US Codex
Bill
Notes

To amend title XVIII of the Social Security Act to provide for site-of-service price transparency under the Medicare program.

H.R. 2299 · 114th Congress · May 13, 2015 · Lineage

A BILL

Section 1 Medicare site-of-service price transparency

Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by adding at the end the following new subsection:

“(r) Site-of-Service price transparency

“(1) In general—In order to facilitate price transparency with respect to items and services for which payment may be made either to a hospital outpatient department or to an ambulatory surgery center under this title, the Secretary shall, for 2017 and each year thereafter, make available to the public via a searchable website, with respect to an appropriate number of such items and services—

“(A) the estimated payment amount for such items and services under the outpatient department fee schedule under subsection (t) of section 1833 and the ambulatory surgical center payment system under subsection (i) of such section; and

“(B) the estimated amount of beneficiary liability applicable to such an item or service.

“(2) Calculation of estimated beneficiary liability—For purposes of subsection (a), the estimated beneficiary liability, with respect to an item or service, is the amount for such item or service for which an individual who does not have coverage under a medicare supplemental policy certified under section 1882 or any other supplemental insurance coverage is responsible.

“(3) Implementation—In carrying out this section, the Secretary—

“(A) shall include in the notice described in section 1804(a) a notification of the availability of the anticipated costs made available under subsection (a); and

“(B) may utilize existing mechanisms, such as the portion of the website of the Centers for Medicare & Medicaid Services on which information comparing physician performance is posted (commonly referred to as the Physician Compare website), to make available such anticipated costs under such subsection.

“(4) Funding—For purposes of implementing this subsection, the Secretary shall provide for the transfer, from the Supplemental Medical Insurance Trust Fund under section 1841 to the Centers for Medicare & Medicaid Services Program Management Account, of $6,000,000 for fiscal year 2015, to remain available until expended.”