[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3668 Enrolled Bill (ENR)]
H.R.3668
One Hundred Tenth Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Thursday,
the fourth day of January, two thousand and seven
An Act
To provide for the extension of transitional medical assistance (TMA),
the abstinence education program, and the qualifying individuals (QI)
program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``TMA, Abstinence Education, and QI
Programs Extension Act of 2007''.
SEC. 2. EXTENSION OF TRANSITIONAL MEDICAL ASSISTANCE (TMA) AND
ABSTINENCE EDUCATION PROGRAM THROUGH DECEMBER 31, 2007.
Section 401 of division B of the Tax Relief and Health Care Act of
2006 (Public Law 109-432), as amended by section 1 of Public Law 110-
48, is amended--
(1) by striking ``September 30'' and inserting ``December 31'';
(2) by striking ``for fiscal year 2006'' and inserting ``for
fiscal year 2007'';
(3) by striking ``the fourth quarter of fiscal year 2007'' and
inserting ``the first quarter of fiscal year 2008''; and
(4) by striking ``the fourth quarter of fiscal year 2006'' and
inserting ``the first quarter of fiscal year 2007''.
SEC. 3. EXTENSION OF QUALIFYING INDIVIDUAL (QI) PROGRAM THROUGH
DECEMBER 2007.
(a) Through December 2007.--Section 1902(a)(10)(E)(iv) of the
Social Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended by
striking ``September 2007'' and inserting ``December 2007''.
(b) Extending Total Amount Available for Allocation.--Section
1933(g) of such Act (42 U.S.C. 1396u-3(g)) is amended--
(1) in paragraph (2)--
(A) by striking ``and'' at the end of subparagraph (F);
(B) by striking the period at the end of subparagraph (G)
and inserting ``; and''; and
(C) by adding at the end the following new subparagraph:
``(H) for the period that begins on October 1, 2007, and
ends on December 31, 2007, the total allocation amount is
$100,000,000.''; and
(2) in paragraph (3), in the matter preceding subparagraph (A),
by striking ``or (F)'' and inserting ``(F), or (H)''.
(c) Effective Date.--The amendments made by this section shall be
effective as of September 30, 2007.
SEC. 4. EXTENSION OF SSI WEB-BASED ASSET DEMONSTRATION PROJECT TO THE
MEDICAID PROGRAM.
(a) In General.--Beginning on October 1, 2007, and ending on
September 30, 2012, the Secretary of Health and Human Services shall
provide for the application to asset eligibility determinations under
the Medicaid program under title XIX of the Social Security Act of the
automated, secure, web-based asset verification request and response
process being applied for determining eligibility for benefits under
the Supplemental Security Income (SSI) program under title XVI of such
Act under a demonstration project conducted under the authority of
section 1631(e)(1)(B)(ii) of such Act (42 U.S.C. 1383(e)(1)(B)(ii)).
(b) Limitation.--Such application shall only extend to those States
in which such demonstration project is operating and only for the
period in which such project is otherwise provided.
(c) Rules of Application.--For purposes of carrying out subsection
(a), notwithstanding any other provision of law, information obtained
from a financial institution that is used for purposes of eligibility
determinations under such demonstration project with respect to the
Secretary of Health and Human Services under the SSI program may also
be shared and used by States for purposes of eligibility determinations
under the Medicaid program. In applying section 1631(e)(1)(B)(ii) of
the Social Security Act under this subsection, references to the
Commissioner of Social Security and benefits under title XVI of such
Act shall be treated as including a reference to a State described in
subsection (b) and medical assistance under title XIX of such Act
provided by such a State.
SEC. 5. 6-MONTH DELAY IN REQUIREMENT TO USE TAMPER-RESISTANT
PRESCRIPTION PADS UNDER MEDICAID.
Effective as if included in the enactment of section 7002(b) of the
U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq
Accountability Appropriations Act, 2007 (Public Law 110-28, 121 Sta.
187), paragraph (2) of such section is amended by striking ``September
30, 2007'' and inserting ``March 31, 2008''.
SEC. 6. ADDITIONAL FUNDING FOR THE MEDICARE PHYSICIAN ASSISTANCE AND
QUALITY INITIATIVE FUND.
