[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.