H. R. 2—74 
‘‘(3) TREATMENT OF WAIVERED STATES.—In the case of a 
State described in subsection (p)(6), nothing in this section 
shall be construed as preventing the State from modifying 
its alternative simplification program under such subsection 
so as to eliminate the coverage of the part B deductible for 
any medical supplemental policy sold or issued under such 
program to a newly eligible Medicare beneficiary on or after 
January 1, 2020. 
‘‘(4) TREATMENT OF REFERENCES TO CERTAIN POLICIES.— 
In the case of a newly eligible Medicare beneficiary, except 
as the Secretary may otherwise provide, any reference in this 
section to a medicare supplemental policy which has a benefit 
package classified as ‘C’ or ‘F’ shall be deemed, as of January 
1, 2020, to be a reference to a medicare supplemental policy 
which has a benefit package classified as ‘D’ or ‘G’, respectively. 
‘‘(5) ENFORCEMENT.—The penalties described in clause (ii) 
of subsection (d)(3)(A) shall apply with respect to a violation 
of paragraph (1) in the same manner as it applies to a violation 
of clause (i) of such subsection.’’. 
SEC. 402. INCOME-RELATED PREMIUM ADJUSTMENT FOR PARTS B AND 
D. 
(a) IN GENERAL.—Section 1839(i)(3)(C)(i) of the Social Security 
Act (42 U.S.C. 1395r(i)(3)(C)(i)) is amended— 
(1) by inserting after ‘‘IN GENERAL.—’’ the following: 
‘‘(I) Subject to paragraphs (5) and (6), for years 
before 2018:’’; and 
(2) by adding at the end the following: 
‘‘(II) Subject to paragraph (5), for years begin-
ning with 2018: 
‘‘If the modified adjusted gross income is: 
The applicable 
percentage is:
More than $85,000 but not more than 
$107,000 ...................................................
35 percent
More than $107,000 but not more than 
$133,500 ...................................................
50 percent
More than $133,500 but not more than 
$160,000 ...................................................
65 percent
More than $160,000 ....................................
80 percent.’’. 
(b) CONFORMING AMENDMENTS.—Section 1839(i) of the Social 
Security Act (42 U.S.C. 1395r(i)) is amended— 
(1) in paragraph (2)(A), by inserting ‘‘(or, beginning with 
2018, $85,000)’’ after ‘‘$80,000’’; 
(2) in paragraph (3)(A)(i), by inserting ‘‘applicable’’ before 
‘‘table’’; 
(3) in paragraph (5)(A)— 
(A) in the matter before clause (i), by inserting ‘‘(other 
than 2018 and 2019)’’ after ‘‘2007’’; and 
(B) in clause (ii), by inserting ‘‘(or, in the case of 
a calendar year beginning with 2020, August 2018)’’ after 
‘‘August 2006’’; and 
(4) in paragraph (6), in the matter before subparagraph 
(A), by striking ‘‘2019’’ and inserting ‘‘2017’’.
H. R. 2—75 
Subtitle B—Other Offsets 
SEC. 411. MEDICARE PAYMENT UPDATES FOR POST-ACUTE PRO-
VIDERS. 
(a) SNFS.—Section 1888(e) of the Social Security Act (42 U.S.C. 
1395yy(e))— 
(1) in paragraph (5)(B)— 
(A) in clause (i), by striking ‘‘clause (ii)’’ and inserting 
‘‘clauses (ii) and (iii)’’; 
(B) in clause (ii), by inserting ‘‘subject to clause (iii),’’ 
after ‘‘each subsequent fiscal year,’’; and 
(C) by adding at the end the following new clause: 
‘‘(iii) SPECIAL
RULE
FOR
FISCAL
YEAR
2018.—For 
fiscal year 2018 (or other similar annual period speci-
fied in clause (i)), the skilled nursing facility market 
basket percentage, after application of clause (ii), is 
equal to 1 percent.’’; and 
(2) in paragraph (6)(A), by striking ‘‘paragraph (5)(B)(ii)’’ 
and inserting ‘‘clauses (ii) and (iii) of paragraph (5)(B)’’ each 
place it appears. 
(b) IRFS.—Section 1886(j) of the Social Security Act (42 U.S.C. 
