Summary:
SGR Repeal and Medicare Provider Payment Modernization Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) end and remove sustainable growth rate (SGR) methodology from the determination of annual conversion factors in the formula for payment for physicians' services; (2) establish an update to the single conversion factor for 2014 through 2018 of 0.5%, (3) freeze the update to the single conversion factor at 0.00% for 2019 through 2023, and (4) establish an update of 1% for health professionals participating in alternative payment models (APMs) and an update of 0.5% for all other health professionals after 2023.

Directs the Medicare Payment Advisory Commission (MEDPAC) to report to Congress on the relationship between: (1) physician and other health professional utilization and expenditures (and their rate of increase) of items and services for which Medicare payment is made, and (2) total utilization and expenditures (and their rate of increase) under Medicare parts A (Hospital Insurance), B (Supplementary Medical Insurance), and D (Voluntary Prescription Drug Benefit Program).

Directs MEDPAC to report to Congress on: (1) the payment update for professional services applied under Medicare for 2014 through 2018, (2) the effect of such update on the efficiency, economy, and quality of care provided under such program, (3) the effect of such update on ensuring a sufficient number of providers to maintain access to care by Medicare beneficiaries, and (4) recommendations for any future payment updates for professional services under such program to ensure adequate access to care is maintained for Medicare beneficiaries

Revises and consolidates components of the three specified existing performance incentive programs into a merit-based incentive payment system (MIPS) the Secretary of Health and Human Services (HHS) is directed to establish, under which MIPS-eligible professionals (excluding most Alternative Payment Model [APM] participants) receive annual payment increases or decreases based on their performance. Applies the MIPS program to payments for items and services furnished on or after January 1, 2018.

Requires specified incentive payments to be made to eligible partial qualifying APM participants.

Directs the Secretary to make available on the Physician Compare website of the Centers for Medicare & Medicaid Services (CMS) certain information, including information regarding the performance of MIPS-eligible professionals.

Requires the Comptroller General (GAO) to evaluate the MIPS program.

Requires GAO to submit to Congress a report that: (1) compares the similarities and differences in the use of quality measures under the original Medicare fee-for-service programs, the Medicare Advantage (MA) program under Medicare part C (Medicare+Choice), selected state Medicaid programs, and private payer arrangements; and (2) make recommendations on how to reduce the administrative burden involved in applying such quality measures.

Directs GAO to report to Congress on: (1) whether entities that pool financial risk for physician services can play a role in supporting physician practices in assuming financial risk for treatment of patients, and (2) the transition to an APM of professionals in rural areas, health professional shortage areas, or medically underserved areas.

Establishes the Payment Model Technical Advisory Committee to make recommendations to the Secretary on physician-focused payment models.

Requires the Secretary to study: (1) the application of federal fraud prevention laws related to APMs; (2) the effect of individuals' socioeconomic status on quality and resource use outcome measures for individuals under Medicare; and (3) the impact of risk factors, race, health literacy, limited English proficiency (LEP), and patient activation, on quality and resource use outcome measures under Medicare.

Directs the Secretary to: (1) post on the CMS Internet website a draft plan for the development of quality measures to assess professionals, (2) establish new Healthcare Common Procedure Coding System (HCPCS) codes for chronic care management services, and (3) conduct an education and outreach campaign to inform professionals who furnish items and services under Medicare part B and Medicare part B enrollees of the benefits of chronic care management services.

Authorizes the Secretary to: (1) collect and use information on the resources directly or indirectly related to physicians' services in the determination of relative values under the Medicare physician fee schedule; and (2) establish or adjust practice expense relative values using cost, charge, or other data from suppliers or service providers.

Revises and expands factors for identification of potentially misvalued codes. Sets an annual target for relative value adjustments for misvalued services. Phases-in of significant relative value unit (RVU) reductions.

Directs GAO to study the processes used by the Relative Value Scale Update Committee (RUC) to make recommendations to the Secretary regarding relative values for specific services under the Medicare physician fee schedule.

Makes Metropolitan Statistical Areas in California fee schedule areas for Medicare payments.

Directs the Secretary to: (1) establish a program to promote the use of appropriate use criteria for certain imaging services furnished by ordering professionals and furnishing professionals, and (2) make publicly available on the CMS Physician Compare website specified information with respect to eligible professionals.

Expands the kinds and uses of data available to qualified entities for quality improvement activities.

Directs the Secretary to provide Medicare data to qualified clinical data registries to facilitate quality improvement or patient safety.

Permits continuing automatic extensions of a Medicare physician and practitioner election to opt-out of the Medicare physician payment system into private contracts.

Directs the Secretary to: (1) make publicly available through an appropriate publicly accessible website information on the number and characteristics of opt-out physicians and practitioners, and (2) report to Congress recommendations to amend existing fraud and abuse laws, through exceptions, safe harbors, or other narrowly targeted provisions, to permit gainsharing or similar arrangements between physicians and hospitals that improve care while reducing waste and increasing efficiency.

Declares it a national objective to achieve widespread exchange of health information through interoperable certified electronic health record (EHR) technology nationwide by December 31, 2017, as a consequence of a significant federal investment in the implementation of health information technology through the Medicare and Medicaid EHR programs.

Directs the Secretary to study the feasibility of establishing mechanisms that includes aggregated results of surveys of meaningful EHR users on the functionality of certified EHR products to enable such users to compare directly the functionality and other features of such products.

Requires GAO studies on the use of telehealth under federal programs and on remote patient monitoring services.

Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) with respect to savings from Overseas Contingency Operations/Global War on Terrorism (OCO/GWOT).

Establishes caps on any amount of OCO/GWOT budget authority subject to sequestration for FY2016-FY2021.

Declares that any amount of OCO/GWOT budget authority for FY2016-FY2021 in excess of such established levels shall be counted in determining whether a breach has occurred in the security category and the nonsecurity category on a proportional basis to the total spending for overseas contingency operation in the security category and the nonsecurity category.

sgr_repeal medicare provider payment modernization act amends title xviii medicare social security act ssa end remove sustainable growth rate sgr methodology determination annual conversion factors formula payment physicians services establish update single conversion factor freeze update single conversion factor establish update health professionals participating alternative payment models apms update health professionals directs medicare_payment_advisory_commission medpac report congress relationship physician health professional utilization expenditures rate increase items services medicare payment total utilization expenditures rate increase medicare parts voluntary prescription drug benefit program directs medpac report congress payment update professional services applied medicare effect update efficiency economy quality care provided program effect update ensuring sufficient number providers maintain access care medicare beneficiaries recommendations future payment updates professional services program ensure adequate access care maintained medicare beneficiaries revises consolidates components specified existing performance incentive programs merit based incentive payment system secretary health_and_human_services hhs directed establish eligible professionals excluding alternative payment model apm participants receive annual payment increases decreases based performance applies program payments items services furnished january requires specified incentive payments eligible partial qualifying apm participants directs secretary available website centers cms certain information including information performance eligible professionals requires comptroller general gao evaluate program requires gao submit congress report compares similarities differences use quality measures original medicare fee service programs medicare_advantage program medicare selected state medicaid programs private payer arrangements recommendations reduce administrative burden involved applying quality measures directs gao report congress entities pool financial risk physician services play role supporting physician practices assuming financial risk treatment patients transition apm professionals rural areas health professional shortage areas medically underserved areas establishes recommendations secretary physician focused payment models requires secretary study application federal fraud prevention laws related apms effect individuals socioeconomic status quality resource use outcome measures individuals medicare impact risk factors race health literacy limited english proficiency lep patient activation quality resource use outcome measures medicare directs secretary post cms internet website draft plan development quality measures assess professionals establish new healthcare common procedure coding system hcpcs codes chronic care management services conduct education outreach campaign inform professionals furnish items services medicare medicare enrollees benefits chronic care management services authorizes secretary collect use information resources directly indirectly related physicians services determination relative values medicare physician fee schedule establish adjust practice expense relative values cost charge data suppliers service providers revises expands factors identification potentially misvalued codes sets annual target relative value adjustments misvalued services phases significant relative value unit reductions directs gao study processes ruc recommendations secretary relative values specific services medicare physician fee schedule makes metropolitan statistical areas california fee schedule areas medicare payments directs secretary establish program promote use appropriate use criteria certain imaging services furnished ordering professionals furnishing professionals publicly available website specified information respect eligible professionals expands kinds uses data available qualified entities quality improvement activities directs secretary provide medicare data qualified clinical data registries facilitate quality improvement patient safety permits continuing automatic extensions medicare physician practitioner election opt medicare physician payment system private contracts directs secretary publicly available appropriate publicly accessible website information number characteristics opt physicians practitioners report congress recommendations amend existing fraud abuse laws exceptions safe harbors narrowly targeted provisions permit gainsharing similar arrangements physicians hospitals improve care reducing waste increasing efficiency declares national objective achieve widespread exchange health information interoperable certified electronic health record ehr technology nationwide december consequence significant federal investment implementation health information technology medicare medicaid ehr programs directs secretary study feasibility establishing mechanisms includes aggregated results surveys meaningful ehr users functionality certified ehr products enable users compare directly functionality features products requires gao studies use telehealth federal programs remote patient monitoring services amends balanced_budget emergency deficit control act gramm rudman hollings act respect savings overseas contingency operations global war terrorism establishes caps budget authority subject sequestration fy2016 fy2021 declares budget authority fy2016 fy2021 excess established levels shall counted determining breach occurred security category nonsecurity category proportional basis total spending overseas contingency operation security category nonsecurity category


