I 
112TH CONGRESS 
1ST SESSION H. R. 2925 
To establish a smart card pilot program under the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 14, 2011 
Mr. GERLACH (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 
A BILL 
To establish a smart card pilot program under the Medicare 
program. 
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 Common Ac-
cess Card Act of 2011’’. 
SEC. 2. SECURE MEDICARE CARD PILOT PROGRAM. 
(a) PILOT PROGRAM IMPLEMENTATION (PHASE I).— 
(1) IN GENERAL.—Not later than 18 months 
after the date of the enactment of this Act, the Sec-
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retary shall conduct a pilot program under title 
XVIII of the Social Security Act for the purpose of 
utilizing smart card technology for Medicare bene-
ficiary and provider identification cards in order 
to— 
(A) increase the quality of care furnished 
to Medicare beneficiaries; 
(B) improve the accuracy and efficiency in 
the billing for Medicare items and services fur-
nished by Medicare providers; 
(C) reduce the potential for identity theft 
and other unlawful use of Medicare beneficiary 
and provider identifying information; and 
(D) reduce waste, fraud, and abuse in the 
Medicare program. 
(2) SITE REQUIREMENTS.—The Secretary shall 
conduct the pilot program in at least 5 geographic 
areas in which the Secretary determines there is a 
high risk for waste, fraud, or abuse. 
(3) DESIGN OF PILOT PROGRAM.—In designing 
the pilot program, the Secretary shall provide for the 
following: 
(A) Implementation of a system that uti-
lizes a smart card as a Medicare identification 
card for Medicare beneficiaries and Medicare 
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providers. Such a card shall contain appropriate 
security features and protect personal privacy. 
(B) Issuance of a new smart card to all 
Medicare beneficiaries participating in the pilot 
program. Such card shall not have the Social 
Security number printed on the front but, in-
stead shall have such number stored securely on 
the smart card chip along with other informa-
tion the Secretary deems necessary. 
(C) Issuance of a new provider card to all 
Medicare providers participating in the pilot 
program. Such card shall include a photograph 
of the provider and shall not have the Medicare 
provider number printed on the front of the 
card but, instead shall have such number stored 
securely on the smart card chip along with 
other information the Secretary deems nec-
essary. 
(D) A process for enrollment of all Medi-
care providers that includes— 
(i) identity and certification verifica-
tion; and 
(ii) utilization of biometric data, such 
as fingerprints, for provider identification 
and authentication. 
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(E) A process under which the cards 
issued under subparagraphs (B) and (C) are 
used by both Medicare beneficiaries and Medi-
care providers to verify eligibility, prevent 
fraud, and authorize transactions. 
(F) Distribution of necessary equipment, 
including cards, card readers, kiosks, biometric 
readers, and other materials or documents to 
Medicare beneficiaries and providers at no cost 
to them. 
(G) Regular monitoring and review by the 
Secretary of Medicare providers’ Medicare bil-
lings and Medicare beneficiaries’ Medicare 
records in order to identify and address inac-
curate charges and instances of waste, fraud, or 
abuse. 
(H) Reporting mechanisms for measuring 
the cost savings to the Medicare program by 
reason of the pilot program. 
(I) Including provisions— 
(i) to ensure that all devices and sys-
tems utilized as part of the pilot program 
comply with standards for identity creden-
tials and biometric data developed by the 
American National Standards Institute 
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and the National Institute of Standards 
and Technology and Federal requirements 
relating to interoperability and information 
security, including all requirements under 
the Health Insurance Portability and Ac-
countability Act of 1996; 
(ii) to ensure that a Medicare bene-
ficiary’s and provider’s personal identi-
fying, health, and other information is pro-
tected from unauthorized access or disclo-
sure through the use of at least two-factor 
authentication; 
(iii) for the development of procedures 
and guidelines for the use of identification 
cards, card readers, kiosks, biometric data 
and readers, and other equipment to verify 
a Medicare beneficiary’s identity and eligi-
bility for services; 
(iv) to ensure that each Medicare ben-
eficiary and provider participating in the 
pilot program is informed of— 
(I) the purpose of the program; 
(II) the processes for capturing, 
enrolling, and verifying their eligibility 
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and, with respect to providers, their 
biometric data; 
(III) the manner in which the bi-
ometric data for providers will be 
used; and 
(IV) the steps that will be taken 
to protect personal identifying, health, 
and other information from unauthor-
ized access and disclosure; 
(v) for addressing problems related to 
the loss, theft, or malfunction of or dam-
age to equipment and any identifying docu-
ments or materials provided by the Sec-
retary; 
(vi) for development of a hotline, Web 
site, or other means by which Medicare 
beneficiaries and providers can contact the 
Secretary for assistance; and 
(vii) for addressing problems related 
to accessing care outside the pilot area and 
cases where the individual faces issues re-
lated to physical or other capacity limita-
tions. 
