Fairness for Medical Providers Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 373 To amend title XVIII of the Social Security Act to provide for certain administrative or judicial review respecting the identification of primary care practitioners under part B of the Medicare program. IN THE HOUSE OF REPRESENTATIVES JANUARY 9, 2019 Ms. BROWNLEY of California introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Com- mittee 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 provide for certain administrative or judicial review respecting the identification of primary care practitioners under part B of the Medicare program. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Fairness for Medical 4 Providers Act of 2019’’. 5 VerDate Sep 11 2014 02:19 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H373.IH H373 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 373 IH SEC. 2. PROVIDING FOR CERTAIN ADMINISTRATIVE OR JU- 1 DICIAL REVIEW RESPECTING THE IDENTI- 2 FICATION OF PRIMARY CARE PRACTI- 3 TIONERS UNDER PART B OF THE MEDICARE 4 PROGRAM. 5 (a) IN GENERAL.—Section 1833(x)(4) of the Social 6 Security Act (42 U.S.C. 1395l(x)(4)) is amended to read 7 as follows: 8 ‘‘(4) LIMITATION ON REVIEW.— 9 ‘‘(A) IN GENERAL.—Subject to subpara- 10 graph (B), there shall be no administrative or 11 judicial review under section 1869, 1878, or 12 otherwise, respecting the identification of pri- 13 mary care practitioners under this subsection. 14 ‘‘(B) EXCEPTION.—Subparagraph (A) 15 shall not apply in the case of administrative or 16 judicial review under section 1869, 1878, or 17 otherwise, of the issue of whether the Secretary 18 (or an entity contracting with the Secretary) 19 failed to identify an individual described in 20 clause (i) of paragraph (2)(A) as a primary 21 care practitioner by reason of coding error with 22 respect to items and services furnished by such 23 individual during an applicable prior period (as 24 described in clause (ii) of such paragraph).’’. 25 VerDate Sep 11 2014 02:19 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H373.IH H373 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 373 IH (b) EFFECTIVE DATE.—The amendment made by 1 subsection (a) shall apply as if included in the enactment 2 of the Patient Protection and Affordable Care Act (Public 3 Law 111–148). 4 Æ VerDate Sep 11 2014 02:19 Jan 19, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6301 E:\BILLS\H373.IH H373 pamtmann on DSKBFK8HB2PROD with BILLS