116th CONGRESS 1st Session |
To direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program.
May 7, 2019
Mr. Kilmer (for himself and Ms. Stefanik) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
To direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
This Act may be cited as the “Protecting Local Access to Care for Everyone Act of 2019” or the “PLACE Act of 2019”.
SEC. 2. Preventing certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program.
(a) In general.—The Secretary of Health and Human Services shall, for purposes of payment under part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.) for clinic visit services (as defined in subsection (c)) furnished during the period beginning on January 1, 2019, and ending on December 31, 2020, by an applicable provider (as defined in such subsection), treat such services as if such services had been furnished by a department of a provider located on the campus (as defined in section 413.65(a)(2) of title 42, Code of Federal Regulations (or any successor regulation)) of such provider.
(b) Reimbursement.—In the case of such clinic visit services furnished during the period described in subsection (a) by such an applicable provider for which payment has already been made under such part B as of the date of the enactment of this Act, the Secretary of Health and Human Services shall promptly reimburse such provider in an amount equal to the difference between the payment for such services under subsection (a) and the amount actually paid for such services.
(c) Definitions.—In this section:
(1) APPLICABLE PROVIDER.—The term “applicable provider” means a department of a provider that would be an off-campus outpatient department of a provider (as defined in section 1833(t)(21)(B) of the Social Security Act (42 U.S.C. 1395l(t)(21)(B)) but for the application of clause (ii) or (iv) of such section.
(2) CLINIC VISIT SERVICES.—The term “clinic visit services” means those services identified by Healthcare Common Procedure Coding System code G0463 (or a successor code).
(3) DEPARTMENT OF A PROVIDER.—The term “department of a provider” has the meaning given such term in section 413.65(a)(2) of title 42, Code of Federal Regulations, as in effect as of the date of the enactment of this Act.