Summary: Amends title XI of the Social Security Act to restrict civil monetary penalties for inducements to physicians to limit services to services that are medically necessary only. (Thus eliminates such penalties for inducements to physicians to limit services that are not medically necessary.)

amends title social security act restrict civil monetary penalties inducements physicians limit services services medically necessary eliminates penalties inducements physicians limit services medically necessary


Summary: Protect Patient Access and Promote Hospital Efficiency Act - Amends title XVIII (Medicare) of the Social Security Act to authorize nurse practitioners, clinical nurse specialists, physician assistants, and certified nurse-midwives who order inpatient hospital services to certify their medical necessity for payment under the Medicare program.

protect patient access promote hospital efficiency act amends title xviii medicare social security act authorize nurse practitioners clinical nurse specialists physician assistants certified nurse midwives order inpatient hospital services certify medical necessity payment medicare program


Summary:
Doctors Helping Heroes Act of 2014 - Amends the Immigration and Nationality Technical Corrections Act of 1994 to make permanent the J-1 visa waiver program (Conrad state 30/medical services in underserved areas).

Excludes from numerical immigration limitations alien physicians who have completed national interest waiver requirements by working in a health care shortage area (including alien physicians who completed such service before enactment of this Act and any of their spouses or children).

Sets forth specified employment protections and contract requirements for alien physicians working in underserved areas.

Increases the number of alien physicians that a state may be allocated from 30 to 35 per fiscal year in specified circumstances. Provides for additional increases or decreases based upon demand.

Provides up to three visa waivers per fiscal year per state for physicians in academic medical centers.

Permits dual intent for an alien coming to the United States to receive graduate medical education or training, or to take examinations required for graduate medical education or training.

Exempts from specified entry limitations H-1B nonimmigrant aliens seeking to enter the United States to pursue graduate medical education or training.

Amends the Immigration and Nationality Act to authorize waiver of the two-year foreign residency requirement for an alien who has received graduate medical eduction or training in the United States and seeks to apply for an immigrant visa or permanent resident status if:

 the Secretary of Veterans Affairs (VA) determines that VA facilities are not capable of furnishing covered health services to eligible veterans because they lack the required personnel or cannot provide timely and reasonable access; and the head of the appropriate state agency determines that the alien will practice medicine in a Veterans Health Administration facility, the alien physician's work is in the public interest, and such waiver would not cause the number of waivers allotted for that state for that fiscal year to exceed five.

doctors helping heroes act amends immigration nationality technical corrections act permanent j-1 visa waiver program conrad state medical services underserved areas excludes numerical immigration limitations alien physicians completed national interest waiver requirements working health care shortage area including alien physicians completed service enactment act spouses children sets forth specified employment protections contract requirements alien physicians working underserved areas increases number alien physicians state allocated fiscal year specified circumstances provides additional increases decreases based demand provides visa waivers fiscal year state physicians academic medical centers permits dual intent alien coming united_states receive graduate medical education training examinations required graduate medical education training exempts specified entry limitations h-1b nonimmigrant aliens seeking enter united_states pursue graduate medical education training amends immigration nationality act authorize waiver year foreign residency requirement alien received graduate medical training united_states seeks apply immigrant visa permanent resident status secretary veterans_affairs determines facilities capable furnishing covered health services eligible veterans lack required personnel provide timely reasonable access head appropriate state agency determines alien practice medicine veterans_health_administration facility alien physician work public interest waiver cause number waivers allotted state fiscal year exceed


Summary:
Access to Care and Treatment Now for Veterans Act or the ACT Now for Veterans Act - Directs the Secretary of Veterans Affairs (VA) to reimburse any non-VA medical provider, including such a provider who has not been pre-approved by the Secretary, who furnishes covered hospital care or medical services to an eligible veteran.

Defines "covered hospital care or medical services" as hospital care or medical services for which the veteran is eligible under the VA health care program. Defines an "eligible veteran" as a veteran who: (1) is enrolled in the VA patient enrollment system and provides a VA identification card or proof of such enrollment, (2) is eligible to receive hospital care or medical services furnished by the Secretary, and (3) has been unable to schedule an appointment at a VA facility to receive such care or services within 30 days of the date preferred by the veteran.

Terminates the authority under this Act: (1) one year after this Act's enactment if the Secretary certifies that the Veterans Health Administration is meeting wait-time goals, or (2) two years after this Act's enactment if the Secretary has not submitted such certification.

access care treatment veterans act act veterans act directs secretary veterans_affairs reimburse non medical provider including provider pre approved secretary furnishes covered hospital care medical services eligible veteran defines covered hospital care medical services hospital care medical services veteran eligible health care program defines eligible veteran veteran enrolled patient enrollment system provides identification card proof enrollment eligible receive hospital care medical services furnished secretary unable schedule appointment facility receive care services days date preferred veteran terminates authority act year act enactment secretary certifies veterans_health_administration meeting wait time goals years act enactment secretary submitted certification


Summary:
Veterans' Credit Protection Act - Directs the Secretary of Veterans Affairs (VA) to: (1) conduct outreach to inform veterans of how to resolve credit issues caused by a delayed payment (i.e., a proper invoice that is not paid by the Secretary until after the required payment date); and (2) establish a toll-free telephone number for veterans to report such issues to the Veterans Integrated Service Networks.

Requires the Secretary to report annually on the effectiveness of each Network in providing timely payment of proper invoices during both the preceding five-year period and the preceding one-year period. Requires such report to include:

 the number of veterans who contacted the Secretary regarding delayed payments that could negatively affect their credit; the total amount of interest penalties paid by the Secretary by reason of delayed payments; the number of proper invoices submitted, the amount owed for and the payment status of such invoices, and the periods that elapsed before such invoices were paid; any comments regarding delayed payments made by medical providers; identification of the Networks with the least and most delayed payments; and a description of the best practices to provide timely payment of a proper invoice, including a plan for under-performing Networks to improve. Directs the Comptroller General (GAO) to conduct a study that compares the effectiveness of Networks in providing timely payment of proper invoices.

secretary veterans_affairs conduct outreach inform veterans resolve credit issues caused delayed payment proper invoice paid secretary required payment date establish toll free telephone number veterans report issues veterans_integrated_service_networks requires secretary report annually effectiveness network providing timely payment proper preceding year period preceding year period requires report include number veterans contacted secretary delayed payments negatively affect credit total interest penalties paid secretary reason delayed payments number proper submitted owed payment status periods elapsed paid comments delayed payments medical providers identification networks delayed payments description best practices provide timely payment proper invoice including plan performing networks improve directs comptroller_general gao conduct study compares effectiveness networks providing timely payment proper


Summary:
Audiology Patient Choice Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act to revise the coverage of audiology services to treat as physicians qualified audiologists authorized by the state and acting within the scope of their license to furnish such services.

Enables Medicare beneficiaries to choose a qualified audiologist without regard to any requirement to be under the care of (or referred by) a physician or other health care practitioner, or that services be provided under the supervision of a physician or other health care practitioner.

audiology patient choice act amends title xviii medicare social security act revise coverage audiology services treat physicians qualified audiologists authorized state acting scope license furnish services enables medicare beneficiaries choose qualified audiologist regard requirement care referred physician health care practitioner services provided supervision physician health care practitioner


Summary: Medicaid Parity Act of 2014 - Amends title XIX (Medicaid) of the Social Security Act to extend through 2019: (1) Medicaid payment parity with Medicare for primary care services furnished under the Medicaid program, and (2) the increased (to 100%) federal medical assistance percentage (FMAP, or federal matching rate) for additional payments for primary care services.

medicaid parity act amends title xix medicaid social security act extend medicaid payment parity medicare primary care services furnished medicaid program increased federal medical assistance percentage fmap federal matching rate additional payments primary care services


Summary: Directs the Secretary of Health and Human Services (HHS), in specifying the electronic health record (EHR) reporting period under EHR electronic health record technology incentive payment programs under titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act, to continue through 2015 (in the case of eligible professionals) and FY2015 (in the case of eligible hospitals and critical access hospitals) to permit the use of a three-month quarter EHR reporting period to demonstrate meaningful use without regard to the payment year or the stage of meaningful use criteria involved.

directs secretary health_and_human_services hhs specifying electronic health record ehr reporting period ehr electronic health record technology incentive payment programs titles xviii medicare xix medicaid social security act continue case eligible professionals fy2015 case eligible hospitals critical access hospitals permit use month quarter ehr reporting period demonstrate meaningful use regard payment year stage meaningful use criteria involved


Summary:
Physician Ambassadors Helping Veterans Act - Requires the Secretary of Veterans Affairs (VA) to use the Secretary's authority to employ certain personnel without regard to civil service or classification laws, rules, or regulations to employ physicians on a without compensation basis in any practice area or specialty for which: (1) the average waiting time for veterans seeking an appointment with a physician exceeds the VA's waiting time goals, or (2) the VA facility where the physician will be employed has demonstrated staffing shortages.