1395ww(j)) is amended— 
(1) in paragraph (3)(C)— 
(A) in clause (i), by striking ‘‘clause (ii)’’ and inserting 
‘‘clauses (ii) and (iii)’’; 
(B) in clause (ii), by striking ‘‘After’’ and inserting 
‘‘Subject to clause (iii), after’’; and 
(C) by adding at the end the following new clause: 
‘‘(iii) SPECIAL
RULE
FOR
FISCAL
YEAR
2018.—The 
increase factor to be applied under this subparagraph 
for fiscal year 2018, after the application of clause 
(ii), shall be 1 percent.’’; and 
(2) in paragraph (7)(A)(i), by striking ‘‘paragraph (3)(D)’’ 
and inserting ‘‘subparagraphs (C)(iii) and (D) of paragraph (3)’’. 
(c) HHAS.—Section 1895(b)(3)(B) of the Social Security Act 
(42 U.S.C. 1395fff(b)(3)(B)) is amended— 
(1) in clause (iii), by adding at the end the following: 
‘‘Notwithstanding the previous sentence, the home health 
market basket percentage increase for 2018 shall be 1 percent.’’; 
and 
(2) in clause (vi)(I), by inserting ‘‘(except 2018)’’ after ‘‘each 
subsequent year’’. 
(d) HOSPICE.—Section 1814(i) of the Social Security Act (42 
U.S.C. 1395f(i)) is amended— 
(1) in paragraph (1)(C)— 
(A) in clause (ii)(VII), by striking ‘‘clause (iv),,’’ and 
inserting ‘‘clauses (iv) and (vi),’’; 
(B) in clause (iii), by striking ‘‘clause (iv),’’ and inserting 
‘‘clauses (iv) and (vi),’’; 
(C) in clause (iv), by striking ‘‘After determining’’ and 
inserting ‘‘Subject to clause (vi), after determining’’; and 
(D) by adding at the end the following new clause: 
‘‘(vi) For fiscal year 2018, the market basket percentage increase 
under clause (ii)(VII) or (iii), as applicable, after application of 
clause (iv), shall be 1 percent.’’; and
H. R. 2—76 
(2) in paragraph (5)(A)(i), by striking ‘‘paragraph (1)(C)(iv)’’ 
and inserting ‘‘clauses (iv) and (vi) of paragraph (1)(C)’’. 
(e) LTCHS.—Section 1886(m)(3) of the Social Security Act (42 
U.S.C. 1395ww(m)(3)) is amended— 
(1) in subparagraph (A), in the matter preceding clause 
(i), by striking ‘‘In implementing’’ and inserting ‘‘Subject to 
subparagraph (C), in implementing’’; and 
(2) by adding at the end the following new subparagraph: 
‘‘(C) ADDITIONAL SPECIAL RULE.—For fiscal year 2018, 
the annual update under subparagraph (A) for the fiscal 
year, after application of clauses (i) and (ii) of subparagraph 
(A), shall be 1 percent.’’. 
SEC. 412. DELAY OF REDUCTION TO MEDICAID DSH ALLOTMENTS. 
Section 1923(f) of the Social Security Act (42 U.S.C. 1396r– 
4(f)) is amended— 
(1) in paragraph (7)(A)— 
(A) in clause (i), by striking ‘‘2017 through 2024’’ and 
inserting ‘‘2018 through 2025’’; 
(B) by striking clause (ii) and inserting the following 
new clause: 
‘‘(ii) 
AGGREGATE
REDUCTIONS.—The 
aggregate 
reductions in DSH allotments for all States under 
clause (i)(I) shall be equal to— 
‘‘(I) $2,000,000,000 for fiscal year 2018; 
‘‘(II) $3,000,000,000 for fiscal year 2019; 
‘‘(III) $4,000,000,000 for fiscal year 2020; 
‘‘(IV) $5,000,000,000 for fiscal year 2021; 
‘‘(V) $6,000,000,000 for fiscal year 2022; 
‘‘(VI) $7,000,000,000 for fiscal year 2023; 
‘‘(VII) $8,000,000,000 for fiscal year 2024; and 
‘‘(VIII) $8,000,000,000 for fiscal year 2025.’’; 
and 
(C) by adding at the end the following new clause: 
‘‘(v) DISTRIBUTION OF AGGREGATE REDUCTIONS.— 
The Secretary shall distribute the aggregate reductions 
under clause (ii) among States in accordance with 
subparagraph (B).’’; and 
(2) in paragraph (8), by striking ‘‘2024’’ and inserting 
‘‘2025’’. 
