24 CEDURES.—
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1 (1) INFORMATION INCLUDED IN UPN.—The

2 Secretary of Health and Human Services, in con3 sultation with manufacturers and entities with ap4 propriate expertise, shall determine the relevant de5 scriptive information appropriate for inclusion in a

6 universal product number for a UPN covered item.

7 (2) REVIEW OF PROCEDURE.—From the infor8 mation obtained by the use of universal product

9 numbers on claims for reimbursement under the

10 medicare program, the Secretary of Health and

11 Human Services, in consultation with interested par12 ties, shall periodically review the UPN covered items

13 billed under the Health Care Financing Administra14 tion Common Procedure Coding System and adjust

15 such coding system to ensure that functionally

16 equivalent UPN covered items are billed and reim17 bursed under the same codes.

18 (d) EFFECTIVE DATE.—The amendment made by

19 subsection (b) shall apply to claims for reimbursement

20 submitted on and after February 1, 2002.

21 SEC. 3. STUDY AND REPORTS TO CONGRESS.

22 (a) STUDY.—The Secretary of Health and Human

23 Services shall conduct a study on the results of the imple24 mentation of the provisions in subsections (a) and (c) of
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1 section 2 and the amendment to the Social Security Act

2 in subsection (b) of that section.

3 (b) REPORTS.—

4 (1) PROGRESS REPORT.—Not later than 6

5 months after the date of enactment of this Act, the

6 Secretary of Health and Human Services shall sub7 mit a report to Congress that contains a detailed de8 scription of the progress of the matters studied pur9 suant to subsection (a).

10 (2) IMPLEMENTATION.—Not later than 18

11 months after the date of enactment of this Act, and

12 annually thereafter for 3 years, the Secretary of

13 Health and Human Services shall submit a report to

14 Congress that contains a detailed description of the

15 results of the study conducted pursuant to sub16 section (a), together with the Secretary’s rec17 ommendations regarding the use of universal prod18 uct numbers and the use of data obtained from the

19 use of such numbers.

20 SEC. 4. DEFINITIONS.

21 In this Act:

22 (1) UPN COVERED ITEM.—The term ‘‘UPN

23 covered item’’ has the meaning given such term in

24 section 1897(b)(1) of the Social Security Act (as

25 added by section 2(b)).
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1 (2) UNIVERSAL PRODUCT NUMBER.—The term

2 ‘‘universal product number’’ has the meaning given

3 such term in section 1897(b)(2) of the Social Secu4 rity Act (as added by section 2(b)).

5 SEC. 5. AUTHORIZATION OF APPROPRIATIONS.

6 The are authorized to be appropriated such sums as

7 may be necessary for the purpose of carrying out the pro8 visions in subsections (a) and (c) of section 2, section 3,

9 and section 1897 of the Social Security Act (as added by

10 section 2(b)).

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