[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6269 Introduced in House (IH)]
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115th CONGRESS
2d Session
H. R. 6269
To amend title XVIII of the Social Security Act to restructure the
payment adjustment for non-emergency ESRD ambulance transports under
the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 28, 2018
Mr. LaHood (for himself and Ms. Sewell of Alabama) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, 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 title XVIII of the Social Security Act to restructure the
payment adjustment for non-emergency ESRD ambulance transports under
the Medicare program.
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 ``Non-Emergency Ambulance
Transportation Sustainability and Accountability Act of 2018'' or the
``NEATSA Act''.
SEC. 2. RESTRUCTURE OF MEDICARE PAYMENT ADJUSTMENT FOR NON-EMERGENCY
ESRD AMBULANCE TRANSPORTS.
(a) In General.--Section 1834(l)(15) of the Social Security Act (42
U.S.C. 1395m(l)(15)) is amended to read as follows:
``(15) Restructure of payment adjustment for non-emergency
ambulance transports for esrd beneficiaries.--
``(A) In general.--In the case of applicable
ambulance services, the fee schedule amount otherwise
applicable under the preceding provisions of this
subsection shall be reduced as follows:
``(i) In the case of applicable ambulance
services furnished during the period beginning
on October 1, 2013, and ending on December 31,
2018, reduced by 10 percent.
``(ii) In the case of applicable ambulance
services furnished during 2019, reduced by 15.5
percent.
``(iii) In the case of applicable ambulance
services furnished during 2020 or a subsequent
year--
``(I) by a provider or supplier of
ambulance services that the Secretary
has designated under subparagraph (C)
for the year and for which such
transport originates in an area not
described in paragraph (13)(A)(i),
reduced by 29.5 percent; or
``(II) that are not described in
subclause (I), reduced by 15.5 percent.
``(B) Applicable ambulance services.--In this
paragraph, the term `applicable ambulance services'
means ambulance services consisting of non-emergency
basic life support services involving transport of an
individual with end-stage renal disease for renal
dialysis services (as described in section
1881(b)(14)(B)) furnished other than on an emergency
basis by a provider of services or a renal dialysis
facility.
``(C) Designation.--
``(i) In general.--For 2020 and each
subsequent year, the Secretary shall designate
the providers or suppliers of ambulance
services for which the total payments made to
the provider or supplier for applicable
ambulance services furnished during the
applicable period for the year makes up at
least 50 percent of the total payments made to
the provider or supplier under this part for
all ambulance services furnished during such
applicable period.
``(ii) Methodology.--The Secretary shall,
through notice and comment rulemaking,
establish the methodology for designating
providers and suppliers under clause (i) for a
year. Under such methodology, the applicable
period for a year shall be a 12-month period
determined by the Secretary that begins and
ends prior to the beginning of such year.
``(iii) Timing.--Not later than November 1
of each year (beginning with 2019), the
Secretary shall notify any provider or supplier
that will be designated under clause (i) for
the subsequent year.
``(iv) Targeted review.--The Secretary
shall establish a process under which a
provider or supplier may seek an informal
review of the designation under clause (i) with
respect to the provider or supplier.
``(v) Public reporting.--Beginning in 2021,
the Secretary shall, in an easily
understandable format, make available on the
Internet website of the Centers for Medicare &
Medicaid Services the following:
``(I) The total number of claims
paid under this part for applicable
ambulance services.
``(II) The total number of claims
paid under this part for applicable
ambulance services that were subject to
the payment reduction under
subparagraph (A)(iii), broken out for
each of subclauses (I) and (II) of such
subparagraph.
``(III) The total number of
providers and suppliers that were
designated under clause (i).
``(IV) Any other data regarding
applicable ambulance services that the
Secretary determines appropriate.''.
(b) GAO Study and Report.--
(1) In general.--The Comptroller General of the United
States (in this subsection referred to as the ``Comptroller
General'') shall conduct a study on payments under section
1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) for
applicable ambulance services (as defined in subparagraph (B)
of paragraph (15) of such section, as added by subsection (a)).
Such study shall include an analysis of the impact of the
amendment made by subsection (a), including the impact on
beneficiary access and any steps providers and suppliers of
ambulance services have taken to avoid payment reductions under
such paragraph (15).
(2) Report.--Not later than March 1, 2023, the Comptroller
General shall submit to Congress a report containing the
results of the study conducted under paragraph (1), together
with recommendations for such legislation and administrative
action as the Comptroller General determines appropriate.
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