text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Medicare Patient Empowerment Act''.
  
  SEC. 2. GUARANTEEING FREEDOM OF CHOICE AND CONTRACTING FOR PATIENTS.
  
      (a) In General.--Section 1802 of the Social Security Act (42 U.S.C. 
  1395a) is amended to read as follows:
  
         ``freedom of choice and contracting by patient guaranteed
  
      ``Sec. 1802.  (a) Basic Freedom of Choice.--Any individual entitled 
  to insurance benefits under this title may obtain health services from 
  any institution, agency, or person qualified to participate under this 
  title if such institution, agency, or person undertakes to provide that 
  individual such services.
      ``(b) Freedom To Contract by Medicare Beneficiaries.--
              ``(1) In general.--Subject to the provisions of this 
          subsection, nothing in this title shall prohibit a Medicare 
          beneficiary from entering into a contract with a participating 
          or non-participating physician or practitioner for any item or 
          service covered under this title.
              ``(2) Submission of claims.--Any Medicare beneficiary that 
          enters into a contract under this section shall be permitted to 
          submit a claim for payment under this title, and such payment 
          shall be made in the amount that would otherwise apply under 
          this title if such claim had been filed by a participating 
          physician or practitioner (as defined in section 1842(i)(2)) in 
          the payment area where the physician or practitioner covered by 
          the contract resides. Payment made under this title for any 
          item or service provided under the contract shall not render 
          the physician a participating or non-participating physician, 
          and as such, requirements of this title that may otherwise 
          apply to a participating or non-participating physician would 
          not apply with respect to any items or services furnished under 
          the contract.
              ``(3) Beneficiary protections.--
                      ``(A) In general.--Paragraph (1) shall not apply to 
                  any contract unless--
                              ``(i) the contract is in writing, is signed 
                          by the Medicare beneficiary and the physician 
                          or practitioner, and establishes all terms of 
                          the contract (including specific payment for 
                          physicians' services covered by the contract) 
                          before any item or service is provided pursuant 
                          to the contract, and the beneficiary shall be 
                          held harmless for any subsequent payment 
                          charged for a service in excess of the amount 
                          established under the contract during the 
                          period the contract is in effect;
                              ``(ii) the contract contains the items 
                          described in subparagraph (B); and
                              ``(iii) the contract is not entered into at 
                          a time when the Medicare beneficiary is facing 
                          an emergency medical condition or urgent health 
                          care situation.
                      ``(B) Items required to be included in contract.--
                  Any contract to provide items and services to which 
                  paragraph (1) applies shall clearly indicate to the 
                  Medicare beneficiary that by signing such contract the 
                  beneficiary--
                              ``(i) agrees to be responsible for payment 
                          to such physician or practitioner for such 
                          items or services under the terms of and 
                          amounts established under the contract;
                              ``(ii) agrees to be responsible for 
                          submitting claims under this title to the 
                          Secretary, and to any other supplemental 
                          insurance plan that may provide supplemental 
                          insurance, for such items or services furnished 
                          under the contract if such items or services 
                          are covered by this title, unless otherwise 
                          provided in the contract under subparagraph 
                          (C)(i); and
                              ``(iii) acknowledges that no limits or 
                          other payment incentives that may otherwise 
                          apply under this title (such as the limits 
                          under subsection (g) of section 1848 or 
                          incentives under subsection (a)(5), (m), (q), 
                          and (p) of such section) shall apply to amounts 
                          that may be charged, or paid to a beneficiary 
                          for, such items or services.
                  Such contract shall also clearly indicate whether the 
                  physician or practitioner is excluded from 
                  participation under the Medicare program under section 
                  1128.
                      ``(C) Beneficiary elections under the contract.--
                  Any Medicare beneficiary that enters into a contract 
                  under this section may elect to negotiate, as a term of 
                  the contract, a provision under which--
                              ``(i) the physician or practitioner shall 
                          file claims on behalf of the beneficiary with 
                          the Secretary and any supplemental insurance 
                          plan for items or services furnished under the 
                          contract if such items or services are covered 
                          under this title or under the plan; and
                              ``(ii) the beneficiary assigns payment to 
                          the physician for any claims filed by, or on 
                          behalf of, the beneficiary with the Secretary 
                          and any supplemental insurance plan for items 
                          or services furnished under the contract.
                      ``(D) Exclusion of dual eligible individuals.--
                  Paragraph (1) shall not apply to any contract if a 
                  beneficiary who is eligible for medical assistance 
                  under title XIX is a party to the contract.
              ``(4) Limitation on actual charge and claim submission 
          requirement not applicable.--Section 1848(g) shall not apply 
          with respect to any item or service provided to a Medicare 
          beneficiary under a contract described in paragraph (1).
              ``(5) Construction.--Nothing in this section shall be 
          construed to prohibit any physician or practitioner from 
          maintaining an election and acting as a participating or non-
          participating physician or practitioner with respect to any 
          patient not covered under a contract established under this 
          section.
              ``(6) Definitions.--In this subsection:
                      ``(A) Medicare beneficiary.--The term `Medicare 
                  beneficiary' means an individual who is entitled to 
                  benefits under part A or enrolled under part B.
                      ``(B) Physician.--The term `physician' has the 
                  meaning given such term by paragraphs (1), (2), (3), 
                  and (4) of section 1861(r).
                      ``(C) Practitioner.--The term `practitioner' means 
                  a practitioner described in section 1842(b)(18)(C).
                      ``(D) Emergency medical condition.--The term 
                  `emergency medical condition' means a medical condition 
                  manifesting itself by acute symptoms of sufficient 
                  severity (including severe pain) such that a prudent 
                  layperson, with an average knowledge of health and 
                  medicine, could reasonably expect the absence of 
                  immediate medical attention to result in--
                              ``(i) serious jeopardy to the health of the 
                          individual or, in the case of a pregnant woman, 
                          the health of the woman or her unborn child;
                              ``(ii) serious impairment to bodily 
                          functions; or
                              ``(iii) serious dysfunction of any bodily 
                          organ or part.
                      ``(E) Urgent health care situation.--The term 
                  `urgent health care situation' means services furnished 
                  to an individual who requires services to be furnished 
                  within 12 hours in order to avoid the likely onset of 
                  an emergency medical condition.''.
  