(4) PRIVACY.—Information on the smart card 
shall only be disclosed if the disclosure of such infor-
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mation is permitted under the Federal regulations 
(concerning the privacy of individually identifiable 
health information) promulgated under section 
264(c) of the Health Insurance Portability and Ac-
countability Act of 1996. 
(5) DISCLOSURE EXEMPTION.—Information on 
the smart card shall be exempt from disclosure 
under section 552(b)(3) of title 5, United States 
Code. 
(b) EXPANDED IMPLEMENTATION (PHASE II).— 
Taking into account the interim report under subsection 
(d)(2), the Secretary shall, through rulemaking, expand 
the duration and the scope of the pilot program, to the 
extent determined appropriate by the Secretary. 
(c) WAIVER AUTHORITY.—The Secretary may waive 
such provisions of titles XI and XVIII of the Social Secu-
rity Act as the Secretary determines to be appropriate for 
the conduct of the pilot program. 
(d) REPORTS TO CONGRESS.— 
(1) PLAN.—Not later than 6 months after the 
date of the enactment of this Act, the Secretary 
shall submit to Congress a report that contains a de-
scription of the design and development of the pilot 
program, including the Secretary’s plan for imple-
mentation. 
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(2) INTERIM REPORT.—Not later than 1 year 
after the date that the pilot program is first imple-
mented, the Secretary shall conduct an evaluation of 
the pilot program and submit an interim report to 
Congress. Such an evaluation shall include an initial 
analysis of the deployment of the program, the 
usability of the card system, and the measures taken 
to protect beneficiary and provider information. 
(3) ADDITIONAL
REPORT.—Not later than 2 
years after the date that the pilot program is first 
implemented, the Secretary shall submit to Congress 
a report on the pilot program. Such report shall con-
tain a detailed description of issues related to the ex-
pansion of the program under subsection (b) and 
recommendations for such legislation and adminis-
trative actions as the Secretary considers appro-
priate for implementation of the program on a na-
tionwide basis. 
(e) 
FUNDING.—There 
are 
appropriated, 
from 
amounts in the Treasury not otherwise appropriated, 
$29,000,000 for the design, implementation, and evalua-
tion of the pilot program. Amounts appropriated under the 
preceding sentence shall remain available until expended. 
(f) DEFINITIONS.—In this section: 
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(1) 
MEDICARE
BENEFICIARY.—The 
term 
‘‘Medicare beneficiary’’ means an individual entitled 
to, or enrolled for, benefits under part A of title 
XVIII of the Social Security Act or enrolled for ben-
efits under part B of such title. 
(2) MEDICARE PROGRAM.—The term ‘‘Medicare 
program’’ means the health benefits program under 
title XVIII of the Social Security Act. 
(3) MEDICARE
PROVIDER.—The term ‘‘Medi-
care provider’’ means a provider of services (as de-
fined in subsection (u) of section 1861 of the Social 
Security Act (42 U.S.C. 1395x)) and a supplier (as 
defined in subsection (d) of such section), including 
a supplier of durable medical equipment and sup-
plies. 
(4) PILOT
PROGRAM.—The term ‘‘pilot pro-
gram’’ means the pilot program conducted under 
this section. 
(5) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(6) SMART
CARD.—The term ‘‘smart card’’ 
means a secure, electronic, machine readable, fraud- 
resistant, tamper-resistant card that includes an em-
bedded integrated circuit chip with a secure micro- 
controller. 
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(g) REVISION OF MEDICARE IMPROVEMENT FUND.— 
Section 1898(b)(1) of the Social Security Act (42 U.S.C. 
1395iii(b)(1)) is amended— 
(1) by striking subparagraphs (A) and (B) and 
inserting the following subparagraph: 
‘‘(A) fiscal year 2015, $246,000,000; and’’; 
and 
(2) by redesignating subparagraph (C) as sub-
paragraph (B). 
Æ 
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