[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2962 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 2962

 To amend title XVIII of the Social Security Act to provide for a wrap-
 around payment under the Medicare Program for community health center 
    services to account for reductions in payments attributable to 
             individuals covered under managed care plans.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 8, 1997

 Mr. Rangel (for himself and Mr. Stark) introduced the following bill; 
which was referred to the Committee on Commerce, and in addition to the 
Committee on Ways and Means, 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

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to provide for a wrap-
 around payment under the Medicare Program for community health center 
    services to account for reductions in payments attributable to 
             individuals covered under managed care plans.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. WRAP-AROUND PAYMENT FOR COMMUNITY HEALTH CENTERS [AND RURAL 
              HEALTH CLINICS] UNDER THE MEDICARE PROGRAM.

    (a) In General.--Section 1833(a)(3) of the Social Security Act (42 
U.S.C. 1395l(a)(3)) is amended--
            (1) by inserting ``(A)'' after ``(3)'';
            (2) by inserting ``other than services described in 
        subparagraph (B)'' after ``1832(a)(2)(D)'';
            (3) by adding at the end the following:
            ``(B) in the case of services described in section 
        1832(a)(2)(D) furnished to an individual enrolled with an 
        eligible organization under a risk-sharing contract under 
        section 1876 or Medicare+Choice organization under part C 
        pursuant to a subcontract or participation agreement with the 
        organization, an amount (if any) by which the amount of payment 
        that would have been provided under subparagraph (A) with 
        respect to the services if the individual had not been so 
        enrolled and the amount of the payments provided under such 
        contract with respect to such services;''.
    (b) Conforming Amendment to Contract Requirement.--
            (1) In general.--Section 1857(e) of the Social Security Act 
        (42 U.S.C. 1395w-27(e)) is amended by adding at the end the 
        following:
            ``(3) Nondiscrimination in payment for center services.--
        The contract shall provide that in the case of a 
        Medicare+Choice organization that has entered into a contract 
        with a center or clinic for the provision of services described 
        in section 1832(a)(2)(D), that the organization shall provide 
        payment that is not less than the level and amount of payment 
        which the organization would make for the services if the 
        services were furnished by a provider which is not a Federally-
        qualified health center or a rural health clinic;''.
            (2) Application to eligible organizations.--Section 
        1876(k)(4) of such Act (42 U.S.C. 1395mm(k)(4)) is amended by 
        adding at the end the following:
            ``(E) The requirement of nondiscrimination in payment for 
        center and clinic services under section 1857(e)(3).''.
            (3) Additional conforming amendments.--
                    (A) Section 1851(i)(1) of such Act (42 U.S.C. 
                1395w-21(i)(1)) is amended by inserting ``1857(e)(3),'' 
                after ``1853(h),''.
                    (B) Section 1876(a)(3) of such Act (42 U.S.C. 
                1395mm(a)(3)) is amended by striking ``and (c)(7)'' and 
                inserting ``(c)(7), and (k)(4)(E)''.
    (c) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after October 1, 1999.
                                 <all>