Sec. 106. REDUCING ADMINISTRATIVE BURDEN AND OTHER PROVISIONS

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## SEC. 106 REDUCING ADMINISTRATIVE BURDEN AND OTHER PROVISIONS ###

(a)Medicare Physician and Practitioner Opt-Out to Private Contract ####

(1)Indefinite, continuing automatic extension of opt out election #####

(A)In general Section 1802(b)(3) of the Social Security Act (42 U.S.C. 1395a(b)(3)) is amended— ######

(i)in subparagraph (B)(ii), by striking “during the 2-year period beginning on the date the affidavit is signed” and inserting “during the applicable 2-year period (as defined in subparagraph (D))”; ######

(ii)in subparagraph (C), by striking “during the 2-year period described in subparagraph (B)(ii)” and inserting “during the applicable 2-year period”; and ######

(iii)by adding at the end the following new subparagraph: > > ##### “(D) Applicable 2-year periods for effectiveness of affidavits > > In this subsection, the term ‘applicable 2-year period’ means, with respect to an affidavit of a physician or practitioner under subparagraph (B), the 2-year period beginning on the date the affidavit is signed and includes each subsequent 2-year period unless the physician or practitioner involved provides notice to the Secretary (in a form and manner specified by the Secretary), not later than 30 days before the end of the previous 2-year period, that the physician or practitioner does not want to extend the application of the affidavit for such subsequent 2-year period.” > . #####

(B)Effective Date **[**[42 U.S.C. 1395a note](/us/usc/t42/s1395a)**]** The amendments made by subparagraph

(A)shall apply to affidavits entered into on or after the date that is 60 days after the date of the enactment of this Act. ####

(2)Public availability of information on opt-out physicians and practitioners Section 1802(b) of the Social Security Act (42 U.S.C. 1395a(b)) is amended— #####

(A)in paragraph (5), by adding at the end the following new subparagraph: > > ##### “(D) Opt-out physician or practitioner > > The term ‘opt-out physician or practitioner’ means a physician or practitioner who has in effect an affidavit under paragraph (3)(B).” > ; #####

(B)by redesignating paragraph

(5)as paragraph (6); and #####

(C)by inserting after paragraph

(4)the following new paragraph: > > #### “(5) Posting of information on opt-out physicians and practitioners > > > ##### “(A) In general > > Beginning not later than February 1, 2016, the Secretary shall make publicly available through an appropriate publicly accessible website of the Department of Health and Human Services information on the number and characteristics of opt-out physicians and practitioners and shall update such information on such website not less often than annually. > > > ##### “(B) Information to be included > > The information to be made available under subparagraph

(A)shall include at least the following with respect to opt-out physicians and practitioners: > > > ###### “(i) > > Their number. > > > ###### “(ii) > > Their physician or professional specialty or other designation. > > > ###### “(iii) > > Their geographic distribution. > > > ###### “(iv) > > The timing of their becoming opt-out physicians and practitioners, relative, to the extent feasible, to when they first enrolled in the program under this title and with respect to applicable 2-year periods. > > > ###### “(v) > > The proportion of such physicians and practitioners who billed for emergency or urgent care services.” > . ###

(b)Promoting Interoperability of Electronic Health Record Systems ####

(1)Recommendations for achieving widespread ehr interoperability #####

(A)Objective As a consequence of a significant Federal investment in the implementation of health information technology through the Medicare and Medicaid EHR incentive programs, Congress declares it a national objective to achieve widespread exchange of health information through interoperable certified EHR technology nationwide by December 31, 2018. #####

(B)Definitions In this paragraph: ######

(i)Widespread interoperability The term “widespread interoperability” means interoperability between certified EHR technology systems employed by meaningful EHR users under the Medicare and Medicaid EHR incentive programs and other clinicians and health care providers on a nationwide basis. ######

(ii)Interoperability The term “interoperability” means the ability of two or more health information systems or components to exchange clinical and other information and to use the information that has been exchanged using common standards as to provide access to longitudinal information for health care providers in order to facilitate coordinated care and improved patient outcomes. #####

(C)Establishment of metrics Not later than July 1, 2016, and in consultation with stakeholders, the Secretary shall establish metrics to be used to determine if and to the extent that the objective described in subparagraph