SEC. 413. LEVY ON DELINQUENT PROVIDERS. 
(a) IN GENERAL.—Paragraph (3) of section 6331(h) of the 
Internal Revenue Code of 1986 is amended by striking ‘‘30 percent’’ 
and inserting ‘‘100 percent’’. 
(b) EFFECTIVE DATE.—The amendment made by this section 
shall apply to payments made after 180 days after the date of 
the enactment of this Act. 
SEC. 414. ADJUSTMENTS TO INPATIENT HOSPITAL PAYMENT RATES. 
Section 7(b) of the TMA, Abstinence Education, and QI Pro-
grams Extension Act of 2007 (Public Law 110–90), as amended 
by section 631(b) of the American Taxpayer Relief Act of 2012 
(Public Law 112–240), is amended— 
(1) in paragraph (1)— 
(A) in the matter preceding subparagraph (A), by 
striking ‘‘, 2009, or 2010’’ and inserting ‘‘or 2009’’; and 
(B) in subparagraph (B)—
H. R. 2—77 
(i) in clause (i), by striking ‘‘and’’ at the end; 
(ii) in clause (ii), by striking the period at the 
end and inserting ‘‘; and’’; and 
(iii) by adding at the end the following new clause: 
‘‘(iii) make an additional adjustment to the standard-
ized amounts under such section 1886(d) of an increase 
of 0.5 percentage points for discharges occurring during 
each of fiscal years 2018 through 2023 and not make the 
adjustment (estimated to be an increase of 3.2 percent) 
that would otherwise apply for discharges occurring during 
fiscal year 2018 by reason of the completion of the adjust-
ments required under clause (ii).’’; 
(2) in paragraph (3)— 
(A) by striking ‘‘shall be construed’’ and all that follows 
through ‘‘providing authority’’ and inserting ‘‘shall be con-
strued as providing authority’’; and 
(B) by inserting ‘‘and each succeeding fiscal year 
through fiscal year 2023’’ after ‘‘2017’’; 
(3) by redesignating paragraphs (3) and (4) as paragraphs 
(4) and (5), respectively; and 
(4) by inserting after paragraph (2) the following new para-
graph: 
‘‘(3) PROHIBITION.—The Secretary shall not make an addi-
tional prospective adjustment (estimated to be a decrease of 
0.55 percent) to the standardized amounts under such section 
1886(d) to offset the amount of the increase in aggregate pay-
ments related to documentation and coding changes for dis-
charges occurring during fiscal year 2010.’’. 
TITLE V—MISCELLANEOUS 
Subtitle A—Protecting the Integrity of 
Medicare 
SEC. 501. PROHIBITION OF INCLUSION OF SOCIAL SECURITY ACCOUNT 
NUMBERS ON MEDICARE CARDS. 
(a) IN GENERAL.—Section 205(c)(2)(C) of the Social Security 
Act (42 U.S.C. 405(c)(2)(C)) is amended— 
(1) by moving clause (x), as added by section 1414(a)(2) 
of the Patient Protection and Affordable Care Act, 6 ems to 
the left; 
(2) by redesignating clause (x), as added by section 2(a)(1) 
of the Social Security Number Protection Act of 2010, and 
clause (xi) as clauses (xi) and (xii), respectively; and 
(3) by adding at the end the following new clause: 
‘‘(xiii) The Secretary of Health and Human Services, in consulta-
tion with the Commissioner of Social Security, shall establish cost- 
effective procedures to ensure that a Social Security account number 
(or derivative thereof) is not displayed, coded, or embedded on 
the Medicare card issued to an individual who is entitled to benefits 
under part A of title XVIII or enrolled under part B of title XVIII 
and that any other identifier displayed on such card is not identifi-
able as a Social Security account number (or derivative thereof).’’. 
(b) IMPLEMENTATION.—In implementing clause (xiii) of section 
205(c)(2)(C) of the Social Security Act (42 U.S.C. 405(c)(2)(C)), as
H. R. 2—78 
added by subsection (a)(3), the Secretary of Health and Human 
Services shall do the following: 
(1) IN
GENERAL.—Establish a cost-effective process that 
involves the least amount of disruption to, as well as necessary 
assistance for, Medicare beneficiaries and health care providers, 
such as a process that provides such beneficiaries with access 
to assistance through a toll-free telephone number and provides 
outreach to providers. 
