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<bill bill-stage="Engrossed-in-Senate" bill-type="olc" dms-id="A1" public-print="no" public-private="public" stage-count="1" star-print="no-star-print">
	<form display="yes">
		<congress display="yes">110th CONGRESS</congress>
		<session display="yes">1st Session</session>
		<legis-num display="yes">S. 2499</legis-num>
		<current-chamber display="no">IN THE SENATE OF THE UNITED
		  STATES</current-chamber>
		<legis-type display="yes">AN ACT</legis-type>
		<official-title display="yes">To amend titles XVIII, XIX, and XXI of the
		  Social Security Act to extend provisions under the Medicare, Medicaid, and
		  SCHIP programs, and for other purposes.</official-title>
	</form>
	<legis-body display-enacting-clause="yes-display-enacting-clause" style="OLC">
		<section commented="no" display-inline="no-display-inline" id="S1" section-type="section-one"><enum>1.</enum><header display-inline="yes-display-inline">Short title; table of contents</header>
			<subsection commented="no" display-inline="no-display-inline" id="id5EF2F9C483264FFC89B21FA5C4C97A22"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">This Act may be cited as the
			 <quote><short-title>Medicare, Medicaid, and SCHIP
			 Extension Act of 2007</short-title></quote>.</text>
			</subsection><subsection commented="no" display-inline="no-display-inline" id="idFD720DD066C1454AADFA3BE0A93AF049"><enum>(b)</enum><header display-inline="yes-display-inline">Table of contents</header><text display-inline="yes-display-inline">The table of contents of this Act is as
			 follows:</text>
				<toc>
					<toc-entry bold="off" idref="S1" level="section">Sec. 1. Short title;
				table of contents.</toc-entry>
					<toc-entry bold="off" idref="id5DA05C3BE8B44363AFF7A330FDC2DBE9" level="title">TITLE I—Medicare</toc-entry>
					<toc-entry bold="off" idref="H0BD1C61FECC54F2CBF2D0300354D2323" level="section">Sec. 101. Increase in
				physician payment update; extension of the physician quality reporting
				system.</toc-entry>
					<toc-entry bold="off" idref="HA9B31C9F1B9E41AD8C930600008CD58F" level="section">Sec. 102. Extension
				of Medicare incentive payment program for physician scarcity areas.</toc-entry>
					<toc-entry bold="off" idref="H7C6BF9A6A0954ACFA38C097EE3AD5E5D" level="section">Sec. 103. Extension
				of floor on work geographic adjustment under the Medicare physician fee
				schedule.</toc-entry>
					<toc-entry bold="off" idref="IDB4F6FB08B8FB4763AF28883C6819D5F2" level="section">Sec. 104. Extension of treatment of certain physician pathology
				services under Medicare.</toc-entry>
					<toc-entry bold="off" idref="id5E445FF0FB9247DB8B1B318ACE6DE9D5" level="section">Sec. 105. Extension of exceptions process for Medicare therapy
				caps.</toc-entry>
					<toc-entry bold="off" idref="idD31A9507CD944285B702653BAF1D7057" level="section">Sec. 106. Extension of payment rule for brachytherapy;
				extension to therapeutic radiopharmaceuticals.</toc-entry>
					<toc-entry bold="off" idref="id9E8FB1807F134B7AAC2E03BBBFE100B1" level="section">Sec. 107. Extension of Medicare reasonable costs payments for
				certain clinical diagnostic laboratory tests furnished to hospital patients in
				certain rural areas.</toc-entry>
					<toc-entry bold="off" idref="id58FFAF432C8E42419B0F86D00FBC3141" level="section">Sec. 108. Extension of authority of specialized Medicare
				Advantage plans for special needs individuals to restrict
				enrollment.</toc-entry>
					<toc-entry bold="off" idref="idBEFCD4ADBCDF4DFCBC9837A69265B77C" level="section">Sec. 109. Extension of deadline for application of limitation
				on extension or renewal of Medicare reasonable cost contract plans.</toc-entry>
					<toc-entry bold="off" idref="HA6BE9C2E325B4BF0A64034D17768DDB8" level="section">Sec. 110. Adjustment
				to the Medicare Advantage stabilization fund.</toc-entry>
					<toc-entry bold="off" idref="H5CE6D9B4B09F45BD8091CC777FEBB97" level="section">Sec. 111. Medicare secondary payor.</toc-entry>
					<toc-entry bold="off" idref="H96D2E3DC4A914D72A048FD3BABFEABDE" level="section">Sec. 112. Payment for
				part B drugs.</toc-entry>
					<toc-entry bold="off" idref="H8D3D680BE81D46158276BE3D56D33E1C" level="section">Sec. 113. Payment
				rate for certain diagnostic laboratory tests.</toc-entry>
					<toc-entry bold="off" idref="H602663D9710C4444BD064808A21BFCB" level="section">Sec. 114. Long-term care hospitals.</toc-entry>
					<toc-entry bold="off" idref="HCB928EAB5E7941EEAAF065316364AA1E" level="section">Sec. 115. Payment for
				inpatient rehabilitation facility (IRF) services.</toc-entry>
					<toc-entry bold="off" idref="H81CEF34DA978412996712F389B380465" level="section">Sec. 116. Extension
				of accommodation of physicians ordered to active duty in the Armed
				Services.</toc-entry>
					<toc-entry bold="off" idref="H0B0550F964294956A8A58550F28C16F" level="section">Sec. 117. Treatment of certain hospitals.</toc-entry>
					<toc-entry bold="off" idref="idD50A6D5D1CF54775BF79942B33013F1D" level="section">Sec. 118. Additional Funding for State Health Insurance
				Assistance Programs, Area Agencies on Aging, and Aging and Disability Resource
				Centers.</toc-entry>
					<toc-entry bold="off" idref="id6C7184B6049C4A1EBE83927118204214" level="title">TITLE II—Medicaid and SCHIP</toc-entry>
					<toc-entry bold="off" idref="H32C280AEFA5A416F8FCCC4D842C3C542" level="section">Sec. 201. Extending
				SCHIP funding through March 31, 2009.</toc-entry>
					<toc-entry bold="off" idref="H4308253E655749828F119CCDC65EC8FE" level="section">Sec. 202. Extension
				of transitional medical assistance (TMA) and abstinence education
				program.</toc-entry>
					<toc-entry bold="off" idref="H8C90C2499662434E84948B6959E24942" level="section">Sec. 203. Extension
				of qualifying individual (QI) program.</toc-entry>
					<toc-entry bold="off" idref="HC8808302347C" level="section">Sec. 204.
