A bill to amend title XVIII of the Social Security Act to promote the use of universal product numbers on claims forms submitted for reimbursement under the Medicare program

6 Pages·1999·0.26 MB·English

by  United States. Congress. Senate

CCh2'-iS07U-bii3sry s
7?0GSecurityB!vd.
iicltirrtore, Maryierri 21?.4't
106thcongress 256
1stSession S.
To amend title XVIII of the Social Security Act to promote the use of
universalproductnumbersonclaimsformssubmittedforreimbursement
underthemedicareprogram.
IN THE SENATE OF THE UNITED STATES
January20,1999
Mr.Grassley(forhimself,Mr.Breaux,andMr.CONTlAD)introducedthe.
followngbill;wliichwasreadtw-ieeandreferredtotheCommitteeonFinance
A
BILL
To amendtitleXVm ofthe Social SecurityActto promote
' the use of universal product numbers on claims forms
submitted for reimbursement under the medicare pro-
gram.
1 BeitenactedhytheSenateandHouseofRepresenta-
2 tivesoftJieUnitedStatesofAmericainCongressassembled,
3 SECTION1.SHORTTITLE.
4 Tliis Act may be cited as the "Medicare Universal
5 ProductNumberActof1999".
—
2
1 SEC.2.UNIVERSALPRODUCTNUMBERSONCLAIMSFORMS
2 FOR REIMBURSEMENT UNDER THE MEDI-
3 CAREPROGRAM. r
4 (a) Accommodation of UPNs ox Medicaiie »
—
5 Claims Forms. Not later than February' 1, 2001, all
6 claimsformsdevelopedorusedbytheSecretary^ofHealth
7 andHuman Services forreimbursementunderthe medi-
8 careprogramundertitleX\TIIoftheSocialSecuritv'^Act
9 (42 U.S.C. 1395 et seq.) shall accommodate the use of
10 universalproductnumbersforaUPNcovereditem.
—
11 (b)RequirementforPa^'mentofClaims. Title
12 X\^noftheSocialSecurityAct(42U.S.C. 1395etseq.)
13 isamendedbyaddingattheendthefollowing:
14 "USEOFUNT\^RSALPRODUCTNUMBERS
—
15 "Sec. 1897. (a)InGeneral. Nopaymentshallbe
16 madeunderthistitleforanyclaimforreimbursementfor
17 anyUPNcovereditemunlesstheclaimcontainstheuni-
18 versalproductnumberoftheUPNcovereditem.
—
19 "(b)DEFIN^TIONS. Intliissection:
—
20 "(1)UPNco^t:reditem.
—
21 "(A) In general. Except asprovidedin
22 subparagraph (B), the term 'UPN covered
23 item' means
24 "(i) acovereditemasthattermisde-
25 finedinsection1834(a)(13);
>S256IS
——
a
1 *'(ii) an item described in parag^raph
2 (8)or(9) ofsection1861(s);
3 "(iii) an item described in paragraph
4 (5)ofsection 1861(s);and
5 "(iv) any other item for which pay-
6 mentismadeunderthistitlethattheSec-
7 retarydeterminestobeappropriate.
8 "(B) Exclusion.—The term 'UPN cov-
9 ered item' does not include a customized item
10 forwliichpajTuentismadeunderthistitle.
—
11 "(2) Unr^rsal product number. The
12 term 'universal product number' means a number
13 thatis
14 "(A) affixed by the manufacturer to each
15 indi\idual UPN covered item that uniquely
16 identifiesthe item at eachpackaginglevel; and
17 "(B) based on commercially acceptable
18 identificationstandardssuchas,butnotlimited
19 to, standards establishedbythe Uniform Code
20 Council-International Article Numbering Sys-
21 tern or the Health Industry Business Commu-
22 - nicationCouncil.".
23 (c) De\^lopment and Implementation of Pro-
24 CEDURES.
•S256IS
—
1 (1) Information included in upn. The
2 Secretan" of Health and Human Sendees, in con-
3 sultation with manufacturers and entities with ap-
4 propriate expertise, shah determine the relevant de-
5 scriptive information appropriate for mclusion in a
6 universal product number for a UPN covered item.
—
7 (2) Re\^ew of procedure. From the infor-
8 mation obtained by the use of universal product
9 numbers on claims for reimbursement under the
10 medicare program, the Secretary of Health and
11 HumanServices,inconsultationwithinterestedpar-
12 ties, shallperiodicallyreviewtheUPNcovereditems
13 billedunderthe Health CareFinancingAdministra-
14 tion Common Procedure Coding System and adjust
15 such coding system to ensure that functionally
16 equivalent UPN covered items are billed and reim-
17 bursedunderthesamecodes.
—
18 (d) Effective Date. The amendment made by
19 subsection (b) shall apply to claims for reimbursement
20 submittedonandafterFebruary1,2002.
21 SEC.3.STUDYANDREPORTSTOCONGRESS.
—
22 (a) Study. The Secretarv^ of Health and Human
23 Servicesshallconductastudyontheresultsoftheimple-
24 mentation ofthe provisions insubsections (a) and (c) of
>S256IS
C2-G7-i3
K 7?0CSocu:'!vBlvd.
o:-li:iri->org, t'^isr/irrrt 21?/t4
1 section 2 andthe amendment tothe Social SecurityAct
2 insubsection(b)ofthatsection.
—
3 (b)Reports. '
—
4 (1) Progress report. Not later than 6
5 months afterthe date ofenactment ofthisAct, the
6 SecretaryofHealth and Human Sendees shall sub-
7 mitareporttoCongressthatcontainsadetailedde-
8 scriptionoftheprogress ofthematters studiedpur-
9 suanttosubsection(a).
—
10 (2) Implementation. Not later than 18
11 months afterthe date ofenactment ofthisAct, and
12 annually thereafter for 3 years, the Secretary of
13 HealthandHumanServicesshallsubmitareportto
14 Congress that contains a detailed description ofthe
15 results of the study conducted pursuant to sub-
,
16 .section (a), together with the Secretaiy^'s rec-
17 ommendations regarding the use ofuniversal prod-
18 uct numbers and the use ofdata obtained fromthe
19 useofsuchnumbers.
20 SEC.4.DEFINITIONS.
21 InthisAct:
22 (1) UPN co\t:red item.—The term "UPN
23 covered item" has the meaning given such term in
24 section 1897(b)(1) of the Social Security- Act (as
25 addedbysection2(b)).
•S256IS
6 3 flOTS DDDLD3T5
fl
—
1 (2) Uni\'t:rsal product number. The term
2 "universal product number" has the meaning given
3 such term in section 1897(b)(2) ofthe Social Secu-
4 rityAct (asaddedbysection2(b)).
5 SEC.5.AUTHORIZATIONOFAPPROPRIATIONS.
6 Theare authorizedtobe appropriatedsuchsums as
7 maybenecessaryforthepurposeofcarryingoutthepro-
8 visionsin subsections (a) and (c) ofsection 2, section 3,
9 andsection 1897 ofthe Social SecurityAct (asaddedby
10 section2(b)).
O
'S266IS