II 

113TH CONGRESS 

2D SESSION S. 2586 

To establish a smart card pilot program under the Medicare program. 

IN THE SENATE OF THE UNITED STATES 

JULY 10, 2014 

Mr. KIRK (for himself and Mr. RUBIO) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

To establish a smart card pilot program 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 Common Ac5 cess Card Act of 2014’’. 

6 SEC. 2. SECURE MEDICARE CARD PILOT PROGRAM. 

7 (a) PILOT PROGRAM IMPLEMENTATION (PHASE I).— 

8 (1) IN GENERAL.—Not later than 18 months 

9 after the date of the enactment of this Act, the Sec10 retary shall conduct a pilot program under title 

11 XVIII of the Social Security Act for the purpose of 


tjames on DSK5VPTVN1PROD with BILLS
2 

•S 2586 IS

1 utilizing smart card technology for Medicare bene2 ficiary and provider identification cards in order 

3 to— 

4 (A) increase the quality of care furnished 

5 to Medicare beneficiaries; 

6 (B) improve the accuracy and efficiency in 

7 the billing for Medicare items and services fur8 nished by Medicare providers; 

9 (C) reduce the potential for identity theft 

10 and other unlawful use of Medicare beneficiary 

11 and provider identifying information; and 

12 (D) reduce waste, fraud, and abuse in the 

13 Medicare program. 

14 (2) SITE REQUIREMENTS.—The Secretary shall 

15 conduct the pilot program in at least 5 geographic 

16 areas in which the Secretary determines there is a 

17 high risk for waste, fraud, or abuse. 

18 (3) DESIGN OF PILOT PROGRAM.—In designing 

19 the pilot program, the Secretary shall provide for the 

20 following: 

21 (A) Implementation of a system that uti22 lizes a smart card as a Medicare identification 

23 card for Medicare beneficiaries and Medicare 

24 providers. Such a card shall contain appropriate 

25 security features and protect personal privacy. 


tjames on DSK5VPTVN1PROD with BILLS
3 

•S 2586 IS

1 (B) Issuance of a new smart card to all 

2 Medicare beneficiaries participating in the pilot 

3 program. Such card shall not have the Social 

4 Security number printed on the front but, in5 stead shall have such number stored securely on 

6 the smart card chip along with other informa7 tion the Secretary deems necessary. 

8 (C) Issuance of a new provider card to all 

9 Medicare providers participating in the pilot 

10 program. Such card shall include a photograph 

11 of the provider and shall not have the Medicare 

12 provider number printed on the front of the 

13 card but, instead shall have such number stored 

14 securely on the smart card chip along with 

15 other information the Secretary deems nec16 essary. 

17 (D) A process for enrollment of all Medi18 care providers that includes— 

19 (i) identity and certification 

20 verification; and 

21 (ii) utilization of biometric data, such 

22 as fingerprints, for provider identification 

23 and authentication. 

24 (E) A process under which the cards 

25 issued under subparagraphs (B) and (C) are 


tjames on DSK5VPTVN1PROD with BILLS
4 

•S 2586 IS

1 used by both Medicare beneficiaries and Medi2 care providers to verify eligibility, prevent 

3 fraud, and authorize transactions. 

4 (F) Distribution of necessary equipment, 

5 including cards, card readers, kiosks, biometric 

6 readers, and other materials or documents to 

7 Medicare beneficiaries and providers at no cost 

8 to them. 

9 (G) Regular monitoring and review by the 

10 Secretary of Medicare providers’ Medicare bil11 lings and Medicare beneficiaries’ Medicare 

12 records in order to identify and address inac13 curate charges and instances of waste, fraud, or 

14 abuse. 

15 (H) Reporting mechanisms for measuring 

16 the cost savings to the Medicare program by 

17 reason of the pilot program. 

18 (I) Include provisions— 

19 (i) to ensure that all devices and sys20 tems utilized as part of the pilot program 

21 comply with standards for identity creden22 tials and biometric data developed by the 

23 American National Standards Institute 

24 and the National Institute of Standards 

25 and Technology and Federal requirements 


tjames on DSK5VPTVN1PROD with BILLS
5 

•S 2586 IS

1 relating to interoperability and information 

2 security, including all requirements under 

3 the Health Insurance Portability and Ac4 countability Act of 1996; 

5 (ii) to ensure that a Medicare bene6 ficiary’s and provider’s personal identi7 fying, health, and other information is pro8 tected from unauthorized access or disclo9 sure through the use of at least two-factor 

10 authentication; 

11 (iii) for the development of procedures 

12 and guidelines for the use of identification 

13 cards, card readers, kiosks, biometric data 

14 and readers, and other equipment to verify 

15 a Medicare beneficiary’s identity and eligi16 bility for services; 

17 (iv) to ensure that each Medicare ben18 eficiary and provider participating in the 

19 pilot program is informed of— 

20 (I) the purpose of the program; 

21 (II) the processes for capturing, 

22 enrolling, and verifying their eligibility 

23 and, with respect to providers, their 

24 biometric data; 


tjames on DSK5VPTVN1PROD with BILLS
6 

•S 2586 IS

1 (III) the manner in which the bi2 ometric data for providers will be 

3 used; and 

4 (IV) the steps that will be taken 

5 to protect personal identifying, health, 

6 and other information from unauthor7 ized access and disclosure; 

8 (v) for addressing problems related to 

9 the loss, theft, or malfunction of or dam10 age to equipment and any identifying docu11 ments or materials provided by the Sec12 retary; 

13 (vi) for development of a hotline, Web 

14 site, or other means by which Medicare 

15 beneficiaries and providers can contact the 

16 Secretary for assistance; and 

17 (vii) for addressing problems related 

18 to accessing care outside the pilot area and 

19 cases where the individual faces issues re20 lated to physical or other capacity limita21 tions. 

