I

107TH CONGRESS

1ST SESSION H. R. 186

To amend title XVIII of the Social Security Act to require universal product

numbers on claims forms submitted for reimbursement for durable medical equipment and other items under the Medicare Program.

IN THE HOUSE OF REPRESENTATIVES

JANUARY 3, 2001

Ms. SLAUGHTER (for herself and Mr. HOUGHTON) 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 title XVIII of the Social Security Act to require

universal product numbers on claims forms submitted

for reimbursement for durable medical equipment and

other items 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 2001’’.
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1 SEC. 2. UNIVERSAL PRODUCT NUMBERS FOR CERTAIN

2 ITEMS OF DURABLE MEDICAL EQUIPMENT

3 ON CLAIM FORMS FOR REIMBURSEMENT

4 UNDER THE MEDICARE PROGRAM.

5 (a) IN GENERAL.—Section 1842 of the Social Secu6 rity Act (42 U.S.C. 1395u) is amended by adding at the

7 end the following new subsection:

8 ‘‘(u)(1) Each request for payment, or bill submitted,

9 on or after February 1, 2004, for a covered item (as de10 fined in paragraph (3)) for which payment may be made

11 under this part shall include a universal product number

12 under the system established by the Secretary under para13 graph (4) for such covered item.

14 ‘‘(2) No payment may be made under this part on

15 or after February 1, 2004, for a covered item if the re16 quest for payment or bill submitted does not include the

17 universal product number of the covered item.

18 ‘‘(3)(A) Except as provided in subparagraph (B), for

19 purposes of this subsection, the term ‘covered item’ means

20 the following items:

21 ‘‘(i) A covered item (as defined in section

22 1834(a)(13)).

23 ‘‘(ii) An item described in paragraph (8) or (9)

24 of section 1861(s).

25 ‘‘(iii) An item described in paragraph (5) of

26 section 1861(s).
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1 ‘‘(iv) Such other items as the Secretary deter2 mines appropriate.

3 ‘‘(B) Such term does not include a customized item

4 for which payment may be made under this title.

5 ‘‘(4) The Secretary, in consultation with appropriate

6 experts, shall establish a system under which a covered

7 item under this subsection is assigned a universal product

8 number that permits the Secretary to—

9 ‘‘(A) identify the covered item;

10 ‘‘(B) develop appropriate data to adjust rates of

11 reimbursement for the covered item, as appropriate;

12 and

13 ‘‘(C) review the covered items billed under the

14 coding system established under this title and adjust

15 such coding system to ensure that functionally

16 equivalent covered items are billed and reimbursed

17 under the same codes.’’.

18 (b) ACCOMMODATION OF UPNS ON CLAIMS

19 FORMS.—Not later than February 1, 2003, any claims

20 form developed or used by the Secretary of Health and

21 Human Services for reimbursement for a covered item (as

22 that term is defined in section 1842(u)(3) of the Social

23 Security Act, as added by subsection (a)) that is furnished

24 under the medicare program under title XVIII of such Act

25 shall accommodate the use of universal product numbers.
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1 (c) REPORT.—Not later than December 31, 2004,

2 and annually thereafter through 2006, the Secretary of

3 Health and Human Services shall submit to Congress a

4 report that describes—

5 (1) the additional information made available to

6 the Secretary from the use of universal product

7 numbers on covered items furnished under part B of

8 the medicare program (as that term is defined in

9 section 1842(u)(3) of the Social Security Act, as

10 added by subsection (a));

11 (2) any change by the Secretary in reimburse12 ment rates for the covered items by reason of such

13 information; and

14 (3) the Secretary’s recommendations for addi15 tional items reimbursed under the medicare program

16 for which the use of universal product numbers is

17 appropriate.

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