I
106TH CONGRESS
1ST SESSION
H. R. 1646
To authorize the Secretary of Health and Human Services to provide for
an extra payment amount under the Medicare Program to rural providers
of services who furnish case manager services to Medicare beneficiaries.
IN THE HOUSE OF REPRESENTATIVES
APRIL 29, 1999
Mr. STARK introduced the following bill; which was referred to the Committee
on Ways and Means, and in addition to the Committee on 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 concerned
A BILL
To authorize the Secretary of Health and Human Services
to provide for an extra payment amount under the Medi-
care Program to rural providers of services who furnish
case manager services to Medicare beneficiaries.
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 referred to as the ‘‘Rural Case Man-
agement Act of 1999’’.
SEC. 2. ADDITIONAL PAYMENT AMOUNT TO RURAL PRO-
VIDERS OF SERVICES WHO FURNISH CASE
MANAGER SERVICES.
(a) AUTHORITY TO PROVIDE ADDITIONAL PAYMENT
FOR RURAL CASE MANAGER SERVICES.—In the case of
a provider of services or a physician that furnishes services
to Medicare beneficiaries in a rural area, the Secretary
of Health and Human Services may provide for an addi-
tional payment under the Medicare Program for rural case
manager services furnished by such provider or physician
to Medicare beneficiaries.
(b) REQUIREMENT FOR RURAL CASE MANAGEMENT
PLAN.—No payment may be made under subsection (a)
for rural case manager services furnished to a Medicare
beneficiary unless such provider or physician establishes,
and periodically reviews, a rural case management plan
for furnishing items and services for the treatment of the
illness or injury of the Medicare beneficiary. The Secretary
shall establish such standards as the Secretary finds nec-
essary for the effective and efficient development and over-
sight of rural case manager services and rural case man-
agement plans to ensure the health and safety of Medicare
beneficiaries furnished services under such a plan.
(c) PAYMENT.—
(1) IN
GENERAL.—Payment may be made
under this section for rural case manager services
with respect to a Medicare beneficiary only—
(A) for the initial development of the rural
case management plan for the individual, and
(B) for the subsequent review and modi-
fication of such plan, as provided by the Sec-
retary in regulations.
(2) PAYMENT
UNDER
FEE
SCHEDULE.—Pay-
ment under this section for rural case manager serv-
ices shall be made pursuant to the fee schedule es-
tablished by the Secretary.
(3) ESTABLISHMENT OF FEE SCHEDULE.—
(A) IN GENERAL.—The Secretary shall es-
tablish a fee schedule for payment for rural
case manager services. Such schedule may pro-
vide for rates that differ for such services that
comprise the establishment of a rural case man-
agement plan and that comprise review and
modification of such a plan.
(B) 
CONSIDERATIONS.—In 
establishing
such fee schedule, the Secretary shall consider
appropriate regional and operational differences
and adjustments to payment rates to account
for inflation and other relevant factors.