I 

112TH CONGRESS 

1ST SESSION H. R. 2925 

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

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 14, 2011 

Mr. GERLACH (for himself and Mr. BLUMENAUER) introduced the following 

bill; which was referred to the Committee on Ways and Means, and in 

addition to the Committee on Energy and 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 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 2011’’. 

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 SecVerDate Mar 15 2010 03:12 Sep 17, 2011 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2925.IH H2925

tjames on DSK6SPTVN1PROD with BILLS
2 

•HR 2925 IH

1 retary shall conduct a pilot program under title 

2 XVIII of the Social Security Act for the purpose of 

3 utilizing smart card technology for Medicare bene4 ficiary and provider identification cards in order 

5 to— 

6 (A) increase the quality of care furnished 

7 to Medicare beneficiaries; 

8 (B) improve the accuracy and efficiency in 

9 the billing for Medicare items and services fur10 nished by Medicare providers; 

11 (C) reduce the potential for identity theft 

12 and other unlawful use of Medicare beneficiary 

13 and provider identifying information; and 

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

15 Medicare program. 

16 (2) SITE REQUIREMENTS.—The Secretary shall 

17 conduct the pilot program in at least 5 geographic 

18 areas in which the Secretary determines there is a 

19 high risk for waste, fraud, or abuse. 

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

21 the pilot program, the Secretary shall provide for the 

22 following: 

23 (A) Implementation of a system that uti24 lizes a smart card as a Medicare identification 

25 card for Medicare beneficiaries and Medicare 


tjames on DSK6SPTVN1PROD with BILLS
3 

•HR 2925 IH

1 providers. Such a card shall contain appropriate 

2 security features and protect personal privacy. 

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

4 Medicare beneficiaries participating in the pilot 

5 program. Such card shall not have the Social 

6 Security number printed on the front but, in7 stead shall have such number stored securely on 

8 the smart card chip along with other informa9 tion the Secretary deems necessary. 

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

11 Medicare providers participating in the pilot 

12 program. Such card shall include a photograph 

13 of the provider and shall not have the Medicare 

14 provider number printed on the front of the 

15 card but, instead shall have such number stored 

16 securely on the smart card chip along with 

17 other information the Secretary deems nec18 essary. 

19 (D) A process for enrollment of all Medi20 care providers that includes— 

21 (i) identity and certification verifica22 tion; and 

23 (ii) utilization of biometric data, such 

24 as fingerprints, for provider identification 

25 and authentication. 


tjames on DSK6SPTVN1PROD with BILLS
4 

•HR 2925 IH

1 (E) A process under which the cards 

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

3 used by both Medicare beneficiaries and Medi4 care providers to verify eligibility, prevent 

5 fraud, and authorize transactions. 

6 (F) Distribution of necessary equipment, 

7 including cards, card readers, kiosks, biometric 

8 readers, and other materials or documents to 

9 Medicare beneficiaries and providers at no cost 

10 to them. 

11 (G) Regular monitoring and review by the 

12 Secretary of Medicare providers’ Medicare bil13 lings and Medicare beneficiaries’ Medicare 

14 records in order to identify and address inac15 curate charges and instances of waste, fraud, or 

16 abuse. 

17 (H) Reporting mechanisms for measuring 

18 the cost savings to the Medicare program by 

19 reason of the pilot program. 

20 (I) Including provisions— 

21 (i) to ensure that all devices and sys22 tems utilized as part of the pilot program 

23 comply with standards for identity creden24 tials and biometric data developed by the 

25 American National Standards Institute 


tjames on DSK6SPTVN1PROD with BILLS
5 

•HR 2925 IH

1 and the National Institute of Standards 

2 and Technology and Federal requirements 

3 relating to interoperability and information 

4 security, including all requirements under 

5 the Health Insurance Portability and Ac6 countability Act of 1996; 

7 (ii) to ensure that a Medicare bene8 ficiary’s and provider’s personal identi9 fying, health, and other information is pro10 tected from unauthorized access or disclo11 sure through the use of at least two-factor 

12 authentication; 

13 (iii) for the development of procedures 

14 and guidelines for the use of identification 

15 cards, card readers, kiosks, biometric data 

16 and readers, and other equipment to verify 

17 a Medicare beneficiary’s identity and eligi18 bility for services; 

19 (iv) to ensure that each Medicare ben20 eficiary and provider participating in the 

21 pilot program is informed of— 

22 (I) the purpose of the program; 

23 (II) the processes for capturing, 

24 enrolling, and verifying their eligibility 


tjames on DSK6SPTVN1PROD with BILLS
6 

•HR 2925 IH

1 and, with respect to providers, their 

2 biometric data; 