				Medicaid DSH extension.</toc-entry>
					<toc-entry bold="off" idref="HB999D96FC99F421C8033239500FB1373" level="section">Sec. 205. Improving
				data collection.</toc-entry>
					<toc-entry bold="off" idref="HCEAF4191D3A64C0EAC9E445B010047D2" level="section">Sec. 206. Moratorium
				on certain payment restrictions.</toc-entry>
					<toc-entry bold="off" idref="id314BA201933142E9900066D7B1C2130F" level="title">TITLE III—Miscellaneous</toc-entry>
					<toc-entry bold="off" idref="id3197D6A88EFC4DA8AB0E74160B1CCAB8" level="section">Sec. 301. Medicare Payment Advisory Commission
				status.</toc-entry>
					<toc-entry bold="off" idref="IDE81560453319427CB39FA6E5A9EE8DC1" level="section">Sec. 302. Special Diabetes Programs for Type I Diabetes and
				Indians.</toc-entry>
				</toc>
			</subsection></section><title commented="no" id="id5DA05C3BE8B44363AFF7A330FDC2DBE9" level-type="subsequent"><enum>I</enum><header display-inline="yes-display-inline">Medicare</header>
			<section commented="no" display-inline="no-display-inline" id="H0BD1C61FECC54F2CBF2D0300354D2323" section-type="subsequent-section"><enum>101.</enum><header display-inline="yes-display-inline">Increase in physician payment update;
			 extension of the physician quality reporting system</header>
				<subsection commented="no" display-inline="no-display-inline" id="id6FB45011F3A24604884BD094FD7F46E9"><enum>(a)</enum><header display-inline="yes-display-inline">Increase in physician payment
			 update</header>
					<paragraph commented="no" display-inline="no-display-inline" id="id535229D2B73A40C78CB68A01ABC4CCD4"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1848(d) of the
			 <act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
			 1395w–4(d)) is amended—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="id57F2012D64E843E4835F597BD802F286"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (4)(B), by striking <quote>and
			 paragraphs (5) and (6)</quote> and inserting <quote>and the succeeding
			 paragraphs of this subsection</quote>; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id3D0905B0C5E9450C8493A97865437C02"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 paragraph:</text>
							<quoted-block display-inline="no-display-inline" id="H83F46070F12349FBAC7941F91428D1DB" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="HE5E9EDB745A34D268D85A1AD6D9800C4"><enum>(8)</enum><header display-inline="yes-display-inline">Update for a portion of 2008</header>
									<subparagraph commented="no" display-inline="no-display-inline" id="idD45C1183B94D4469B6F14243CDF849CB"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subject to paragraph (7)(B), in lieu of the
				update to the single conversion factor established in paragraph (1)(C) that
				would otherwise apply for 2008, for the period beginning on January 1, 2008,
				and ending on June 30, 2008, the update to the single conversion factor shall
				be 0.5 percent.</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID33530AAF5F3C43C8AF955EBD0E6BC0C9"><enum>(B)</enum><header display-inline="yes-display-inline">No effect on computation of conversion
				factor for the remaining portion of 2008 and 2009</header><text display-inline="yes-display-inline">The conversion factor under this subsection
				shall be computed under paragraph (1)(A) for the period beginning on July 1,
				2008, and ending on December 31, 2008, and for 2009 and subsequent years as if
				subparagraph (A) had never
				applied.</text>
									</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3532325F3B1742AB00B31AC6CEC042F"><enum>(2)</enum><header display-inline="yes-display-inline">Revision of the Physician Assistance and
			 Quality Initiative Fund</header>
						<subparagraph commented="no" display-inline="no-display-inline" id="id99009DC9264E499DAE2C966295F1E2AE"><enum>(A)</enum><header display-inline="yes-display-inline">Revision</header><text display-inline="yes-display-inline">Section 1848(l)(2) of the Social Security
			 Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4(l)(2)</external-xref>) is amended—</text>
							<clause commented="no" display-inline="no-display-inline" id="id2C4D0371608849B1A7AD574A95DAFBAC"><enum>(i)</enum><text display-inline="yes-display-inline">by striking subparagraph (A) and inserting
			 the following:</text>
								<quoted-block display-inline="no-display-inline" id="idA2239984FAF9418C8AF79753BCFCE6C6" style="OLC">
									<subparagraph commented="no" display-inline="no-display-inline" id="id0B9B399E350E4C5D8EF1E2A8E7218F7D"><enum>(A)</enum><header display-inline="yes-display-inline">Amount available</header>
										<clause commented="no" display-inline="no-display-inline" id="id9035002959854879AA56003DE3D9E429"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subject to clause (ii), there shall be
				available to the Fund the following amounts:</text>
											<subclause commented="no" display-inline="no-display-inline" id="id005B6932887D46DBB92BABDD34267770"><enum>(I)</enum><text display-inline="yes-display-inline">For expenditures during 2008, an amount
				equal to $150,500,000.</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="id1F253A85FB504F8B9D0FE81BAB5B3D00"><enum>(II)</enum><text display-inline="yes-display-inline">For expenditures during 2009, an amount
				equal to $24,500,000.</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="id96B79A6666874B42BE25AD9DFECD6C9B"><enum>(III)</enum><text display-inline="yes-display-inline">For expenditures during 2013, an amount
				equal to $4,960,000,000.</text>
											</subclause></clause><clause commented="no" display-inline="no-display-inline" id="idCE43358E6B204A559F9811046CF4B7AF"><enum>(ii)</enum><header display-inline="yes-display-inline">Limitations on expenditures</header>
											<subclause commented="no" display-inline="no-display-inline" id="idFAA25694700147ADB94CC4E65DE0C47B"><enum>(I)</enum><header display-inline="yes-display-inline">2008</header><text display-inline="yes-display-inline">The amount available for expenditures
				during 2008 shall be reduced as provided by subparagraph (A) of section
				225(c)(1) and section 524 of the Departments of Labor, Health and Human
				Services, and Education, and Related Agencies Appropriations Act, 2008
				(division G of the Consolidated Appropriations Act, 2008).</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="idEC1330E466D04C748843191378B6A248"><enum>(II)</enum><header display-inline="yes-display-inline">2009</header><text display-inline="yes-display-inline">The amount available for expenditures
				during 2009 shall be reduced as provided by subparagraph (B) of such section
				225(c)(1).</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="idE71885B0250741F39596D6285C147CE6"><enum>(III)</enum><header display-inline="yes-display-inline">2013</header><text display-inline="yes-display-inline">The amount available for expenditures
				during 2013 shall only be available for an adjustment to the update of the
				conversion factor under subsection (d) for that
				year.</text>
											</subclause></clause></subparagraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</clause><clause commented="no" display-inline="no-display-inline" id="idE7E21923CFE04A8C87F5211CC42B3511"><enum>(ii)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking
			 <quote>entire amount specified in the first sentence of subparagraph
			 (A)</quote> and all that follows and inserting the following: “entire amount
			 available for expenditures, after application of subparagraph (A)(ii),
			 during—</text>
								<quoted-block display-inline="no-display-inline" id="idF0F057F33ABB4F3897145BCB3D9211C8" style="OLC">
									<clause commented="no" display-inline="no-display-inline" id="id2BBC0B1D72614F34879E092B5857B0C2"><enum>(i)</enum><text display-inline="yes-display-inline">2008 for payment with respect to
				physicians' services furnished during 2008;</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="id3CFA8DF85A2E48A19D1AC9910A90018B"><enum>(ii)</enum><text display-inline="yes-display-inline">2009 for payment with respect to
				physicians' services furnished during 2009; and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="idE0C3198AAD9543D796831D9866631782"><enum>(iii)</enum><text display-inline="yes-display-inline">2013 for payment with respect to
