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HR 4077 114th Congress House

Medicare Established Provider Act of 2015

Official title: To amend title XVIII of the Social Security Act to provide for a Medicare established provider system under which providers of services and suppliers represent… Show full official titleShow less

Official title: To amend title XVIII of the Social Security Act to provide for a Medicare established provider system under which providers of services and suppliers representing a low risk for submitting fraudulent Medicare claims are provided certain claim review protections.

Introduced: November 18, 2015 Introduced by: Williams, Roger Republican · Texas See on congress.gov
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This bill died when the 114th Congress ended
It never became law before the 114th Congress (2015–2016) adjourned, and bills don't carry over to the next Congress. It would have to be reintroduced. You can still save it for reference, but it won't receive updates.
 Everywhere this bill has been 4 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Nov 20, 2015
Referred to the Subcommittee on Health.
Nov 18, 2015
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Nov 18, 2015
Referred to the Subcommittee on Health.
Nov 18, 2015
Introduced in House
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 Latest action November 20, 2015

Referred to the Subcommittee on Health.

 Plain-English summary Congressional Research Service

Medicare Established Provider Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to direct the Department of Health and Human Services (HHS) to develop a system for designating providers that represent a low risk of submitting fraudulent Medicare claims as "established providers" for purposes of applying for special treatment in the claim review process.

To qualify as an established provider, a provider must demonstrate that, within a specified timeframe: (1) at least 90% of Medicare claims submitted by the provider were determined to be eligible for full or partial payment, and (2) the provider appealed at least 90% of all Medicare claims that were not initially determined to be eligible for payment.

HHS may withhold payment for a Medicare claim made by an established provider only if a final determination has been made that the claim is ineligible for payment. If such a final determination is made, the provider shall repay such payment electronically and within a specified timeframe.

 Bill text 1 version

Source documents hosted by congress.gov.

 Committees of jurisdiction 4
 Cosponsors 2
All 2 Republican 1
R
Scott, Austin
Georgia · Nov 18, 2015
THORNBERRY, WILLIAM
· Nov 18, 2015
Cite this page click to expand
APA
U.S. Congress. (2026). H.R. 4077: Medicare Established Provider Act of 2015. 114th Congress. Open America. https://openamerica.io/bill/114-HR-4077/
MLA
"H.R. 4077: Medicare Established Provider Act of 2015." 114th Congress, 2026, Open America, https://openamerica.io/bill/114-HR-4077/.
Bluebook (legal)
H.R. 4077, 114th Cong. (2026), https://openamerica.io/bill/114-HR-4077/.
Markdown link
[H.R. 4077: Medicare Established Provider Act of 2015](https://openamerica.io/bill/114-HR-4077/)
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