(A)has been achieved. #####

(D)Recommendations if objective not achieved If the Secretary of Health and Human Services determines that the objective described in subparagraph

(A)has not been achieved by December 31, 2018, then the Secretary shall submit to Congress a report, by not later than December 31, 2019, that identifies barriers to such objective and recommends actions that the Federal Government can take to achieve such objective. Such recommended actions may include recommendations— ######

(i)to adjust payments for not being meaningful EHR users under the Medicare EHR incentive programs; and ######

(ii)for criteria for decertifying certified EHR technology products. ####

(2)Preventing blocking the sharing of information #####

(A)For meaningful use ehr professionals Section 1848(o)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1395w-4(o)(2)(A)(ii)) is amended by inserting before the period at the end the following: “, and the professional demonstrates (through a process specified by the Secretary, such as the use of an attestation) that the professional has not knowingly and willfully taken action (such as to disable functionality) to limit or restrict the compatibility or interoperability of the certified EHR technology”. #####

(B)For meaningful use ehr hospitals Section 1886(n)(3)(A)(ii) of the Social Security Act (42 U.S.C. 1395ww(n)(3)(A)(ii)) is amended by inserting before the period at the end the following: “, and the hospital demonstrates (through a process specified by the Secretary, such as the use of an attestation) that the hospital has not knowingly and willfully taken action (such as to disable functionality) to limit or restrict the compatibility or interoperability of the certified EHR technology”. #####

(C)Effective Date **[**[42 U.S.C. 1395w-4 note](/us/usc/t42/s1395w-4)**]** The amendments made by this subsection shall apply to meaningful EHR users as of the date that is one year after the date of the enactment of this Act. ####

(3)Study and report on the feasibility of establishing a mechanism to compare certified ehr technology products #####

(A)Study The Secretary shall conduct a study to examine the feasibility of establishing one or more mechanisms to assist providers in comparing and selecting certified EHR technology products. Such mechanisms may include— ######

(i)a website with aggregated results of surveys of meaningful EHR users on the functionality of certified EHR technology products to enable such users to directly compare the functionality and other features of such products; and ######

(ii)information from vendors of certified products that is made publicly available in a standardized format. The aggregated results of the surveys described in clause

(i)may be made available through contracts with physicians, hospitals, or other organizations that maintain such comparative information described in such clause. #####

(B)Report Not later than 1 year after the date of the enactment of this Act, the Secretary shall submit to Congress a report on mechanisms that would assist providers in comparing and selecting certified EHR technology products. The report shall include information on the benefits of, and resources needed to develop and maintain, such mechanisms. ####

(4)Definitions In this subsection: #####

(A)The term “certified EHR technology” has the meaning given such term in section 1848(o)(4) of the Social Security Act (42 U.S.C. 1395w-4(o)(4)). #####

(B)The term “meaningful EHR user” has the meaning given such term under the Medicare EHR incentive programs. #####

(C)The term “Medicare and Medicaid EHR incentive programs” means— ######

(i)in the case of the Medicare program under title XVIII of the Social Security Act, the incentive programs under section 1814(l)(3), section 1848(o), subsections

(l)and

(m)of section 1853, and section 1886(n) of the Social Security Act (42 U.S.C. 1395f(l)(3), 1395w-4(o), 1395w-23, 1395ww(n)); and ######

(ii)in the case of the Medicaid program under title XIX of such Act, the incentive program under subsections (a)(3)(F) and

(t)of section 1903 of such Act (42 U.S.C. 1396b). #####

(D)The term “Secretary” means the Secretary of Health and Human Services. ###

(c)GAO Studies and Reports on the Use of Telehealth Under Federal Programs and on Remote Patient Monitoring Services ####

(1)Study on telehealth services The Comptroller General of the United States shall conduct a study on the following: #####

(A)How the definition of telehealth across various Federal programs and Federal efforts can inform the use of telehealth in the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.). #####

(B)Issues that can facilitate or inhibit the use of telehealth under the Medicare program under such title, including oversight and professional licensure, changing technology, privacy and security, infrastructure requirements, and varying needs across urban and rural areas. #####