				physicians' services furnished during
				2013.</text>
									</clause><after-quoted-block>.</after-quoted-block></quoted-block>
							</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idCBF6F846067E45BFA62BE3EECC5C490E"><enum>(B)</enum><header display-inline="yes-display-inline">Effective Date</header>
							<clause commented="no" display-inline="no-display-inline" id="id2D5CE03867E34419BB0A1133B267B111"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subject to clause (ii), the amendments made
			 by subparagraph (A) shall take effect on the date of the enactment of this
			 Act.</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="idFBCCAF2887194F10ADB00C36C7555A5E"><enum>(ii)</enum><header display-inline="yes-display-inline">Special rule for coordination with
			 Consolidated Appropriations Act, 2008</header><text display-inline="yes-display-inline">If the date of the enactment of the
			 Consolidated Appropriations Act, 2008, occurs on or after the date described in
			 clause (i), the amendments made by subparagraph (A) shall be deemed to be made
			 on the day after the effective date of sections 225(c)(1) and 524 of the
			 Departments of Labor, Health and Human Services, and Education, and Related
			 Agencies Appropriations Act, 2008 (division G of the Consolidated
			 Appropriations Act, 2008).</text>
							</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF9338752BB5945BABED675A740FCABD"><enum>(C)</enum><header display-inline="yes-display-inline">Transfer of funds to part B trust
			 fund</header><text display-inline="yes-display-inline">Amounts that would have
			 been available to the Physician Assistance and Quality Initiative Fund under
			 section 1848(l)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4(l)(2)</external-xref>) for
			 payment with respect to physicians' services furnished prior to January 1,
			 2013, but for the amendments made by subparagraph (A), shall be deposited into,
			 and made available for expenditures from, the Federal Supplementary Medical
			 Insurance Trust Fund under section 1841 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395t">42 U.S.C. 1395t</external-xref>).</text>
						</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id3703D12BA86C4890B17E14CA7D09F51E"><enum>(b)</enum><header display-inline="yes-display-inline">Extension of the physician quality
			 reporting system</header>
					<paragraph commented="no" display-inline="no-display-inline" id="idBE54AC3FDC8F47E4874B2F8C038D674A"><enum>(1)</enum><header display-inline="yes-display-inline">System</header><text display-inline="yes-display-inline">Section 1848(k)(2)(B) of the Social
			 Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4(k)(2)(B)</external-xref>) is amended—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="idDC9335730F4D4950AF4489F2D8C4039E"><enum>(A)</enum><text display-inline="yes-display-inline">in the heading, by inserting
			 <quote><header-in-text level="subparagraph" style="OLC">and
			 2009</header-in-text></quote> after <quote><header-in-text level="subparagraph" style="OLC">2008</header-in-text></quote>;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id95C2F2F311C94BF797029234BD81E488"><enum>(B)</enum><text display-inline="yes-display-inline">in clause (i), by inserting <quote>and
			 2009</quote> after <quote>2008</quote>; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id4CBBEAF3FF23481088BA8C1502262B89"><enum>(C)</enum><text display-inline="yes-display-inline">in each of clauses (ii) and (iii)—</text>
							<clause commented="no" display-inline="no-display-inline" id="idAE265718D85D4323BD37FE712645AFEA"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>, 2007</quote> and
			 inserting <quote>of each of 2007 and 2008</quote>; and</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="id0815594A46984D23B0078D16ACF15D87"><enum>(ii)</enum><text display-inline="yes-display-inline">by inserting <quote>or 2009, as
			 applicable</quote> after <quote>2008</quote>.</text>
							</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id3C49EB75A373478386746D244030B61F"><enum>(2)</enum><header display-inline="yes-display-inline">Reporting</header><text display-inline="yes-display-inline">Section 101(c) of division B of the Tax
			 Relief and Health Care Act of 2006 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4</external-xref> note) is amended—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="id63132E6653BF453C878AA58B91A650E1"><enum>(A)</enum><text display-inline="yes-display-inline">in the heading, by inserting
			 <quote><header-in-text level="subsection" style="OLC">and
			 2008</header-in-text></quote> after <quote><header-in-text level="subsection" style="OLC">2007</header-in-text></quote>;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idD373446121C84BDF9D896AF724F755E8"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (5), by adding at the end the
			 following:</text>
							<quoted-block display-inline="no-display-inline" id="idCBA63E9FAC1545B58100D44D90F90C8D" style="OLC">
								<subparagraph commented="no" display-inline="no-display-inline" id="idC0312AC167924EA5B5508D1AA4AD0220"><enum>(F)</enum><header display-inline="yes-display-inline">Extension</header><text display-inline="yes-display-inline">For 2008 and 2009, paragraph (3) shall not
				apply, and the Secretary shall establish alternative criteria for
				satisfactorily reporting under paragraph (2) and alternative reporting periods
				under paragraph (6)(C) for reporting groups of measures under paragraph (2)(B)
				of section 1848(k) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4(k)</external-xref>) and for
				reporting using the method specified in paragraph (4) of such
				section.</text>
								</subparagraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id61217048E30848C8A6C7DCA3DB291A39"><enum>(C)</enum><text display-inline="yes-display-inline">in paragraph (6), by striking subparagraph
			 (C) and inserting the following new subparagraph:</text>
							<quoted-block display-inline="no-display-inline" id="id14C7D483B7B843FBBD12D5FC36722E37" style="OLC">
								<subparagraph commented="no" display-inline="no-display-inline" id="id9DACC20096184A7AB7BAFE212DF99F91"><enum>(C)</enum><header display-inline="yes-display-inline">Reporting period</header><text display-inline="yes-display-inline">The term <quote>reporting period</quote>
				means—</text>
									<clause commented="no" display-inline="no-display-inline" id="idFE5CBA6B53734893AE429E8C62766369"><enum>(i)</enum><text display-inline="yes-display-inline">for 2007, the period beginning on July 1,
				2007, and ending on December 31, 2007; and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="id6A117F69E3D84C68AC20CDD0E6E026C6"><enum>(ii)</enum><text display-inline="yes-display-inline">for 2008, all of
				2008.</text>
									</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id09B781E077EA49E6AACE5112BAB06903"><enum>(c)</enum><header display-inline="yes-display-inline">Implementation</header><text display-inline="yes-display-inline">For purposes of carrying out the provisions
			 of, and amendments made by subsections (a) and (b), in addition to any amounts
			 otherwise provided in this title, there are appropriated to the Centers for
			 Medicare &amp; Medicaid Services Program Management Account, out of any money
			 in the Treasury not otherwise appropriated, $25,000,000 for the period of
			 fiscal years 2008 and 2009.</text>
				</subsection></section><section commented="no" display-inline="no-display-inline" id="HA9B31C9F1B9E41AD8C930600008CD58F" section-type="subsequent-section"><enum>102.</enum><header display-inline="yes-display-inline">Extension of Medicare incentive payment
			 program for physician scarcity areas</header><text display-inline="no-display-inline">Section 1833(u) of the Social Security Act
			 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(u)</external-xref>) is amended—</text>
				<paragraph commented="no" display-inline="no-display-inline" id="idBC23D2BFF2B047059A0922618DE041A5"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1), by striking <quote>before
			 January 1, 2008</quote> and inserting <quote>before July 1, 2008</quote>;