Section 1848(l)(2) of the Social Security Act (42 U.S.C. 1395w-
4(l)(2)) is amended--
(1) in subparagraph (A), by adding at the end the following:
``In addition, there shall be available to the Fund for
expenditures during 2009 an amount equal to $325,000,000 and for
expenditures during or after 2013 an amount equal to
$60,000,000.''; and
(2) in subparagraph (B)--
(A) in the heading, by striking ``furnished during 2008'';
(B) by striking ``specified in subparagraph (A)'' and
inserting ``specified in the first sentence of subparagraph
(A)''; and
(C) by inserting after ``furnished during 2008'' the
following: ``and for the obligation of the entire first amount
specified in the second sentence of such subparagraph for
payment with respect to physicians' services furnished during
2009 and of the entire second amount so specified for payment
with respect to physicians' services furnished on or after
January 1, 2013''.
SEC. 7. LIMITATION ON IMPLEMENTATION FOR FISCAL YEARS 2008 AND 2009 OF
A PROSPECTIVE DOCUMENTATION AND CODING ADJUSTMENT IN RESPONSE TO THE
IMPLEMENTATION OF THE MEDICARE SEVERITY DIAGNOSIS RELATED GROUP (MS-
DRG) SYSTEM UNDER THE MEDICARE PROSPECTIVE PAYMENT SYSTEM FOR INPATIENT
HOSPITAL SERVICES.
(a) In General.--In implementing the final rule published on August
22, 2007, on pages 47130 through 48175 of volume 72 of the Federal
Register, the Secretary of Health and Human Services (in this section
referred to as the ``Secretary'') shall apply prospective documentation
and coding adjustments (made in response to the implementation of a
Medicare Severity Diagnosis Related Group (MS-DRG) system under the
hospital inpatient prospective payment system under section 1886(d) of
the Social Security Act (42 U.S.C. 1395ww(d)) of--
(1) for discharges occurring during fiscal year 2008, 0.6
percent rather than the 1.2 percent specified in such final rule;
and
(2) for discharges occurring during fiscal year 2009, 0.9
percent rather than the 1.8 percent specified in such final rule.
(b) Subsequent Adjustments.--
(1) In general.--Notwithstanding any other provision of law, if
the Secretary determines that implementation of such Medicare
Severity Diagnosis Related Group (MS-DRG) system resulted in
changes in coding and classification that did not reflect real
changes in case mix under section 1886(d) of the Social Security
Act (42 U.S.C. 1395ww(d)) for discharges occurring during fiscal
year 2008 or 2009 that are different than the prospective
documentation and coding adjustments applied under subsection (a),
the Secretary shall--
(A) make an appropriate adjustment under paragraph
(3)(A)(vi) of such section 1886(d); and
(B) make an additional adjustment to the standardized
amounts under such section 1886(d) for discharges occurring
only during fiscal years 2010, 2011, and 2012 to offset the
estimated amount of the increase or decrease in aggregate
payments (including interest as determined by the Secretary)
determined, based upon a retrospective evaluation of claims
data submitted under such Medicare Severity Diagnosis Related
Group (MS-DRG) system, by the Secretary with respect to
discharges occurring during fiscal years 2008 and 2009.
(2) Requirement.--Any adjustment under paragraph (1)(B) shall
reflect the difference between the amount the Secretary estimates
that implementation of such Medicare Severity Diagnosis Related
Group (MS-DRG) system resulted in changes in coding and
classification that did not reflect real changes in case mix and
the prospective documentation and coding adjustments applied under
subsection (a). An adjustment made under paragraph (1)(B) for
discharges occurring in a year shall not be included in the
determination of standardized amounts for discharges occurring in a
subsequent year.
(3) Rule of construction.--Nothing in this section shall be
construed as--
(A) requiring the Secretary to adjust the average
standardized amounts under paragraph (3)(A)(vi) of such section
1886(d) other than as provided under this section; or
(B) providing authority to apply the adjustment under
paragraph (1)(B) other than for discharges occurring during
fiscal years 2010, 2011, and 2012.
(4) Judicial review.--There shall be no administrative or
judicial review under section 1878 of the Social Security Act (42
U.S.C. 1395oo) or otherwise of any determination or adjustments
made under this subsection.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.