I 
112TH CONGRESS 
1ST SESSION H. R. 1700 
To amend title XVIII of the Social Security Act to establish a Medicare 
payment option for patients and physicians or practitioners to freely 
contract, without penalty, for Medicare fee-for-service items and services, 
while allowing Medicare beneficiaries to use their Medicare benefits. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 3, 2011 
Mr. PRICE of Georgia (for himself and Mr. SESSIONS) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to establish 
a Medicare payment option for patients and physicians 
or practitioners to freely contract, without penalty, for 
Medicare fee-for-service items and services, while allow-
ing Medicare beneficiaries to use their Medicare benefits. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Patient Em-
powerment Act’’. 
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SEC. 2. GUARANTEEING FREEDOM OF CHOICE AND CON-
TRACTING FOR PATIENTS. 
(a) IN GENERAL.—Section 1802 of the Social Secu-
rity Act (42 U.S.C. 1395a) is amended to read as follows: 
‘‘FREEDOM OF CHOICE AND CONTRACTING BY PATIENT 
GUARANTEED 
‘‘SEC. 1802. (a) BASIC FREEDOM OF CHOICE.—Any 
individual entitled to insurance benefits under this title 
may obtain health services from any institution, agency, 
or person qualified to participate under this title if such 
institution, agency, or person undertakes to provide that 
individual such services. 
‘‘(b) FREEDOM TO CONTRACT BY MEDICARE BENE-
FICIARIES.— 
‘‘(1) IN GENERAL.—Subject to the provisions of 
this subsection, nothing in this title shall prohibit a 
Medicare beneficiary from entering into a contract 
with a participating or non-participating physician 
or practitioner for any item or service covered under 
this title. 
‘‘(2) SUBMISSION OF CLAIMS.—Any Medicare 
beneficiary that enters into a contract under this 
section shall be permitted to submit a claim for pay-
ment under this title, and such payment shall be 
made in the amount that would otherwise apply 
under this title if such claim had been filed by a par-
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ticipating physician or practitioner (as defined in 
section 1842(i)(2)) in the payment area where the 
physician or practitioner covered by the contract re-
sides. Payment made under this title for any item or 
service provided under the contract shall not render 
the physician a participating or non-participating 
physician, and as such, requirements of this title 
that may otherwise apply to a participating or non- 
participating physician would not apply with respect 
to any items or services furnished under the con-
tract. 
‘‘(3) BENEFICIARY PROTECTIONS.— 
‘‘(A) IN
GENERAL.—Paragraph (1) shall 
not apply to any contract unless— 
‘‘(i) the contract is in writing, is 
signed by the Medicare beneficiary and the 
physician or practitioner, and establishes 
all terms of the contract (including specific 
payment for physicians’ services covered by 
the contract) before any item or service is 
provided pursuant to the contract, and the 
beneficiary shall be held harmless for any 
subsequent payment charged for a service 
in excess of the amount established under 
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unless otherwise provided in the contract 
under subparagraph (C)(i); and 
‘‘(iii) acknowledges that no limits or 
other payment incentives that may other-
wise apply under this title (such as the 
limits under subsection (g) of section 1848 
or incentives under subsection (a)(5), (m), 
(q), and (p) of such section) shall apply to 
amounts that may be charged, or paid to 
a beneficiary for, such items or services. 
Such contract shall also clearly indicate whether 
the physician or practitioner is excluded from 
participation under the Medicare program 
under section 1128. 
‘‘(C) BENEFICIARY
ELECTIONS
UNDER 
THE
CONTRACT.—Any Medicare beneficiary 
that enters into a contract under this section 
may elect to negotiate, as a term of the con-
tract, a provision under which— 
‘‘(i) the physician or practitioner shall 
file claims on behalf of the beneficiary with 
the Secretary and any supplemental insur-
ance plan for items or services furnished 
under the contract if such items or services 
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are covered under this title or under the 
plan; and 
‘‘(ii) the beneficiary assigns payment 
to the physician for any claims filed by, or 
on behalf of, the beneficiary with the Sec-
retary and any supplemental insurance 
plan for items or services furnished under 
the contract. 
‘‘(D) EXCLUSION OF DUAL ELIGIBLE INDI-
VIDUALS.—Paragraph (1) shall not apply to 
any contract if a beneficiary who is eligible for 
medical assistance under title XIX is a party to 
the contract. 
‘‘(4) LIMITATION
ON
ACTUAL
CHARGE
AND 
CLAIM
SUBMISSION
REQUIREMENT
NOT
APPLICA-
BLE.—Section 1848(g) shall not apply with respect 
to any item or service provided to a Medicare bene-
ficiary under a contract described in paragraph (1). 
‘‘(5) CONSTRUCTION.—Nothing in this section 
shall be construed to prohibit any physician or prac-
titioner from maintaining an election and acting as 
a participating or non-participating physician or 
practitioner with respect to any patient not covered 
under a contract established under this section. 
‘‘(6) DEFINITIONS.—In this subsection: 
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‘‘(A) MEDICARE BENEFICIARY.—The term 
‘Medicare beneficiary’ means an individual who 
is entitled to benefits under part A or enrolled 
under part B. 
‘‘(B) PHYSICIAN.—The term ‘physician’ 
has the meaning given such term by paragraphs 
(1), (2), (3), and (4) of section 1861(r). 
‘‘(C) PRACTITIONER.—The term ‘practi-
tioner’ means a practitioner described in section 
1842(b)(18)(C). 
‘‘(D) EMERGENCY MEDICAL CONDITION.— 
The term ‘emergency medical condition’ means 
a medical condition manifesting itself by acute 
symptoms of sufficient severity (including se-
vere pain) such that a prudent layperson, with 
an average knowledge of health and medicine, 
could reasonably expect the absence of imme-
diate medical attention to result in— 
‘‘(i) serious jeopardy to the health of 
the individual or, in the case of a pregnant 
woman, the health of the woman or her 
unborn child; 
‘‘(ii) serious impairment to bodily 
functions; or 
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‘‘(iii) serious dysfunction of any bodily 
organ or part. 
‘‘(E) 
URGENT
HEALTH
CARE
SITUA-
TION.—The term ‘urgent health care situation’ 
means services furnished to an individual who 
requires services to be furnished within 12 
hours in order to avoid the likely onset of an 
emergency medical condition.’’. 
SEC. 3. PREEMPTION OF STATE LAWS LIMITING CHARGES 
FOR PHYSICIAN AND PRACTITIONER SERV-
ICES. 
(a) IN GENERAL.—No State may impose a limit on 
the amount of charges for services, furnished by a physi-
cian or practitioner, for which payment is made under sec-
tion 1848 of the Social Security Act (42 U.S.C. 1395w– 
4), and any such limit is hereby preempted. 
(b) STATE.—In this section, the term ‘‘State’’ in-
cludes the District of Columbia, Puerto Rico, the Virgin 
Islands, Guam, and American Samoa. 
Æ 
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