			 and</text>
				</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id1FD1D9B22C7447FD8A475464F59887C4"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (4)—</text>
					<subparagraph commented="no" display-inline="no-display-inline" id="idB8237649EF074F5588911850FDEC4754"><enum>(A)</enum><text display-inline="yes-display-inline">by redesignating subparagraph (D) as
			 subparagraph (E); and</text>
					</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idE0986B8CF1684F3C8CE82293C38328FE"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting after subparagraph (C) the
			 following new subparagraph:</text>
						<quoted-block display-inline="no-display-inline" id="id375E3EEE74924D2FABDC0FCED844CA0B" style="OLC">
							<subparagraph commented="no" display-inline="no-display-inline" id="id5D52EC10BAB64CDCACD9E8ED73573233"><enum>(D)</enum><header display-inline="yes-display-inline">Special rule</header><text display-inline="yes-display-inline">With respect to physicians' services
				furnished on or after January 1, 2008, and before July 1, 2008, for purposes of
				this subsection, the Secretary shall use the primary care scarcity counties and
				the specialty care scarcity counties (as identified under the preceding
				provisions of this paragraph) that the Secretary was using under this
				subsection with respect to physicians' services furnished on December 31,
				2007.</text>
							</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</subparagraph></paragraph></section><section commented="no" display-inline="no-display-inline" id="H7C6BF9A6A0954ACFA38C097EE3AD5E5D" section-type="subsequent-section"><enum>103.</enum><header display-inline="yes-display-inline">Extension of floor on work geographic
			 adjustment under the Medicare physician fee schedule</header><text display-inline="no-display-inline">Section 1848(e)(1)(E) of the Social Security
			 Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4(e)(1)(E)</external-xref>), as amended by section 102 of division B of
			 the Tax Relief and Health Care Act of 2006, is amended by striking
			 <quote>before January 1, 2008</quote> and inserting <quote>before July 1,
			 2008</quote>.</text>
			</section><section commented="no" display-inline="no-display-inline" id="IDB4F6FB08B8FB4763AF28883C6819D5F2" section-type="subsequent-section"><enum>104.</enum><header display-inline="yes-display-inline">Extension of treatment of certain physician
			 pathology services under Medicare</header><text display-inline="no-display-inline">Section 542(c) of the Medicare, Medicaid,
			 and SCHIP Benefits Improvement and Protection Act of 2000 (as enacted into law
			 by section 1(a)(6) of <external-xref legal-doc="public-law" parsable-cite="pl/106/554">Public Law 106–554</external-xref>), as amended by section 732 of the
			 Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (42
			 U.S.C. 1395w–4 note) and section 104 of division B of the Tax Relief and Health
			 Care Act of 2006 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4</external-xref> note), is amended by striking <quote>and
			 2007</quote> and inserting <quote>2007, and the first 6 months of
			 2008</quote>.</text>
			</section><section commented="no" display-inline="no-display-inline" id="id5E445FF0FB9247DB8B1B318ACE6DE9D5" section-type="subsequent-section"><enum>105.</enum><header display-inline="yes-display-inline">Extension of exceptions process for
			 Medicare therapy caps</header><text display-inline="no-display-inline">Section
			 1833(g)(5) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(g)(5)</external-xref>) is amended by
			 striking <quote>December 31, 2007</quote> and inserting <quote>June 30,
			 2008</quote>.</text>
			</section><section commented="no" display-inline="no-display-inline" id="idD31A9507CD944285B702653BAF1D7057" section-type="subsequent-section"><enum>106.</enum><header display-inline="yes-display-inline">Extension of payment rule for
			 brachytherapy; extension to therapeutic radiopharmaceuticals</header>
				<subsection commented="no" display-inline="no-display-inline" id="id169094046E9F4038AE37E7031F90D86F"><enum>(a)</enum><header display-inline="yes-display-inline">Extension of payment rule for
			 brachytherapy</header><text display-inline="yes-display-inline">Section
			 1833(t)(16)(C) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(t)(16)(C)</external-xref>), as
			 amended by section 107(a) of division B of the Tax Relief and Health Care Act
			 of 2006, is amended by striking <quote>January 1, 2008</quote> and inserting
			 <quote>July 1, 2008</quote>.</text>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="id52B704BD66344444818D9FD4192C6368"><enum>(b)</enum><header display-inline="yes-display-inline">Payment for therapeutic
			 radiopharmaceuticals</header><text display-inline="yes-display-inline">Section
			 1833(t)(16)(C) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(t)(16)(C)</external-xref>), as
			 amended by subsection (a), is amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="id119717C71C1A4A0EB05E63F355210D4E"><enum>(1)</enum><text display-inline="yes-display-inline">in the heading, by inserting
			 <quote><header-in-text level="subparagraph" style="OLC">and therapeutic
			 radiopharmaceuticals</header-in-text></quote> before <quote><header-in-text level="subparagraph" style="OLC">at charges</header-in-text></quote>;</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id976D233C87D64DD590EF76ED9510DDE5"><enum>(2)</enum><text display-inline="yes-display-inline">in the first sentence—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="idCB8876D7D4DD4455A8B635E8D7E9DB13"><enum>(A)</enum><text display-inline="yes-display-inline">by inserting <quote>and for therapeutic
			 radiopharmaceuticals furnished on or after January 1, 2008, and before July 1,
			 2008,</quote> after <quote>July 1, 2008,</quote>;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idE584FFBD6B91457789E259338C45FBE0"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting <quote>or therapeutic
			 radiopharmaceutical</quote> after <quote>the device</quote>; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id871FA41FE57B43709A3B8BD565585DE4"><enum>(C)</enum><text display-inline="yes-display-inline">by inserting <quote>or therapeutic
			 radiopharmaceutical</quote> after <quote>each device</quote>; and</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idA48E2A6AEEEF40C5ABF303B491BE7B56"><enum>(3)</enum><text display-inline="yes-display-inline">in the second sentence, by inserting
			 <quote>or therapeutic radiopharmaceuticals</quote> after <quote>such
			 devices</quote>.</text>
					</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="id9E8FB1807F134B7AAC2E03BBBFE100B1" section-type="subsequent-section"><enum>107.</enum><header display-inline="yes-display-inline">Extension of Medicare reasonable costs
			 payments for certain clinical diagnostic laboratory tests furnished to hospital
			 patients in certain rural areas</header><text display-inline="no-display-inline">Section 416(b) of the Medicare Prescription
			 Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l-4">42 U.S.C. 1395l–4</external-xref>), as
			 amended by section 105 of division B of the Tax Relief and Health Care Act of
			 2006 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l</external-xref> note), is amended by striking <quote>the 3-year period
			 beginning on July 1, 2004</quote> and inserting <quote>the period beginning on
			 July 1, 2004, and ending on June 30, 2008</quote>.</text>
			</section><section commented="no" display-inline="no-display-inline" id="id58FFAF432C8E42419B0F86D00FBC3141" section-type="subsequent-section"><enum>108.</enum><header display-inline="yes-display-inline">Extension of authority of specialized
			 Medicare Advantage plans for special needs individuals to restrict
			 enrollment</header>
				<subsection commented="no" display-inline="no-display-inline" id="H1E9334E2A1B440EE9156A5A94081E973"><enum>(a)</enum><header display-inline="yes-display-inline">Extension of authority To restrict
			 enrollment</header><text display-inline="yes-display-inline">Section 1859(f) of
			 the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-28">42 U.S.C. 1395w–28(f)</external-xref>) is amended by striking