Requires each VA medical facility to have a volunteer coordinator who: (1) seeks to establish relationships with medical associations serving the area, (2) recruits physicians for uncompensated employment at the facility, and (3) serves as the initial point of contact for physicians seeking uncompensated employment at the facility.

Conditions an uncompensated physician's receipt of a credential or privilege to practice medicine in a VA facility on the physician's commitment to serve at least 40 hours in the facility during the ensuing 12-month period.

Requires the Secretary to decide whether to grant an uncompensated physician's request for a credential or privilege to practice medicine in the VA facility within 60 days.

Requires the director of a VA medical facility to approve, and accept the uncompensated services of, any physician who has made the requisite service commitment and receives a credential or privilege to practice medicine in such facility.

veterans act requires secretary veterans_affairs use secretary authority employ certain personnel regard civil service classification laws rules regulations employ physicians compensation basis practice area specialty average waiting time veterans seeking appointment physician exceeds waiting time goals facility physician employed demonstrated staffing shortages requires medical facility volunteer coordinator seeks establish relationships medical associations serving area recruits physicians uncompensated employment facility serves initial point contact physicians seeking uncompensated employment facility conditions uncompensated physician receipt credential privilege practice medicine facility physician commitment serve hours facility ensuing month period requires secretary decide grant uncompensated physician request credential privilege practice medicine facility days requires director medical facility approve accept uncompensated services physician requisite service commitment receives credential privilege practice medicine facility


Summary:
Ensuring Access to Primary Care for Women and Children Act - Amends title XIX (Medicaid) of the Social Security Act to require that the primary care services furnished in 2015 and 2016 by a physician with a primary specialty designation of family medicine, general internal medicine, or pediatric medicine be paid at a rate that is not less than 100% of the payment rate that applies to such services and physician under Medicare part B (Supplementary Medical Insurance).

Extends this 100% of Medicare payment floor under certain conditions to the following providers, who are self-attested as Board-certified and at least 60% of whose services billed for under Medicaid must be for primary care services: (1) physicians with a primary specialty designation of obstetrics and gynecology; (2) advanced practice clinicians; (3) rural health clinics, federally-qualified health centers, or other specified health clinics; and (4) nurse practitioners, physician assistants, or certified nurse-midwives.

Excludes from coverage of primary care services any such services provided in an emergency department of a hospital.

ensuring access primary care women children act amends title xix medicaid social security act require primary care services furnished physician primary specialty designation family medicine general internal medicine pediatric medicine paid rate payment rate applies services physician medicare supplementary_medical_insurance extends medicare payment floor certain conditions following providers self board certified services billed medicaid primary care services physicians primary specialty designation obstetrics gynecology advanced practice clinicians rural health clinics federally qualified health centers specified health clinics nurse practitioners physician assistants certified nurse midwives excludes coverage primary care services services provided emergency department hospital


Summary: Amends title XVIII (Medicare) of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs.

amends title xviii medicare social security act allow physician assistants nurse practitioners clinical nurse specialists supervise cardiac intensive cardiac pulmonary rehabilitation programs


Summary: Enhanced Access to Medicaid Services Act of 2013 - Amends title XIX (Medicaid) of the Social Security Act to apply the Medicaid primary care payment rate in 2013 and 2014 to additional physicians with a primary specialty designation of neurology, psychiatry, or obstetrics and gynecology.

enhanced access medicaid services act amends title xix medicaid social security act apply medicaid primary care payment rate additional physicians primary specialty designation psychiatry obstetrics gynecology


Summary: Medicare Ambulance Access Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to extend through December 31, 2018, certain temporary increases in rates (add-on payments) for ground and super rural ambulance services.

medicare ambulance access act amends title xviii medicare social security act extend december certain temporary increases rates add payments ground super rural ambulance services


Summary: Medicare Access to Rural Anesthesiology Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to provide payment under Medicare part A (Hospital Insurance) on a reasonable cost basis for anesthesia services furnished by a physician who is an anesthesiologist in certain rural hospitals in the same manner as payment is made for anesthesia services furnished by a certified registered nurse anesthetist in such hospitals.

medicare access rural act amends title xviii medicare social security act provide payment medicare reasonable cost basis anesthesia services furnished physician anesthesiologist certain rural hospitals manner payment anesthesia services furnished certified registered nurse anesthetist hospitals


Summary:
Amends the Veterans Benefits Act of 2003 to extend until December 31, 2016, the authority of the Department of Veterans Affairs (VA) to provide for persons other than VA employees (i.e., contract physicians) to conduct medical disability examinations of applicants for benefits under laws administered by the Secretary of Veterans Affairs.

Permits licensed, VA-contracted physicians to conduct such examinations at any location in any state, the District of Columbia, or a Commonwealth, territory, or possession of the United States, so long as the examination is authorized under the contract.

Amends the Veterans' Benefits Improvement Act of 1996 to provide similar authorities with respect to permissible examination locations to licensed physicians under the pilot program authorizing the VA to use contract physicians to perform medical disability examinations of applicants for benefits under laws carried out through the Under Secretary for Benefits. Expands from 10 to 15 the maximum number of VA regional offices through which the Secretary is authorized to carry out such pilot program. Sets forth criteria for the selection of such regional offices.

Directs the Secretary to conduct an annual data analysis (including an analysis of backlogged claims, pending workloads, and the timeliness of completed cases) to determine the regional offices requiring support.

amends veterans benefits act extend december authority department_of_veterans_affairs provide persons employees contract physicians conduct medical disability examinations applicants benefits laws administered secretary veterans_affairs permits licensed contracted physicians conduct examinations location state district_of_columbia commonwealth territory possession united_states long examination authorized contract amends veterans benefits improvement act provide similar authorities respect permissible examination locations licensed physicians pilot program authorizing use contract physicians perform medical disability examinations applicants benefits laws carried secretary benefits expands maximum number regional offices secretary authorized carry pilot program sets forth criteria selection regional offices directs secretary conduct annual data analysis including analysis claims pending workloads timeliness completed cases determine regional offices requiring support


Summary:
SGR Repeal and Medicare Provider Payment Modernization Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) end and remove sustainable growth rate (SGR) methodology from the determination of annual conversion factors in the formula for payment for physicians' services; (2) establish an update to the single conversion factor for 2014 through 2018 of 0.5%, (3) freeze the update to the single conversion factor at 0.00% for 2019 through 2023, and (4) establish an update of 1% for health professionals participating in alternative payment models (APMs) and an update of 0.5% for all other health professionals after 2023.

Directs the Medicare Payment Advisory Commission (MEDPAC) to report to Congress on the relationship between: (1) physician and other health professional utilization and expenditures (and their rate of increase) of items and services for which Medicare payment is made, and (2) total utilization and expenditures (and their rate of increase) under Medicare parts A (Hospital Insurance), B (Supplementary Medical Insurance), and D (Voluntary Prescription Drug Benefit Program).

Directs MEDPAC to report to Congress on: (1) the payment update for professional services applied under Medicare for 2014 through 2018, (2) the effect of such update on the efficiency, economy, and quality of care provided under such program, (3) the effect of such update on ensuring a sufficient number of providers to maintain access to care by Medicare beneficiaries, and (4) recommendations for any future payment updates for professional services under such program to ensure adequate access to care is maintained for Medicare beneficiaries

Revises and consolidates components of the three specified existing performance incentive programs into a merit-based incentive payment system (MIPS) the Secretary of Health and Human Services (HHS) is directed to establish, under which MIPS-eligible professionals (excluding most Alternative Payment Model [APM] participants) receive annual payment increases or decreases based on their performance. Applies the MIPS program to payments for items and services furnished on or after January 1, 2018.

Requires specified incentive payments to be made to eligible partial qualifying APM participants.

Directs the Secretary to make available on the Physician Compare website of the Centers for Medicare & Medicaid Services (CMS) certain information, including information regarding the performance of MIPS-eligible professionals.

Requires the Comptroller General (GAO) to evaluate the MIPS program.

Requires GAO to submit to Congress a report that: (1) compares the similarities and differences in the use of quality measures under the original Medicare fee-for-service programs, the Medicare Advantage (MA) program under Medicare part C (Medicare+Choice), selected state Medicaid programs, and private payer arrangements; and (2) make recommendations on how to reduce the administrative burden involved in applying such quality measures.

Directs GAO to report to Congress on: (1) whether entities that pool financial risk for physician services can play a role in supporting physician practices in assuming financial risk for treatment of patients, and (2) the transition to an APM of professionals in rural areas, health professional shortage areas, or medically underserved areas.

