I
106TH CONGRESS
2D SESSION
H. R. 5334
To establish a Patients Before Paperwork Medicare Red Tape Reduction
Commission to study the proliferation of paperwork under the medicare
program.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 28, 2000
Mr. DICKEY introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Com-
merce, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned
A BILL
To establish a Patients Before Paperwork Medicare Red
Tape Reduction Commission to study the proliferation
of paperwork 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 ‘‘Patients Before Paper-
work Medicare Red Tape Reduction Act of 2000’’.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Regulations promulgated by the Health
Care Financing Administration to administer the
medicare program under title XVIII of the Social
Security Act are 3 times as long as the regulations
relating to the Internal Revenue Code of 1986.
(2) According to American Medical Association
Immediate Past President Dr. Nancy W. Dickey, for
most doctors, ‘‘the biggest challenge is getting
through mountains of medicare paperwork’’.
(3) The Health Care Financing Administration
uses 23 different forms in the administration of the
medicare program.
(4) In 1998, the average processing time for
appeals of claims denied under part A of the medi-
care program was 310 days and the average appeal
time was 524 days under part B of such program.
SEC. 3. PATIENTS BEFORE PAPERWORK MEDICARE RED
TAPE REDUCTION COMMISSION.
(a) ESTABLISHMENT.—There is established a com-
mission to be known as the Patients Before Paperwork
Medicare Red Tape Reduction Commission (in this section
referred to as the ‘‘Commission’’).
(b) DUTIES OF THE COMMISSION.—The Commission
shall—
(1) review existing paperwork burdens and re-
lated regulations under the medicare program under
title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.), with the goal of reducing the paper-
work burdens under such program;
(2) analyze whether existing and proposed pa-
perwork requirements and related regulations have
proven benefits, including a positive health benefit
for medicare beneficiaries;
(3) make recommendations regarding methods
to streamline and to simplify the coding method for
items and services for which reimbursement is pro-
vided under the medicare program;
(4) make recommendations regarding the facili-
tation of electronic filing of claims for reimburse-
ment and the elimination of paperwork under the
medicare program;
(5) develop a standard form that will minimize
any duplication of data and that facilitates the cre-
ation of an electronic system that relies on less pa-
perwork than the current system;
(6) determine the effect of the paperwork re-
quirements under the medicare program on relation-
ships between doctors and patients; and
(7) review and analyze such other matters relat-
ing to paperwork reduction under the medicare pro-
gram as the Commission deems appropriate.
(c) MEMBERSHIP.—
(1) COMPOSITION.—The Commission shall be
composed of 10 voting members appointed in accord-
ance with paragraph (2) and one ex officio voting
member designated under paragraph (3).
(2) IN GENERAL.—Not later than 60 days after
the date of the enactment of this Act, members of
the Commission shall be appointed as follows:
(A) The President shall appoint 3 mem-
bers, of whom not more than 2 shall be of the
same political party.
(B) The majority leader of the Senate,
after consultation with the minority leader of
the Senate, shall appoint 3 members, of whom
not more than 2 shall be of the same political
party.
(C) The Speaker of the House of Rep-
resentatives, after consultation with the minor-
ity leader of the House of Representatives, shall
appoint 3 members, of whom not more than 2
shall be of the same political party.
(D) The President, majority leader of the
Senate, and the Speaker of the House of Rep-
resentatives shall jointly appoint 1 member,
who shall serve as Chairperson of the Commis-
sion.
(3) EX OFFICIO MEMBER.—The Secretary of
Health and Human Services (or the Secretary’s des-
ignee) shall serve as an ex officio member of the
Commission.
(4) QUALIFICATIONS.—
(A) IN
GENERAL.—Subject to subpara-
graph (B), each member appointed under para-
graph (2) shall be a health care provider, in-
surer, an individual with expertise in the medi-
care program, or a medicare beneficiary.
(B) INCLUSION
OF
PRACTICING
PHYSI-
CIANS.—At least 1 member appointed under
paragraph (2) shall be a practicing physician.
(5) TERMS
OF
APPOINTMENT.—The term of
any appointment under paragraph (1) to the Com-
mission shall be for the life of the Commission.
(6) MEETINGS.—The Commission shall meet at
the call of its Chairperson or a majority of its mem-
bers.
(7) QUORUM.—A quorum shall consist of a ma-
jority of the members of the Commission, except
that 3 members may conduct a hearing under sub-
section (e)(1).
(8) VACANCIES.—A vacancy on the Commission
shall be filled in the same manner in which the origi-
nal appointment was made not later than 30 days
after the Commission is given notice of the vacancy
and shall not affect the power of the remaining
members to execute the duties of the Commission.
