220
gram’’) under which medicare specialists em-
ployed by the Department of Health and 
Human Services provide advice and assist-
ance to individuals entitled to benefits under 
part A of title XVIII of the Social Security Act, 
or enrolled under part B of such title, or both, 
regarding the medicare program at the loca-
tion of existing local offices of the Social Secu-
rity Administration. 
(b) LOCATIONS.—
(1) IN
GENERAL.—The demonstration 
program shall be conducted in at least 6 
offices or areas. Subject to paragraph (2), 
in selecting such offices and areas, the 
Secretary shall provide preference for of-
fices with a high volume of visits by indi-
viduals referred to in subsection (a). 
(2) 
ASSISTANCE
FOR
RURAL
BENE-
FICIARIES.—The Secretary shall provide 
for the selection of at least 2 rural areas 
to participate in the demonstration pro-
gram. In conducting the demonstration 
program in such rural areas, the Sec-
retary shall provide for medicare special-
221
ists to travel among local offices in a 
rural area on a scheduled basis. 
(c) DURATION.—The demonstration pro-
gram shall be conducted over a 3-year period. 
(d) EVALUATION AND REPORT.—
(1) EVALUATION.—The Secretary shall 
provide for an evaluation of the dem-
onstration 
program. 
Such 
evaluation 
shall include an analysis of—
(A) utilization of, and satisfaction 
of those individuals referred to in 
subsection (a) with, the assistance 
provided under the program; and 
(B) the cost-effectiveness of pro-
viding beneficiary assistance through 
out-stationing medicare specialists at 
local offices of the Social Security Ad-
ministration. 
(2) REPORT.—The Secretary shall sub-
mit to Congress a report on such evalua-
tion and shall include in such report rec-
ommendations regarding the feasibility 
of permanently out-stationing medicare 
specialists at local offices of the Social 
Security Administration.
222
SEC. 305. INCLUSION OF ADDITIONAL INFORMATION IN NO-
TICES TO BENEFICIARIES ABOUT SKILLED 
NURSING FACILITY BENEFITS. 
(a) IN GENERAL.—The Secretary shall pro-
vide that in medicare beneficiary notices pro-
vided (under section 1806(a) of the Social Se-
curity Act, 42 U.S.C. 1395b–7(a)) with respect 
to the provision of post-hospital extended 
care services under part A of title XVIII of the 
Social Security Act, there shall be included in-
formation on the number of days of coverage 
of such services remaining under such part 
for the medicare beneficiary and spell of ill-
ness involved. 
(b) EFFECTIVE DATE.—Subsection (a) shall 
apply to notices provided during calendar 
quarters beginning more than 6 months after 
the date of the enactment of this Act. 
SEC. 
306. 
INFORMATION 
ON 
MEDICARE-CERTIFIED 
SKILLED NURSING FACILITIES IN HOSPITAL 
DISCHARGE PLANS. 
(a) AVAILABILITY OF DATA.—The Secretary 
shall publicly provide information that en-
ables hospital discharge planners, medicare 
beneficiaries, and the public to identify
223
skilled nursing facilities that are partici-
pating in the medicare program. 
(b) INCLUSION OF INFORMATION IN CERTAIN 
HOSPITAL DISCHARGE PLANS.—
(1) 
IN
GENERAL.—Section 
1861(ee)(2)(D) (42 U.S.C. 1395x(ee)(2)(D)) 
is amended—
(A) by striking ‘‘hospice services’’ 
and inserting ‘‘hospice care and post-
hospital extended care services’’; and 
(B) by inserting before the period 
at the end the following: ‘‘and, in the 
case of individuals who are likely to 
need 
post-hospital 
extended 
care 
services, the availability of such serv-
ices through facilities that partici-
pate in the program under this title 
and that serve the area in which the 
patient resides’’. 
(2) EFFECTIVE DATE.—The amendments 
made by paragraph (1) shall apply to dis-
charge plans made on or after such date 
as the Secretary shall specify, but not 
later than 6 months after the date the
224
Secretary provides for availability of in-
formation under subsection (a). 
TITLE IV—APPEALS AND 
RECOVERY 
SEC. 401. TRANSFER OF RESPONSIBILITY FOR MEDICARE 
APPEALS. 
(a) TRANSITION PLAN.—
(1) IN GENERAL.—Not later than Octo-
ber 1, 2004, the Commissioner of Social 
Security and the Secretary shall develop 
and transmit to Congress and the Comp-
troller General of the United States a 
plan under which the functions of admin-
istrative law judges responsible for hear-
ing cases under title XVIII of the Social 
Security Act (and related provisions in 
title XI of such Act) are transferred from 
the responsibility of the Commissioner 
and the Social Security Administration to 
the Secretary and the Department of 
Health and Human Services. 
(2) 
GAO 
EVALUATION.—The 
Comp-
troller General of the United States shall 
evaluate the plan and, not later than the 
date that is 6 months after the date on
225
which the plan is received by the Comp-
troller General, shall submit to Congress 
a report on such evaluation. 
(b) TRANSFER
OF ADJUDICATION AUTHOR-
ITY.—
(1) IN GENERAL.—Not earlier than July 
1, 2005, and not later than October 1, 
2005, the Commissioner of Social Security 
and the Secretary shall implement the 
transition plan under subsection (a) and 
transfer the administrative law judge
functions described in such subsection 
from the Social Security Administration 
to the Secretary. 
(2) 
ASSURING
INDEPENDENCE
OF 
JUDGES.—The Secretary shall assure the 
independence 
of 
administrative 
law 
judges performing the administrative law 
judge functions transferred under para-
graph (1) from the Centers for Medicare 
& Medicaid Services and its contractors. 