Establishes the Payment Model Technical Advisory Committee to make recommendations to the Secretary on physician-focused payment models.

Requires the Secretary to study: (1) the application of federal fraud prevention laws related to APMs; (2) the effect of individuals' socioeconomic status on quality and resource use outcome measures for individuals under Medicare; and (3) the impact of risk factors, race, health literacy, limited English proficiency (LEP), and patient activation, on quality and resource use outcome measures under Medicare.

Directs the Secretary to: (1) post on the CMS Internet website a draft plan for the development of quality measures to assess professionals, (2) establish new Healthcare Common Procedure Coding System (HCPCS) codes for chronic care management services, and (3) conduct an education and outreach campaign to inform professionals who furnish items and services under Medicare part B and Medicare part B enrollees of the benefits of chronic care management services.

Authorizes the Secretary to: (1) collect and use information on the resources directly or indirectly related to physicians' services in the determination of relative values under the Medicare physician fee schedule; and (2) establish or adjust practice expense relative values using cost, charge, or other data from suppliers or service providers.

Revises and expands factors for identification of potentially misvalued codes. Sets an annual target for relative value adjustments for misvalued services. Phases-in of significant relative value unit (RVU) reductions.

Directs GAO to study the processes used by the Relative Value Scale Update Committee (RUC) to make recommendations to the Secretary regarding relative values for specific services under the Medicare physician fee schedule.

Makes Metropolitan Statistical Areas in California fee schedule areas for Medicare payments.

Directs the Secretary to: (1) establish a program to promote the use of appropriate use criteria for certain imaging services furnished by ordering professionals and furnishing professionals, and (2) make publicly available on the CMS Physician Compare website specified information with respect to eligible professionals.

Expands the kinds and uses of data available to qualified entities for quality improvement activities.

Directs the Secretary to provide Medicare data to qualified clinical data registries to facilitate quality improvement or patient safety.

Permits continuing automatic extensions of a Medicare physician and practitioner election to opt-out of the Medicare physician payment system into private contracts.

Directs the Secretary to: (1) make publicly available through an appropriate publicly accessible website information on the number and characteristics of opt-out physicians and practitioners, and (2) report to Congress recommendations to amend existing fraud and abuse laws, through exceptions, safe harbors, or other narrowly targeted provisions, to permit gainsharing or similar arrangements between physicians and hospitals that improve care while reducing waste and increasing efficiency.

Declares it a national objective to achieve widespread exchange of health information through interoperable certified electronic health record (EHR) technology nationwide by December 31, 2017, as a consequence of a significant federal investment in the implementation of health information technology through the Medicare and Medicaid EHR programs.

Directs the Secretary to study the feasibility of establishing mechanisms that includes aggregated results of surveys of meaningful EHR users on the functionality of certified EHR products to enable such users to compare directly the functionality and other features of such products.

Requires GAO studies on the use of telehealth under federal programs and on remote patient monitoring services.

sgr_repeal medicare provider payment modernization act amends title xviii medicare social security act ssa end remove sustainable growth rate sgr methodology determination annual conversion factors formula payment physicians services establish update single conversion factor freeze update single conversion factor establish update health professionals participating alternative payment models apms update health professionals directs medicare_payment_advisory_commission medpac report congress relationship physician health professional utilization expenditures rate increase items services medicare payment total utilization expenditures rate increase medicare parts voluntary prescription drug benefit program directs medpac report congress payment update professional services applied medicare effect update efficiency economy quality care provided program effect update ensuring sufficient number providers maintain access care medicare beneficiaries recommendations future payment updates professional services program ensure adequate access care maintained medicare beneficiaries revises consolidates components specified existing performance incentive programs merit based incentive payment system secretary health_and_human_services hhs directed establish eligible professionals excluding alternative payment model apm participants receive annual payment increases decreases based performance applies program payments items services furnished january requires specified incentive payments eligible partial qualifying apm participants directs secretary available website centers cms certain information including information performance eligible professionals requires comptroller general gao evaluate program requires gao submit congress report compares similarities differences use quality measures original medicare fee service programs medicare_advantage program medicare selected state medicaid programs private payer arrangements recommendations reduce administrative burden involved applying quality measures directs gao report congress entities pool financial risk physician services play role supporting physician practices assuming financial risk treatment patients transition apm professionals rural areas health professional shortage areas medically underserved areas establishes recommendations secretary physician focused payment models requires secretary study application federal fraud prevention laws related apms effect individuals socioeconomic status quality resource use outcome measures individuals medicare impact risk factors race health literacy limited english proficiency lep patient activation quality resource use outcome measures medicare directs secretary post cms internet website draft plan development quality measures assess professionals establish new healthcare common procedure coding system hcpcs codes chronic care management services conduct education outreach campaign inform professionals furnish items services medicare medicare enrollees benefits chronic care management services authorizes secretary collect use information resources directly indirectly related physicians services determination relative values medicare physician fee schedule establish adjust practice expense relative values cost charge data suppliers service providers revises expands factors identification potentially misvalued codes sets annual target relative value adjustments misvalued services phases significant relative value unit reductions directs gao study processes ruc recommendations secretary relative values specific services medicare physician fee schedule makes metropolitan statistical areas california fee schedule areas medicare payments directs secretary establish program promote use appropriate use criteria certain imaging services furnished ordering professionals furnishing professionals publicly available website specified information respect eligible professionals expands kinds uses data available qualified entities quality improvement activities directs secretary provide medicare data qualified clinical data registries facilitate quality improvement patient safety permits continuing automatic extensions medicare physician practitioner election opt medicare physician payment system private contracts directs secretary publicly available appropriate publicly accessible website information number characteristics opt physicians practitioners report congress recommendations amend existing fraud abuse laws exceptions safe harbors narrowly targeted provisions permit gainsharing similar arrangements physicians hospitals improve care reducing waste increasing efficiency declares national objective achieve widespread exchange health information interoperable certified electronic health record ehr technology nationwide december consequence significant federal investment implementation health information technology medicare medicaid ehr programs directs secretary study feasibility establishing mechanisms includes aggregated results surveys meaningful ehr users functionality certified ehr products enable users compare directly functionality features products requires gao studies use telehealth federal programs remote patient monitoring services


Summary: Medicare Access Improvement Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act to establish a minimum payment rate for primary care services furnished in 2015 and 2016 by a primary care physician (in family medicine, general internal medicine, or geriatric medicine).

medicare access improvement act amends title xviii medicare social security act establish minimum payment rate primary care services furnished primary care physician family medicine general internal medicine geriatric medicine


Summary: Safeguarding Care Of Patients Everywhere Act or SCOPE Act - Amends the Patient Protection and Affordable Care Act to repeal the requirement that qualified health plans contract only with health care providers, including hospitals with more than 50 beds, that implement a specified patient safety evaluation system and health care quality mechanisms required by the Secretary of Health and Human Services (HHS).

safeguarding care patients act patient protection affordable care act repeal requirement qualified health plans contract health care providers including hospitals beds implement specified patient safety evaluation system health care quality mechanisms required secretary health_and_human_services hhs


Summary:
Authorizes the Secretary of Veterans Affairs (VA) to appoint licensed hearing aid specialists in the Veterans Health Administration.

Requires the Secretary to submit an annual report on: (1) timely access of veterans to hearing health services through the VA, and (2) contracting policies of the VA with respect to providing hearing health services to veterans in non-VA facilities.

authorizes secretary veterans_affairs appoint licensed hearing aid specialists veterans_health_administration requires secretary submit annual report timely access veterans hearing health services contracting policies respect providing hearing health services veterans non-va facilities


Summary:
Veterans Emergency Health Care Safety Net Expansion Act of 2014 - Eliminates the requirement limiting reimbursement for emergency treatment in a non-Department of Veterans Affairs (VA) facility to veterans who are active participants in the VA's health care system. Requires the veteran to be an enrollee in the VA's patient enrollment system.

Treats the VA as a participating provider for purposes of allowing the VA to recover the costs it incurs in providing care to a veteran for a non-service connected disability that is covered under the veteran's health plan contract.

requirement limiting reimbursement emergency treatment non-department_of_veterans_affairs facility veterans active participants health care system requires veteran enrollee patient enrollment system treats participating provider purposes allowing recover costs incurs providing care veteran non service connected disability covered veteran health plan contract


Summary:
Prevent Interruptions in Physical Therapy Act of 2014 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to require physical therapists furnishing outpatient physical therapy services to use specified locum tenens arrangements for payment purposes in the same manner as such arrangements are used to apply to physicians furnishing substitute physicians services for other physicians.

(Locum tenens [place holder], or substitute, physicians usually assume professional practices in the absence of a regular physician for reasons such as illness, pregnancy, vacation, or continuing medical education.)

prevent interruptions physical therapy act amends supplementary_medical_insurance title xviii medicare social security act require physical therapists furnishing outpatient physical therapy services use specified locum tenens arrangements payment purposes manner arrangements apply physicians furnishing substitute physicians services physicians locum tenens place holder substitute physicians usually assume professional practices absence regular physician reasons illness pregnancy vacation continuing medical education


Summary:
Medicare DMEPOS Competitive Bidding Improvement Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act with respect to the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive acquisition program.