22 (4) PRIVACY.—Information on the smart card 

23 shall only be disclosed if the disclosure of such infor24 mation is permitted under the Federal regulations 

25 (concerning the privacy of individually identifiable 


tjames on DSK5VPTVN1PROD with BILLS
7 

•S 2586 IS

1 health information) promulgated under section 

2 264(c) of the Health Insurance Portability and Ac3 countability Act of 1996. 

4 (5) DISCLOSURE EXEMPTION.—Information on 

5 the smart card shall be exempt from disclosure 

6 under section 552(b)(3) of title 5, United States 

7 Code. 

8 (b) EXPANDED IMPLEMENTATION (PHASE II).— 

9 Taking into account the interim report under subsection 

10 (d)(2) the Secretary shall, through rulemaking, expand 

11 the duration and the scope of the pilot program, to the 

12 extent determined appropriate by the Secretary. 

13 (c) WAIVER AUTHORITY.—The Secretary may waive 

14 such provisions of titles XI and XVIII of the Social Secu15 rity Act as the Secretary determines to be appropriate for 

16 the conduct of the pilot program. 

17 (d) REPORTS TO CONGRESS.— 

18 (1) PLAN.—Not later than 6 months after the 

19 date of the enactment of this Act, the Secretary 

20 shall submit to Congress a report that contains a de21 scription of the design and development of the pilot 

22 program, including the Secretary’s plan for imple23 mentation. 

24 (2) INTERIM REPORT.—Not later than 1 year 

25 after the pilot program is first implemented, the 


tjames on DSK5VPTVN1PROD with BILLS
8 

•S 2586 IS

1 Secretary shall conduct an evaluation of the pilot 

2 program and submit an interim report to Congress. 

3 Such an evaluation shall include an initial analysis 

4 of the deployment of the program, the usability of 

5 the card system, and the measures taken to protect 

6 beneficiary and provider information. 

7 (3) ADDITIONAL REPORT.—Not later than 2 

8 years after the date that the pilot program is first 

9 implemented, the Secretary shall submit to Congress 

10 a report on the pilot program. Such report shall con11 tain a detailed description of issues related to the ex12 pansion of the program under subsection (b) and 

13 recommendations for such legislation and adminis14 trative actions as the Secretary considers appro15 priate for implementation of the program on a na16 tionwide basis. 

17 (e) FUNDING.—There are appropriated, from 

18 amounts in the Treasury not otherwise appropriated, 

19 $29,000,000 for the design, implementation, and evalua20 tion of the pilot program. Amounts appropriated under the 

21 preceding sentence shall remain available until expended. 

22 (f) DEFINITIONS.—In this section: 

23 (1) MEDICARE BENEFICIARY.—The term 

24 ‘‘Medicare beneficiary’’ means an individual entitled 

25 to, or enrolled for, benefits under part A of title 


tjames on DSK5VPTVN1PROD with BILLS
9 

•S 2586 IS

1 XVIII of the Social Security Act or enrolled for ben2 efits under part B of such title. 

3 (2) MEDICARE PROGRAM.—The term ‘‘Medicare 

4 program’’ means the health benefits program under 

5 title XVIII of the Social Security Act. 

6 (3) MEDICARE PROVIDER.—The term ‘‘Medi7 care provider’’ means a provider of services (as de8 fined in subsection (u) of section 1861 of the Social 

9 Security Act (42 U.S.C. 1395x)) and a supplier (as 

10 defined in subsection (d) of such section), including 

11 a supplier of durable medical equipment and sup12 plies. 

13 (4) PILOT PROGRAM.—The term ‘‘pilot pro14 gram’’ means the pilot program conducted under 

15 this section. 

16 (5) SECRETARY.—The term ‘‘Secretary’’ means 

17 the Secretary of Health and Human Services. 

18 (6) SMART CARD.—The term ‘‘smart card’’ 

19 means a secure, electronic, machine readable, fraud20 resistant, tamper-resistant card that includes an em21 bedded integrated circuit chip with a secure micro22 controller. 


tjames on DSK5VPTVN1PROD with BILLS
10 

•S 2586 IS

1 SEC. 3. REVISION OF FUNDING FOR THE CENTER FOR 

2 MEDICARE AND MEDICAID INNOVATION. 

3 Section 1115A(f) of the Social Security Act (42 

4 U.S.C. 1315a(f)) is amended— 

5 (1) In paragraph (1)— 

6 (A) in subparagraph (B), by striking 

7 ‘‘and’’ at the end; 

8 (B) by redesignating subparagraph (C) as 

9 subparagraph (D); 

10 (C) by inserting after subparagraph (B) 

11 the following new subparagraph: 

12 ‘‘(C) $8,900,000,000 for the activities ini13 tiated under this section for the period of fiscal 

14 years 2020 through 2029; and’’; and 

15 (D) in subparagraph (D), as redesignated 

16 by subparagraph (B) of this paragraph, by 

17 striking ‘‘2020’’ and inserting ‘‘2030’’; and 

18 (2) in paragraph (2), by striking ‘‘and (C)’’ and 

19 inserting ‘‘, (C), and (D)’’. 

Æ 


tjames on DSK5VPTVN1PROD with BILLS