In order to assure such independence, 
the Secretary shall place such judges in 
an administrative office that is organiza-
tionally and functionally separate from
226
such Centers. Such judges shall report to, 
and be under the general supervision of, 
the Secretary, but shall not report to, or 
be subject to supervision by, another 
other officer of the Department. 
(3) 
GEOGRAPHIC
DISTRIBUTION.—The 
Secretary shall provide for an appro-
priate geographic distribution of admin-
istrative law judges performing the ad-
ministrative law judge functions trans-
ferred under paragraph (1) throughout 
the United States to ensure timely access 
to such judges. 
(4) HIRING AUTHORITY.—Subject to the 
amounts provided in advance in appro-
priations Act, the Secretary shall have 
authority to hire administrative law 
judges to hear such cases, giving priority 
to those judges with prior experience in 
handling medicare appeals and in a man-
ner consistent with paragraph (3), and to 
hire support staff for such judges. 
(5) 
FINANCING.—Amounts 
payable 
under law to the Commissioner for ad-
ministrative law judges performing the
227
administrative law judge functions trans-
ferred under paragraph (1) from the Fed-
eral Hospital Insurance Trust Fund and 
the Federal Supplementary Medical In-
surance Trust Fund shall become payable 
to the Secretary for the functions so 
transferred. 
(6) 
SHARED
RESOURCES.—The 
Sec-
retary shall enter into such arrangements 
with the Commissioner as may be appro-
priate with respect to transferred func-
tions of administrative law judges to 
share office space, support staff, and 
other resources, with appropriate reim-
bursement from the Trust Funds de-
scribed in paragraph (5). 
(c) INCREASED FINANCIAL SUPPORT.—In ad-
dition to any amounts otherwise appro-
priated, to ensure timely action on appeals be-
fore administrative law judges and the De-
partmental Appeals Board consistent with 
section 1869 of the Social Security Act (as 
amended by section 521 of BIPA, 114 Stat. 
2763A–534), there are authorized to be appro-
priated (in appropriate part from the Federal
228
Hospital Insurance Trust Fund and the Fed-
eral Supplementary Medical Insurance Trust 
Fund) to the Secretary such sums as are nec-
essary for fiscal year 2005 and each subse-
quent fiscal year to—
(1) increase the number of adminis-
trative law judges (and their staffs) 
under subsection (b)(4); 
(2) improve education and training 
opportunities 
for 
administrative 
law 
judges (and their staffs); and 
(3) increase the staff of the Depart-
mental Appeals Board. 
(d) 
CONFORMING
AMENDMENT.—Section 
1869(f)(2)(A)(i) (42 U.S.C. 1395ff(f)(2)(A)(i)), as 
added by section 522(a) of BIPA (114 Stat. 
2763A–543), is amended by striking ‘‘of the So-
cial Security Administration’’. 
SEC. 402. PROCESS FOR EXPEDITED ACCESS TO REVIEW. 
(a) EXPEDITED
ACCESS
TO
JUDICIAL
RE-
VIEW.—Section 1869(b) (42 U.S.C. 1395ff(b)) as 
amended by BIPA, is amended—
(1) in paragraph (1)(A), by inserting ‘‘, 
subject to paragraph (2),’’ before ‘‘to judi-
229
cial review of the Secretary’s final deci-
sion’’; 
(2) in paragraph (1)(F)—
(A) by striking clause (ii); 
(B) by striking ‘‘PROCEEDING’’ and 
all that follows through ‘‘DETERMINA-
TION’’ and inserting ‘‘DETERMINATIONS 
AND RECONSIDERATIONS’’; and 
(C) by redesignating subclauses 
(I) and (II) as clauses (i) and (ii) and 
by moving the indentation of such
subclauses (and the matter that fol-
lows) 2 ems to the left; and 
(3) by adding at the end the following 
new paragraph: 
‘‘(2) EXPEDITED ACCESS TO JUDICIAL RE-
VIEW.—
‘‘(A) IN
GENERAL.—The Secretary 
shall establish a process under which 
a provider of services or supplier that 
furnishes an item or service or an in-
dividual entitled to benefits under 
part A or enrolled under part B, or 
both, who has filed an appeal under 
paragraph (1) may obtain access to
230
judicial review when a review panel 
(described in subparagraph (D)), on 
its own motion or at the request of 
the appellant, determines that no en-
tity in the administrative appeals 
process has the authority to decide 
the question of law or regulation rel-
evant to the matters in controversy 
and that there is no material issue of 
fact in dispute. The appellant may 
make such request only once with re-
spect to a question of law or regula-
tion in a case of an appeal. 
‘‘(B) PROMPT DETERMINATIONS.—If, 
after 
or 
coincident 
with 
appro-
priately filing a request for an admin-
istrative hearing, the appellant re-
quests a determination by the appro-
priate review panel that no review 
panel has the authority to decide the 
question of law or regulations rel-
evant to the matters in controversy 
and that there is no material issue of 
fact in dispute and if such request is 
accompanied by the documents and
231
materials as the appropriate review 
panel shall require for purposes of 
making such determination, such re-
view panel shall make a determina-
tion on the request in writing within 
60 days after the date such review 
panel receives the request and such 
accompanying documents and mate-
rials. Such a determination by such 
review panel shall be considered a 
final decision and not subject to re-
view by the Secretary. 
‘‘(C) ACCESS TO JUDICIAL REVIEW.—
‘‘(i) IN GENERAL.—If the appro-
priate review panel—
‘‘(I) determines that there 
are no material issues of fact 
in dispute and that the only 
issue is one of law or regula-
tion that no review panel has 
the authority to decide; or 
‘‘(II) fails to make such de-
termination within the period 
provided under subparagraph 
(B);