(2) CONSIDERATION
OF
MEDICARE
BENEFICIARY
IDENTI-
FIED.—Consider implementing a process, similar to the process 
involving Railroad Retirement Board beneficiaries, under which 
a Medicare beneficiary identifier which is not a Social Security 
account number (or derivative thereof) is used external to the 
Department of Health and Human Services and is convertible 
over to a Social Security account number (or derivative thereof) 
for use internal to such Department and the Social Security 
Administration. 
(c) FUNDING
FOR IMPLEMENTATION.—For purposes of imple-
menting the provisions of and the amendments made by this section, 
the Secretary of Health and Human Services shall provide for 
the following transfers from the Federal Hospital Insurance Trust 
Fund under section 1817 of the Social Security Act (42 U.S.C. 
1395i) and from the Federal Supplementary Medical Insurance 
Trust Fund established under section 1841 of such Act (42 U.S.C. 
1395t), in such proportions as the Secretary determines appropriate: 
(1) To the Centers for Medicare & Medicaid Program 
Management Account, transfers of the following amounts: 
(A) For fiscal year 2015, $65,000,000, to be made avail-
able through fiscal year 2018. 
(B) For each of fiscal years 2016 and 2017, $53,000,000, 
to be made available through fiscal year 2018. 
(C) For fiscal year 2018, $48,000,000, to be made avail-
able until expended. 
(2) To the Social Security Administration Limitation on 
Administration Account, transfers of the following amounts: 
(A) For fiscal year 2015, $27,000,000, to be made avail-
able through fiscal year 2018. 
(B) For each of fiscal years 2016 and 2017, $22,000,000, 
to be made available through fiscal year 2018. 
(C) For fiscal year 2018, $27,000,000, to be made avail-
able until expended. 
(3) To the Railroad Retirement Board Limitation on 
Administration Account, the following amount: 
(A) For fiscal year 2015, $3,000,000, to be made avail-
able until expended. 
(d) EFFECTIVE DATE.— 
(1) IN
GENERAL.—Clause (xiii) of section 205(c)(2)(C) of 
the Social Security Act (42 U.S.C. 405(c)(2)(C)), as added by 
subsection (a)(3), shall apply with respect to Medicare cards 
issued on and after an effective date specified by the Secretary 
of Health and Human Services, but in no case shall such 
effective date be later than the date that is four years after 
the date of the enactment of this Act. 
(2) REISSUANCE.—The Secretary shall provide for the 
reissuance of Medicare cards that comply with the requirements 
of such clause not later than four years after the effective 
date specified by the Secretary under paragraph (1).
H. R. 2—79 
SEC. 502. PREVENTING WRONGFUL MEDICARE PAYMENTS FOR ITEMS 
AND SERVICES FURNISHED TO INCARCERATED INDIVID-
UALS, 
INDIVIDUALS 
NOT 
LAWFULLY 
PRESENT, 
AND 
DECEASED INDIVIDUALS. 
(a) REQUIREMENT FOR THE SECRETARY TO ESTABLISH POLICIES 
AND
CLAIMS
EDITS
RELATING
TO
INCARCERATED
INDIVIDUALS, 
INDIVIDUALS NOT LAWFULLY PRESENT, AND DECEASED INDIVID-
UALS.—Section 1874 of the Social Security Act (42 U.S.C. 1395kk) 
is amended by adding at the end the following new subsection: 
‘‘(f) REQUIREMENT FOR THE SECRETARY TO ESTABLISH POLICIES 
AND
CLAIMS
EDITS
RELATING
TO
INCARCERATED
INDIVIDUALS, 
INDIVIDUALS NOT LAWFULLY PRESENT, AND DECEASED INDIVID-
UALS.—The Secretary shall establish and maintain procedures, 
including procedures for using claims processing edits, updating 
eligibility information to improve provider accessibility, and con-
ducting recoupment activities such as through recovery audit con-
tractors, in order to ensure that payment is not made under this 
title for items and services furnished to an individual who is one 
of the following: 
‘‘(1) An individual who is incarcerated. 