(C)Potential implications of greater use of telehealth with respect to payment and delivery system transformations under the Medicare program under such title XVIII and the Medicaid program under title XIX of such Act (42 U.S.C. 1396 et seq.). #####

(D)How the Centers for Medicare & Medicaid Services monitors payments made under the Medicare program under such title XVIII to providers for telehealth services. ####

(2)Study on remote patient monitoring services #####

(A)In general The Comptroller General of the United States shall conduct a study— ######

(i)of the dissemination of remote patient monitoring technology in the private health insurance market; ######

(ii)of the financial incentives in the private health insurance market relating to adoption of such technology; ######

(iii)of the barriers to adoption of such services under the Medicare program under title XVIII of the Social Security Act; ######

(iv)that evaluates the patients, conditions, and clinical circumstances that could most benefit from remote patient monitoring services; and ######

(v)that evaluates the challenges related to establishing appropriate valuation for remote patient monitoring services under the Medicare physician fee schedule under section 1848 of the Social Security Act (42 U.S.C. 1395w-4) in order to accurately reflect the resources involved in furnishing such services. #####

(B)Definitions For purposes of this paragraph: ######

(i)Remote patient monitoring services The term “remote patient monitoring services” means services furnished through remote patient monitoring technology. ######

(ii)Remote patient monitoring technology The term “remote patient monitoring technology” means a coordinated system that uses one or more home-based or mobile monitoring devices that automatically transmit vital sign data or information on activities of daily living and may include responses to assessment questions collected on the devices wirelessly or through a telecommunications connection to a server that complies with the Federal regulations (concerning the privacy of individually identifiable health information) promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996, as part of an established plan of care for that patient that includes the review and interpretation of that data by a health care professional. ####

(3)Reports Not later than 24 months after the date of the enactment of this Act, the Comptroller General shall submit to Congress— #####

(A)a report containing the results of the study conducted under paragraph (1); and #####

(B)a report containing the results of the study conducted under paragraph (2). A report required under this paragraph shall be submitted together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate. The Comptroller General may submit one report containing the results described in subparagraphs

(A)and

(B)and the recommendations described in the previous sentence. ###

(d)Rule of Construction Regarding Health Care Providers **[**[42 U.S.C. 18122 note](/us/usc/t42/s18122)**]** ####

(1)In general Subject to paragraph (3), the development, recognition, or implementation of any guideline or other standard under any Federal health care provision shall not be construed to establish the standard of care or duty of care owed by a health care provider to a patient in any medical malpractice or medical product liability action or claim. ####

(2)Definitions For purposes of this subsection: #####

(A)Federal health care provision The term “Federal health care provision” means any provision of the Patient Protection and Affordable Care Act (Public Law 111-148), title I or subtitle B of title II of the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), or title XVIII or XIX of the Social Security Act (42 U.S.C. 1395 et seq., 42 U.S.C. 1396 et seq.). #####

(B)Health care provider The term “health care provider” means any individual, group practice, corporation of health care professionals, or hospital— ######

(i)licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or ######

(ii)required to be so licensed, registered, or certified but that is exempted by other statute or regulation. #####

(C)Medical malpractice or medical product liability action or claim The term “medical malpractice or medical product liability action or claim” means a medical malpractice action or claim (as defined in section 431(7) of the Health Care Quality Improvement Act of 1986 (42 U.S.C. 11151(7))) and includes a liability action or claim relating to a health care provider’s prescription or provision of a drug, device, or biological product (as such terms are defined in section 201 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321) or section 351 of the Public Health Service Act (42 U.S.C. 262)). #####

(D)State The term “State” includes the District of Columbia, Puerto Rico, and any other commonwealth, possession, or territory of the United States. ####

(3)No preemption **[**[42 U.S.C. 18122 note](/us/usc/t42/s18122)**]** Nothing in paragraph

(1)or any provision of the Patient Protection and Affordable Care Act (Public Law 111-148), title I or subtitle B of title II of the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), or title XVIII or XIX of the Social Security Act (42 U.S.C. 1395 et seq., 42 U.S.C. 1396 et seq.) shall be construed to preempt any State or common law governing medical professional or medical product liability actions or claims. # TITLE II MEDICARE AND OTHER HEALTH EXTENDERS ## Subtitle A Medicare Extenders

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