MEDICARE AND MEDICAID COVERAGE DATA BANK.

SEC. 13531. MEDICARE AND MEDICAID COVERAGE DATA BANK. (a) Establishment of Medicare and Medicaid Coverage Data Bank— Part A of title XI (42 U.S.C. 1301 et seq.) is amended by adding at the end the following new section: “medicare and medicaid coverage data bank “Sec. 1144. (a) Establishment of Data Bank.— The Secretary shall establish a Medicare and Medicaid Coverage Data Bank (hereafter in this section referred to as the ‘Data Bank’) to— “(1) further the purposes of section 1862(b) in the identification of, and collection from, third parties responsible for payment for health care items and services furnished to medicare beneficiaries, and “(2) assist in the identification of, and the collection from, third parties responsible for the reimbursement of costs incurred by any State plan under title XIX with respect to medicaid beneficiaries, upon request by the State agency described in section 1902(a)(5) administering such plan. “(b) Information in Data Bank.— “(1) In general.— The Data Bank shall contain information obtained pursuant to section 6103(l)(12) of the Internal Revenue Code of 1986 and subsection (c). “(2) Disclosure of information in data bank.— The Secretary is authorized until September 30, 1998— “(A) (subject to the restriction in subparagraph (D)(i) of section 6103(l)(12) of the Internal Revenue Code of 1986) to disclose any information in the Data Bank obtained pursuant to such section solely for the purposes of such section, and “(B) (subject to the restriction in subsection (c)(7)) to disclose any other information in the Data Bank to any State agency described in section 1902(a)(5), employer, or group health plan solely for the purposes described in subsection (a). “(c) Requirement That Employers Report Information.— “(1) Reporting requirement.— “(A) In general.— Any employer described in paragraph (2) shall report to the Secretary (in such form and manner as the Secretary determines will minimize the burden of such reporting) with respect to each electing 107 STAT. 610individual the information required under paragraph (5) for each calendar year beginning on or after January 1, 1994, and before January 1, 1998. “(B) Special rule.— To the extent a group health plan provides information required under paragraph (5) m a form and manner specified by the Secretary (in consultation with the Secretary of Labor) on behalf of an employer in accordance with section 101(f) of the Employee Retirement Income Security Act of 1974, the employer has complied with the reporting requirement under subparagraph (A) with respect to the reporting of such information. “(2) Employer described.— An employer is described in this paragraph if such employer has, or contributes to, a group health plan, with respect to which at least 1 employee of such employer is an electing individual. “(3) Electing individual.— For purposes of this subsection, the term ‘electing individual’ means an individual associated or formerly associated with the employer in a business relationship who elects coverage under the employer’s group health plan. “(4) Certain individuals excluded.— For purposes of this subsection, an individual providing service referred to in section 3121(a)(7)(B) of the Internal Revenue Code of 1986 shall not be considered an employee or electing individual with respect to an employer. “(5) Information required.— For purposes of paragraph (1), each employer shall provide the following information: “(A) The name and TIN of the electing individual. “(B) The type of group health plan coverage (single or family) elected by the electing individual. “(C) The name, address, and identifying number of the group health plan elected by such electing individual. “(D) The name and TIN of each other individual covered under the group health plan pursuant to such election. “(E) The period during which such coverage is elected. “(F) The name, address, and TIN of the employer. “(6) Time of filing.— For purposes of determining the date for filing the report under paragraph (1), such report shall be treated as a statement described in section 6051(d) of the Internal Revenue Code of 1986. “(7) Limits on disclosure of information reported.— “(A) In general.— The disclosure of the information reported under paragraph (1) shall be restricted by the Secretary under rules similar to the rules of subsections (a) and (p) of section 6103 of the Internal Revenue Code of 1986. “(B) Penalty for unauthorized willful disclosure of information.— The unauthorized disclosure of any information reported under paragraph (1) shall be subject to the penalty described in paragraph (1), (2), (3), or (4) of section 7213(a) of such Code. “(9) Penalty for failure to report.— In the case of the failure of an employer (other than a Federal or other governmental entity) to report under paragraph (1)(A) with respect to each electing individual, the Secretary shall impose a penalty as described in part II of subchapter B of chapter 68 of the Internal Revenue Code of 1986. 107 STAT. 611 “(d) Fees for Data Bank Services.— The Secretary shall establish fees for services provided under this section which shall remain available, without fiscal year limitation, to the Secretary to cover the administrative costs to the Data Bank of providing such services. “(f) Definitions.—In this section: “(1) Medicare beneficiary.— The term ‘medicare beneficiary’ means an individual entitled to benefits under part A, or enrolled under part B, of title XVIII, but does not include such an individual enrolled in part A under section 1818. “(2) Medicaid beneficiary.— The term ‘medicaid beneficiary’ means an individual entitled to benefits under a State plan for medical assistance under title XIX (including a State plan operating under a statewide waiver under section 1115). “(3) Group health plan.— The term ‘group health plan’ shall have the meaning given to such term by section 5000(b)(1) of the Internal Revenue Code of 1986. “(4) TIN.— The term TIN’ shall have the meaning given to such term by section 7701(a)(41) of such Code.”. (b) Conforming Amendments.— (1) Medicare.— Section 1862(b)(5) (42 U.S.C. 1395y(b)(5)) is amended— (A) in subparagraph (B), by striking “under subparagraph (A)” and all that follows and inserting “under— “(i) subparagraph (A), and “(ii) section 1144, for purposes of carrying out this subsection.”, and (B) in subparagraph (C)(i), by striking “subparagraph (B)” and inserting “subparagraph (B)(i)”. (2) Medicaid.— Section 1902(a)(25)(A)(i) (42 U.S.C. 1396a(a)(25)(A)(i)) is amended by striking “(as specified” and inserting “(including the use of information collected by the Medicare and Medicaid Coverage Data Bank under section 1144 and any additional measures as specified”. (c) Conforming Amendment Relating to Data Matches.— Subsection (a)(8)(B) of section 552a of title 5, United States Code, is amended— (1) in clause (v), by striking “; or” at the end; (2) in clause (vi), by striking the semicolon at the end and inserting “; or”; and (3) by adding at the end the following new clause: “(vii) matches performed pursuant to section 6103(l)(12) of the Internal Revenue Code of 1986 and section 1144 of the Social Security Act;”. (d) Effective Date.— The amendments made by this section shall take effect on January 1, 1994.