3 (III) the manner in which the bi4 ometric data for providers will be 

5 used; and 

6 (IV) the steps that will be taken 

7 to protect personal identifying, health, 

8 and other information from unauthor9 ized access and disclosure; 

10 (v) for addressing problems related to 

11 the loss, theft, or malfunction of or dam12 age to equipment and any identifying docu13 ments or materials provided by the Sec14 retary; 

15 (vi) for development of a hotline, Web 

16 site, or other means by which Medicare 

17 beneficiaries and providers can contact the 

18 Secretary for assistance; and 

19 (vii) for addressing problems related 

20 to accessing care outside the pilot area and 

21 cases where the individual faces issues re22 lated to physical or other capacity limita23 tions. 

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

25 shall only be disclosed if the disclosure of such inforVerDate Mar 15 2010 03:12 Sep 17, 2011 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2925.IH H2925

tjames on DSK6SPTVN1PROD with BILLS
7 

•HR 2925 IH

1 mation is permitted under the Federal regulations 

2 (concerning the privacy of individually identifiable 

3 health information) promulgated under section 

4 264(c) of the Health Insurance Portability and Ac5 countability Act of 1996. 

6 (5) DISCLOSURE EXEMPTION.—Information on 

7 the smart card shall be exempt from disclosure 

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

9 Code. 

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

11 Taking into account the interim report under subsection 

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

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

14 extent determined appropriate by the Secretary. 

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

16 such provisions of titles XI and XVIII of the Social Secu17 rity Act as the Secretary determines to be appropriate for 

18 the conduct of the pilot program. 

19 (d) REPORTS TO CONGRESS.— 

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

21 date of the enactment of this Act, the Secretary 

22 shall submit to Congress a report that contains a de23 scription of the design and development of the pilot 

24 program, including the Secretary’s plan for imple25 mentation. 


tjames on DSK6SPTVN1PROD with BILLS
8 

•HR 2925 IH

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

2 after the date that the pilot program is first imple3 mented, the Secretary shall conduct an evaluation of 

4 the pilot program and submit an interim report to 

5 Congress. Such an evaluation shall include an initial 

6 analysis of the deployment of the program, the 

7 usability of the card system, and the measures taken 

8 to protect beneficiary and provider information. 

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

10 years after the date that the pilot program is first 

11 implemented, the Secretary shall submit to Congress 

12 a report on the pilot program. Such report shall con13 tain a detailed description of issues related to the ex14 pansion of the program under subsection (b) and 

15 recommendations for such legislation and adminis16 trative actions as the Secretary considers appro17 priate for implementation of the program on a na18 tionwide basis. 

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

20 amounts in the Treasury not otherwise appropriated, 

21 $29,000,000 for the design, implementation, and evalua22 tion of the pilot program. Amounts appropriated under the 

23 preceding sentence shall remain available until expended. 

24 (f) DEFINITIONS.—In this section: 


tjames on DSK6SPTVN1PROD with BILLS
9 

•HR 2925 IH

1 (1) MEDICARE BENEFICIARY.—The term 

2 ‘‘Medicare beneficiary’’ means an individual entitled 

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

4 XVIII of the Social Security Act or enrolled for ben5 efits under part B of such title. 

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

7 program’’ means the health benefits program under 

8 title XVIII of the Social Security Act. 

9 (3) MEDICARE PROVIDER.—The term ‘‘Medi10 care provider’’ means a provider of services (as de11 fined in subsection (u) of section 1861 of the Social 

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

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

14 a supplier of durable medical equipment and sup15 plies. 

16 (4) PILOT PROGRAM.—The term ‘‘pilot pro17 gram’’ means the pilot program conducted under 

18 this section. 

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

20 the Secretary of Health and Human Services. 

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

22 means a secure, electronic, machine readable, fraud23 resistant, tamper-resistant card that includes an em24 bedded integrated circuit chip with a secure micro25 controller. 


tjames on DSK6SPTVN1PROD with BILLS
10 

•HR 2925 IH

1 (g) REVISION OF MEDICARE IMPROVEMENT FUND.— 

2 Section 1898(b)(1) of the Social Security Act (42 U.S.C. 

3 1395iii(b)(1)) is amended— 

4 (1) by striking subparagraphs (A) and (B) and 

5 inserting the following subparagraph: 

6 ‘‘(A) fiscal year 2015, $246,000,000; and’’; 

7 and 

8 (2) by redesignating subparagraph (C) as sub9 paragraph (B). 

Æ 


tjames on DSK6SPTVN1PROD with BILLS