[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3668 Received in Senate (RDS)]
1st Session
H. R. 3668
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 26, 2007
Received
_______________________________________________________________________
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.
Passed the House of Representatives September 26, 2007.
Attest:
LORRAINE C. MILLER,
Clerk.