Fairness for Medical Providers Act of 2019

Bill: 116-hr-373
Sponsor: full_name: Rep. Brownley, Julia [D-CA-26]
Introduced: 2019-01-09
Policy area: Health
Subjects: Administrative law and regulatory procedures

Health information and medical records

Health personnel

Medicare
Latest action: action_date: 2019-03-01
text: Referred to the Subcommittee on Worker and Family Support.

Summaries:
action_date: 2019-01-09
action_desc: Introduced in House
text: <p><b>Fairness for Medical Providers Act of 2019</b></p> <p>This bill allows&nbsp;administrative or judicial review of certain decisions by the Centers for Medicare &amp; Medicaid Services (CMS) relating to the Medicare Primary Care Incentive Payment Program. (The program authorized additional payments to certain primary-care practitioners who provided primary-care services on or after January 1, 2011, and before January 1, 2016.) </p> <p>Current law prohibits administrative or judicial review of CMS decisions regarding the eligibility of primary-care practitioners to receive incentive payments under the program. The bill authorizes review of such decisions in cases where the practitioner failed to meet eligibility criteria due to a coding error for provided items and services.</p>

tv_txt: I 116th CONGRESS 1st Session H. R. 373 IN THE HOUSE OF REPRESENTATIVES January 9, 2019 Ms. Brownley of California introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committee on Ways and Means , for a period to be subsequently determined 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 provide for certain administrative or judicial review respecting the identification of primary care practitioners under part B of the Medicare program.

1. Short title This Act may be cited as the Fairness for Medical Providers Act of 2019 . 2. Providing for certain administrative or judicial review respecting the identification of primary care practitioners under part B of the Medicare program (a) In general Section 1833(x)(4) of the Social Security Act ( 42 U.S.C. 1395l(x)(4) ) is amended to read as follows: (4) Limitation on review (A) In general Subject to subparagraph (B), there shall be no administrative or judicial review under section 1869, 1878, or otherwise, respecting the identification of primary care practitioners under this subsection. (B) Exception Subparagraph (A) shall not apply in the case of administrative or judicial review under section 1869, 1878, or otherwise, of the issue of whether the Secretary (or an entity contracting with the Secretary) failed to identify an individual described in clause (i) of paragraph (2)(A) as a primary care practitioner by reason of coding error with respect to items and services furnished by such individual during an applicable prior period (as described in clause (ii) of such paragraph). . (b) Effective date The amendment made by subsection (a) shall apply as if included in the enactment of the Patient Protection and Affordable Care Act ( Public Law 111–148 ).