‘‘(2) An individual who is not lawfully present in the United 
States and who is not eligible for coverage under this title. 
‘‘(3) A deceased individual.’’. 
(b) REPORT.—Not later than 18 months after the date of the 
enactment of this section, and periodically thereafter as determined 
necessary by the Office of Inspector General of the Department 
of Health and Human Services, such Office shall submit to Congress 
a report on the activities described in subsection (f) of section 
1874 of the Social Security Act (42 U.S.C. 1395kk), as added by 
subsection (a), that have been conducted since such date of enact-
ment. 
SEC. 503. CONSIDERATION OF MEASURES REGARDING MEDICARE 
BENEFICIARY SMART CARDS. 
To the extent the Secretary of Health and Human Services 
determines that it is cost effective and technologically viable to 
use electronic Medicare beneficiary and provider cards (such as 
cards that use smart card technology, including an embedded and 
secure integrated circuit chip), as presented in the Government 
Accountability Office report required by the conference report 
accompanying the Consolidated Appropriations Act, 2014 (Public 
Law 113–76), the Secretary shall consider such measures as deter-
mined appropriate by the Secretary to implement such use of such 
cards for beneficiary and provider use under title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.). In the case that 
the Secretary considers measures under the preceding sentence, 
the Secretary shall submit to the Committees on Ways and Means 
and Energy and Commerce of the House of Representatives, and 
to the Committee on Finance of the Senate, a report outlining 
the considerations undertaken by the Secretary under such sen-
tence. 
SEC. 504. MODIFYING MEDICARE DURABLE MEDICAL EQUIPMENT 
FACE-TO-FACE ENCOUNTER DOCUMENTATION REQUIRE-
MENT. 
(a) IN GENERAL.—Section 1834(a)(11)(B)(ii) of the Social Secu-
rity Act (42 U.S.C. 1395m(a)(11)(B)(ii)) is amended—
H. R. 2—80 
(1) by striking ‘‘the physician documenting that’’; and 
(2) by striking ‘‘has had a face-to-face encounter’’ and 
inserting ‘‘documenting such physician, physician assistant, 
practitioner, or specialist has had a face-to-face encounter’’. 
(b) IMPLEMENTATION.—Notwithstanding any other provision of 
law, the Secretary of Health and Human Services may implement 
the amendments made by subsection (a) by program instruction 
or otherwise. 
SEC. 505. REDUCING IMPROPER MEDICARE PAYMENTS. 
(a) MEDICARE ADMINISTRATIVE CONTRACTOR IMPROPER PAY-
MENT OUTREACH AND EDUCATION PROGRAM.—Section 1874A of the 
Social Security Act (42 U.S.C. 1395kk–1) is amended— 
(1) in subsection (a)(4)— 
(A) by redesignating subparagraph (G) as subpara-
graph (H); and 
(B) by inserting after subparagraph (F) the following 
new subparagraph: 
‘‘(G) IMPROPER
PAYMENT
OUTREACH
AND
EDUCATION 
PROGRAM.—Having in place an improper payment outreach 
and education program described in subsection (h).’’; and 
(2) by adding at the end the following new subsection: 
‘‘(h) IMPROPER
PAYMENT
OUTREACH
AND
EDUCATION
PRO-
GRAM.— 
‘‘(1) IN GENERAL.—In order to reduce improper payments 
under this title, each medicare administrative contractor shall 
establish and have in place an improper payment outreach 
and education program under which the contractor, through 
outreach, education, training, and technical assistance or other 
activities, shall provide providers of services and suppliers 
located in the region covered by the contract under this section 
with the information described in paragraph (2). The activities 
described in the preceding sentence shall be conducted on a 
regular basis. 
‘‘(2) INFORMATION TO BE PROVIDED THROUGH ACTIVITIES.— 
The information to be provided under such payment outreach 
and education program shall include information the Secretary 
determines to be appropriate, which may include the following 
information: 
‘‘(A) A list of the providers’ or suppliers’ most frequent 
and expensive payment errors over the last quarter. 
‘‘(B) Specific instructions regarding how to correct or 
avoid such errors in the future. 
‘‘(C) A notice of new topics that have been approved 
by the Secretary for audits conducted by recovery audit 
contractors under section 1893(h). 
‘‘(D) Specific instructions to prevent future issues 
related to such new audits. 