Prohibits the Secretary of Health and Human Services (HHS) from accepting a bid from an entity for an area unless it: (1) meets state licensure requirements for the area for all items in the submitted bid for a product category, and (2) has obtained a bid surety bond of between $50,000 and $100,000 for each such area.

Prescribes requirements for the treatment of losing bidders and successful bidders that do not accept a contract.

medicare dmepos competitive bidding improvement act amends title xviii medicare social security act respect medicare durable medical equipment prosthetics orthotics supplies dmepos competitive acquisition program prohibits secretary health_and_human_services hhs accepting bid entity area meets state licensure requirements area items submitted bid product category obtained bid surety bond area prescribes requirements treatment losing bidders successful bidders accept contract


Summary:
Ensuring Enhanced Access to Primary Care Act - Extends through calendar 2016 the requirement that state plans under title XIX (Medicaid) of the Social Security Act provide for payment of 100% of the payment rate for primary care services.

Adds physicians with primary specialties in neurology, psychiatry, obstetrics and gynecology to the types of those eligible for reimbursement for providing such services.

ensuring enhanced access primary care act extends calendar requirement state plans title xix medicaid social security act provide payment payment rate primary care services adds physicians primary specialties psychiatry obstetrics gynecology types eligible reimbursement providing services


Summary:
(This measure has not been amended since it was introduced. The expanded summary of the House passed version is repeated here.)

Medicare Access and CHIP Reauthorization Act of 2015 TITLE I--SGR REPEAL AND MEDICARE PROVIDER PAYMENT MODERNIZATION (Sec. 101) Amends title XVIII (Medicare) of the Social Security Act (SSAct) to: (1) remove sustainable growth rate (SGR) methodology from the determination of annual conversion factors in the formula for payment for physicians' services, and (2) revise the update in rates for 2015 and subsequent years.

Requires two separate conversion factors for each year beginning with 2026, one for items and services furnished by a qualifying alternative payment model (APM) participant (qualifying APM conversion factor), and the other for other items and services (nonqualifying APM conversion factor).

Freezes the update to the single conversion factor at 0.0% for January through June 2015.

Sets the same update at 0.5% for July1 through December 31, 2015, as well as for 2016 through 2019, then reduces it to 0.00% for 2020 through 2025.

Sets the update to the qualifying APM conversion factor at 0.75%, and the update to the nonqualifying APM conversion factor at .0.25%, for 2026 and each subsequent year.

Directs the Medicare Payment Advisory Commission (MEDPAC) to report to Congress on the relationship between: (1) physician and other health professional utilization and expenditures (and their rate of increase) of items and services for which Medicare payment is made; and (2) total utilization and expenditures (and their rate of increase) under Medicare parts A (Hospital Insurance), B (Supplementary Medical Insurance), and D (Voluntary Prescription Drug Benefit Program). Requires a separate report on the 2015-2019 update to physicians' services under Medicare.

Directs the Secretary of Health and Human Services to consolidate components of the three specified existing performance incentive programs into a new Merit-based Incentive Payment (MIP) system under which eligible professionals (including physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists, but excluding most APM participants) shall receive annual payment increases or decreases based on their performance as measured by standards the Secretary shall establish according to specified criteria.

Requires the Government Accountability Office (GAO) to: (1) evaluate the MIP System; (2) examine the similarities and differences in the use of quality measures under the original Medicare fee-for-service program under SSAct title XVIII parts A (Hospital Insurance) and B (Supplementary Medical Insurance), the Medicare Advantage program under SSAct title XVIII part C (Medicare+Choice), selected state medical assistance programs under SSA title XIX (Medicaid), and private payer arrangements; and (3) make recommendations on how to reduce the administrative burden in applying such measures.

Directs GAO also to: (1) examine whether entities that pool financial risk for physician practices, such as independent risk managers, can play a role in supporting such practices, particularly small physician practices, in assuming financial risk for the treatment of patients; (2) report on the transition of professionals in rural areas, health professional shortage areas, or medically underserved areas to an APM; and (3) make recommendations for removing administrative barriers to such arrangements, on the one hand, and practices, including small practices, in such areas to participate in APM models.

Establishes an ad hoc Physician-Focused Payment Technical Advisory Committee to make comments and recommendations to the Secretary on physician-focused payment models..

Prescribes requirements for incentive payments to eligible APM participants.

Directs the Secretary to study: (1) the feasibility of integrating APMs into the Medicare Advantage payment system; and (2) the applicability of federal fraud prevention laws to items and services paid for under an APM.

(Sec. 102) Directs the Secretary to draft a plan for development of quality measures to assess professionals, including non-patient-facing professionals.

(Sec. 103) Directs the Secretary to make payments for chronic care management services furnished by a physician, physician assistant or nurse practitioner, clinical nurse specialist, or certified nurse midwife.

Directs the Secretary to conduct an education and outreach campaign to inform relevant professionals and Medicare part B enrollees of the benefits of chronic care management services.

(Sec. 104) Directs the Secretary to make publicly available, on an annual basis, information with respect to physicians and other eligible professionals on items and services furnished to Medicare beneficiaries.

(Sec. 105) Expands the kinds of uses of Medicare data available to qualified entities for quality improvement activities.

Directs the Secretary to provide Medicare data to qualified clinical data registries to facilitate quality improvement or patient safety.

(Sec. 106) Allows continuing renewals of any two-year period for which a physician or practitioner opts out of the Medicare claims process under a private contract.

Directs the Secretary to make publicly available through an appropriate HHS website information on the number and characteristics of opt-out physicians and practitioners.

Declares it a national objective to achieve widespread exchange of health information through interoperable certified electronic health records (EHR) technology nationwide by December 31, 2018. Directs the Secretary to establish related metrics.

Requires the Secretary to examine the feasibility of establishing one or more mechanisms to assist providers in comparing and selecting certified EHR technology products

Directs GAO to study specified telehealth and remote patient monitoring services.

TITLE II--MEDICARE AND OTHER HEALTH EXTENDERS

Subtitle A--Medicare Extenders

(Sec. 201) Amends SSAct title XVIII to extend through calendar year 2017 the current 1.0 floor for the work geographic practice cost index for adjusting the Medicare fee schedule for physician services.

(Sec. 202) Extends through calendar year 2017 the process under which an individual may, upon request, obtain an exception from the uniform dollar limitation for physical therapy services, speech-language pathology services, and occupational therapy services.

Directs the Secretary, in place of the manual medical review process, to implement a targeted medical review process to identify and conduct medical reviews for outpatient therapy services furnished by a service provider or supplier.

(Sec. 203) Extends through calendar year 2017 the temporary increase in payment for ground ambulance services, including urban, rural, and super rural ground ambulance services.

(Sec. 204) Extends through FY2017 the increased inpatient hospital payment adjustment for certain low-volume (subsection [d]) hospitals. (Generally, a subsection [d] hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system when providing covered inpatient services to eligible beneficiaries.)

(Sec. 205) Extends through FY2016 the Medicare-dependent hospital program for certain small rural subsection (d) hospitals.

(Sec. 206) Extends through calendar year 2018 the authority of specialized MA plans for special needs individuals to restrict enrollment to individuals within one or more classes of special needs individuals. (Sec. 207) Extends through FY2017 increased funding for contracts with a consensus-based entity regarding health care performance measurement (endorsement, input, and selection).

(Sec. 208) Amends the Medicare Improvements for Patients and Providers Act of 2008 to provide through FY2017 additional funding for: (1) state health insurance programs, (2) area agencies on aging, (3) Aging and Disability Resource Centers, and (4) Secretary's contract with the National Center for Benefits and Outreach Enrollment.

(Sec. 209) Revises requirements for reasonable cost reimbursement contracts for health maintenance organizations whose contracts cannot be renewed or extended for a service area which, during the entire previous year, was within the service area of two or more MA regional or local plans meeting certain minimum enrollment requirements and offered by different MA organizations.

Allows extension of such a contract for the two years following 2016 only if the organization converts into a Medicare Advantage (MA) plan under Medicare part C.

Allows reasonable cost plans that otherwise meet MA plan requirements to transition voluntarily into MA plans.

Deems an MA eligible individual, unless electing otherwise, to have elected to receive benefits through an applicable MA plan, and to be enrolled in it, if the individual is enrolled in a reasonable cost reimbursement contract in the previous plan year and the applicable MA plan is the plan that was converted from that reasonable cost reimbursement contract.

Gives beneficiaries the option to discontinue or change the MA plan or MA prescription plan after deemed enrollment.

(Sec. 210) Amends the Medicare Prescription Drug Improvement and Modernization Act of 2003 to extend through calendar 2017 the payment increase for home health services provided in rural areas.