			 <quote>2009</quote> and inserting <quote>2010</quote>.</text>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="H6EE59BF450034B69009818AEB2590024"><enum>(b)</enum><header display-inline="yes-display-inline">Moratorium</header>
					<paragraph commented="no" display-inline="no-display-inline" id="id5D125EF21F8D46818AD6924D435EED97"><enum>(1)</enum><header display-inline="yes-display-inline">Authority To designate other plans as
			 specialized MA plans</header><text display-inline="yes-display-inline">During
			 the period beginning on January 1, 2008, and ending on December 31, 2009, the
			 Secretary of Health and Human Services shall not exercise the authority
			 provided under section 231(d) of the Medicare Prescription Drug, Improvement,
			 and Modernization Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-21">42 U.S.C. 1395w–21</external-xref> note) to designate other
			 plans as specialized MA plans for special needs individuals under part C of
			 title XVIII of the Social Security Act. The preceding sentence shall not apply
			 to plans designated as specialized MA plans for special needs individuals under
			 such authority prior to January 1, 2008.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id295EC2584F60455199EF2CFDAEC81E34"><enum>(2)</enum><header display-inline="yes-display-inline">Enrollment in new plans</header><text display-inline="yes-display-inline">During the period beginning on January 1,
			 2008, and ending on December 31, 2009, the Secretary of Health and Human
			 Services shall not permit enrollment of any individual residing in an area in a
			 specialized Medicare Advantage plan for special needs individuals under part C
			 of title XVIII of the Social Security Act to take effect unless that
			 specialized Medicare Advantage plan for special needs individuals was available
			 for enrollment for individuals residing in that area on January 1, 2008.</text>
					</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="idBEFCD4ADBCDF4DFCBC9837A69265B77C" section-type="subsequent-section"><enum>109.</enum><header display-inline="yes-display-inline">Extension of deadline for application of
			 limitation on extension or renewal of Medicare reasonable cost contract
			 plans</header><text display-inline="no-display-inline">Section
			 1876(h)(5)(C)(ii) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395mm">42 U.S.C. 1395mm(h)(5)(C)(ii)</external-xref>),
			 in the matter preceding subclause (I), is amended by striking <quote>January 1,
			 2008</quote> and inserting <quote>January 1, 2009</quote>.</text>
			</section><section commented="no" display-inline="no-display-inline" id="HA6BE9C2E325B4BF0A64034D17768DDB8" section-type="subsequent-section"><enum>110.</enum><header display-inline="yes-display-inline">Adjustment to the Medicare Advantage
			 stabilization fund</header><text display-inline="no-display-inline">Section
			 1858(e)(2)(A)(i) of the <act-name parsable-cite="SSA">Social Security
			 Act</act-name> (42 U.S.C. 1395w–27a(e)(2)(A)(i)), as amended by section 3 of
			 <external-xref legal-doc="public-law" parsable-cite="pl/110/48">Public Law 110–48</external-xref>, is amended by striking <quote>the Fund</quote> and all that
			 follows and inserting <quote>the Fund during 2013,
			 $1,790,000,000.</quote></text>
			</section><section commented="no" display-inline="no-display-inline" id="H5CE6D9B4B09F45BD8091CC777FEBB97" section-type="subsequent-section"><enum>111.</enum><header display-inline="yes-display-inline">Medicare secondary payor</header>
				<subsection commented="no" display-inline="no-display-inline" id="H346674005AAD4EC6B468CF70CEB9CE1F"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1862(b) of the Social Security Act
			 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395y">42 U.S.C. 1395y(b)</external-xref>) is amended by adding at the end the following new
			 paragraphs:</text>
					<quoted-block display-inline="no-display-inline" id="H40863B4401EF4ED49FA805B4FA409F65" style="OLC">
						<paragraph commented="no" display-inline="no-display-inline" id="H110126B3647B4CFAA1B82CB446E779A5"><enum>(7)</enum><header display-inline="yes-display-inline">Required submission of information by group
				health plans</header>
							<subparagraph commented="no" display-inline="no-display-inline" id="HB114CFD4F645426AA5940037486975A1"><enum>(A)</enum><header display-inline="yes-display-inline">Requirement</header><text display-inline="yes-display-inline">On and after the first day of the first
				calendar quarter beginning after the date that is 1 year after the date of the
				enactment of this paragraph, an entity serving as an insurer or third party
				administrator for a group health plan, as defined in paragraph (1)(A)(v), and,
				in the case of a group health plan that is self-insured and self-administered,
				a plan administrator or fiduciary, shall—</text>
								<clause commented="no" display-inline="no-display-inline" id="HDA3047280BF64E08B82B4773EE048460"><enum>(i)</enum><text display-inline="yes-display-inline">secure from the plan sponsor and plan
				participants such information as the Secretary shall specify for the purpose of
				identifying situations where the group health plan is or has been a primary
				plan to the program under this title; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H22CACB6F61FB4D40BAD6D509051776E0"><enum>(ii)</enum><text display-inline="yes-display-inline">submit such information to the Secretary in
				a form and manner (including frequency) specified by the Secretary.</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HB46D0773AFAF49E2A24700E8FF4FCDE4"><enum>(B)</enum><header display-inline="yes-display-inline">Enforcement</header>
								<clause commented="no" display-inline="no-display-inline" id="H7F279FD4E0CC44310000879200630000"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">An entity, a plan administrator, or a
				fiduciary described in subparagraph (A) that fails to comply with the
				requirements under such subparagraph shall be subject to a civil money penalty
				of $1,000 for each day of noncompliance for each individual for which the
				information under such subparagraph should have been submitted. The provisions
				of subsections (e) and (k) of section 1128A shall apply to a civil money
				penalty under the previous sentence in the same manner as such provisions apply
				to a penalty or proceeding under section 1128A(a). A civil money penalty under
				this clause shall be in addition to any other penalties prescribed by law and
				in addition to any Medicare secondary payer claim under this title with respect
				to an individual.</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H8444C60FFC744722B023BBC33500AA38"><enum>(ii)</enum><header display-inline="yes-display-inline">Deposit of amounts collected</header><text display-inline="yes-display-inline">Any amounts collected pursuant to clause
				(i) shall be deposited in the Federal Hospital Insurance Trust Fund under
				section 1817.</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3D38B32CA3244A8EBFEE1C954906BCE"><enum>(C)</enum><header display-inline="yes-display-inline">Sharing of information</header><text display-inline="yes-display-inline">Notwithstanding any other provision of law,
				under terms and conditions established by the Secretary, the Secretary—</text>
								<clause commented="no" display-inline="no-display-inline" id="H65B0775472184E098D3603ADA705DE84"><enum>(i)</enum><text display-inline="yes-display-inline">shall share information on entitlement
				under Part A and enrollment under Part B under this title with entities, plan
				administrators, and fiduciaries described in subparagraph (A);</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HF932C75E028844829EE218C9916C21D1"><enum>(ii)</enum><text display-inline="yes-display-inline">may share the entitlement and enrollment
				information described in clause (i) with entities and persons not described in
				such clause; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H565DF921CEF543629B058545EDC9984E"><enum>(iii)</enum><text display-inline="yes-display-inline">may share information collected under this
				paragraph as necessary for purposes of the proper coordination of