‘‘(E) Other information determined appropriate by the 
Secretary. 
‘‘(3) PRIORITY.—A medicare administrative contractor shall 
give priority to activities under such program that will reduce 
improper payments that are one or more of the following: 
‘‘(A) Are for items and services that have the highest 
rate of improper payment. 
‘‘(B) Are for items and service that have the greatest 
total dollar amount of improper payments.
H. R. 2—81 
‘‘(C) Are due to clear misapplication or misinterpreta-
tion of Medicare policies. 
‘‘(D) Are clearly due to common and inadvertent clerical 
or administrative errors. 
‘‘(E) Are due to other types of errors that the Secretary 
determines could be prevented through activities under 
the program. 
‘‘(4) INFORMATION ON IMPROPER PAYMENTS FROM RECOVERY 
AUDIT CONTRACTORS.— 
‘‘(A) IN GENERAL.—In order to assist medicare adminis-
trative contractors in carrying out improper payment out-
reach and education programs, the Secretary shall provide 
each contractor with a complete list of the types of improper 
payments identified by recovery audit contractors under 
section 1893(h) with respect to providers of services and 
suppliers located in the region covered by the contract 
under this section. Such information shall be provided on 
a time frame the Secretary determines appropriate which 
may be on a quarterly basis. 
‘‘(B) INFORMATION.—The information described in 
subparagraph (A) shall include information such as the 
following: 
‘‘(i) Providers of services and suppliers that have 
the highest rate of improper payments. 
‘‘(ii) Providers of services and suppliers that have 
the greatest total dollar amounts of improper pay-
ments. 
‘‘(iii) Items and services furnished in the region 
that have the highest rates of improper payments. 
‘‘(iv) Items and services furnished in the region 
that are responsible for the greatest total dollar 
amount of improper payments. 
‘‘(v) Other information the Secretary determines 
would assist the contractor in carrying out the pro-
gram. 
‘‘(5) COMMUNICATIONS.—Communications with providers of 
services and suppliers under an improper payment outreach 
and education program are subject to the standards and 
requirements of subsection (g).’’. 
(b) USE
OF CERTAIN FUNDS RECOVERED
BY RACS.—Section 
1893(h) of the Social Security Act (42 U.S.C. 1395ddd(h)) is 
amended— 
(1) in paragraph (2), by inserting ‘‘or paragraph (10)’’ after 
‘‘paragraph (1)(C)’’; and 
(2) by adding at the end the following new paragraph: 
‘‘(10) USE OF CERTAIN RECOVERED FUNDS.— 
‘‘(A) IN
GENERAL.—After application of paragraph 
(1)(C), the Secretary shall retain a portion of the amounts 
recovered by recovery audit contractors for each year under 
this section which shall be available to the program 
management account of the Centers for Medicare & Med-
icaid Services for purposes of, subject to subparagraph (B), 
carrying 
out 
sections 
1833(z), 
1834(l)(16), 
and 
1874A(a)(4)(G), carrying out section 514(b) of the Medicare 
Access and CHIP Reauthorization Act of 2015, and imple-
menting strategies (such as claims processing edits) to 
help reduce the error rate of payments under this title.
H. R. 2—82 
The amounts retained under the preceding sentence shall 
not exceed an amount equal to 15 percent of the amounts 
recovered under this subsection, and shall remain available 
until expended. 
‘‘(B) LIMITATION.—Except for uses that support claims 
processing (including edits) or system functionality for 
detecting fraud, amounts retained under subparagraph (A) 
may not be used for technological-related infrastructure, 
capital investments, or information systems. 
‘‘(C) NO REDUCTION IN PAYMENTS TO RECOVERY AUDIT 
CONTRACTORS.—Nothing in subparagraph (A) shall reduce 
amounts available for payments to recovery audit contrac-
tors under this subsection.’’. 
SEC. 506. IMPROVING SENIOR MEDICARE PATROL AND FRAUD 
REPORTING REWARDS. 
(a) IN GENERAL.—The Secretary of Health and Human Services 
(in this section referred to as the ‘‘Secretary’’) shall develop a 
plan to revise the incentive program under section 203(b) of the 
Health Insurance Portability and Accountability Act of 1996 (42 
U.S.C. 1395b–5(b)) to encourage greater participation by individuals 
to report fraud and abuse in the Medicare program. Such plan 
shall include recommendations for— 
(1) ways to enhance rewards for individuals reporting under 
the incentive program, including rewards based on information 
that leads to an administrative action; and 
(2) extending the incentive program to the Medicaid pro-
gram. 