Subtitle B--Other Health Extenders (Sec. 211) Makes permanent the qualifying individual (QI) program under which states pay Medicare Part B premiums for low-income Medicare beneficiaries with income between 120% and 135% of the federal poverty level. Extends funding for the QI program through FY2016, with a formula for increasing subsequent allocations.

(Sec. 212) Makes permanent the work-related transitional medical assistance (TMA) program requiring states to provide from 6 to 12 additional months of coverage for families that lose Medicaid eligibility because of increased hours of work or income from employment or from the loss of a time-limited earned income disregard.

(Sec. 213) Amends the Public Health Service Act to extend through FY2017 the two special diabetes programs for type 1 diabetes and for Indians.

(Sec. 214) Amends SSAct title V (Maternal and Child Health Services) to extend through FY2017 at increased levels the separate formula grant program for premarital sexual abstinence education.

Requires the baseline to be calculated assuming that no grant shall be made under the program after FY2017.

(Sec. 215) Extends through FY2017 the personal responsibility education program of formula grants to states to support evidence-based programs designed to educate adolescents about sexual abstinence, contraception, and adulthood.

(Sec. 216) Extends through FY2017 Family-to-Family Health Information Centers providing information and resources to families of children with special health care needs.

(Sec. 217) Amends SSAct title XX (Block Grants to States for Social Services) to extend through FY2017 demonstration projects to aid low-income individuals to train for health care professions.

(Sec. 218) Amends SSAct title V to extend through FY2017 the Maternal, Infant, and Early Childhood Home Visiting programs.

(Sec. 219) Amends SSAct title XIX to specify the FY2015-FY2025 allotments for Tennessee for disproportionate share hospital (DSH) payments to hospitals treating large numbers of low-income patients.

(Sec. 220) Amends the Bipartisan Budget Act of 2013, as amended by the Protecting Access to Medicare Act of 2014, to delay until October 1, 2017, the effective date for certain Medicaid amendments relating to third-party liability settlements and judgments received by Medicaid beneficiaries from all portions of which a state may recover Medicaid payments.

(Sec. 221) Amends the Patient Protection and Affordable Care Act to extend through FY2017 funding for Community Health Centers and the National Health Service Corps.

Amends the Public Health Service Act to extend through FY2017 funding for direct and indirect graduate medical education payments to teaching health centers.

TITLE III--CHIP (Sec. 301) Amends SSAct title XXI (State Children's Health Insurance Program) (CHIP) to extend the CHIP program through FY2017, with revised allotment requirements. Prescribes a special rule formula for FY2016.

Extends through FY2017 a qualifying state's option to use their CHIP allotment funds to finance the difference between the Medicaid and CHIP matching rates.

Extends through FY2017 the Child Enrollment Contingency Fund.

(Sec. 302) Amends SSAct XIX to extend through FY2017 the state option to rely on express lane agency determinations of CHIP eligibility.

(Sec. 303) Extends the outreach and enrollment program under CHIP through FY2017.

(Sec. 304) Extends through FY2017 the childhood obesity demonstration project and the pediatric quality measures program under SSA title XI.

(Sec. 305) Directs the HHS Inspector General to report to Congress to: (1) provide data on the number of individuals enrolled in the Medicaid program and in CHIP through the use of the Express Lane option, (2) assess the extent to which individuals so enrolled meet the eligibility requirements under Medicaid or CHIP, and (3) provide data on federal and state expenditures under Medicaid and CHIP for individuals so enrolled.

TITLE IV--OFFSETS

Subtitle A--Medicare Beneficiary Reforms

(Sec. 401) Amends SSAct title XVIII to deny Medigap policies that cover Part B deductibles to Medicare beneficiaries newly eligible on or after January 1, 2020.

(Sec. 402) Adjusts income thresholds for Medicare part B (Supplementary Medical Insurance) premiums for years beginning with 2018.

Subtitle B--Other Offsets (Sec. 411) Amends SSA title XVIII to set 1% market basket percentage increases or annual updates for hospice, long-term care hospital, and other providers.

(Sec. 412) Revises or sets the aggregate reductions in Medicaid DSH allotments for FY2018-FY2025.

(Sec. 413) Amends the Internal Revenue Code to increase from 30% to 100% the amount of a levy applied against a tax payer for any specified payment due a Medicare provider or supplier.

(Sec. 414) Amends the TMA, Abstinence Education, and QI Programs Extension Act of 2007, as amended by the American Taxpayer Relief Act of 2012, to adjust inpatient hospital payment rates for discharges occurring during FY2018-FY2023.

TITLE V--MISCELLANEOUS

Subtitle A--Protecting the Integrity of Medicare

(Sec. 501) Amends SSAct II (Old Age Survivors and Disability Insurance) to direct the Secretary to establish procedures to ensure that a Social Security number is not displayed on an individual's Medicare card.

(Sec. 502) Directs the Secretary to establish procedures to ensure that Medicare payments are not furnished to incarcerated individuals, individuals not lawfully present in the United States, and deceased individuals.

(Sec. 503) Requires the use of Medicare beneficiary smart cards, subject to certain conditions.

(Sec. 504) Modifies the requirement that a physician order for Medicare durable medical equipment (DME) document that the physician, physician assistant, practitioner, or specialist concerned has had face-to-face encounter with the patient.

(Sec. 505) Requires Medicare administrative contractors (MACs) to establish an improper payment outreach and education program.

(Sec. 506) Directs the Secretary to develop a plan to revise the incentive program under the Health Insurance Portability and Accountability Act of 1996 to encourage greater participation by individuals in reporting fraud and abuse in the Medicare program.

(Sec. 507) Directs the Secretary to require valid prescriber National Provider Identifiers on pharmacy claims for part D drugs.

(Sec. 508) Allows individuals the option to receive the Medicare summary notice electronically.

(Sec. 509) Requires the Secretary to: (1) provide for the application of competitive procedures under a contract with a MAC once every 10 years (currently once every 5 years); and (2) make available to the public the performance of each MAC.

(Sec. 510) Requires the Secretary to study and specify incentives for states to work with the Secretary under the Medicare-Medicaid Data Match Program to coordinate appropriate actions to protect the federal and state share of expenditures under the Medicare and Medicaid programs.

(Sec. 511) Directs the Secretary to issue a clarification or modification with respect to the application of certain regulations (commonly known as "the Common Rule") to qualified clinical data registries.

(Sec. 512) Eliminates civil monetary penalties for inducements to physicians to limit services that are not medically necessary. Applies such penalties only where the services reduced or limited are medically necessary.

Requires the Secretary to report to Congress on permitting gainsharing arrangements between physicians and hospitals that improve care while reducing waste and increasing efficiency.

(Sec. 513) Requires Medicare home health agencies to post a surety bond of at least $50,000 or an amount commensurate with the volume of payments to the agency.

(Sec. 514) Requires a medical review process for spinal subluxation services to a Medicare beneficiary by a chiropractor.

Directs the Secretary to develop educational and training programs to improve the ability of the chiropractors to provide documentation to the Secretary

Requires GAO to study the effectiveness of the process for such a medical review.

(Sec. 515) Adds a new requirement for the testing of a prior authorization model for repetitive scheduled non-emergent ambulance transport in New Jersey, Pennsylvania, and South Carolina. Directs the Secretary to revise the testing to cover additional, specified states located in MAC regions L and 11. Requires the Secretary to expand such model to all states in certain circumstances.

(Sec. 517) Requires the Secretary to submit to Congress a plan for expanding data in the annual Comprehensive Error Rate Testing program report.

(Sec. 518) Amends SSA title XVIII to remove funds for the Medicare Improvement Fund that were added by the Improving Medicare Post-Acute Care Transformation Act of 2014.

Subtitle B--Other Provisions (Sec. 521) Amends the Protecting Access to Medicare Act of 2014 to extend certain medical review activities involving the two-midnight rule. (The two-midnight rule allows Medicare coverage only of hospital stays where a physician admits to a hospital a beneficiary expected to require care that crosses two midnights, but generally denies coverage of care expected to require less than a two-midnight stay.)

(Sec. 522) Prohibits an entity from submitting a bid for a competitive acquisition area, during calendar 2017-2019, under a competitive DME and prosthetics, orthotics, and supplies (DMEPOS) acquisition program, unless it has obtained a bid surety bond of between $50,000 and $100,000 for each such area.

Requires the forfeit of any bid bond submitted for a competitive acquisition area if the bidding entity does not accept a contract offered for a product category when its composite bid was at or below the median composite bid rate for all bidding entities included in the calculation of the single payment amounts for the product category and the area. Requires the Secretary to collect on the forfeited bond.

Requires return of a bid bond within a specified 90-day period to a bidding entity that does not meet such bid forfeiture conditions.

Prohibits the Secretary from awarding a contract to any entity that does not meet state licensure requirements.

Requires a GAO study on the effect of this bid surety bond requirement on the participation of small suppliers in the Medicare DMEPOS competitive acquisition program.

