Medicare Common Access Card Act of 2015

To establish a smart card pilot program under the Medicare program. 1. Short title This Act may be cited as the Medicare Common Access Card Act of 2015 2. Secure Medicare card pilot program (a) Pilot program implementation (Phase I (1) In general Not later than 18 months after the date of the enactment of this Act, the Secretary shall conduct a pilot program under title XVIII of the Social Security Act for the purpose of utilizing smart card technology for Medicare beneficiary identification cards in order to— (A) increase the quality of care furnished to Medicare beneficiaries; (B) improve the accuracy and efficiency in the billing for Medicare items and services; (C) reduce the potential for identity theft and other unlawful use of Medicare beneficiary identifying information; and (D) reduce waste, fraud, and abuse in the Medicare program. (2) Site requirements (A) In general The Secretary shall conduct the pilot program in at least 3 areas in which the Secretary determines there is a high risk for waste and abuse. (B) Priority in timing of distribution of cards In each site selected by the Secretary under subparagraph (A), the Secretary shall give priority in the provision of the identification cards to Medicare beneficiaries who self-identify that their personal identity and health information has previously been compromised. (3) Design of pilot program In designing the pilot program, the Secretary shall provide for the following: (A) Implementation of a system that utilizes a smart card as a Medicare identification card for Medicare beneficiaries. Such a card shall contain appropriate security features and protect personal privacy. (B) Issuance of a new smart card to all Medicare beneficiaries participating in the pilot program. Such card shall have the Medicare identification number of the Medicare beneficiary stored securely on the smart card chip along with other information the Secretary deems necessary. (C) A process under which the cards issued under subparagraph (B) are used by both Medicare beneficiaries and Medicare providers to verify eligibility, prevent fraud, and authorize transactions. (D) Regular monitoring and review by the Secretary of Medicare providers’ Medicare billings and Medicare beneficiaries’ Medicare records in order to identify and address inaccurate charges and instances of waste, fraud, or abuse. (E) Reporting mechanisms for measuring the cost savings to the Medicare program by reason of the pilot program. (F) Include provisions— (i) to ensure that all devices and systems utilized as part of the pilot program comply with standards for identity credentials developed by the American National Standards Institute and the National Institute of Standards and Technology and Federal requirements relating to interoperability and information security, including all requirements under the Health Insurance Portability and Accountability Act of 1996; (ii) to ensure that a Medicare beneficiary’s personal identifying, health, and other information is protected from unauthorized access or disclosure through the use of at least two-factor authentication; (iii) for the development of procedures and guidelines for the use of identification cards, card readers, kiosks, and other equipment to verify a Medicare beneficiary’s identity and eligibility for services; (iv) to ensure that each Medicare beneficiary participating in the pilot program is informed of— (I) the purpose of the program; (II) the processes for capturing, enrolling, and verifying their eligibility; and (III) the steps that will be taken to protect personal identifying, health, and other information from unauthorized access and disclosure; (v) for addressing problems related to the loss, theft, or malfunction of or damage to equipment and any identifying documents or materials provided by the Secretary; (vi) for development of a hotline or other means by which Medicare beneficiaries can contact the Secretary for assistance; and (vii) for addressing problems related to accessing care outside the pilot area and cases where the individual faces issues related to physical or other capacity limitations. (4) Privacy Information on the smart card shall only be disclosed if the disclosure of such information is permitted under the Federal regulations (concerning the privacy of individually identifiable health information) promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996. (5) Disclosure exemption Information on the smart card shall be exempt from disclosure under section 552(b)(3) of title 5, United States Code. (b) Expanded implementation (Phase II Taking into account the interim report under subsection (d)(2) the Secretary shall, through rulemaking, expand the duration and the scope of the pilot program, to the extent determined appropriate by the Secretary. (c) Waiver authority The Secretary may waive such provisions of titles XI and XVIII of the Social Security Act as the Secretary determines to be appropriate for the conduct of the pilot program. (d) Reports to Congress (1) Plan Not later than 6 months after the date of the enactment of this Act, the Secretary shall submit to Congress a report that contains a description of the design and development of the pilot program, including the Secretary’s plan for implementation. (2) Additional report Not later than 2 years after the date that the pilot program is first implemented, the Secretary shall submit to Congress a report on the pilot program. Such report shall contain— (A) a detailed description of issues related to the expansion of the program under subsection (b); (B) recommendations for such legislation and administrative actions as the Secretary considers appropriate for implementation of the program on a nationwide basis; and (C) a justification for each recommendation described in subparagraph (B). (e) Definitions In this section: (1) Medicare beneficiary The term Medicare beneficiary (2) Medicare program The term Medicare program (3) Medicare provider The term Medicare provider 42 U.S.C. 1395x (4) Pilot program The term pilot program (5) Secretary The term Secretary (6) Smart card The term smart card

Summary: Medicare Common Access Card Act of 2015 This bill establishes a pilot program under title XVIII (Medicare) of the Social Security Act for the purpose of utilizing smart card technology for Medicare beneficiary identification cards. A “smart card” is a secure, electronic, machine readable, fraud-resistant, tamper-resistant card that includes an embedded integrated circuit chip with a secure micro-controller. The Centers for Medicare & Medicaid Services (CMS) must conduct the pilot program in at least three areas in which there is a high risk for waste and abuse, and must give priority in the provision of cards to Medicare beneficiaries who self-identify as individuals whose personal identity and health information has previously been compromised. In designing the program, CMS must include, among other provisions: (1) regular monitoring and review of Medicare billings and records in order to identify and address inaccurate changes and instances of waste, fraud, or abuse; and (2) reporting mechanisms for measuring Medicare cost savings attributable to the pilot program. CMS must report to Congress on issues and recommendations related the pilot program within two years of program implementation.