(b) PUBLIC AWARENESS AND EDUCATION CAMPAIGN.—The plan 
developed under subsection (a) shall also include recommendations 
for the use of the Senior Medicare Patrols authorized under section 
411 of the Older Americans Act of 1965 (42 U.S.C. 3032) to conduct 
a public awareness and education campaign to encourage participa-
tion in the revised incentive program under subsection (a). 
(c) SUBMISSION OF PLAN.—Not later than 180 days after the 
date of enactment of this Act, the Secretary shall submit to Congress 
the plan developed under subsection (a). 
SEC. 507. REQUIRING VALID PRESCRIBER NATIONAL PROVIDER 
IDENTIFIERS ON PHARMACY CLAIMS. 
Section 1860D–4(c) of the Social Security Act (42 U.S.C. 1395w– 
104(c)) is amended by adding at the end the following new para-
graph: 
‘‘(4) REQUIRING
VALID
PRESCRIBER
NATIONAL
PROVIDER 
IDENTIFIERS ON PHARMACY CLAIMS.— 
‘‘(A) IN GENERAL.—For plan year 2016 and subsequent 
plan years, the Secretary shall require a claim for a covered 
part D drug for a part D eligible individual enrolled in 
a prescription drug plan under this part or an MA–PD 
plan under part C to include a prescriber National Provider 
Identifier that is determined to be valid under the proce-
dures established under subparagraph (B)(i). 
‘‘(B) PROCEDURES.— 
‘‘(i) VALIDITY OF PRESCRIBER NATIONAL PROVIDER 
IDENTIFIERS.—The Secretary, in consultation with 
appropriate stakeholders, shall establish procedures for 
determining the validity of prescriber National Pro-
vider Identifiers under subparagraph (A).
H. R. 2—83 
‘‘(ii) INFORMING
BENEFICIARIES
OF
REASON
FOR 
DENIAL.—The Secretary shall establish procedures to 
ensure that, in the case that a claim for a covered 
part D drug of an individual described in subparagraph 
(A) is denied because the claim does not meet the 
requirements of this paragraph, the individual is prop-
erly informed at the point of service of the reason 
for the denial. 
‘‘(C) REPORT.—Not later than January 1, 2018, the 
Inspector General of the Department of Health and Human 
Services shall submit to Congress a report on the effective-
ness of the procedures established under subparagraph 
(B)(i).’’. 
SEC. 508. OPTION TO RECEIVE MEDICARE SUMMARY NOTICE ELEC-
TRONICALLY. 
(a) IN GENERAL.—Section 1806 of the Social Security Act (42 
U.S.C. 1395b–7) is amended by adding at the end the following 
new subsection: 
‘‘(c) FORMAT OF STATEMENTS FROM SECRETARY.— 
‘‘(1) ELECTRONIC
OPTION
BEGINNING
IN
2016.—Subject to 
paragraph (2), for statements described in subsection (a) that 
are furnished for a period in 2016 or a subsequent year, in 
the case that an individual described in subsection (a) elects, 
in accordance with such form, manner, and time specified by 
the Secretary, to receive such statement in an electronic format, 
such statement shall be furnished to such individual for each 
period subsequent to such election in such a format and shall 
not be mailed to the individual. 
‘‘(2) LIMITATION ON REVOCATION OPTION.— 
‘‘(A) IN GENERAL.—Subject to subparagraph (B), the 
Secretary may determine a maximum number of elections 
described in paragraph (1) by an individual that may be 
revoked by the individual. 
‘‘(B) MINIMUM OF ONE REVOCATION OPTION.—In no case 
may the Secretary determine a maximum number under 
subparagraph (A) that is less than one. 
‘‘(3) NOTIFICATION.—The Secretary shall ensure that, in 
the most cost effective manner and beginning January 1, 2017, 
a clear notification of the option to elect to receive statements 
described in subsection (a) in an electronic format is made 
available, such as through the notices distributed under section 
1804, to individuals described in subsection (a).’’. 
