Comprehensive Operations, Sustainability, and Transport 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. 3729 Introduced in House (IH)]
<DOC>
115th CONGRESS
1st Session
H. R. 3729
To amend titles XI and XVIII of the Social Security Act to facilitate
provider and supplier cost reporting of ambulance services under the
Medicare program, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 11, 2017
Mr. Nunes (for himself and Ms. Sewell of Alabama) 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 facilitate
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 ``Comprehensive Operations,
Sustainability, and Transport 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'';
(B) by inserting ``suppliers of ground ambulance
services,'' after ``health maintenance
organizations,''; and
(C) in the matter at the end, by adding the
following new sentence: ``Not later than December 31,
2019, the Secretary shall modify the uniform reporting
system for providers of services with respect to
ambulance services to ensure that such system contains
information similar (as determined by the Secretary) to
information required under the uniform reporting system
for suppliers of ground ambulance services.''; and
(2) by adding at the end the following new subsection:
``(d) In the case of a supplier of ground ambulance services that
furnishes such services for fewer than 20 individuals entitled to
benefits under part A of title XVIII and enrolled under part B of such
title in a cost 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) Suspension of Payment for Ground Ambulance Services; Deeming
Certain Payments Overpayments.--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) Requirement to submit cost report and authority to
suspend payments and deem certain payments overpayments for
ground ambulance services.--
``(A) In general.--With respect to ground ambulance
services furnished by a supplier of such services
during cost reporting periods beginning on or after
January 1, 2020, such supplier 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 such suppliers and,
as may be required by the Secretary, of any of the
information described in subparagraph (B).
``(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) for
such suppliers):
``(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) The average number of volunteer
hours a week used by the supplier.
``(C) Suspension of payment.--Subject to
subparagraph (E), in the case that the Secretary
determines that a supplier of ground ambulance services
has not made to the Secretary a timely report described
in subparagraph (A) with respect to a cost reporting
period beginning on or after January 1, 2020, and
before January 1, 2022, the Secretary may suspend
payments made under this subsection, in whole or in
part, to such supplier until the Secretary finds that
such supplier has made such a report.
``(D) Deeming certain payments overpayments.--
Subject to subparagraphs (E) and (F), in the case that
the Secretary determines that a supplier of ground
ambulance services has not made to the Secretary a
complete, accurate, and timely report described in
subparagraph (A) with respect to a cost reporting
period beginning on or after January 1, 2022, the
Secretary may deem payments made under this subsection
to such supplier for such period to be overpayments and
recoup such overpayments.
``(E) Hardship delay.--The Secretary shall
establish a process whereby a supplier of ground
ambulance services may request a delay in making a
report described in subparagraph (A) with respect to a
cost reporting period for reason of significant
hardship (as determined by the Secretary).
``(F) Authority to modify cost reporting elements
and enforcement.--Not earlier than January 1, 2023, the
Secretary may provide that subparagraph (D) no longer
applies to ground ambulance services suppliers or a
category of such suppliers after--
``(i) 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 reports made
by suppliers or a category of suppliers (as
specified for purposes of the report submitted
under such section) should be required or
modified; and
``(ii) undertaking notice and comment
rulemaking.
``(G) Audit of cost reports.--The Secretary shall
audit reports described in subparagraph (A) submitted
with respect to cost reporting periods beginning on or
after January 1, 2021.
``(H) Appeals.--The Secretary shall establish a
process whereby a supplier of ground ambulance services
may appeal a determination described in subparagraph
(C) or (D) made with respect to a cost report required
to be made by such supplier under subparagraph (A).''.
(c) Stakeholder Feedback.--
(1) In general.--The Secretary of Health and Human Services
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--
(A) the development and implementation of the
uniform reporting system required under section 1121(a)
of the Social Security Act (42 U.S.C. 1320a(a)) for
suppliers of ground ambulance services and reports
required to be made under section 1834(l)(17) of such
Act (42 U.S.C. 1395m(l)(17)); and
(B) the modification of the uniform reporting
systems under such section 1121(a) of such Act for
providers of such services and reports required to be
made under section 1861(v)(1)(F) of such Act (42 U.S.C.
1395x(v)(1)(F)).
(d) Implementation Resources.--
(1) In general.--There are hereby appropriated to the
Secretary from the Federal Hospital Insurance Trust Fund under
section 1817 of the Social Security Act (42 U.S.C. 1395i)
$8,000,000 and from the Federal Supplementary Medical Insurance
Trust Fund under section 1841 of such Act (42 U.S.C. 1395t)
$92,000,000 (of which not less than $10,000,000 shall be used
to fulfill the auditing requirement under section
1834(l)(17)(G) of such Act, as added by subsection (b) of this
section) to carry out the provisions of this section, including
the amendments made by this section, to remain available
through December 31, 2022.
(2) Funding for employees.--The Secretary of Health and
Human Services shall provide for the transfer to the Centers
for Medicare & Medicaid Services Program Management Account,
from the Supplemental Insurance Trust Fund under section 1841
of the Social Security Act (42 U.S.C. 1395t), of such sums as
may be necessary in order to directly hire no more than 2 full-
time employees to carry out the provisions of this section,
including the amendments made by this section.
(e) Sense of Congress.--It is the sense of Congress that--
(1) a cost report made by a supplier of ground ambulance
services with respect to a cost reporting period beginning
before January 1, 2022, may not contain complete and accurate
information on ground ambulance services furnished during such
a period by the supplier; and
(2) the Secretary should take into account only the
timeliness of such a report made with respect to such a period
when determining whether to suspend payments to a supplier
under section 1834(l) of the Social Security Act (42 U.S.C.
1395m(l)).
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 cost reports
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 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 reports of
ambulance services made by suppliers or a category of suppliers
(as specified by the Secretary) of such services, or the ground
ambulance portion of cost reports made by providers 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 AND PAY-FOR.
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'';
(2) in paragraph (13)(A), by striking ``2018'' each place
it appears and inserting ``2023''; and
(3) in paragraph (15), by striking ``on or after October 1,
2013'' and inserting ``during the period beginning on October
1, 2013, and ending on September 30, 2018, and by 32 percent
for such services furnished on or after October 1, 2018''.
<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.
Committee Consideration and Mark-up Session Held.
Ordered to be Reported (Amended) by Voice Vote.
Referred to the Subcommittee on Health.
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-481, Part I.
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-481, Part I.
Committee on Energy and Commerce discharged.
Committee on Energy and Commerce discharged.
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Placed on the Union Calendar, Calendar No. 356.