Common Sense Medicare Reform Act of 1995

Summary

TABLE OF CONTENTS: Title I: Fraud and Abuse Subtitle A: Provisions Relating to Durable Medical Equipment Subtitle B: Anti-Fraud Provisions Subtitle C: Health Care Fraud Abuse Account Title II: Medicare Plus Pilot Program Title III: Commission on the Effect of the Baby Boom Generation on the Medicare Program Title IV: Development of Single Medicare Administrative System Title V: Lock-Box Provision Common Sense Medicare Reform Act of 1995 - Title I: Fraud and Abuse - Subtitle A: Provisions Relating to Durable Medical Equipment - Revises the payment methodology under title XVIII (Medicare) of the Social Security Act (SSA) for durable medical equipment to provide for: (1) the use of competitive pricing to determine payment amounts; and (2) a permanent freeze in updates for covered items (starting in 1996) and orthotics and prosthetics (starting in 1995). Subtitle B: Anti-Fraud Provisions - Amends the Federal criminal code to provide for: (1) various specified sanctions for certain health care-related violations involving illegal remuneration in the form of kickbacks and other arrangements in connection with specified health care benefit programs; and (2) other specified changes relating to health care fraud and abuse and such matters as disclosure of grand jury information and investigations of acts or activities constituting or involving health care fraud. Subtitle C: Health Care Fraud Abuse Account - Establishes in the Treasury the HHS Fraud and Abuse Control Fund, consisting of deposits of penalties and other specified payments made pursuant to a court or administrative order or voluntary settlement agreement, in order to support various specified anti-fraud and abuse activities under the Medicare and Medicaid programs. Authorizes appropriations. Title II: Medicare Plus Pilot Program - Directs the Secretary of Health and Human Services to establish a pilot program under which provider-sponsored networks, Taft-Hartley plans, association plans, and high-deductible health plans (with contributions to medical savings accounts) may qualify for payments to health maintenance organizations and competitive medical plans. Requires certain studies in conjunction with such program for a report to the Congress. Title III: Commission on the Effect of the Baby Boom Generation on the Medicare Program - Establishes the Commission on the Effect of the Baby Boom Generation on the Medicare Program to examine the financial impact on Medicare of the increase in Medicare-eligible individuals from approximately 2010 to 2035 for a report to the Congress, including specific recommendations for preserving Medicare. Authorizes appropriations. Title IV: Development of Single Medicare Administrative System - Directs the Secretary to take necessary steps to provide for improved Medicare efficiency through a common payment form for all Medicare payments and consolidated administration of Medicare parts A and B. Title V: Lock-Box Provision - Provides that all savings resulting from the enactment of this Act shall be transferred to the credit of the Federal Hospital Insurance Trust Fund under Medicare part A and may not be used to offset revenue losses from a tax cut.

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3 official files

• Introduced in House (text)

  Introduced in House · EN · 12 October 1995

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• Introduced in House (PDF)

  Introduced in House · EN · 12 October 1995

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• Introduced in House

  summary · EN · 12 October 1995

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