I 
117TH CONGRESS 
1ST SESSION H. R. 3322 
To amend title XVIII of the Social Security Act to establish a Medicare 
payment option for patients and eligible professionals to freely contract, 
without penalty, for Medicare fee-for-service items and services, while 
allowing Medicare beneficiaries to use their Medicare benefits. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 18, 2021 
Mr. SESSIONS introduced the following bill; which was referred to the Com-
mittee on Energy and 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 amend title XVIII of the Social Security Act to establish 
a Medicare payment option for patients and eligible pro-
fessionals to freely contract, without penalty, for Medi-
care fee-for-service items and services, while allowing 
Medicare beneficiaries to use their Medicare benefits. 
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 Patient Em-
powerment Act of 2021’’. 
VerDate Sep 11 2014 
00:31 Jun 22, 2021
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H3322.IH
H3322
kjohnson on DSK79L0C42PROD with BILLS
SEC. 2. GUARANTEEING FREEDOM OF CHOICE AND CON-
TRACTING FOR PATIENTS UNDER MEDICARE. 
(a) IN GENERAL.—Section 1802 of the Social Secu-
rity Act (42 U.S.C. 1395a) is amended to read as follows: 
‘‘FREEDOM OF CHOICE AND CONTRACTING BY PATIENT 
GUARANTEED 
‘‘SEC. 1802. (a) BASIC FREEDOM OF CHOICE.—Any 
individual entitled to insurance benefits under this title 
may obtain health services from any institution, agency, 
or person qualified to participate under this title if such 
institution, agency, or person undertakes to provide that 
individual such services. 
‘‘(b) FREEDOM TO CONTRACT BY MEDICARE BENE-
FICIARIES.— 
‘‘(1) IN GENERAL.—Subject to the provisions of 
this subsection, nothing in this title shall prohibit a 
Medicare beneficiary from entering into a contract 
with an eligible professional (whether or not the pro-
fessional is a participating or non-participating phy-
sician or practitioner) for any item or service cov-
ered under this title. 
‘‘(2) SUBMISSION OF CLAIMS.—Any Medicare 
beneficiary that enters into a contract under this 
section with an eligible professional shall be per-
mitted to submit a claim for payment under this 
title for services furnished by such professional, and 
VerDate Sep 11 2014 
00:31 Jun 22, 2021
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H3322.IH
H3322
kjohnson on DSK79L0C42PROD with BILLS
unless otherwise provided in the contract 
under subparagraph (C)(i); and 
‘‘(iii) acknowledges that no limits or 
other payment incentives that may other-
wise apply under this title (such as the 
limits under subsection (g) of section 1848 
or incentives under subsection (a)(5), (m), 
(q), and (p) of such section) shall apply to 
amounts that may be charged, or paid to 
a beneficiary for, such items or services. 
Such contract shall also clearly indicate whether 
the eligible professional is excluded from par-
ticipation under the Medicare program under 
section 1128. 
‘‘(C) BENEFICIARY
ELECTIONS
UNDER 
THE
CONTRACT.—Any Medicare beneficiary 
that enters into a contract under this section 
may elect to negotiate, as a term of the con-
tract, a provision under which— 
‘‘(i) the eligible professional shall file 
claims on behalf of the beneficiary with the 
Secretary and any supplemental insurance 
plan for items or services furnished under 
the contract if such items or services are 
VerDate Sep 11 2014 
00:31 Jun 22, 2021
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H3322.IH
H3322
kjohnson on DSK79L0C42PROD with BILLS
covered under this title or under the plan; 
and 
‘‘(ii) the beneficiary assigns payment 
to the eligible professional for any claims 
filed by, or on behalf of, the beneficiary 
with the Secretary and any supplemental 
insurance plan for items or services fur-
nished under the contract. 
‘‘(D) EXCLUSION OF DUAL ELIGIBLE INDI-
VIDUALS.—Paragraph (1) shall not apply to 
any contract if a beneficiary who is eligible for 
medical assistance under title XIX is a party to 
the contract. 
‘‘(4) LIMITATION
ON
ACTUAL
CHARGE
AND 
CLAIM
SUBMISSION
REQUIREMENT
NOT
APPLICA-
BLE.—Section 1848(g) shall not apply with respect 
to any item or service provided to a Medicare bene-
ficiary under a contract described in paragraph (1). 
‘‘(5) CONSTRUCTION.—Nothing in this section 
shall be construed— 
‘‘(A) to prohibit any eligible professional 
from maintaining an election and acting as a 
participating or non-participating physician or 
practitioner with respect to any patient not cov-
VerDate Sep 11 2014 
00:31 Jun 22, 2021
Jkt 019200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H3322.IH
H3322
kjohnson on DSK79L0C42PROD with BILLS
ered under a contract established under this 
section; and 
‘‘(B) as changing the items and services 
for which an eligible professional may bill under 
this title. 
‘‘(6) DEFINITIONS.—In this subsection: 
‘‘(A) MEDICARE BENEFICIARY.—The term 
‘Medicare beneficiary’ means an individual who 
is entitled to benefits under part A or enrolled 
under part B. 
‘‘(B) ELIGIBLE PROFESSIONAL.—The term 
‘eligible professional’ has the meaning given 
such term in section 1848(k)(3)(B). 
‘‘(C) EMERGENCY MEDICAL CONDITION.— 
The term ‘emergency medical condition’ means 
a medical condition manifesting itself by acute 
symptoms of sufficient severity (including se-
vere pain) such that a prudent layperson, with 
an average knowledge of health and medicine, 
could reasonably expect the absence of imme-
diate medical attention to result in— 
‘‘(i) serious jeopardy to the health of 
the individual or, in the case of a pregnant 
woman, the health of the woman or her 
unborn child; 
VerDate Sep 11 2014 
00:31 Jun 22, 2021
Jkt 019200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H3322.IH
H3322
kjohnson on DSK79L0C42PROD with BILLS
‘‘(ii) serious impairment to bodily 
functions; or 
‘‘(iii) serious dysfunction of any bodily 
organ or part. 
‘‘(D) 
PARTICIPATING; 
NON-PARTICI-
PATING.—The terms ‘participating’ and ‘non-
participating’ have the meanings given such 
terms under subsection (h) of section 1842 for 
purposes of such section. 
‘‘(E) 
URGENT
HEALTH
CARE
SITUA-
TION.—The term ‘urgent health care situation’ 
means services furnished to an individual who 
requires services to be furnished within 12 
hours in order to avoid the likely onset of an 
emergency medical condition.’’. 
SEC. 3. PREEMPTION OF STATE LAWS LIMITING CHARGES 
FOR SERVICES BY AN ELIGIBLE PROFES-
SIONAL. 
(a) IN GENERAL.—No State may impose a limit on 
the amount of charges for services, furnished by an eligible 
professional (as defined in subsection (k)(3)(B) of section 
1848 of the Social Security Act, 42 U.S.C. 1395w–4), for 
which payment is made under such section, and any such 
limit is hereby preempted. 
VerDate Sep 11 2014 
00:31 Jun 22, 2021
Jkt 019200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H3322.IH
H3322
kjohnson on DSK79L0C42PROD with BILLS
(b) STATE.—In this section, the term ‘‘State’’ in-
cludes the District of Columbia, Puerto Rico, the Virgin 
Islands, Guam, and American Samoa. 
Æ 
VerDate Sep 11 2014 
00:31 Jun 22, 2021
Jkt 019200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6301
E:\BILLS\H3322.IH
H3322
kjohnson on DSK79L0C42PROD with BILLS