				benefits.</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H57C1F019B9E14508A45D73F196EFFE5"><enum>(D)</enum><header display-inline="yes-display-inline">Implementation</header><text display-inline="yes-display-inline">Notwithstanding any other provision of law,
				the Secretary may implement this paragraph by program instruction or
				otherwise.</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H44444961C24B4C77A57200C4FCB95E8"><enum>(8)</enum><header display-inline="yes-display-inline">Required submission of information by or on
				behalf of liability insurance (including self-insurance), no fault insurance,
				and workers’ compensation laws and plans</header>
							<subparagraph commented="no" display-inline="no-display-inline" id="H8D48C6003CD44892A45BD22C35CF7657"><enum>(A)</enum><header display-inline="yes-display-inline">Requirement</header><text display-inline="yes-display-inline">On and after the first day of the first
				calendar quarter beginning after the date that is 18 months after the date of
				the enactment of this paragraph, an applicable plan shall—</text>
								<clause commented="no" display-inline="no-display-inline" id="H8B4F9478CC2941728972DC9A057B86C"><enum>(i)</enum><text display-inline="yes-display-inline">determine whether a claimant (including an
				individual whose claim is unresolved) is entitled to benefits under the program
				under this title on any basis; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H292C27072BC84154B69301B37500922F"><enum>(ii)</enum><text display-inline="yes-display-inline">if the claimant is determined to be so
				entitled, submit the information described in subparagraph (B) with respect to
				the claimant to the Secretary in a form and manner (including frequency)
				specified by the Secretary.</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H2C0F469A625846A8A7732259A4003EB"><enum>(B)</enum><header display-inline="yes-display-inline">Required information</header><text display-inline="yes-display-inline">The information described in this
				subparagraph is—</text>
								<clause commented="no" display-inline="no-display-inline" id="HFB77ED4DF33E4F6B843E12B64033E7BD"><enum>(i)</enum><text display-inline="yes-display-inline">the identity of the claimant for which the
				determination under subparagraph (A) was made; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HF51DF7A5151745F5A6952150CB4F2B2F"><enum>(ii)</enum><text display-inline="yes-display-inline">such other information as the Secretary
				shall specify in order to enable the Secretary to make an appropriate
				determination concerning coordination of benefits, including any applicable
				recovery claim.</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HA5F7C86AB841413D9C5EB79B33DD5D2F"><enum>(C)</enum><header display-inline="yes-display-inline">Timing</header><text display-inline="yes-display-inline">Information shall be submitted under
				subparagraph (A)(ii) within a time specified by the Secretary after the claim
				is resolved through a settlement, judgment, award, or other payment (regardless
				of whether or not there is a determination or admission of liability).</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HCB8FB40473324E019FBE1FB76FD27500"><enum>(D)</enum><header display-inline="yes-display-inline">Claimant</header><text display-inline="yes-display-inline">For purposes of subparagraph (A), the term
				<quote>claimant</quote> includes—</text>
								<clause commented="no" display-inline="no-display-inline" id="HEB355C098656429D8E938DC867AEEE5"><enum>(i)</enum><text display-inline="yes-display-inline">an individual filing a claim directly
				against the applicable plan; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HFD7BEC88E38249AA00B1043736DFF44B"><enum>(ii)</enum><text display-inline="yes-display-inline">an individual filing a claim against an
				individual or entity insured or covered by the applicable plan.</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H62909EEFC8C84599B70515E146BF5D3"><enum>(E)</enum><header display-inline="yes-display-inline">Enforcement</header>
								<clause commented="no" display-inline="no-display-inline" id="H7033350608604FBC9922681B4200BE33"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">An applicable plan that fails to comply
				with the requirements under subparagraph (A) with respect to any claimant shall
				be subject to a civil money penalty of $1,000 for each day of noncompliance
				with respect to each claimant. The provisions of subsections (e) and (k) of
				section 1128A shall apply to a civil money penalty under the previous sentence
				in the same manner as such provisions apply to a penalty or proceeding under
				section 1128A(a). A civil money penalty under this clause shall be in addition
				to any other penalties prescribed by law and in addition to any Medicare
				secondary payer claim under this title with respect to an individual.</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HD8F3136B51714E0888A0BFB1BA075F03"><enum>(ii)</enum><header display-inline="yes-display-inline">Deposit of amounts collected</header><text display-inline="yes-display-inline">Any amounts collected pursuant to clause
				(i) shall be deposited in the Federal Hospital Insurance Trust Fund.</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H838FA55790324709B974B85B5BBFE702"><enum>(F)</enum><header display-inline="yes-display-inline">Applicable plan</header><text display-inline="yes-display-inline">In this paragraph, the term
				<quote>applicable plan</quote> means the following laws, plans, or other
				arrangements, including the fiduciary or administrator for such law, plan, or
				arrangement:</text>
								<clause commented="no" display-inline="no-display-inline" id="H954EDDAB832545C79FFDC0CCAA271E5C"><enum>(i)</enum><text display-inline="yes-display-inline">Liability insurance (including
				self-insurance).</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HEDDF9A9096A94EA4BB2B562F38AAC158"><enum>(ii)</enum><text display-inline="yes-display-inline">No fault insurance.</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H9B37218C59E54802BB06DDB57D51A622"><enum>(iii)</enum><text display-inline="yes-display-inline">Workers’ compensation laws or plans.</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD88D91EC717A4631ADEFED3200C84F09"><enum>(G)</enum><header display-inline="yes-display-inline">Sharing of information</header><text display-inline="yes-display-inline">The Secretary may share information
				collected under this paragraph as necessary for purposes of the proper
				coordination of benefits.</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H9FF7131AECF2441FA63D69F73FD0FF2D"><enum>(H)</enum><header display-inline="yes-display-inline">Implementation</header><text display-inline="yes-display-inline">Notwithstanding any other provision of law,
				the Secretary may implement this paragraph by program instruction or
				otherwise.</text>
							</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="H7CDAB11277F643ED00D2D6EEAC9E5F94"><enum>(b)</enum><header display-inline="yes-display-inline">Rule of construction</header><text display-inline="yes-display-inline">Nothing in the amendments made by this
			 section shall be construed to limit the authority of the Secretary of Health
			 and Human Services to collect information to carry out Medicare secondary payer
			 provisions under title XVIII of the Social Security Act, including under parts
			 C and D of such title.</text>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="H470C0A03962E4C29807000F1837DF649"><enum>(c)</enum><header display-inline="yes-display-inline">Implementation</header><text display-inline="yes-display-inline">For purposes of implementing paragraphs (7)
			 and (8) of section 1862(b) of the Social Security Act, as added by subsection
			 (a), to ensure appropriate payments under title XVIII of such Act, the
			 Secretary of Health and Human Services shall provide for the transfer, from the
			 Federal Hospital Insurance Trust Fund established under section 1817 of the
			 Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i">42 U.S.C. 1395i</external-xref>) and the Federal Supplementary Medical
			 Insurance Trust Fund established under section 1841 of such Act (42 U.S.C.
