Accuracy in Medicare Physician Payment Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to establish and appoint an expert outside advisory panel for purposes of providing oversight to the processes relating to valuation of physicians' services.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2545 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 2545
To amend title XVIII of the Social Security Act to provide for an
expert advisory panel regarding relative value scale process used under
the Medicare physician fee schedule, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 27, 2013
Mr. McDermott 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 an
expert advisory panel regarding relative value scale process used under
the Medicare physician fee schedule, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Accuracy in Medicare Physician
Payment Act of 2013''.
SEC. 2. EXPERT ADVISORY PANEL REGARDING RELATIVE VALUE SCALE PROCESS
USED IN MEDICARE PHYSICIAN FEE SCHEDULE.
Section 1848(c)(2) of the Social Security Act (42 U.S.C.
1395m(c)(2)) is amended by adding at the end the following new
subparagraph:
``(M) Use of expert advisory panel regarding
relative value scale process used.--
``(i) In general.--For purposes of
providing oversight to the processes (including
the process described in subparagraph (K))
relating to valuation of physicians' services,
not later than 90 days after the date of the
enactment of this subparagraph, the Secretary
shall establish and appoint an expert outside
advisory panel (in this subparagraph referred
to as the `panel').
``(ii) Composition of panel.--The panel
shall be composed of individuals with expertise
in the valuation of physicians' services, such
as individuals who are medical directors for
carriers, experts in medical economics and
technology diffusion, and private payer plan
representatives, and shall include a mix of
physicians in different specialty areas,
particularly physicians who are not directly
affected by changes in the valuation of
physicians' services under this section (such
as retired physicians and physicians who are
employed by managed care organizations or
academic medical centers), as well as
representatives of individuals enrolled under
this part.
``(iii) Duties.--
``(I) In general.--The panel shall
provide oversight to the processes of
identifying, reviewing, and adjusting
valuations for physicians' services
under this section, including
activities described in the succeeding
provisions of this clause.
``(II) Establishment of screens.--
The panel may establish screens (in
addition to the screens identified
under subparagraph (K)(ii)) and other
means for identifying physicians'
services for which there are
potentially misvalued codes for review,
such as services that have experienced
substantial changes in length of stay,
site of service, volume, practice
expense, and other factors that may
indicate changes in physician work.
``(III) Data collection.--The panel
may collect data and develop supporting
evidence relating to the valuation of
physicians' services.
``(IV) Surveys.--The panel may
conduct surveys of suppliers of
physicians' services and may conduct
time and motion studies relating to
such valuations.
``(V) Transmitting codes for review
and recommendations.--The panel may
transmit with supporting evidence codes
for review and recommendations through
the means described in subparagraphs
(I) through (III) of subparagraph
(K)(iii).
``(VI) Evaluation of
recommendations submitted.--The panel
shall evaluate any recommendations
submitted through such means (whether
pursuant to the solicitation under
subclause (V) or otherwise) and report
to the Secretary on such evaluation.
The panel's activities under subclauses (III)
and (IV) may be conducted directly or through
contracts with appropriate, qualified entities.
``(iv) Application of faca.--The Federal
Advisory Committee Act (5 U.S.C. App.) shall
apply to the panel, except that section 14 of
such Act shall not apply.
``(v) Funding.--The Secretary shall provide
for the transfer of not to exceed $10,000,000
for each fiscal year (beginning with fiscal
year 2014) from the Federal Medical
Supplementary Medical Insurance Trust Fund
established in section 1841 to the Center for
Medicare & Medicaid Services Program Management
Account to carry out this subparagraph,
including for the management and staffing of
the panel and the conduct of activities
described in clause (iii).''.
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Introduced in House
Introduced in House
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.
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.
Sponsor introductory remarks on measure. (CR E992)
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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