S.975 - Seniors and Taxpayers Obligation Protection Act of 2009

A bill to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program. view all titles (2)

All Bill Titles

  • Official: A bill to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program. as introduced.
  • Short: Seniors and Taxpayers Obligation Protection Act of 2009 as introduced.

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Introduced
 
Senate
Passes
 
House
Passes
 
President
Signs
 

 
05/05/09
 
 
 
 
 
 
 

Official Summary

Seniors and Taxpayers Obligation Protection Act of 2009 - Directs the Secretary of Health and Human Services, in order to protect beneficiaries from identity theft, to establish and implement procedures to change the Medicare beneficiary identifier used to identify individuals entitled to b

Official Summary

Seniors and Taxpayers Obligation Protection Act of 2009 - Directs the Secretary of Health and Human Services, in order to protect beneficiaries from identity theft, to establish and implement procedures to change the Medicare beneficiary identifier used to identify individuals entitled to benefits under part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act (SSA), or enrolled under part B (Supplementary Medical Insurance), so that such an individual's Social Security number is not used. Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to direct the Commissioner of Social Security, upon the Secretary's request, to enter into a data matching agreement with the Secretary to determine if individuals are eligible for benefits or if providers are eligible to provide services or supplies. Directs the Secretary to investigate claims involving certain individuals who are not eligible for benefits or are not eligible providers of services or suppliers. Amends SSA title XVIII to direct the Secretary to establish and implement a system to verify on a monthly basis that the claims for payment under Medicare part B for physicians' services furnished in high risk areas are:
(1) for physicians' services actually furnished by the physician (or the physician's group practice); and
(2) otherwise accurate. Requires the Secretary to establish a system to identify the 50 counties most vulnerable (high risk areas) to Medicare fraud. Directs the Secretary to establish procedures for the use of technology (similar to that used with respect to the analysis of credit card charging patterns) to provide real-time data analysis of claims for payment under the Medicare program to identify and investigate unusual billing or order practices under the Medicare program that could indicate fraud or abuse. Requires the Secretary to establish procedures to require carriers, before paying a claim for payment for durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS) to confirm with the National Supplier Clearinghouse that:
(1) the physician's or practitioner's National Provider Identifier is valid and active;
(2) the supplier's Medicare identification number is valid and active; and
(3) that the item or service for which the claim for payment is submitted was properly identified on the CMS-855S Medicare enrollment application. Directs the Secretary to develop a strategic plan for the development and implementation of a serial number tracking system for DME, including mechanisms to ensure unique identifiers for DME items without them. Directs the Comptroller General to study and report to Congress on the effectiveness of the surety bond requirement for DME suppliers in combating fraud.

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