			 1395t), in such proportions as the Secretary determines appropriate, of
			 $35,000,000 to the Centers for Medicare &amp; Medicaid Services Program
			 Management Account for the period of fiscal years 2008, 2009, and 2010.</text>
				</subsection></section><section commented="no" display-inline="no-display-inline" id="H96D2E3DC4A914D72A048FD3BABFEABDE" section-type="subsequent-section"><enum>112.</enum><header display-inline="yes-display-inline">Payment for part B drugs</header>
				<subsection commented="no" display-inline="no-display-inline" id="H7BEE2077E47C4E5C89E8A4517CC80027"><enum>(a)</enum><header display-inline="yes-display-inline">Application of alternative volume weighting
			 in computation of ASP</header><text display-inline="yes-display-inline">Section
			 1847A(b) of the Social Security Act (42 U.S.C. 1395w–3a(b)) is amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="HEAF1BD51FDD942269FE5A2F4D2708409"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1)(A), by inserting
			 <quote>for a multiple source drug furnished before April 1, 2008, or 106
			 percent of the amount determined under paragraph (6) for a multiple source drug
			 furnished on or after April 1, 2008</quote> after <quote>paragraph
			 (3)</quote>;</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H514D9E4762274A39A080CFF7595EE31"><enum>(2)</enum><text display-inline="yes-display-inline">in each of subparagraphs (A) and (B) of
			 paragraph (4), by inserting <quote>for single source drugs and biologicals
			 furnished before April 1, 2008, and using the methodology applied under
			 paragraph (6) for single source drugs and biologicals furnished on or after
			 April 1, 2008,</quote> after <quote>paragraph (3)</quote>; and</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE5681A5A746A4CE4A95F225D15C81900"><enum>(3)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 paragraph:</text>
						<quoted-block display-inline="no-display-inline" id="HC186DE0C709E4A5F810066AD00964726" style="OLC">
							<paragraph commented="no" display-inline="no-display-inline" id="H956A46E524EC4CCE97BF290747F3944B"><enum>(6)</enum><header display-inline="yes-display-inline">Use of volume-weighted average sales prices
				in calculation of average sales price</header>
								<subparagraph commented="no" display-inline="no-display-inline" id="H8FA3918D4026453A9217CDC4B0DB7675"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">For all drug products included within the
				same multiple source drug billing and payment code, the amount specified in
				this paragraph is the volume-weighted average of the average sales prices
				reported under section 1927(b)(3)(A)(iii) determined by—</text>
									<clause commented="no" display-inline="no-display-inline" id="H704799B6DC884FC6ADC662ADFAC585B1"><enum>(i)</enum><text display-inline="yes-display-inline">computing the sum of the products (for each
				National Drug Code assigned to such drug products) of—</text>
										<subclause commented="no" display-inline="no-display-inline" id="H3A3E1626F83246A0AD9335512F40C96C"><enum>(I)</enum><text display-inline="yes-display-inline">the manufacturer's average sales price (as
				defined in subsection (c)), determined by the Secretary without dividing such
				price by the total number of billing units for the National Drug Code for the
				billing and payment code; and</text>
										</subclause><subclause commented="no" display-inline="no-display-inline" id="H01A094F6DEF545F6AEF09E5F0400F1C9"><enum>(II)</enum><text display-inline="yes-display-inline">the total number of units specified under
				paragraph (2) sold; and</text>
										</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HF2891285DCFD45708226C219C90067B9"><enum>(ii)</enum><text display-inline="yes-display-inline">dividing the sum determined under clause
				(i) by the sum of the products (for each National Drug Code assigned to such
				drug products) of—</text>
										<subclause commented="no" display-inline="no-display-inline" id="H2793410973AE4611AE6EAD560EE05AB"><enum>(I)</enum><text display-inline="yes-display-inline">the total number of units specified under
				paragraph (2) sold; and</text>
										</subclause><subclause commented="no" display-inline="no-display-inline" id="H8E98E34567464B5D00CCF7D355FECFDE"><enum>(II)</enum><text display-inline="yes-display-inline">the total number of billing units for the
				National Drug Code for the billing and payment code.</text>
										</subclause></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H01FA6835615D41FB993EF824C7FAB12"><enum>(B)</enum><header display-inline="yes-display-inline">Billing unit defined</header><text display-inline="yes-display-inline">For purposes of this subsection, the term
				<term>billing unit</term> means the identifiable quantity associated with a
				billing and payment code, as established by the
				Secretary.</text>
								</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H49209AE176F748B38E20DB34F921D248"><enum>(b)</enum><header display-inline="yes-display-inline">Treatment of certain drugs</header><text display-inline="yes-display-inline">Section 1847A(b) of the Social Security Act
			 (42 U.S.C. 1395w–3a(b)), as amended by subsection (a), is amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="HADB831E9A41245AFB900D4EC56986735"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1), by inserting
			 <quote>paragraph (7) and</quote> after <quote>Subject to</quote>; and</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H26F53C873605476595DCB1C972E5B98"><enum>(2)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 paragraph:</text>
						<quoted-block display-inline="no-display-inline" id="H555E6BBD8CFB4D378863ECB2EB3DF136" style="OLC">
							<paragraph commented="no" display-inline="no-display-inline" id="H10EF654FB76A4CEB8EF7B46BE05887B2"><enum>(7)</enum><header display-inline="yes-display-inline">Special rule</header><text display-inline="yes-display-inline">Beginning with April 1, 2008, the payment
				amount for—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H43D156913CDA481DBF14DF835D8DE283"><enum>(A)</enum><text display-inline="yes-display-inline">each single source drug or biological
				described in section 1842(o)(1)(G) that is treated as a multiple source drug
				because of the application of subsection (c)(6)(C)(ii) is the lower of—</text>
									<clause commented="no" display-inline="no-display-inline" id="H532C3E5D8B69449DBB5691ED809E00C9"><enum>(i)</enum><text display-inline="yes-display-inline">the payment amount that would be determined
				for such drug or biological applying such subsection; or</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="HC4DA12036CC1433797C1009638D01877"><enum>(ii)</enum><text display-inline="yes-display-inline">the payment amount that would have been
				determined for such drug or biological if such subsection were not applied;
				and</text>
									</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HFDD5BBC5FF50472E9261DEEC28DAC399"><enum>(B)</enum><text display-inline="yes-display-inline">a multiple source drug described in section
				1842(o)(1)(G) (excluding a drug or biological that is treated as a multiple
				source drug because of the application of such subsection) is the lower
				of—</text>
									<clause commented="no" display-inline="no-display-inline" id="H819DC59BB109436EA13171BBB7CF4300"><enum>(i)</enum><text display-inline="yes-display-inline">the payment amount that would be determined
				for such drug or biological taking into account the application of such
				subsection; or</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="HE3360A67D9084AF185C54494109CADF"><enum>(ii)</enum><text display-inline="yes-display-inline">the payment amount that would have been
				determined for such drug or biological if such subsection were not
				applied.</text>
									</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H8D3D680BE81D46158276BE3D56D33E1C" section-type="subsequent-section"><enum>113.</enum><header display-inline="yes-display-inline">Payment rate for certain diagnostic
			 laboratory tests</header><text display-inline="no-display-inline">Section
			 1833(h) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(h)</external-xref>) is amended by adding at
			 the end the following new paragraph:</text>
				<quoted-block display-inline="no-display-inline" id="H0459BCEF301A42C295DACABEE4C2526E" style="OLC">
					<paragraph commented="no" display-inline="no-display-inline" id="H59EB98DB59324E9DAE1F4E04DD8BB1BB" indent="up1"><enum>(9)</enum><text display-inline="yes-display-inline">Notwithstanding any other provision in this
				part, in the case of any diagnostic laboratory test for HbA1c that is labeled
