SEC. 1221. ENSURING EFFECTIVE COMMUNICATION IN MEDICARE.

[a] Ensuring Effective Communication by the Centers for Medicare & Medicaid Services-

[1] STUDY ON MEDICARE PAYMENTS FOR LANGUAGE SERVICES- The Secretary of Health and Human Services shall conduct a study that examines the extent to which Medicare service providers utilize, offer, or make available language services for beneficiaries who are limited English proficient and ways that Medicare should develop payment systems for language services.

[2] ANALYSES- The study shall include an analysis of each of the following:

[A] How to develop and structure appropriate payment systems for language services for all Medicare service providers.

[B] The feasibility of adopting a payment methodology for on-site interpreters, including interpreters who work as independent contractors and interpreters who work for agencies that provide on-site interpretation, pursuant to which such interpreters could directly bill Medicare for services provided in support of physician office services for an LEP Medicare patient.

[C] The feasibility of Medicare contracting directly with agencies that provide off-site interpretation including telephonic and video interpretation pursuant to which such contractors could directly bill Medicare for the services provided in support of physician office services for an LEP Medicare patient.

[D] The feasibility of modifying the existing Medicare resource-based relative value scale [RBRVS] by using adjustments [such as multipliers or add-ons] when a patient is LEP.

[E] How each of options described in a previous paragraph would be funded and how such funding would affect physician payments, a physician's practice, and beneficiary cost-sharing.

[F] The extent to which providers under parts A and B of title XVIII of the Social Security Act, MA organizations offering Medicare Advantage plans under part C of such title and PDP sponsors of a prescription drug plan under part D of such title utilize, offer, or make available language services for beneficiaries with limited English proficiency.

[G] The nature and type of language services provided by States under title XIX of the Social Security Act and the extent to which such services could be utilized by beneficiaries and providers under title XVIII of such Act.

[3] VARIATION IN PAYMENT SYSTEM DESCRIBED- The payment systems described in paragraph [2][A] may allow variations based upon types of service providers, available delivery methods, and costs for providing language services including such factors as--

[A] the type of language services provided [such as provision of health care or health care related services directly in a non-English language by a bilingual provider or use of an interpreter];

[B] type of interpretation services provided [such as in-person, telephonic, video interpretation];

[C] the methods and costs of providing language services [including the costs of providing language services with internal staff or through contract with external independent contractors or agencies, or both];

[D] providing services for languages not frequently encountered in the United States; and

[E] providing services in rural areas.

[4] REPORT- The Secretary shall submit a report on the study conducted under subsection [a] to appropriate committees of Congress not later than 12 months after the date of the enactment of this Act.

[5] EXEMPTION FROM PAPERWORK REDUCTION ACT- Chapter 35 of title 44, United States Code [commonly known as the 'Paperwork Reduction Act'], shall not apply for purposes of carrying out this subsection.

[6] AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated to carry out this subsection such sums as are necessary.

[b] Health Plans- Section- 1857[g][1] of the Social Security Act [42 U.S.C. 1395w-27[g][1]] is amended--

[1] by striking 'or' at the end of subparagraph [F];

[2] by adding 'or' at the end of subparagraph [G]; and

[3] by inserting after subparagraph [G] the following new subparagraph:

'[H] fails substantially to provide language services to limited English proficient beneficiaries enrolled in the plan that are required under law;'.