I 
114TH CONGRESS 
1ST SESSION 
H. R. 795 
To amend title XVIII of the Social Security Act to make publicly available 
on the official Medicare Internet site Medicare payment rates for fre-
quently reimbursed hospital inpatient procedures, hospital outpatient pro-
cedures, and physicians’ services. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 5, 2015 
Mr. HUIZENGA of Michigan 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 with-
in the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to make 
publicly available on the official Medicare Internet site 
Medicare payment rates for frequently reimbursed hos-
pital inpatient procedures, hospital outpatient proce-
dures, and physicians’ services. 
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 Payment 
Rate Disclosure Act of 2015’’. 
VerDate Sep 11 2014 
06:55 Feb 13, 2015
Jkt 049200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H795.IH
H795
SSpencer on DSK4SPTVN1PROD with BILLS
SEC. 2. PUBLIC INTERNET AVAILABILITY OF MEDICARE 
PAYMENT RATES FOR FREQUENTLY REIM-
BURSED PROCEDURES AND SERVICES. 
Title XVIII of the Social Security Act is amended by 
adding at the end the following new section: 
‘‘SEC. 1899C. PUBLIC INTERNET AVAILABILITY OF MEDI-
CARE PAYMENT RATES FOR FREQUENTLY 
REIMBURSED PROCEDURES AND SERVICES. 
‘‘(a) IN GENERAL.— 
‘‘(1) INITIAL POSTING.—During the initial pe-
riod beginning on a date not later than 120 days 
after the date of the enactment of this section and 
ending on the date that is 240 days after such start-
ing date, the Secretary shall make publicly available 
on the official Medicare Internet site the following: 
‘‘(A) PAYMENT RATES FOR HOSPITAL IN-
PATIENT
PROCEDURES.—For each procedure 
selected under subsection (b)(1)(A)(i) and for 
each Metropolitan Statistical Area or other pay-
ment area used for purposes of section 1886(d), 
the average rate of payment under such section 
for the procedure, determined without regard to 
the application of any deduction or coinsurance 
amount or any adjustment under subparagraph 
(B), (D), (F), or (G) of paragraph (5) of such 
section. 
VerDate Sep 11 2014 
06:55 Feb 13, 2015
Jkt 049200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H795.IH
H795
SSpencer on DSK4SPTVN1PROD with BILLS
‘‘(B) PAYMENT RATES FOR HOSPITAL OUT-
PATIENT
PROCEDURES.—For each procedure 
selected under subsection (b)(1)(A)(ii) and for 
each county or other payment area used for 
purposes of section 1833(t), the average rate of 
payment under such section for the procedure, 
determined without regard to the application of 
any deductible or coinsurance. 
‘‘(C) PHYSICIAN
PAYMENT
RATES
FOR 
PHYSICIANS’ SERVICES.—For each physicians’ 
service selected under subsection (b)(1)(A)(iii) 
and for each fee schedule area under section 
1848, the average payment amount determined 
under the fee schedule under such section for 
the service, determined without regard to the 
application of any deductible or coinsurance. 
‘‘(D) PERIOD FOR WHICH PAYMENT RATES 
ARE APPLICABLE.—A description of the period 
for which each payment rate or amount under 
subparagraph (A), (B), or (C) is applicable. 
‘‘(E) SERVICES
INCLUDED
IN
PROCE-
DURES.—A description of the items and serv-
ices included in each procedure selected under 
clauses (i) and (ii) of subsection (b)(1)(A). 
VerDate Sep 11 2014 
06:55 Feb 13, 2015
Jkt 049200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H795.IH
H795
SSpencer on DSK4SPTVN1PROD with BILLS
‘‘(F) NOTICE.—A statement that the aver-
age payment rates and average payment 
amounts 
described 
in 
subparagraphs 
(A) 
through (C) are only applicable to the Medicare 
program under this title and may not be avail-
able for an individual who is not purchasing 
such a procedure or service under such pro-
gram. 
‘‘(2) POSTING
OF
EXPANDED
SELECTION.— 
During the period beginning on the date that is one 
day after the last day of the initial period described 
in paragraph (1), the Secretary shall make publicly 
available on the official Medicare Internet site the 
following: 
‘‘(A) PAYMENT RATES FOR HOSPITAL IN-
PATIENT
PROCEDURES.—For each procedure 
selected under subsection (b)(1)(B)(i) and for 
each Metropolitan Statistical Area or other pay-
ment area used for purposes of section 1886(d), 
the average rate of payment described in para-
graph (1)(A) for the procedure. 
