who is covered under the plan by reason of em-
ployment with that employer or membership in
the organization.
‘‘(C) INFORMATION
ELEMENTS.—The in-
formation elements described in this subpara-
graph are the following:
‘‘(i) ELEMENTS CONCERNING THE IN-
DIVIDUAL.—
‘‘(I) The individual’s name.
‘‘(II) The individual’s date of
birth.
‘‘(III) The individual’s sex.
‘‘(IV) The individual’s social se-
curity insurance number.
‘‘(V) The number assigned by the
Secretary to the individual for claims
under this title.
‘‘(VI) The family relationship of
the individual to the person who has
or had current or employment status
with the employer.
‘‘(ii) ELEMENTS
CONCERNING
THE
FAMILY
MEMBER
WITH
CURRENT
OR
FORMER EMPLOYMENT STATUS.—
‘‘(I) The name of the person in
the individual’s family who has cur-
rent or former employment status
with the employer.
‘‘(II) That person’s social secu-
rity insurance number.
‘‘(III) The number or other iden-
tifier assigned by the plan to that per-
son.
‘‘(IV) The periods of coverage for
that person under the plan.
‘‘(V) The employment status of
that person (current or former) dur-
ing those periods of coverage.
‘‘(VI) The classes (of that per-
son’s family members) covered under
the plan.
‘‘(iii) PLAN ELEMENTS.—
‘‘(I) The items and services cov-
ered under the plan.
‘‘(II) The name and address to
which claims under the plan are to be
sent.
‘‘(iv) ELEMENTS
CONCERNING
THE
EMPLOYER.—
‘‘(I) The employer’s name.
‘‘(II) The employer’s address.
‘‘(III) The employer identifica-
tion number of the employer.
‘‘(D) USE OF IDENTIFIERS.—The adminis-
trator of a group health plan shall utilize a
unique identifier for the plan in providing infor-
mation under subparagraph (A) and in other
transactions, as may be specified by the Sec-
retary, related to the provisions of this sub-
section. The Secretary may provide to the ad-
ministrator the unique identifier described in
the preceding sentence.
‘‘(E) PENALTY
FOR
NONCOMPLIANCE.—
Any entity that knowingly and willfully fails to
comply with a requirement imposed by the pre-
vious subparagraphs shall be subject to a civil
money penalty not to exceed $1,000 for each in-
cident of such failure. The provisions of section
1128A (other than subsections (a) and (b))
shall apply to a civil money penalty under the
previous sentence in the same manner as those
provisions apply to a penalty or proceeding
under section 1128A(a).’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall take effect 180 days after the date
of enactment of this Act.
SEC. 6. CENTERS OF EXCELLENCE.
(a) IN GENERAL.—Title XVIII of the Social Security
Act is amended by inserting after section 1896 the fol-
lowing new section:
‘‘CENTERS OF EXCELLENCE
‘‘SEC. 1897. (a) IN GENERAL.—The Secretary shall
use a competitive process to contract with specific hos-
pitals or other entities for furnishing services related to
surgical procedures, and for furnished services (unrelated
to surgical procedures) to hospital inpatients that the Sec-
retary determines to be appropriate. Such services may in-
clude any services covered under this title that the Sec-
retary determines to be appropriate, including post-hos-
pital services.
‘‘(b) QUALITY STANDARDS.—Only entities that meet
quality standards established by the Secretary shall be eli-
gible to contract under this section. In considering quality,
the Secretary shall take into account the quality, experi-
ence, and quantity of services of physicians who provide
services in more than one entity. Contracting entities shall
implement a quality improvement plan approved by the
Secretary.
‘‘(c) PAYMENT.—Payment under this section shall be
made on the basis of negotiated all-inclusive rates. The
amount of payment made by the Secretary to an entity
under this title for services covered under a contract shall
be less than the aggregate amount of the payments that
the Secretary would have otherwise made for the services.
‘‘(d) CONTRACT PERIOD.—A contract period shall be
3 years (subject to renewal), as long as the entity con-
tinues to meet quality and other contractual standards.
‘‘(e) INCENTIVES FOR USE OF CENTERS.—The Sec-
retary may permit entities under a contract under this sec-
tion to furnish additional services or waive beneficiary
cost-sharing, subject to the approval of the Secretary.
‘‘(f) LIMIT ON NUMBER OF CENTERS.—The Sec-
retary shall limit the number of centers in a geographic
area to the number needed to meet projected demand for
contracted services.’’.
(b) EFFECTIVE DATES.—
(1) The amendment made by subsection (a) ap-
plies to services furnished on or after October 1,
2001.
(2) By October 1, 2001, the Secretary shall
enter into contracts under the amendment made by
subsection (a) for coronary artery by-pass surgery
and other heart procedures, knee replacement sur-
gery, and hip replacement surgery, in geographic
areas nationwide such that at least 20 percent of the
projected number of those procedures can be pro-
vided under such contracts.
Æ