pliers of ambulance services, that are attempting to 
properly submit claims under the Medicare program 
and to ensure that the Secretary does not target in-
advertent billing errors. 
(4) ELECTRONIC FORMS AND PAYMENTS.—Sim-
plifying and updating electronic forms of the Centers 
for Medicare & Medicaid Services to ensure sim-
plicity as well as patient privacy. 
(c) MEMBERSHIP.— 
(1) NUMBER AND APPOINTMENT.—The Com-
mission shall be composed of 17 members, of 
whom— 
(A) four shall be appointed by the Presi-
dent; 
(B) six shall be appointed by the majority 
leader of the Senate, in consultation with the 
minority leader of the Senate, of whom not 
more than 4 shall be of the same political party; 
(C) six shall be appointed by the Speaker 
of the House of Representatives, in consultation 
with the minority leader of the House of Rep-
resentatives, of whom not more than 4 shall be 
of the same political party; and 
(D) one, who shall serve as Chairman of 
the Commission, shall be appointed jointly by 
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the President, majority leader of the Senate, 
and the Speaker of the House of Representa-
tives. 
(2) APPOINTMENT.—Members of the Commis-
sion shall be appointed by not later than 90 days 
after the date of the enactment of this Act. 
(d) INCORPORATION
OF BIPARTISAN COMMISSION 
PROVISIONS.—The provisions of paragraphs (3) through 
(8) of subsection (c) and subsections (d), (e), and (h) of 
section 4021 of the Balanced Budget Act of 1997 shall 
apply to the Commission under this section in the same 
manner as they applied to the National Bipartisan Com-
mission on the Future of Medicare under such section. 
(e) REPORT.—Not later than December 31, 2011, the 
Commission shall submit to the President and Congress 
a report which shall contain a detailed statement of only 
those recommendations, findings, and conclusions of the 
Commission that receive the approval of at least 11 mem-
bers of the Commission. 
(f) TERMINATION.—The Commission shall terminate 
30 days after the date of submission of the report required 
in subsection (e). 
SEC. 3. EDUCATION OF PHYSICIANS AND PROVIDERS CON-
CERNING MEDICARE PROGRAM PAYMENTS. 
(a) WRITTEN REQUESTS.— 
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(1) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a process under 
which a physician may request, in writing from a 
carrier, assistance in addressing questionable codes 
and procedures under the Medicare program under 
title XVIII of the Social Security Act and then the 
carrier shall respond in writing within 30 business 
days with the correct billing or procedural answer. 
(2) USE OF WRITTEN STATEMENT.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), a written statement under para-
graph (1) may be used as proof against a fu-
ture audit or overpayment under the Medicare 
program. 
(B) LIMIT
ON
APPLICATION.—Subpara-
graph (A) shall not apply retroactively and shall 
not apply to cases of fraudulent billing. 
(b) DEFINITIONS.—For purposes of this section: 
(1) PHYSICIAN.—The term ‘‘physician’’ has the 
meaning given such term in section 1861(r) of the 
Social Security Act (42 U.S.C. 1395x(r)). 
(2) CARRIER.—The term ‘‘carrier’’ means a 
carrier (as defined in section 1842(f) of the Social 
Security Act (42 U.S.C. 1395u(f))) with a contract 
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under title XVIII of such Act to administer benefits 
under part B of such title. 
SEC. 4. POLICY DEVELOPMENT REGARDING E&M GUIDE-
LINES UNDER THE MEDICARE PROGRAM. 
(a) IN GENERAL.—The Administrator of the Centers 
for Medicare & Medicaid Services may not implement any 
new evaluation and management guidelines (in this section 
referred to as ‘‘E&M guidelines’’) under the Medicare pro-
gram, unless the Administrator— 
(1) has provided for an assessment of the pro-
posed guidelines by physicians; 
(2) has established a plan that contains specific 
goals, including a schedule, for improving participa-
tion of physicians in the assessment described in 
paragraph (1); 
(3) has carried out a minimum of 4 pilot 
projects consistent with subsection (b) in at least 4 
different regions (to be specified by the Secretary) to 
test such guidelines; and 
(4) finds that the objectives described in sub-
section (c) will be met in the implementation of such 
guidelines. 
(b) PILOT PROJECTS.— 
(1) LENGTH AND CONSULTATION.—Each pilot 
project under this subsection shall— 
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(A) be of sufficient length to allow for pre-
paratory physician and carrier education, anal-
ysis, and use and assessment of potential E&M 
guidelines; and 
(B) be conducted, throughout the planning 
and operational stages of the project, in con-
sultation with national and State medical soci-
eties. 
(2) 
PEER
REVIEW
AND
RURAL
PILOT 
PROJECTS.—Of the pilot projects conducted under 
this subsection— 
(A) at least one shall focus on a peer re-
view method by physicians which evaluates 
medical record information for statistical outlier 
services relative to definitions and guidelines 
published in the most recent Current Proce-
dural Terminology book, instead of an approach 
using the review of randomly selected medical 
records using non-clinical personnel; and 
(B) at least one shall be conducted for 
services furnished in a rural area. 
(3) STUDY
OF
IMPACT.—Each pilot project 
shall examine the effect of the potential E&M guide-
lines on— 
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