Ambulance Medicare Budget and Operations Act of 2017
This bill modifies Medicare payment rules and reporting requirements with respect to ground-ambulance services.
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3236 Introduced in House (IH)]
<DOC>
115th CONGRESS
1st Session
H. R. 3236
To amend titles XI and XVIII of the Social Security Act to improve
provider and supplier cost reporting of ambulance services under the
Medicare program, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 13, 2017
Mr. Nunes (for himself and Mr. Upton) 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 within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend titles XI and XVIII of the Social Security Act to improve
provider and supplier cost reporting of ambulance services under the
Medicare program, 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 ``Ambulance Medicare Budget and
Operations Act of 2017''.
SEC. 2. GROUND AMBULANCE SERVICES COST REPORTING REQUIREMENT.
(a) In General.--Section 1121 of the Social Security Act (42 U.S.C.
1320a) is amended--
(1) in subsection (a)--
(A) by striking ``For the purposes of'' and
inserting ``Subject to subsection (d), for the purposes
of''; and
(B) by inserting ``providers and suppliers of
ground ambulance services,'' after ``health maintenance
organizations,''; and
(2) by adding at the end the following new subsection:
``(d) In the case of a provider or supplier of ground ambulance
services that furnishes such services for fewer than 20 individuals
entitled to benefits under part A and enrolled under part B in a
reporting period (as defined by the Secretary), the Secretary may
modify the requirements for inclusion of any information specified in
subsection (a) in reports made in accordance with the uniform reporting
system established under this section with respect to such services.''.
(b) Hospital Provider Agreements.--Section 1866(a)(1) of the Social
Security Act (42 U.S.C. 1395cc(a)(1)) is amended--
(1) in subparagraph (X), by striking ``Secretary, and'' and
inserting ``Secretary,'';
(2) in subparagraph (Y)(ii)(V), by striking the period at
the end and inserting ``, and''; and
(3) by inserting after subparagraph (Y) the following new
subparagraph:
``(Z) in the case of a hospital that is a provider of
ground ambulance services, with respect to such services
furnished for reporting periods (as defined by the Secretary)
on or after January 1, 2022, to make reports to the Secretary
of information described in section 1121(a) in accordance with
the uniform reporting system established under such section for
providers and suppliers of ground ambulance services.''.
(c) Skilled Nursing Facility Provider Agreements.--Section 1819(d)
of the Social Security Act (42 U.S.C. 1395i-3(d)) is amended by adding
at the end the following new paragraph:
``(5) Ambulance services cost reporting.--A skilled nursing
facility that furnishes ground ambulance services, with respect
to such services furnished on or after January 1, 2022, shall
make reports to the Secretary of information described in
section 1121(a) in accordance with the uniform reporting system
established under such section for providers and suppliers of
ground ambulance services.''.
(d) Home Health Agency Provider Agreements.--Section 1891(a) of the
Social Security Act (42 U.S.C. 1395bbb(a)) is amended by adding at the
end the following new paragraph:
``(7) In the case of an agency that furnishes ground
ambulance services, with respect to such services furnished on
or after January 1, 2022, the agency makes reports to the
Secretary of information described in section 1121(a) in
accordance with the uniform reporting system established under
such section for providers and suppliers of ground ambulance
services.''.
(e) Suspension of Payment for Ground Ambulance Services.--Section
1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) is amended by
adding at the end the following new paragraph:
``(17) Authority to suspend payments for ground ambulance
services.--
``(A) In general.--Subject to subparagraphs (C) and
(D), in the case that the Secretary determines that a
supplier of ground ambulance services has not made to
the Secretary complete, accurate, and timely reports of
such services for reporting periods (as defined by the
Secretary) with respect to a year beginning with 2020
of information described in section 1121(a) in
accordance with the uniform reporting system
established under such section for providers and
suppliers of ground ambulance services and, as
determined appropriate by the Secretary, of any of the
information described in subparagraph (B), the
Secretary may suspend payments made under this
subsection, in whole or in part, to such supplier until
the Secretary determines that such supplier has
submitted such reports with respect to such reporting
period.
``(B) Additional information.--The Secretary may,
with respect to a supplier of ground ambulance
services, require the following information (to be
reported to the extent practicable under the uniform
reporting system established under section 1121(a)):
``(i) Whether the supplier is part of an
emergency services department, a governmental
organization, or another type of entity (as
described by the Secretary).
``(ii) The number of hours in a week during
which the supplier is available for furnishing
ground ambulance services.
``(iii) Any State regulations regarding
requirements relating to the stocking of
ambulances with certain equipment or drugs.
``(iv) The average number of volunteer
hours a week used by the supplier.
``(C) Hardship delay.--The Secretary shall
establish a process whereby a supplier of ground
ambulance services may request a delay in reporting
information described in subparagraphs (A) and (B) with
respect to a reporting period for reason of significant
hardship (as determined by the Secretary).
``(D) Authority to modify cost reporting elements
and enforcement.--Not earlier than January 1, 2023, the
Secretary may, after taking into account the
recommendation of the Medicare Payment Advisory
Commission in the most recent report available to the
Secretary submitted under section 3 of the Ambulance
Medicare Budget and Operations Act of 2017 regarding
whether cost reporting of ground ambulance services by
a supplier or category of suppliers (as specified for
purposes of the report submitted under such section)
should be required or modified, and through notice and
comment rulemaking, provide that subparagraph (A) no
longer applies to ground ambulance services suppliers
or such a category of such suppliers.''.
(f) Stakeholder Feedback.--
(1) In general.--The Secretary shall implement the
provisions of this section, including the amendments made by
this section, through notice and comment rulemaking and seek
input from stakeholders.
(2) Nonapplication of paperwork reduction act.--Chapter 35
of title 44, United States Code, shall not apply with respect
to notice and comment rulemaking carried out under paragraph
(1).
SEC. 3. GROUND AMBULANCE SERVICES COST REPORTING STUDY.
(a) In General.--Not later than March 15, 2022, and as determined
necessary by the Medicare Payment Advisory Commission thereafter, such
Commission shall assess and submit to Congress a report on ambulance
services cost reporting carried out in accordance with sections 1121(a)
and 1834(l) of the Social Security Act (42 U.S.C. 1320a(a), 1395m(l))
and the adequacy of payments for such services made under section
1834(l) of such Act.
(b) Contents.--The report described in subsection (a) shall contain
the following:
(1) An analysis of the accuracy of cost report data
submitted in accordance with such sections.
(2) An analysis of any burden on providers and suppliers of
such services associated with reporting such data.
(3) A recommendation on whether or not cost reporting of
ambulance services by providers, suppliers, or a category of
suppliers (as specified by the Secretary) of such services
should be required or modified, taking into account the
analyses described in paragraphs (1) and (2).
SEC. 4. EXTENSION OF GROUND AMBULANCE SERVICES EXTENDERS.
Section 1834(l) of the Social Security Act (42. U.S.C. 1395m(l)) is
amended--
(1) in paragraph (12)(A), by striking ``2018'' and
inserting ``2023''; and
(2) in paragraph (13)(A), by striking ``2018'' each place
it appears and inserting ``2023''.
<all>
Introduced in House
Introduced in House
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 within the jurisdiction of the committee concerned.
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 within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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