Bill > HR1650

This bill, the Medicare Patient Empowerment Act of 2015, allows any individual eligible for Medicare benefits to freely contract with a qualified healthcare provider, known as an "eligible professional" (which includes doctors, physician assistants, nurse practitioners, therapists, and others), for any Medicare-covered service, regardless of whether the provider is a participating Medicare provider. Under this contract, the beneficiary agrees in writing to pay the provider directly and to submit the Medicare claim themselves, unless they negotiate for the provider to handle the claim submission. The bill specifies that if a beneficiary submits a claim for a non-participating provider, Medicare will pay as if the provider were participating, and the provider will not be subject to certain Medicare rules for participating or non-participating physicians. Importantly, the contract must be in writing, clearly outline all terms and payment amounts before services are rendered, and ensure the beneficiary is not charged more than the agreed-upon amount. It also requires the contract to state that Medicare payment limits and incentives will not apply to these contracted services, and it prohibits such contracts for individuals facing an emergency or urgent medical situation, or those also eligible for Medicaid. Furthermore, this bill preempts state laws that would limit the charges for services provided by eligible professionals for which Medicare payment is made.