(Sec. 523) Prohibits the Secretary from implementing the final rule requiring the transition of all 10-day and 90-day global surgical packages to 0-day global periods. (A global surgical package, also called global surgery, includes all necessary services normally furnished by a surgeon before, during, and after a procedure, a time-span constituting the global period.)

Directs the Secretary through rulemaking to develop and implement a process to gather, from a representative sample of physicians, information needed to value surgical services.

(Sec. 524) Extends through FY2015 the Secure Rural Schools and Community Self-Determination Act of 2000 and payments in lieu of taxes to the governments of states and counties containing tax-exempt federal land.

Prescribes a special rule for FY2014 payments.

Extends indefinitely requirements for the funding of special projects on federal land for which participating counties elect to expend a portion of such federal funds. Extends through FY2017 the authority to initiate such projects.

Extends indefinitely the authorization of appropriations under the Act.

(Sec. 525) Prohibits the entry of the budgetary effects of this Act on either PAYGO scorecard maintained under the Statutory Pay-As-You-Go Act of 2010 or section 201 of S. Con. Res. 21 (110th Congress).

measure amended introduced expanded summary house passed version repeated title sgr repeal medicare provider payment modernization sec amends title xviii medicare social security act ssact remove sustainable growth rate sgr methodology determination annual conversion factors formula payment physicians services revise update rates subsequent years requires separate conversion factors year beginning items services furnished qualifying alternative payment model apm participant qualifying apm conversion factor items services apm conversion factor freezes update single conversion factor january june sets update december reduces sets update qualifying apm conversion factor update apm conversion factor subsequent year directs medicare_payment_advisory_commission medpac report congress relationship physician health professional utilization expenditures rate increase items services medicare payment total utilization expenditures rate increase medicare parts voluntary prescription drug benefit program requires separate report update physicians services medicare directs secretary health_and_human_services consolidate components specified existing performance incentive programs new merit based mip system eligible professionals including physicians physician assistants nurse practitioners clinical nurse specialists certified registered nurse anesthetists excluding apm participants shall receive annual payment increases decreases based performance measured standards secretary shall establish according specified criteria requires government accountability office gao evaluate mip system examine similarities differences use quality measures original medicare fee service program ssact title xviii parts medicare_advantage program ssact title xviii selected state medical assistance programs ssa title xix medicaid private payer arrangements recommendations reduce administrative burden applying measures directs gao examine entities pool financial risk physician practices independent risk managers play role supporting practices particularly small physician practices assuming financial risk treatment patients report transition professionals rural areas health professional shortage areas medically underserved areas apm recommendations removing administrative barriers arrangements hand practices including small practices areas participate apm models establishes comments recommendations secretary physician focused payment models prescribes requirements incentive payments eligible apm participants directs secretary study feasibility integrating apms medicare_advantage payment system applicability federal fraud prevention laws items services paid apm sec directs secretary draft plan development quality measures assess professionals including non patient facing professionals sec directs secretary payments chronic care management services furnished physician physician assistant nurse practitioner clinical nurse specialist certified nurse midwife directs secretary conduct education outreach campaign inform relevant professionals medicare enrollees benefits chronic care management services sec directs secretary publicly available annual basis information respect physicians eligible professionals items services furnished medicare beneficiaries sec expands kinds uses medicare data available qualified entities quality improvement activities directs secretary provide medicare data qualified clinical data registries facilitate quality improvement patient safety sec allows continuing renewals year period physician practitioner medicare claims process private contract directs secretary publicly available appropriate hhs website information number characteristics opt physicians practitioners declares national objective achieve widespread exchange health information interoperable certified electronic health records ehr technology nationwide december directs secretary establish related metrics requires secretary examine feasibility establishing mechanisms assist providers comparing selecting certified ehr technology products directs gao study specified telehealth remote patient monitoring services title medicare health extenders subtitle sec amends ssact title xviii extend calendar year current floor work geographic practice cost index adjusting medicare fee schedule physician services sec extends calendar year process individual request obtain exception uniform dollar limitation physical therapy services speech language pathology services occupational therapy services directs secretary place manual medical review process implement targeted medical review process identify conduct medical reviews outpatient therapy services furnished service provider supplier sec extends calendar year temporary increase payment ground ambulance services including urban rural super rural ground ambulance services sec extends fy2017 increased inpatient hospital payment adjustment certain low volume subsection hospitals generally subsection hospital acute care hospital particularly receives payments medicare inpatient prospective payment system providing covered inpatient services eligible beneficiaries sec extends fy2016 medicare dependent hospital program certain small rural subsection hospitals sec extends calendar year authority specialized plans special needs individuals restrict enrollment individuals classes special needs individuals sec extends fy2017 increased funding contracts consensus based entity health care performance measurement endorsement input selection sec amends medicare_improvements_for_patients_and_providers_act provide fy2017 additional funding state health insurance programs area agencies aging aging secretary contract sec revises requirements reasonable cost reimbursement contracts health maintenance organizations contracts renewed extended service area entire previous year service area regional local plans meeting certain minimum enrollment requirements offered different organizations allows extension contract years following organization converts medicare advantage plan medicare allows reasonable cost plans meet plan requirements transition voluntarily plans deems eligible individual electing elected receive benefits applicable plan enrolled individual enrolled reasonable cost reimbursement contract previous plan year applicable plan plan converted reasonable cost reimbursement contract gives beneficiaries option discontinue change plan prescription plan deemed enrollment sec amends extend calendar payment increase home health services provided rural areas subtitle health extenders sec makes permanent qualifying individual program states pay medicare premiums low income medicare beneficiaries income federal poverty level extends funding program fy2016 formula increasing subsequent allocations sec makes permanent work related transitional medical assistance tma program requiring states provide additional months coverage families lose medicaid eligibility increased hours work income employment loss time limited earned income disregard sec amends public_health_service_act extend fy2017 special diabetes programs type diabetes indians sec amends ssact title maternal child health services extend fy2017 increased levels separate formula grant program sexual abstinence education requires baseline calculated assuming grant shall program fy2017 sec extends fy2017 personal responsibility education program formula grants states support evidence based programs designed educate adolescents sexual abstinence contraception adulthood sec extends fy2017 family family health information centers providing information resources families children special health care needs sec amends ssact title block grants states social_services extend fy2017 demonstration projects aid low income individuals train health care professions sec amends ssact title extend infant early_childhood_home_visiting programs sec amends ssact title xix specify fy2015 fy2025 allotments tennessee disproportionate share hospital dsh payments hospitals treating large numbers low income patients sec amends bipartisan_budget_act amended protecting_access medicare_act delay october effective date certain medicaid amendments relating party liability settlements judgments received medicaid beneficiaries portions state recover medicaid payments sec amends patient_protection affordable care act extend fy2017 funding national_health_service_corps amends public_health_service_act extend fy2017 funding direct indirect graduate medical education payments teaching health centers title iii chip sec amends ssact title chip extend chip program fy2017 revised allotment requirements prescribes special rule formula fy2016 extends fy2017 qualifying state option use chip allotment funds finance difference medicaid chip matching rates extends fy2017 child enrollment contingency fund sec amends ssact xix extend fy2017 state option rely express lane agency determinations chip eligibility sec extends outreach enrollment program chip fy2017 sec extends fy2017 childhood obesity demonstration project pediatric quality measures program ssa title sec directs report congress provide data number individuals enrolled medicaid program chip use option assess extent individuals enrolled meet eligibility requirements medicaid chip provide data federal state expenditures medicaid chip individuals enrolled title offsets subtitle medicare beneficiary reforms sec amends ssact title xviii deny medigap policies cover deductibles medicare beneficiaries newly eligible january sec adjusts income thresholds medicare supplementary_medical_insurance premiums years beginning subtitle offsets sec amends ssa title xviii set market basket percentage increases annual updates hospice long term care hospital providers sec revises sets aggregate reductions allotments sec amends internal revenue code increase levy applied tax payer specified payment medicare provider supplier sec amends tma programs extension act amended american taxpayer relief act adjust inpatient hospital payment rates discharges occurring title miscellaneous subtitle protecting integrity medicare sec amends ssact old age survivors disability insurance direct secretary establish procedures ensure social_security number displayed individual medicare card sec directs secretary establish procedures ensure medicare payments furnished incarcerated individuals individuals lawfully present united_states deceased individuals sec requires use medicare beneficiary smart cards subject certain conditions sec modifies requirement physician order medicare durable medical equipment dme document physician physician assistant practitioner specialist concerned face face encounter patient sec requires medicare administrative contractors macs establish improper payment outreach education program sec directs secretary develop plan revise incentive program health_insurance_portability_and_accountability_act encourage greater participation individuals reporting fraud abuse medicare program sec directs secretary require valid prescriber pharmacy claims drugs sec allows individuals option receive medicare summary notice electronically sec requires secretary provide application competitive procedures contract mac years currently years available public performance mac sec requires secretary study specify incentives states work secretary medicare-medicaid data_match_program coordinate appropriate actions protect federal state share expenditures medicare medicaid programs sec directs secretary issue clarification modification respect application certain regulations commonly known common rule qualified clinical data registries sec eliminates civil monetary penalties inducements physicians limit services medically necessary applies penalties services reduced limited medically necessary requires secretary report congress permitting gainsharing arrangements physicians hospitals improve care reducing waste increasing efficiency sec requires medicare home health agencies post surety bond commensurate volume payments agency sec requires medical review process spinal services medicare beneficiary chiropractor directs secretary develop educational training programs improve ability chiropractors provide documentation secretary requires gao study effectiveness process medical review sec adds new requirement testing prior authorization model repetitive scheduled non emergent ambulance transport new_jersey pennsylvania south_carolina directs secretary revise testing cover additional specified states located mac regions requires secretary expand model states certain circumstances sec requires secretary submit congress plan expanding data annual comprehensive error rate testing program report sec amends ssa title xviii remove funds medicare_improvement_fund added subtitle amends protecting_access medicare_act extend certain medical review activities involving midnight rule midnight rule allows medicare coverage hospital stays physician hospital beneficiary expected require care crosses generally denies coverage care expected require midnight stay sec prohibits entity submitting bid competitive acquisition area calendar competitive dme prosthetics orthotics supplies dmepos acquisition program obtained bid surety bond area requires forfeit bid bond submitted competitive acquisition area bidding entity accept contract offered product category composite bid median composite bid rate bidding entities included calculation single payment amounts product category area requires secretary collect forfeited bond requires return bid bond specified day period bidding entity meet bid forfeiture conditions prohibits secretary awarding contract entity meet state licensure requirements requires gao study effect bid surety bond requirement participation small suppliers medicare dmepos competitive acquisition program sec prohibits secretary implementing final rule requiring transition day day global surgical packages day global periods global surgical package called global surgery includes necessary services normally furnished surgeon procedure time span constituting global period directs secretary rulemaking develop implement process gather representative sample physicians information needed value surgical services sec extends fy2015 secure rural schools community self determination act payments lieu taxes governments states counties containing tax exempt federal land prescribes special rule fy2014 payments extends indefinitely requirements funding special projects federal land participating counties elect expend portion federal funds extends fy2017 authority initiate projects extends indefinitely authorization appropriations act sec prohibits entry budgetary effects act paygo scorecard maintained statutory pay act section res 110th congress


