I 
115TH CONGRESS 
2D SESSION 
H. R. 6690 
To establish a smart card pilot program to combat fraud, waste, and abuse 
and to protect beneficiary identity under the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
AUGUST 28, 2018 
Mr. ROSKAM (for himself and Mr. BLUMENAUER) introduced the following 
bill; which was referred to the Committee on Ways and Means, and in 
addition to the Committee on Energy and Commerce, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee con-
cerned 
A BILL 
To establish a smart card pilot program to combat fraud, 
waste, and abuse and to protect beneficiary identity 
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 ‘‘Fighting Fraud to Pro-
tect Care for Seniors Act of 2018’’. 
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SEC. 2. MEDICARE SMART CARD PILOT PROGRAM. 
Part E of title XVIII of the Social Security Act is 
amended by inserting after section 1866E the following 
new section: 
‘‘SEC. 1866F. SMART CARD PILOT PROGRAM. 
‘‘(a) IMPLEMENTATION.— 
‘‘(1) IN GENERAL.—Not later than 36 months 
after the date of the enactment of this section, the 
Secretary shall establish a pilot program (in this sec-
tion referred to as the ‘pilot program’) to evaluate 
the feasibility of using smart card technology under 
this title. 
‘‘(2) SMART CARD TECHNOLOGY DEFINED.—In 
this section, the term ‘smart card technology’ means 
the following: 
‘‘(A) BENEFICIARY SMART CARD.—A ma-
chine readable, tamper-resistant card (in this 
section referred to as a ‘smart card’) that in-
cludes an embedded integrated circuit chip with 
a secure micro-controller (as defined by the Na-
tional Institute on Standards and Technology) 
that enables the verification and secure, elec-
tronic authentication of the identity of a Medi-
care beneficiary at the point of service through 
a combination of the smart card and a personal 
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identification number known by or associated 
with such beneficiary. 
‘‘(B) CARD READER TECHNOLOGY.—Infor-
mation technology that enables a supplier and 
provider to authenticate the identity of a Medi-
care beneficiary through presentation of such a 
smart card and such components, with such au-
thentication to be reflected through the use of 
a modifier or in another appropriate manner, as 
determined by the Secretary, in the claims ad-
judication process. 
‘‘(3) PROGRAM DESIGN ELEMENTS.—The pilot 
program shall be conducted for a period of 3 years 
consistent with the following: 
‘‘(A) SELECTION OF AREA.—In consulta-
tion with the Inspector General of the Depart-
ment of Health and Human Services, the Sec-
retary shall select at least 3 geographic areas in 
which the pilot program will operate. 
‘‘(B) SELECTION OF SUPPLIER AND PRO-
VIDER TYPES.—In consultation with the Inspec-
tor General of the Department of Health and 
Human Services, the Secretary shall select sup-
plier and provider types that will be required to 
participate in the pilot program (referred to in 
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this section as ‘participating suppliers and pro-
viders’). In selecting such supplier and provider 
types, the Secretary shall— 
‘‘(i) take into account the risk of 
fraud, waste, and abuse (as described in 
section 1866(j)(2)(B)) with respect to the 
category of provider or supplier) and other 
factors as determined appropriate by the 
Secretary; and 
‘‘(ii) limit the pilot program to no 
more than 2,000 suppliers and providers. 
‘‘(C) SUPPLIER AND PROVIDER HARDSHIP 
EXEMPTIONS.—The Secretary shall exempt 
from participation in the pilot program a sup-
plier or provider that either— 
‘‘(i) does not have access to card read-
er technology (as described in paragraph 
(2)(B)); 
‘‘(ii) does not have sufficient internet 
access; or 
‘‘(iii) has a low volume (as determined 
by the Secretary) of Medicare claims for 
which payment is made under this title. 
‘‘(D) SMART
CARD
AND
SMART
CARD 
READER ISSUANCE.— 
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‘‘(i) 
BENEFICIARY
SMART
CARD 
ISSUANCE.—The Secretary shall provide 
for, at no cost, the issuance (and, if nec-
essary, replacement) of beneficiary smart 
cards described in paragraph (2)(A) to all 
Medicare beneficiaries residing in a geo-
graphic area in which the pilot program is 
conducted under subparagraph (A). Infor-
mation that appears on Medicare cards 
used outside the pilot program may appear 
on the face of the beneficiary smart card. 
‘‘(ii) SUPPLIER AND PROVIDER SMART 
CARD READER ISSUANCE.—At the request 
of a participating supplier or provider, the 
Secretary shall provide for, at no cost, the 
issuance to such supplier or provider of 
smart card hardware and software nec-
essary to participate in the pilot program. 
‘‘(E) INFORMATION
ON
OPERATION
OF 
PILOT PROGRAM.—The Secretary shall provide 
participating suppliers and providers and Medi-
care beneficiaries who are furnished items and 
services by such suppliers and providers, with 
information on the operation of the pilot pro-
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gram, including privacy protections described in 
subparagraph (I). 