(9) COMPENSATION.—Members of the Commis-
sion shall receive no additional pay, allowances, or
benefits by reason of their service on the Commis-
sion.
(10) EXPENSES.—Each member of the Com-
mission shall receive travel expenses and per diem in
lieu of subsistence in accordance with sections 5702
and 5703 of title 5, United States Code.
(d) STAFF AND SUPPORT SERVICES.—
(1) EXECUTIVE DIRECTOR.—
(A) 
APPOINTMENT.—The 
Chairperson
shall appoint an executive director of the Com-
mission.
(B) COMPENSATION.—The executive direc-
tor shall be paid the rate of basic pay for level
V of the Executive Schedule under section 5316
of title 5, United States Code.
(2) STAFF.—With the approval of the Commis-
sion, the executive director may appoint such per-
sonnel as the executive director considers appro-
priate.
(3) APPLICABILITY OF CIVIL SERVICE LAWS.—
The staff of the Commission shall be appointed with-
out regard to the provisions of title 5, United States
Code, governing appointments in the competitive
service, and shall be paid without regard to the pro-
visions of chapter 51 and subchapter III of chapter
53 of such title (relating to classification and Gen-
eral Schedule pay rates).
(4) EXPERTS
AND
CONSULTANTS.—With the
approval of the Commission, the executive director
may procure temporary and intermittent services
under section 3109(b) of title 5, United States Code.
(5) PHYSICAL FACILITIES.—The Administrator
of General Services shall locate suitable office space
for the operation of the Commission. The facilities
shall serve as the headquarters of the Commission
and shall include all necessary equipment and
incidentals required for the proper functioning of the
Commission.
(e) POWERS OF COMMISSION.—
(1) HEARINGS
AND
OTHER
ACTIVITIES.—For
the purpose of carrying out its duties, the Commis-
sion may hold such hearings and undertake such
other activities as the Commission determines to be
necessary to carry out its duties.
(2) STUDIES BY GAO.—Upon the request of the
Commission, the Comptroller General of the United
States shall conduct such studies or investigations as
the Commission determines to be necessary to carry
out its duties.
(3) COST
ESTIMATES
BY
CONGRESSIONAL
BUDGET OFFICE AND OFFICE OF THE CHIEF ACTU-
ARY OF HCFA.—
(A) The Director of the Congressional
Budget Office or the Chief Actuary of the
Health Care Financing Administration shall
provide to the Commission, upon the request of
the Commission, such cost estimates as the
Commission determines to be necessary to carry
out its duties.
(B) The Commission shall reimburse the
Director of the Congressional Budget Office for
expenses relating to the employment in the of-
fice of the Director of such additional staff as
may be necessary for the Director to comply
with requests by the Commission under sub-
paragraph (A).
(4) DETAIL OF FEDERAL EMPLOYEES.—Upon
the request of the Commission, the head of any Fed-
eral agency is authorized to detail, without reim-
bursement, any of the personnel of such agency to
the Commission to assist the Commission in car-
rying out its duties. Any such detail shall not inter-
rupt or otherwise affect the civil service status or
privileges of the Federal employee.
(5) TECHNICAL
ASSISTANCE.—Upon the re-
quest of the Commission, the head of a Federal
agency shall provide such technical assistance to the
Commission as the Commission determines to be
necessary to carry out its duties.
(6) USE OF MAILS.—The Commission may use
the United States mails in the same manner and
under the same conditions as Federal agencies and
shall, for purposes of the frank, be considered a
commission of Congress as described in section 3215
of title 39, United States Code.
(7) OBTAINING
INFORMATION.—The Commis-
sion may secure directly from any Federal agency
information necessary to enable it to carry out its
duties, if the information may be disclosed under
section 552 of title 5, United States Code. Upon re-
quest of the Chairperson of the Commission, the
head of such agency shall furnish such information
to the Commission.
(8) ADMINISTRATIVE
SUPPORT
SERVICES.—
Upon the request of the Commission, the Adminis-
trator of General Services shall provide to the Com-
mission on a reimbursable basis such administrative
support services as the Commission may request.
(9) PRINTING.—For purposes of costs relating
to printing and binding, including the cost of per-
sonnel detailed from the Government Printing Of-
fice, the Commission shall be deemed to be a com-
mittee of Congress.
(f) REPORT.—Not later than 1 year after the date
on which the final member of the Commission is appointed
under subsection (c), the Commission shall submit to the
President and Congress a report which shall contain a de-
tailed statement of only those recommendations, findings,
and conclusions of the Commission that receive the ap-
proval of at least a majority of the members of the Com-
mission.
(g) TERMINATION.—The Commission shall terminate
30 days after the date of submission of the report required
under subsection (f).
(h) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated $500,000 to carry out
this section.
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