Summary:
Flexibility in Health IT Reporting (Flex-IT) Act of 2015

Directs the Secretary of Health and Human Services, in specifying the electronic health record (EHR) reporting period under EHR electronic health record technology incentive payment programs under titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act, to continue through 2015 (in the case of eligible professionals) and FY2015 (in the case of eligible hospitals and critical access hospitals) to permit the use of a three-month quarter EHR reporting period to demonstrate meaningful use without regard to the payment year or the stage of meaningful use criteria involved.

flexibility health reporting flex act directs secretary health_and_human_services specifying electronic health record ehr reporting period ehr electronic health record technology incentive payment programs titles xviii medicare xix medicaid social security act continue case eligible professionals fy2015 case eligible hospitals critical access hospitals permit use month quarter ehr reporting period demonstrate meaningful use regard payment year stage meaningful use criteria involved


Summary:
Prevent Interruptions in Physical Therapy Act of 2015

 Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to require physical therapists furnishing outpatient physical therapy services to use specified locum tenens arrangements for payment purposes in the same manner as such arrangements are used to apply to physicians furnishing substitute physicians services for other physicians.

(Locum tenens [place holder], or substitute, physicians usually assume professional practices in the absence of a regular physician for reasons such as illness, pregnancy, vacation, or continuing medical education.)


Summary:
Patient Access to Higher Quality Health Care Act of 2015

Amends the Patient Protection and Affordable Care Act (PPACA) to repeal the prohibition against Medicare participation by physician-owned hospitals that do not have a provider agreement by August 1, 2010, which nonetheless allows their Medicare participation under a rural provider and hospital exception to a specified ownership or investment prohibition if they meet certain requirements.

Amends the Health Care and Education Reconciliation Act of 2010 (HCERA) to repeal provisions: (1) postponing from August 1, 2010, to December 31, 2010, the date by which physician-owned hospitals must have a provider agreement in order to participate in Medicare under a rural provider and hospital exception to the physician-ownership or -investment prohibition if they also meet certain requirements addressing conflicts of interest, bona fide investments, patient safety issues, and expansion limitations; and (2) modifying the expansion limitation imposed on such a rural hospital

Restores related previous law amended or repealed by PPACA and HCERA as if PPACA or HCERA had not been enacted.

patient access higher quality health care act amends patient protection affordable care act ppaca repeal prohibition medicare participation physician owned hospitals provider agreement august nonetheless allows medicare participation rural provider hospital exception specified ownership investment prohibition meet certain requirements amends health care education reconciliation act repeal provisions august december date physician owned hospitals provider agreement order participate medicare rural provider hospital exception physician ownership prohibition meet certain requirements addressing conflicts interest bona fide investments patient safety issues expansion limitations modifying expansion limitation imposed rural hospital restores related previous law amended repealed ppaca ppaca enacted


Summary:
Medicare Patient Access to Hospice Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to recognize attending physician assistants as attending physicians to serve hospice patients.

medicare_patient_access hospice act amends title xviii medicare social security act recognize attending physician assistants attending physicians serve hospice patients


Summary:
Doctors Helping Heroes Act of 2015

 Amends the Immigration and Nationality Technical Corrections Act of 1994 to make permanent the J-1 visa waiver program (Conrad state 30/medical services in underserved areas).

Excludes from numerical immigration limitations alien physicians who have completed national interest waiver requirements by working in a health care shortage area (including alien physicians who completed such service before enactment of this Act and any of their spouses or children).

Sets forth specified employment protections and contract requirements for alien physicians working in underserved areas.

Increases the number of alien physicians that a state may be allocated from 30 to 35 per fiscal year in specified circumstances. Provides for additional increases or decreases based upon demand.

Provides up to three visa waivers per fiscal year per state for physicians in academic medical centers.

Permits dual intent for an alien coming to the United States to receive graduate medical education or training, or to take examinations required for graduate medical education or training.

Exempts from specified entry limitations H-1B nonimmigrant aliens seeking to enter the United States to pursue graduate medical education or training.

Amends the Immigration and Nationality Act to authorize waiver of the two-year foreign residency requirement for an alien who has received graduate medical eduction or training in the United States and seeks to apply for an immigrant visa or permanent resident status if:

 the Secretary of Veterans Affairs (VA) determines that VA facilities are not capable of furnishing covered health services to eligible veterans because they lack the required personnel or cannot provide timely and reasonable access; and the head of the appropriate state agency determines that the alien will practice medicine in a Veterans Health Administration facility, the alien physician's work is in the public interest, and such waiver would not cause the number of waivers allotted for that state for that fiscal year to exceed five.

doctors helping heroes act amends immigration nationality technical corrections act permanent j-1 visa waiver program conrad state medical services underserved areas excludes numerical immigration limitations alien physicians completed national interest waiver requirements working health care shortage area including alien physicians completed service enactment act spouses children sets forth specified employment protections contract requirements alien physicians working underserved areas increases number alien physicians state allocated fiscal year specified circumstances provides additional increases decreases based demand provides visa waivers fiscal year state physicians academic medical centers permits dual intent alien coming united_states receive graduate medical education training examinations required graduate medical education training exempts specified entry limitations h-1b nonimmigrant aliens seeking enter united_states pursue graduate medical education training amends immigration nationality act authorize waiver year foreign residency requirement alien received graduate medical training united_states seeks apply immigrant visa permanent resident status secretary veterans_affairs determines facilities capable furnishing covered health services eligible veterans lack required personnel provide timely reasonable access head appropriate state agency determines alien practice medicine veterans_health_administration facility alien physician work public interest waiver cause number waivers allotted state fiscal year exceed


Summary:
Health IT Modernization for Underserved Communities Act of 2015

 Amends title XIX (Medicaid) of the Social Security Act to extend to physician assistants eligibility for Medicaid electronic health record incentive payments, regardless of whether or not such physician assistants practice at a rural health center that is led by a physician assistant or in a federally qualified health center.

amends title xix medicaid social security act extend physician assistants eligibility medicaid electronic health record incentive payments regardless physician assistants practice rural health center led physician assistant federally qualified health center


Summary:
Providers Consolidation and Medicare Payments Examined through Evaluation Act of 2015 or the Providers COMPETE Act of 2015

This bill directs the Secretary of Health and Human Services, as part of any annual notice and comment rulemaking process to implement changes to payment systems under title XVIII (Medicare) of the Social Security Act (including those for inpatient and outpatient hospital services, physicians' services, and services furnished by other providers and suppliers), to seek public comment on and evaluate the extent to which, and how, such a change is projected to affect provider consolidation.

medicare payments examined evaluation act providers compete act bill directs secretary health_and_human_services annual notice comment rulemaking process implement changes payment systems title xviii medicare social security act including inpatient outpatient hospital services physicians services services furnished providers suppliers seek public comment evaluate extent change projected affect provider consolidation