‘‘(F) ACCESS TO SERVICES OUTSIDE THE 
PILOT PROGRAM.— 
‘‘(i) BENEFICIARIES.—Medicare bene-
ficiaries who receive beneficiary smart 
cards may receive items and services from 
suppliers and providers not participating in 
the pilot program. 
‘‘(ii) 
SUPPLIERS
AND
PROVIDER 
CLAIMS.— 
‘‘(I) SUPPLIERS AND PROVIDERS 
NOT PARTICIPATING IN PILOT.—Sup-
pliers and providers not participating 
in the pilot program may submit 
claims under this title for items and 
services furnished without use of 
smart card technology to Medicare 
beneficiaries who receive beneficiary 
smart cards. 
‘‘(II) PARTICIPATING SUPPLIERS 
AND
PROVIDERS
FURNISHING
SERV-
ICES
TO
NON-PARTICIPATING
BENE-
FICIARIES.—Supplier and providers 
participating in the pilot program may 
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‘‘(H) 
PRIVATE
SECTOR
IMPLEMENTA-
TION.—The Secretary shall select, by using a 
competitive procurement process in accordance 
with the provisions of chapter 1 of title 48, 
Code of Federal Regulations (or any successor 
regulations), a private sector contractor to im-
plement and operate the pilot program. 
‘‘(I) PRIVACY
PROTECTIONS.—The Sec-
retary shall ensure that the pilot program com-
plies with applicable Federal laws and regula-
tions concerning individually identifiable health 
information, including the Privacy Act of 1974 
and regulations promulgated under section 
264(c) of the Health Insurance Portability and 
Accountability Act of 1996 and such individ-
ually identifiable information shall be exempt 
from disclosure under section 552(b)(3) of title 
5, United States Code. 
‘‘(J) MANDATORY
PARTICIPATION.—Sub-
ject to subparagraph (C), in the case of items 
or services furnished by a provider or supplier 
included in a supplier or provider type selected 
under subparagraph (B) in a geographic area 
selected under subparagraph (A), payment may 
only be made under this title for such items or 
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services during the period of the pilot program 
if the provider or supplier is participating in the 
pilot program. 
‘‘(K) 
PROHIBITION
OF
SMART
CARD 
FEES.—No transaction, utilization, or other 
fees may be imposed on Medicare beneficiaries 
or participating suppliers and providers with re-
spect to the use of smart cards under the pilot 
program. 
‘‘(4) STAKEHOLDER INPUT.— 
‘‘(A) IN
GENERAL.—Not later than 6 
months after the date of the enactment of this 
section, the Secretary shall convene a panel 
consisting of stakeholders (including representa-
tives of providers, suppliers, Medicare bene-
ficiaries, and claims processing contractors) se-
lected by the Secretary for purposes of pro-
viding input to the Secretary on the implemen-
tation of the pilot program (including on the se-
lection of areas and participants under subpara-
graphs (A) and (B) of paragraph (3) and the 
development of exemptions and requirements 
described in such paragraph). 
‘‘(B) NONAPPLICABILITY
OF
FACA.—The 
Federal Advisory Committee Act shall not apply 
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to the panel convened pursuant to subpara-
graph (A). 
‘‘(5) DEFINITIONS.—In this section: 
‘‘(A) The terms ‘supplier’ and ‘provider’ 
have the meanings given the terms ‘supplier’ 
and ‘provider of services’ in subsections (d) and 
(u), respectively, of section 1861. 
‘‘(B) The term ‘Medicare beneficiary’ 
means an individual who is enrolled in the origi-
nal Medicare fee-for-service program under 
parts A and B and is not enrolled in an MA 
plan under part C, an eligible organization 
under section 1876, or a PACE program under 
section 1894. 
‘‘(b) REPORTS TO CONGRESS.—The Secretary shall 
submit to Congress the following reports: 
‘‘(1) INTERIM
PERFORMANCE
REPORT.—Not 
later than 2 years after the date the pilot program 
is implemented, an interim report on the perform-
ance of such program. 
‘‘(2) FINAL PERFORMANCE REPORT.—Not later 
than 18 months after the date of the completion of 
the pilot program, a final evaluation on the effective-
ness of the pilot program. The report shall include 
the following: 
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‘‘(A) An evaluation of the extent to which 
health care fraud schemes were affected by the 
use of smart card technology. 
‘‘(B) A description of any barriers to im-
plementation of the pilot program. 
‘‘(C) Participant feedback on the pilot pro-
gram. 
‘‘(D) Recommendations regarding the fu-
ture use of smart cards to address fraud under 
this title. 
‘‘(E) Data on the information provided 
under subsection (a)(3)(G)(iii).’’. 
Æ 
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