113 HR 5098 IH: Ensuring Medicaid and Medicare Access to Providers Act U.S. House of Representatives 2014-07-14 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I 113th CONGRESS 2d Session H. R. 5098 IN THE HOUSE OF REPRESENTATIVES July 14, 2014 Mr. Daines introduced the following bill; which was referred to the Committee on Ways and Means A BILL To amend the Internal Revenue Code of 1986 to temporarily exempt from the employer health insurance mandate certain Medicare and Medicaid providers.

1.

Short title

This Act may be cited as the Ensuring Medicaid and Medicare Access to Providers Act.

2.

Certain Medicare and Medicaid providers temporarily exempt from employer health insurance mandate

(a)

In general

Section 4980H(c)(2) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph: (F)

Exception for certain Medicare and Medicaid providers

(i)

In general

In the case of any month beginning in 2014 or 2015, the term applicable large employer shall not include any employer who is a specified Medicare and Medicaid provider with respect to the calendar year in which such month begins. (ii)

Specified Medicare and Medicaid provider

The term specified Medicare and Medicaid provider means, with respect to any calendar year, any employer if the total specified Medicare and Medicaid payments received by such employer during the applicable period equals or exceeds 60 percent of the total gross receipts of such employer for such period. (iii)

Specified Medicare and Medicaid payments

The term specified Medicare and Medicaid payments means— (I)any payment made to the employer under title XIX of the Social Security Act for the furnishing of items and services included as medical assistance (as defined in section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a))) under such title, and (II)any payment made to the employer under title XVIII of such Act for the furnishing of items and services to individuals entitled to benefits under part A of such title or enrolled under part B of such title, including dual eligible individuals (as defined in section 1915(h)(2)(B) of such Act (42 U.S.C. 1396n(h)(2)(B))). (iv)

Treatment of payment for items and services furnished through a health plan

In applying clause (iii) with respect to the payment for items and services furnished to individuals enrolled in a health plan under a contract under title XVIII or XIX of the Social Security Act, payment for such items and services under such plan shall be treated as payment under such respective title. (v)

Applicable period

(I)

In general

For purposes of this subparagraph, the term applicable period means, with respect to any calendar year, the 3 taxable years ending before the beginning of such calendar year. (II)

Application of certain rules

Rules similar to the rules of subparagraphs (A), (C), and (D) of section 448(c)(3) shall apply for purposes of this clause. (III)

Special rule for first taxable year of existence

In the case of an employer no taxable year of which ends before the beginning of the calendar year, the applicable period for such calendar year shall be the period beginning on the date that such employer came into existence and ending with the close of such calendar year. . (b)

Effective date

The amendment made by this section shall apply to months beginning after December 31, 2013.