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Code · BILL · 113th Congress · S. 1123 (Introduced in Senate) — To amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid... · Sec. 105

Sec. 105. Establishing Medicare administrative contractor error reduction incentives

232 words·~1 min read·/bill/113/s/1123/is/section-105

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Section 1874A(b)(1)(D) of the Social Security Act ( 42 U.S.C. 1395kk(b)(1)(D) ) is amended— by striking and inserting “ quality .—The Secretary quality .— Subject to clauses
(ii)and (iii), the Secretary ; and by inserting after clause (i), as added by paragraph (1), the following new clauses: The Secretary shall provide incentives for medicare administrative contractors to reduce the improper payment error rates in their jurisdictions. The incentives provided for under clause (ii)— may include a sliding scale of bonus payments and additional incentives to medicare administrative contractors that reduce the improper payment error rates in their jurisdictions to certain benchmark levels, as determined by the Secretary; and shall include substantial reductions in award fee payments under award fee contracts, for any medicare administrative contractor that reaches an upper end error threshold or other threshold as determined by the Secretary. . The amendments made by subsection
(a)shall apply to contracts entered into or renewed on or after the date that is 12 months after the date of enactment of this Act. In the case of contracts in existence on or after the date of the enactment of this Act and that are not subject to the effective date under paragraph (1), the Secretary of Health and Human Services shall, when appropriate and practicable, seek to apply the incentives provided for in the amendments made by subsection
(a)through contract modifications.
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Sec. 105
Establishing Medicare administrative contractor error reduction incentives
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