(b) ENCOURAGED EXPANSION
OF ELECTRONIC STATEMENTS.— 
To the extent to which the Secretary of Health and Human Services 
determines appropriate, the Secretary shall— 
(1) apply an option similar to the option described in sub-
section (c)(1) of section 1806 of the Social Security Act (42 
U.S.C. 1395b–7) (relating to the provision of the Medicare Sum-
mary Notice in an electronic format), as added by subsection 
(a), to other statements and notifications under title XVIII 
of such Act (42 U.S.C. 1395 et seq.); and 
(2) provide such Medicare Summary Notice and any such 
other statements and notifications on a more frequent basis 
than is otherwise required under such title.
H. R. 2—84 
SEC. 509. RENEWAL OF MAC CONTRACTS. 
(a) IN GENERAL.—Section 1874A(b)(1)(B) of the Social Security 
Act (42 U.S.C. 1395kk–1(b)(1)(B)) is amended by striking ‘‘5 years’’ 
and inserting ‘‘10 years’’. 
(b) APPLICATION.—The amendments made by subsection (a) 
shall apply to contracts entered into on or after, and to contracts 
in effect as of, the date of the enactment of this Act. 
(c) 
CONTRACTOR
PERFORMANCE
TRANSPARENCY.—Section 
1874A(b)(3)(A) of the Social Security Act (42 U.S.C. 1395kk– 
1(b)(3)(A)) is amended by adding at the end the following new 
clause: 
‘‘(iv) CONTRACTOR PERFORMANCE TRANSPARENCY.— 
To the extent possible without compromising the 
process for entering into and renewing contracts with 
medicare administrative contractors under this section, 
the Secretary shall make available to the public the 
performance of each medicare administrative con-
tractor with respect to such performance requirements 
and measurement standards.’’. 
SEC. 510. STUDY ON PATHWAY FOR INCENTIVES TO STATES FOR STATE 
PARTICIPATION IN MEDICAID DATA MATCH PROGRAM. 
Section 1893(g) of the Social Security Act (42 U.S.C. 1395ddd(g)) 
is amended by adding at the end the following new paragraph: 
‘‘(3) INCENTIVES FOR STATES.—The Secretary shall study 
and, as appropriate, may specify incentives for States to work 
with the Secretary for the purposes described in paragraph 
(1)(A)(ii). The application of the previous sentence may include 
use of the waiver authority described in paragraph (2).’’. 
SEC. 511. GUIDANCE ON APPLICATION OF COMMON RULE TO CLINICAL 
DATA REGISTRIES. 
Not later than one year after the date of the enactment of 
this section, the Secretary of Health and Human Services shall 
issue a clarification or modification with respect to the application 
of subpart A of part 46 of title 45, Code of Federal Regulations, 
governing the protection of human subjects in research (and com-
monly known as the ‘‘Common Rule’’), to activities, including quality 
improvement activities, involving clinical data registries, including 
entities that are qualified clinical data registries pursuant to section 
1848(m)(3)(E) of the Social Security Act (42 U.S.C. 1395w– 
4(m)(3)(E)). 
SEC. 
512. 
ELIMINATING 
CERTAIN 
CIVIL 
MONEY 
PENALTIES; 
GAINSHARING STUDY AND REPORT. 
(a) ELIMINATING CIVIL MONEY PENALTIES FOR INDUCEMENTS 
TO PHYSICIANS TO LIMIT SERVICES THAT ARE NOT MEDICALLY NEC-
ESSARY.— 
(1) IN GENERAL.—Section 1128A(b)(1) of the Social Security 
Act (42 U.S.C. 1320a–7a(b)(1)) is amended by inserting ‘‘medi-
cally necessary’’ after ‘‘reduce or limit’’. 
(2) EFFECTIVE DATE.—The amendment made by paragraph 
(1) shall apply to payments made on or after the date of 
the enactment of this Act. 
(b) GAINSHARING STUDY
AND REPORT.—Not later than 12 
months after the date of the enactment of this Act, the Secretary 
of Health and Human Services, in consultation with the Inspector 
General of the Department of Health and Human Services, shall
H. R. 2—95 
(b) SENATE PAYGO SCORECARDS.—The budgetary effects of this 
Act shall not be entered on any PAYGO scorecard maintained 
for purposes of section 201 of S. Con. Res. 21 (110th Congress). 
Speaker of the House of Representatives. 
Vice President of the United States and
President of the Senate.