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(4) 
BANNING
OF
TARGETING
OF
PILOT 
PROJECT PARTICIPANTS.—Data collected under this 
subsection shall not be used as the basis for overpay-
ment demands or post-payment audits. Such limita-
tion applies only to claims filed as part of the pilot 
project and lasts only for the duration of the pilot 
project and only as long as the provider is a partici-
pant in the pilot project. 
(5) STUDY
OF
IMPACT.—Each pilot project 
shall examine the effect of the new evaluation and 
management documentation guidelines on—
(A) different types of physician practices, 
including those with fewer than 10 full-time-
equivalent employees (including physicians); 
and 
(B) the costs of physician compliance, in-
cluding education, implementation, auditing, 
and monitoring. 
(6) PERIODIC REPORTS.—The Secretary shall 
submit to Congress periodic reports on the pilot 
projects under this subsection. 
(c) OBJECTIVES FOR EVALUATION AND MANAGE-
MENT GUIDELINES.—The objectives for modified evalua-
tion and management documentation guidelines developed 
by the Secretary shall be to—
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(1) identify clinically relevant documentation 
needed to code accurately and assess coding levels 
accurately; 
(2) decrease the level of non-clinically pertinent 
and burdensome documentation time and content in 
the physician’s medical record; 
(3) increase accuracy by reviewers; and 
(4) educate both physicians and reviewers. 
(d) STUDY OF SIMPLER, ALTERNATIVE SYSTEMS OF 
DOCUMENTATION FOR PHYSICIAN CLAIMS.—
(1) STUDY.—The Secretary shall carry out a 
study of the matters described in paragraph (2). 
(2) MATTERS
DESCRIBED.—The matters re-
ferred to in paragraph (1) are—
(A) the development of a simpler, alter-
native system of requirements for documenta-
tion accompanying claims for evaluation and 
management physician services for which pay-
ment is made under title XVIII of the Social 
Security Act; and 
(B) consideration of systems other than 
current coding and documentation requirements 
for payment for such physician services. 
(3) CONSULTATION
WITH
PRACTICING
PHYSI-
CIANS.—In designing and carrying out the study
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under paragraph (1), the Secretary shall consult 
with practicing physicians, including physicians who 
are part of group practices and including both gen-
eralists and specialists. 
(4) APPLICATION OF HIPAA UNIFORM CODING 
REQUIREMENTS.—In developing an alternative sys-
tem under paragraph (2), the Secretary shall con-
sider requirements of administrative simplification 
under part C of title XI of the Social Security Act. 
(5) REPORT TO CONGRESS.—(A) Not later than 
October 1, 2005, the Secretary shall submit to Con-
gress a report on the results of the study conducted 
under paragraph (1). 
(B) The Medicare Payment Advisory Commis-
sion shall conduct an analysis of the results of the 
study included in the report under subparagraph (A) 
and shall submit a report on such analysis to Con-
gress. 
(e) STUDY ON APPROPRIATE CODING OF CERTAIN 
EXTENDED OFFICE VISITS.—The Secretary shall conduct 
a study of the appropriateness of coding in cases of ex-
tended office visits in which there is no diagnosis made. 
Not later than October 1, 2005, the Secretary shall submit 
a report to Congress on such study and shall include rec-
ommendations on how to code appropriately for such visits
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in a manner that takes into account the amount of time 
the physician spent with the patient. 
(f) DEFINITIONS.—In this section—
(1) the term ‘‘rural area’’ has the meaning 
given that term in section 1886(d)(2)(D) of the So-
cial Security Act, 42 U.S.C. 1395ww(d)(2)(D); and 
(2) the term ‘‘teaching settings’’ are those set-
tings described in section 415.150 of title 42, Code 
of Federal Regulations. 
SEC. 942. IMPROVEMENT IN OVERSIGHT OF TECHNOLOGY 
AND COVERAGE. 
(a) COUNCIL FOR TECHNOLOGY AND INNOVATION.—
Section 1868 (42 U.S.C. 1395ee), as amended by section 
921(a), is amended by adding at the end the following new 
subsection: 
‘‘(c) COUNCIL
FOR
TECHNOLOGY
AND
INNOVA-
TION.—
‘‘(1) ESTABLISHMENT.—The Secretary shall es-
tablish a Council for Technology and Innovation 
within the Centers for Medicare & Medicaid Services 
(in this section referred to as ‘CMS’). 
‘‘(2) COMPOSITION.—The Council shall be com-
posed of senior CMS staff and clinicians and shall 
be chaired by the Executive Coordinator for Tech-
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nology and Innovation (appointed or designated 
under paragraph (4)). 
‘‘(3) DUTIES.—The Council shall coordinate the 
activities of coverage, coding, and payment processes 
under this title with respect to new technologies and 
procedures, including new drug therapies, and shall 
coordinate the exchange of information on new tech-
nologies between CMS and other entities that make 
similar decisions. 
‘‘(4) EXECUTIVE
COORDINATOR
FOR
TECH-
NOLOGY AND INNOVATION.—The Secretary shall ap-
point (or designate) a noncareer appointee (as de-
fined in section 3132(a)(7) of title 5, United States 
Code) who shall serve as the Executive Coordinator 
for Technology and Innovation. Such executive coor-
dinator shall report to the Administrator of CMS, 
shall chair the Council, shall oversee the execution of 
its duties, and shall serve as a single point of con-
tact for outside groups and entities regarding the 
coverage, coding, and payment processes under this 
title.’’. 
(b) METHODS FOR DETERMINING PAYMENT BASIS 
FOR NEW LAB TESTS.—Section 1833(h) (42 U.S.C. 
1395l(h)) is amended by adding at the end the following:
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‘‘(8)(A) The Secretary shall establish by regulation 
procedures for determining the basis for, and amount of, 
payment under this subsection for any clinical diagnostic 
laboratory test with respect to which a new or substan-
tially revised HCPCS code is assigned on or after January 
1, 2005 (in this paragraph referred to as ‘new tests’). 
‘‘(B) Determinations under subparagraph (A) shall 
be made only after the Secretary—
‘‘(i) makes available to the public (through an 
Internet site and other appropriate mechanisms) a 
list that includes any such test for which establish-
ment of a payment amount under this subsection is 
being considered for a year; 
‘‘(ii) on the same day such list is made avail-
able, causes to have published in the Federal Reg-
ister notice of a meeting to receive comments and 
recommendations (and data on which recommenda-
tions are based) from the public on the appropriate 
basis under this subsection for establishing payment 
amounts for the tests on such list; 
‘‘(iii) not less than 30 days after publication of 
such notice convenes a meeting, that includes rep-
resentatives of officials of the Centers for Medicare 
& Medicaid Services involved in determining pay-
ment amounts, to receive such comments and rec-