Sec. 3003. PHYSICIAN PAYMENT UPDATE
510 words·~2 min read·
/statute-compilations/comps-13851/sec-3003A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
## SEC. 3003 PHYSICIAN PAYMENT UPDATE ###
(a)In General Section 1848(d)(13) of the Social Security Act (42 U.S.C. 1395w-4(d)(13)), as added by section 301 of the Temporary Payroll Tax Cut Continuation Act of 2011 (Public Law 112-78), is amended— ####
(1)in the heading, by striking “first two months of 2012” and inserting “2012”; ####
(2)in subparagraph (A), by striking “the period beginning on January 1, 2012, and ending on February 29, 2012” and inserting “2012”; ####
(3)in the heading of subparagraph (B), by striking “remaining portion of 2012” and inserting “2013”; and ####
(4)in subparagraph (B), by striking “for the period beginning on March 1, 2012, and ending on December 31, 2012, and for 2013” and inserting “for 2013”. ###
(b)Mandated Studies on Physician Payment Reform ####
(1)Study by secretary on options for bundled or episode-based payment #####
(A)In general The Secretary of Health and Human Services shall conduct a study that examines options for bundled or episode-based payments, to cover physicians’ services currently paid under the physician fee schedule under section 1848 of the Social Security Act (42 U.S.C. 1395w-4), for one or more prevalent chronic conditions (such as cancer, diabetes, and congestive heart failure) or episodes of care for one or more major procedures (such as medical device implantation). In conducting the study, the Secretary shall consult with medical professional societies and other relevant stakeholders. The study shall include an examination of related private payer payment initiatives. #####
(B)Report Not later than January 1, 2013, the Secretary shall submit to the Committees on Ways and Means and Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate a report on the study conducted under this paragraph. The Secretary shall include in the report recommendations on suitable alternative payment options for services paid under such fee schedule and on associated implementation requirements (such as timelines, operational issues, and interactions with other payment reform initiatives). ####
(2)GAO study of private payer initiatives #####
(A)In general The Comptroller General of the United States shall conduct a study that examines initiatives of private entities offering or administering health insurance coverage, group health plans, or other private health benefit plans to base or adjust physician payment rates under such coverage or plans for performance on quality and efficiency, as well as demonstration of care delivery improvement activities (such as adherence to evidence-based guidelines and patient-shared decision making programs). In conducting such study, the Comptroller General shall consult, to the extent appropriate, with medical professional societies and other relevant stakeholders. #####
(B)Report Not later than January 1, 2013, the Comptroller General shall submit to the Committees on Ways and Means and Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate a report on the study conducted under this paragraph. Such report shall include an assessment of the applicability of the payer initiatives described in subparagraph
(A)to the Medicare program and recommendations on modifications to existing Medicare performance-based initiatives.
Connectionstraces to 1
Traces to 1 document
1 reference not yet in our index
- Pub. L. 112-78
Citation graph
cites case law
Cites 2Cited by 0 across 0 sources