‘‘(B) PAYMENT RATES FOR HOSPITAL OUT-
PATIENT
PROCEDURES.—For each procedure 
selected under subsection (b)(1)(B)(ii) and for 
each county or other payment area used for 
VerDate Sep 11 2014 
06:55 Feb 13, 2015
Jkt 049200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H795.IH
H795
SSpencer on DSK4SPTVN1PROD with BILLS
purposes of section 1833(t), the average rate of 
payment described in paragraph (1)(B) for the 
procedure. 
‘‘(C) PHYSICIAN
PAYMENT
RATES
FOR 
PHYSICIANS’ SERVICES.—For each physicians’ 
service selected under subsection (b)(1)(B)(iii) 
and for each fee schedule area under section 
1848, the average payment amount described in 
paragraph (1)(C) for the physicians’ service. 
‘‘(D) PERIOD FOR WHICH PAYMENT RATES 
ARE APPLICABLE.—A description of the period 
for which each payment rate or amount under 
subparagraph (A), (B), or (C) is applicable. 
‘‘(E) SERVICES
INCLUDED
IN
PROCE-
DURES.—A description of the items and serv-
ices included in each procedure selected under 
clauses (i) and (ii) of subsection (b)(1)(B). 
‘‘(F) NOTICE.—A statement that the aver-
age payment rates and average payment 
amounts 
described 
in 
subparagraphs 
(A) 
through (C) are only applicable to the Medicare 
program under this title and may not be avail-
able for an individual who is not purchasing 
such a procedure or service under such pro-
gram. 
VerDate Sep 11 2014 
06:55 Feb 13, 2015
Jkt 049200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H795.IH
H795
SSpencer on DSK4SPTVN1PROD with BILLS
‘‘(b) SELECTION OF PROCEDURES AND SERVICES.— 
‘‘(1) IN GENERAL.— 
‘‘(A) INITIAL
SELECTION.—For purposes 
of subsection (a)(1) and based on the most re-
cent national data available, the Secretary shall 
select the following: 
‘‘(i) At least the 30 hospital inpatient 
procedures for which payment is most fre-
quently provided under section 1886(d). 
‘‘(ii) At least the 30 hospital out-
patient procedures for which payment is 
most frequently provided under section 
1833(t). 
‘‘(iii) At least the 30 physicians’ serv-
ices (as defined in section 1861(q)) for 
which payment is most frequently provided 
under section 1848. 
‘‘(B) EXPANDED
SELECTION.—For pur-
poses of subsection (a)(2) and based on the 
most recent national data available, the Sec-
retary shall select the following: 
‘‘(i) At least the 100 hospital inpa-
tient procedures for which payment is most 
frequently provided under section 1886(d). 
VerDate Sep 11 2014 
06:55 Feb 13, 2015
Jkt 049200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H795.IH
H795
SSpencer on DSK4SPTVN1PROD with BILLS
‘‘(ii) At least the 100 hospital out-
patient procedures for which payment is 
most frequently provided under section 
1833(t). 
‘‘(iii) At least the 100 physicians’ 
services (as defined in section 1861(q)) for 
which payment is most frequently provided 
under section 1848. 
‘‘(2) UPDATING
EXPANDED
SELECTION.—The 
Secretary shall periodically update the procedures 
and services selected under paragraph (1)(B). 
‘‘(3) FURTHER
EXPANSION
OF
SELECTION.— 
The Secretary shall expand the number of proce-
dures and services selected under paragraph (1)(B) 
to include as many procedures and services as may 
be useful for an individual not entitled to benefits 
under part A or enrolled under part B in the pur-
chase of such procedures and services. 
‘‘(c) AUTHORITY TO POST ADDITIONAL INFORMA-
TION.—The Secretary may make publicly available on the 
official Medicare Internet site such information on the 
payment rate or payment amount under this title for a 
procedure, item, or service not selected under subsection 
(b) as may be useful for an individual not entitled to bene-
fits under part A or enrolled under part B in the purchase 
VerDate Sep 11 2014 
06:55 Feb 13, 2015
Jkt 049200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H795.IH
H795
SSpencer on DSK4SPTVN1PROD with BILLS
of the procedure, item, or service. To the extent prac-
ticable, such information shall be provided for each pay-
ment area involved. 
‘‘(d) ADMINISTRATIVE PROVISIONS.— 
‘‘(1) USE OF MOST RECENT NATIONAL DATA.— 
The information described in paragraph (1) of sub-
section (b) and subsection (c) shall be based on the 
most recent national data available. 
‘‘(2) ACCESSIBILITY BY ZIP CODE.—Such infor-
mation for an applicable payment area shall be ac-
cessible by any zip code included in such area.’’. 
Æ 
VerDate Sep 11 2014 
06:55 Feb 13, 2015
Jkt 049200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6301
E:\BILLS\H795.IH
H795
SSpencer on DSK4SPTVN1PROD with BILLS