I 
112TH CONGRESS 
1ST SESSION H. R. 1051 
To amend title XVIII of the Social Security Act to clarify the use of private 
contracts by medicare beneficiaries for professional services and to allow 
individuals to choose to opt out of the Medicare part A benefits. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 11, 2011 
Mr. SAM JOHNSON of Texas (for himself, Mr. SESSIONS, Mr. PAUL, Mrs. 
BLACK, and Mr. MCCAUL) introduced the following bill; which was re-
ferred to the Committee on Ways and Means, and in addition to the 
Committee on Energy and Commerce, for a period to be subsequently de-
termined 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 clarify 
the use of private contracts by medicare beneficiaries 
for professional services and to allow individuals to 
choose to opt out of the Medicare part A 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 Beneficiary 
Freedom to Choose Act of 2011’’. 
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SEC. 2. USE OF PRIVATE CONTRACTS BY MEDICARE BENE-
FICIARIES FOR PROFESSIONAL SERVICES. 
(a) IN GENERAL.—Section 1802(b) of the Social Se-
curity Act (42 U.S.C. 1395a) is amended to read as fol-
lows: 
‘‘(b) CLARIFICATION
OF USE
OF PRIVATE CON-
TRACTS
BY MEDICARE BENEFICIARIES
FOR PROFES-
SIONAL SERVICES.— 
‘‘(1) IN GENERAL.—Nothing in this title shall 
prohibit a medicare beneficiary from entering into a 
private contract with a physician or health care 
practitioner for the provision of medicare covered 
professional services (as defined in paragraph 
(5)(C)) if— 
‘‘(A) the services are covered under a pri-
vate contract that is between the beneficiary 
and the physician or practitioner and meets the 
requirements of paragraph (2); 
‘‘(B) under the private contract no claim 
for payment for services covered under the con-
tract is to be submitted (and no payment made) 
under part A or B, under a contract under sec-
tion 1876, or under an MA plan (other than an 
MSA plan); and 
‘‘(C)(i) the Secretary has been provided 
with the minimum information necessary to 
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avoid any payment under part A or B for serv-
ices covered under the contract, or 
‘‘(ii) in the case of an individual en-
rolled under a contract under section 1876 
or an MA plan (other than an MSA plan) 
under part C, the eligible organization 
under the contract or the MA organization 
offering the plan has been provided the 
minimum information necessary to avoid 
any payment under such contract or plan 
for services covered under the contract. 
‘‘(2) 
REQUIREMENTS
FOR
PRIVATE
CON-
TRACTS.—The requirements in this paragraph for a 
private contract between a medicare beneficiary and 
a physician or health care practitioner are as fol-
lows: 
‘‘(A) GENERAL FORM OF CONTRACT.—The 
contract is in writing and is signed by the medi-
care beneficiary. 
‘‘(B) NO CLAIMS TO BE SUBMITTED FOR 
COVERED
SERVICES.—The contract provides 
that no party to the contract (and no entity on 
behalf of any party to the contract) shall sub-
mit any claim for (or request) payment for 
services covered under the contract under part 
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A or B, under a contract under section 1876, 
or under an MA plan (other than an MSA 
plan). 
‘‘(C) SCOPE OF SERVICES.—The contract 
identifies the medicare covered professional 
services and the period (if any) to be covered 
under the contract, but does not cover any serv-
ices furnished— 
‘‘(i) before the contract is entered 
into; or 
‘‘(ii) for the treatment of an emer-
gency medical condition (as defined in sec-
tion 1867(e)(1)(A)), unless the contract 
was entered into before the onset of the 
emergency medical condition. 
‘‘(D) CLEAR DISCLOSURE OF TERMS.—The 
contract clearly indicates that by signing the 
contract the medicare beneficiary— 
‘‘(i) agrees not to submit a claim (or 
to request that anyone submit a claim) 
under part A or B (or under section 1876 
or under an MA plan, other than an MSA 
plan) for services covered under the con-
tract; 
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‘‘(ii) agrees to be responsible, whether 
through insurance or otherwise, for pay-
ment for such services and understands 
that no reimbursement will be provided 
under such part, contract, or plan for such 
services; 
‘‘(iii) acknowledges that no limits 
under this title (including limits under 
paragraphs (1) and (3) of section 1848(g)) 
will apply to amounts that may be charged 
for such services; 
‘‘(iv) acknowledges that medicare sup-
plemental policies under section 1882 do 
not, and other supplemental health plans 
and policies may elect not to, make pay-
ments for such services because payment is 
not made under this title; and 
‘‘(v) acknowledges that the beneficiary 
has the right to have such services pro-
vided by (or under the supervision of) 
other physicians or health care practi-
tioners for whom payment would be made 
under such part, contract, or plan. 
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Such contract shall also clearly indicate whether 
the physician or practitioner involved is ex-
cluded from participation under this title. 
‘‘(3) MODIFICATIONS.—The parties to a private 
contract may mutually agree at any time to modify 
or terminate the contract on a prospective basis, 
consistent with the provisions of paragraphs (1) and 
(2). 
‘‘(4) NO REQUIREMENTS FOR SERVICES FUR-
NISHED TO MSA PLAN ENROLLEES.—The require-
ments of paragraphs (1) and (2) do not apply to any 
contract or arrangement for the provision of services 
to a medicare beneficiary enrolled in an MSA plan 
under part C. 
‘‘(5) DEFINITIONS.—In this subsection: 
‘‘(A) HEALTH CARE PRACTITIONER.—The 
term ‘health care practitioner’ means a practi-
tioner described in section 1842(b)(18)(C). 
‘‘(B) MEDICARE BENEFICIARY.—The term 
‘medicare beneficiary’ means an individual who 
is enrolled under part B. 
‘‘(C) MEDICARE COVERED PROFESSIONAL 
SERVICES.—The term ‘medicare covered profes-
sional services’ means— 
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