Down Memory Lane: HR 3391, Medicare Regulatory and Contracting Reform Act of 2001

 Recently a client was using a piece of Medicare law, SSA 1861(e)(1), which prohibits Medicare from making regulations or decisions retroactive (except in rare cases where statute requires it).

Turns out this comes from Section 102 of the Medicare Regulatory and Contracting Reform Act of 2001 (HR 3391).   This apparently replaced a bill with the same title numbered as HR 2768.  2768 was kicking around from August to December of 2001.  3391 is listed as "introduced and passed by House on 12/4/2001."   I assume it was incorporated into some Senate-side bill since parts of it are, in fact, law, but I don't have details.  I see an article dated 6/11/2009 (?) at Kaiser about HR 3391 and refering to a Washington Times op ed and a GAO report (that call centers were inaccurate).  I see another article about it, dated 1/4/2002.  Gray Sheet reported the House passage and commented on Senate outlook in an article on 4/22/2002.  Baucus and Grassley introduced some sort of Medicare access reform act in the Senate on October 1, 2002 - the "Beneficiary Access to Care and Medicare Equity Act of 2002." This became S 3018 and was introduced and not passed.  It has retroactive language at its Section 602.  It would have added this as 1871(d), a section that doesn't exist today (today's statute jumps from 1871(c) to (e).)   Section 603 required an HHS report on Medicare conflicts and in consistencies.

Overall, the scope of Medicare contractor changes and new rules is still interesting to review, although 20-plus years have no doubt changed some of the details.  

Here is the summary of the Section 102 language:

Prohibits the retroactive application of a substantive change in regulations, manual instructions, interpretative rules, statements of policy, or guidelines of general applicability under Medicare to items and services furnished before the change's effective date, unless the Secretary determines that retroactive application is necessary to comply with statutory requirements or failure to apply the change retroactively would be contrary to the public interest. Prohibits a substantive change from becoming effective until after the Secretary has issued or published it, except as provided for in this Act.

The full rule summary is at the link.   To see the actual bill, click on the upper tab called "Text."

https://www.congress.gov/bill/107th-congress/house-bill/3391?s=1&r=33