I 
108TH CONGRESS 
2D SESSION 
H. R. 4822
To amend title XVIII of the Social Security Act to clarify the right of 
Medicare beneficiaries to enter into private contracts with physicians 
and other health care professionals for the provision of health services 
for which no payment is sought under the Medicare Program. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 13, 2004
Mr. SAM JOHNSON of Texas (for himself, Mr. NORWOOD, and Mr. CRANE) 
introduced the following bill; which was referred to the Committee on 
Ways and Means, and in addition to the Committee on Energy and Com-
merce, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to clarify 
the right of Medicare beneficiaries to enter into private 
contracts with physicians and other health care profes-
sionals for the provision of health services for which 
no payment is sought under the Medicare Program.
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 Beneficiary 
Freedom To Contract Act of 2004’’.
SEC. 2. USE OF PRIVATE CONTRACTS BY MEDICARE BENE-
FICIARIES FOR PROFESSIONAL SERVICES. 
(a) IN GENERAL.—Section 1802(b) of the Social Se-
curity Act (42 U.S.C. 1395a) is amended to read as fol-
lows: 
‘‘(b) CLARIFICATION
OF USE
OF PRIVATE CON-
TRACTS
BY MEDICARE BENEFICIARIES
FOR PROFES-
SIONAL SERVICES.—
‘‘(1) IN GENERAL.—Nothing in this title shall 
prohibit a medicare beneficiary from entering into a 
private contract with a physician or health care 
practitioner for the provision of medicare covered 
professional services (as defined in paragraph 
(5)(C)) if—
‘‘(A) the services are covered under a pri-
vate contract that is between the beneficiary 
and the physician or practitioner and meets the 
requirements of paragraph (2); 
‘‘(B) under the private contract no claim 
for payment for services covered under the con-
tract is to be submitted (and no payment made) 
under part A or B, under a contract under sec-
tion 1876, or under a MA plan (other than an 
MSA plan); and 
‘‘(C)(i) the Secretary has been provided 
with the minimum information necessary to
avoid any payment under part A or B for serv-
ices covered under the contract, or 
‘‘(ii) in the case of an individual enrolled 
under a contract under section 1876 or a MA 
plan (other than an MSA plan) under part C, 
the eligible organization under the contract or 
the MA organization offering the plan has been 
provided the minimum information necessary to 
avoid any payment under such contract or plan 
for services covered under the contract. 
‘‘(2) 
REQUIREMENTS
FOR
PRIVATE
CON-
TRACTS.—The requirements in this paragraph for a 
private contract between a medicare beneficiary and 
a physician or health care practitioner are as fol-
lows: 
‘‘(A) GENERAL FORM OF CONTRACT.—The 
contract is in writing and is signed by the medi-
care beneficiary. 
‘‘(B) NO CLAIMS TO BE SUBMITTED FOR 
COVERED
SERVICES.—The contract provides 
that no party to the contract (and no entity on 
behalf of any party to the contract) shall sub-
mit any claim for (or request) payment for 
services covered under the contract under part