  SEC. 3. PREEMPTION OF STATE LAWS LIMITING CHARGES FOR PHYSICIAN AND 
                PRACTITIONER SERVICES.
  
      (a) In General.--No State may impose a limit on the amount of 
  charges for services, furnished by a physician or practitioner, for 
  which payment is made under section 1848 of the Social Security Act (42 
  U.S.C. 1395w-4), and any such limit is hereby preempted.
      (b) State.--In this section, the term ``State'' includes the 
  District of Columbia, Puerto Rico, the Virgin Islands, Guam, and 
  American Samoa.
target: Medicare Patient Empowerment Act - Amends title XVIII (Medicare) of the Social Security Act to allow any Medicare beneficiary to enter into a contract with a non-participating (as well as with a participating) physician or practitioner for any item or service covered by Medicare. Allows such beneficiaries to submit a claim for Medicare payment in the amount that would otherwise apply if the claim had been filed by a participating physician or practitioner in the payment area where the physician or practitioner covered by the contract resides.
  
  Requires a Medicare beneficiary to agree in writing in such a contract to: (1) pay the physician or practitioner for a Medicare-covered item or service; and (2) submit (in lieu of the physician or practitioner) a claim for Medicare payment. Allows a beneficiary, however, to negotiate, as a term of the contract, for the physician or practitioner to file such claims on the beneficiary's behalf.
  
  Preempts state laws from limiting the amount of charges for physician and practitioner services for which Medicare payment is made.
feat_title: A bill to amend title XVIII of the Social Security Act to establish a Medicare payment option for patients and physicians or practitioners to freely contract, without penalty, for Medicare fee-for-service items and services, while allowing Medicare beneficiaries to use their Medicare benefits.