I
106TH CONGRESS
1ST SESSION
H. R. 421
To direct the Secretary of Health and Human Services to reduce the amount
of coinsurance payable in conjunction with outpatient department services
furnished under the Medicare Program, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 19, 1999
Mr. STARK introduced the following bill; which was referred to the Committee
on Commerce, and in addition to the Committee on Ways and Means,
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 direct the Secretary of Health and Human Services to
reduce the amount of coinsurance payable in conjunction
with outpatient department services furnished under the
Medicare Program, and for other purposes.
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 Hospital
Outpatient Coinsurance Assistance Act of 1999’’.
SEC. 2. REDUCTION IN RATE OF COINSURANCE PAYABLE
FOR OUTPATIENT DEPARTMENT SERVICES
FURNISHED UNDER MEDICARE.
(a) REDUCTION IN RATE OF COINSURANCE.—
(1) IN GENERAL.—For services furnished under
the medicare program during the period described in
paragraph (2), the Secretary of Health and Human
Services shall provide for a reduction in the OPD co-
insurance payment by a percentage that the Sec-
retary determines would result in an amount of ag-
gregate savings to effected medicare beneficiaries
equal to $460,000,000, adjusted proportionally in
the manner provided in paragraph (3).
(2) PERIOD
DESCRIBED.—For purposes of
paragraph (1), the period described in this para-
graph is the period beginning on the date of the en-
actment of this Act ending on the date of the imple-
mentation of the prospective payment system for
hospital outpatient department services under sec-
tion 1833(t) of the Social Security Act (42 U.S.C.
1395l(t)).
(3) PROPORTIONAL
ADJUSTMENT.—In deter-
mining the reduction under paragraph (1), the Sec-
retary shall make a proportional adjustment to the
reduction such that the reduction applies such ag-
gregate savings over the period of 1999 that follows
the date of the enactment of this Act.
(b) MEDICARE PAYMENT RATE.—For purposes of
payment to providers of services (as defined in section
1861(u) of such Act (42 U.S.C. 1395x(u)) under the sec-
tions described in subparagraphs (A) through (C) of sub-
section (c)(1), the Secretary of Health and Human Serv-
ices shall make payments to such providers for items and
services furnished without regard to the application of
under subsection (a).
(c) DEFINITIONS.—As used in this section:
(1) OPD COINSURANCE PAYMENT.—The term
‘‘OPD coinsurance payment’’ means the coinsurance
payment imposed under section 1866(a)(2)(A)(ii) of
the 
Social 
Security 
Act 
(42 
U.S.C.
1395cc(a)(2)(A)(ii)) with respect to items and serv-
ices furnished under the following sections of such
Act:
(A) Section 1833(a)(2)(B) (42 U.S.C.
1395l(a)(2)(B)).
(B) Section 1833(i)(2)(A) (42 U.S.C.
1395l(i)(2)(A)).
(C) Section 1833(n) (42 U.S.C. 1395l(n)).
(2) EFFECTED
MEDICARE
BENEFICIARIES.—
The term ‘‘effected medicare beneficiaries’’ means
individuals enrolled under part B of the medicare
program under title XVIII of such Act who are re-
quired to make OPD coinsurance payments for
items and services furnished under such program
during 1999.
(d) PROMPT IMPLEMENTATION.—
(1) IN GENERAL.—The Secretary of Health and
Human Services shall promptly issue (without re-
gard to chapter 8 of title 5, United States Code)
program memoranda as may be necessary to provide
for the reduction under subsection (a) for services
furnished on or after January 1, 1999.
(2) JUDICIAL REVIEW.—There shall be no ad-
ministrative or judicial review under section 1869 of
the Social Security Act (42 U.S.C. 1395ff), 1878 of
such Act (42 U.S.C. 1395ff), or under any other
provision of law of any action by the Secretary in
determining the reduction under subsection (a).
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