IB 
Union Calendar No. 727 
115TH CONGRESS 
2D SESSION 
H. R. 6690 
[Report No. 115–936, Part I] 
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 
SEPTEMBER 10, 2018 
Additional sponsors: Mr. BRENDAN F. BOYLE of Pennsylvania, Mrs. 
DINGELL, Mr. SHIMKUS, and Mr. CONNOLLY 
SEPTEMBER 10, 2018 
Reported from the Committee on Ways and Means with an amendment 
[Strike out all after the enacting clause and insert the part printed in italic] 
SEPTEMBER 10, 2018 
Committee on Energy and Commerce discharged; committed to the Committee 
of the Whole House on the State of the Union and ordered to be printed 
[For text of introduced bill, see copy of bill as introduced on August 28, 2018] 
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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’’. 
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 Sec-
retary shall establish a pilot program (in this section 
referred to as the ‘pilot program’) to evaluate the fea-
sibility 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-
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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 
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 adju-
dication 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 consultation 
with the Inspector General of the Department of 
Health and Human Services, the Secretary shall 
select at least 3 geographic areas in which the 
pilot program will operate. 
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‘‘(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 
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 supplier or 
provider that either— 
‘‘(i) does not have access to card reader 
technology (as described in paragraph 
(2)(B)); 
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‘‘(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 READ-
ER ISSUANCE.— 
‘‘(i) 
BENEFICIARY
SMART
CARD 
ISSUANCE.—The Secretary shall provide for, 
at no cost, the issuance (and, if necessary, 
replacement) of beneficiary smart cards de-
scribed in paragraph (2)(A) to all Medicare 
beneficiaries residing in a geographic area 
in which the pilot program is conducted 
under subparagraph (A). Information 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. 
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‘‘(E) INFORMATION ON OPERATION OF PILOT 
PROGRAM.—The Secretary shall provide partici-
pating suppliers and providers and Medicare 
beneficiaries who are furnished items and serv-
ices by such suppliers and providers, with infor-
mation on the operation of the pilot program, 
including privacy protections described in sub-
paragraph (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 sup-
pliers 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 bene-
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ficiaries who receive beneficiary smart 
cards. 
‘‘(II) PARTICIPATING
SUPPLIERS 
AND PROVIDERS FURNISHING SERVICES 
TO
NON-PARTICIPATING
BENE-
FICIARIES.—Supplier and providers 
participating in the pilot program 
may submit claims under this title for 
items and services furnished to Medi-
care beneficiaries who do not receive 
beneficiary smart cards. 
‘‘(G) CLARIFICATION ON ACCESS TO SERV-
ICES WITHOUT SMART CARDS.—In the case of a 
Medicare beneficiary who receives a beneficiary 
smart card and does not present such card at the 
time of receipt of items or services from a par-
ticipating supplier or provider, the participating 
supplier or provider— 
‘‘(i) shall furnish such items or services 
to such Medicare beneficiary as if such ben-
eficiary does present such card; 
‘‘(ii) may submit claims under this 
title for such items or services; and 
‘‘(iii) shall provide, in accordance with 
such manner, process, and timing as speci-
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fied by the Secretary, information to the 
Secretary (through the contractor described 
in subparagraph (H)) that such beneficiary 
received such a smart card but did not have 
the smart card at the time the items or serv-
ices were furnished. 
‘‘(H) PRIVATE SECTOR IMPLEMENTATION.— 
The Secretary shall select, by using a competitive 
procurement process in accordance with the pro-
visions of chapter 1 of title 48, Code of Federal 
Regulations (or any successor regulations), a 
private sector contractor to implement and oper-
ate the pilot program. 
‘‘(I) PRIVACY PROTECTIONS.—The Secretary 
shall ensure that the pilot program complies 
with applicable Federal laws and regulations 
concerning individually identifiable health infor-
mation, including the Privacy Act of 1974 and 
regulations promulgated under section 264(c) of 
the Health Insurance Portability and Account-
ability Act of 1996 and such individually identi-
fiable information shall be exempt from disclo-
sure under section 552(b)(3) of title 5, United 
States Code. 
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‘‘(J) MANDATORY PARTICIPATION.—Subject 
to subparagraph (C), in the case of items or serv-
ices 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 services 
during the period of the pilot program if the pro-
vider 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 partici-
pating suppliers and providers with respect 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 con-
sisting of stakeholders (including representatives 
of providers, suppliers, technology vendors, Medi-
care beneficiaries, and claims processing contrac-
tors) selected by the Secretary for purposes of 
providing input to the Secretary on the imple-
mentation of the pilot program (including on the 
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selection of areas and participants under sub-
paragraphs (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 
to the panel convened pursuant to subparagraph 
(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 original 
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 im-
plemented, an interim report on the performance of 
such program. 
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‘‘(2) FINAL PERFORMANCE REPORT.—Not later 
than 18 months after the date of the completion of the 
pilot program, a final evaluation on the effectiveness 
of the pilot program. The report shall include the fol-
lowing: 
‘‘(A) An evaluation of the effect of the pilot 
program on potential fraud under the insurance 
programs established under this title. 
‘‘(B) A description of any barriers to imple-
mentation of the pilot program. 
‘‘(C) Participant feedback on the pilot pro-
gram. 
‘‘(D) Recommendations regarding the future 
use of smart cards to address fraud under this 
title. 
‘‘(E) Data on the information provided 
under subsection (a)(3)(G)(iii).’’. 
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Union Calendar No. 727 
115TH CONGRESS 
2D SESSION 
H. R. 6690 
[Report No. 115–936, Part I] 
A BILL 
To establish a smart card pilot program to combat 
fraud, waste, and abuse and to protect bene-
ficiary identity under the Medicare program. 
SEPTEMBER 10, 2018 
Reported from the Committee on Ways and Means with 
an amendment 
SEPTEMBER 10, 2018 
Committee on Energy and Commerce discharged; com-
mitted to the Committee of the Whole House on the 
State of the Union and ordered to be printed 
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