				by the Food and Drug Administration for home use and is furnished on or after
				April 1, 2008, the payment rate for such test shall be the payment rate
				established under this part for a glycated hemoglobin test (identified as of
				October 1, 2007, by HCPCS code 83036 (and any succeeding
				codes)).</text>
					</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
			</section><section commented="no" display-inline="no-display-inline" id="H602663D9710C4444BD064808A21BFCB" section-type="subsequent-section"><enum>114.</enum><header display-inline="yes-display-inline">Long-term care hospitals</header>
				<subsection commented="no" display-inline="no-display-inline" id="HA79FE95091D94246B3B7A17D00309EDB"><enum>(a)</enum><header display-inline="yes-display-inline">Definition of long-term care
			 hospital</header><text display-inline="yes-display-inline">Section 1861 of the
			 Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>) is amended by adding at the end the
			 following new subsection:</text>
					<quoted-block display-inline="no-display-inline" id="H0D320F82F37A4FC48F88D27633006D71" other-style="archaic" style="other">
						<subsection commented="no" display-inline="no-display-inline" id="HFA5507D0C8E04077AE8CF102A232D68F"><enum>(ccc)</enum><header>Long-Term Care Hospital</header><text display-inline="yes-display-inline">The term <term>long-term care
				hospital</term> means a hospital which—</text>
							<paragraph commented="no" display-inline="no-display-inline" id="HCA349227A0C741588B32514C1700E7A"><enum>(1)</enum><text display-inline="yes-display-inline">is primarily engaged in providing inpatient
				services, by or under the supervision of a physician, to Medicare beneficiaries
				whose medically complex conditions require a long hospital stay and programs of
				care provided by a long-term care hospital;</text>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H04013FCEB3F14875A78796773291D9D0"><enum>(2)</enum><text display-inline="yes-display-inline">has an average inpatient length of stay (as
				determined by the Secretary) of greater than 25 days, or meets the requirements
				of clause (II) of section 1886(d)(1)(B)(iv);</text>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5B2706FC0B724C3EA2DF7DE7849B142B"><enum>(3)</enum><text display-inline="yes-display-inline">satisfies the requirements of subsection
				(e); and</text>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA1FD081C4CBF4B9D9316037895EA71D"><enum>(4)</enum><text display-inline="yes-display-inline">meets the following facility
				criteria:</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H614B23A83B7D48E892812BEE46A79507"><enum>(A)</enum><text display-inline="yes-display-inline">the institution has a patient review
				process, documented in the patient medical record, that screens patients prior
				to admission for appropriateness of admission to a long-term care hospital,
				validates within 48 hours of admission that patients meet admission criteria
				for long-term care hospitals, regularly evaluates patients throughout their
				stay for continuation of care in a long-term care hospital, and assesses the
				available discharge options when patients no longer meet such continued stay
				criteria;</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF560BA43E1C14EAC9FFA7859C6F136E6"><enum>(B)</enum><text display-inline="yes-display-inline">the institution has active physician
				involvement with patients during their treatment through an organized medical
				staff, physician-directed treatment with physician on-site availability on a
				daily basis to review patient progress, and consulting physicians on call and
				capable of being at the patient’s side within a moderate period of time, as
				determined by the Secretary; and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H6C2B99CB04144B54B9340422DA57BB98"><enum>(C)</enum><text display-inline="yes-display-inline">the institution has interdisciplinary team
				treatment for patients, requiring interdisciplinary teams of health care
				professionals, including physicians, to prepare and carry out an individualized
				treatment plan for each
				patient.</text>
								</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="HF32F0269E0A64F5AB2F94C935F8ECC3B"><enum>(b)</enum><header display-inline="yes-display-inline">Study and report on long-term care hospital
			 facility and patient criteria</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H036DA4B8EFE24BB9A9EA4F248D588661"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services
			 (in this section referred to as the <quote>Secretary</quote>) shall conduct a
			 study on the establishment of national long-term care hospital facility and
			 patient criteria for purposes of determining medical necessity, appropriateness
			 of admission, and continued stay at, and discharge from, long-term care
			 hospitals.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H512ABAEF37AD485DBB3C7D66BA93AF4F"><enum>(2)</enum><header display-inline="yes-display-inline">Report</header><text display-inline="yes-display-inline">Not later than 18 months after the date of
			 the enactment of this Act, the Secretary shall submit to Congress a report on
			 the study conducted under paragraph (1), together with recommendations for such
			 legislation and administrative actions, including timelines for implementation
			 of patient criteria or other actions, as the Secretary determines
			 appropriate.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H9765C3E9A71A45448E380102F6DD1C3B"><enum>(3)</enum><header display-inline="yes-display-inline">Considerations</header><text display-inline="yes-display-inline">In conducting the study and preparing the
			 report under this subsection, the Secretary shall consider—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HB79F3541F9764562B4BFB6D3AF56C524"><enum>(A)</enum><text display-inline="yes-display-inline">recommendations contained in a report to
			 Congress by the Medicare Payment Advisory Commission in June 2004 for long-term
			 care hospital-specific facility and patient criteria to ensure that patients
			 admitted to long-term care hospitals are medically complex and appropriate to
			 receive long-term care hospital services; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HA4D33F4659AC45C5831134070063A477"><enum>(B)</enum><text display-inline="yes-display-inline">ongoing work by the Secretary to evaluate
			 and determine the feasibility of such recommendations.</text>
						</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H6B477569F6344046B8E831EB6FEDE5D"><enum>(c)</enum><header display-inline="yes-display-inline">Payment for long-term care hospital
			 services</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H14D4B7635BB5468AB3C13B3F37D06C3B"><enum>(1)</enum><header display-inline="yes-display-inline">No application of
			 <enum-in-header>25</enum-in-header> percent patient threshold payment
			 adjustment to freestanding and grandfathered LTCHS</header><text display-inline="yes-display-inline">The
			 Secretary shall not apply, for cost reporting periods beginning on or after the
			 date of the enactment of this Act for a 3-year period—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="id64B88B142A7D444F9050F95C61FE587F"><enum>(A)</enum><text display-inline="yes-display-inline">section 412.536 of title 42, Code of
			 Federal Regulations, or any similar provision, to freestanding long-term care
			 hospitals; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id72EE6739D4FC4EC3AC6E063D793BE82E"><enum>(B)</enum><text display-inline="yes-display-inline">such section or section 412.534 of title
			 42, Code of Federal Regulations, or any similar provisions, to a long-term care
			 hospital identified by the amendment made by section 4417(a) of the Balanced
			 Budget Act of 1997 (<external-xref legal-doc="public-law" parsable-cite="pl/105/33">Public Law 105–33</external-xref>).</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H05FD9B7C27B84A3B98EF95AE619037F2"><enum>(2)</enum><header display-inline="yes-display-inline">Payment for
			 hospitals-within-hospitals</header>
						<subparagraph commented="no" display-inline="no-display-inline" id="HAFBCC5D7C3DB43529F4772F9F73FC5F6"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Payment to an applicable long-term care
			 hospital or satellite facility which is located in a rural area or which is
			 co-located with an urban single or MSA dominant hospital under paragraphs
			 (d)(1), (e)(1), and (e)(4) of <external-xref legal-doc="usc" parsable-cite="usc/42/412">section 412.534</external-xref> of title 42, Code of Federal
			 Regulations, shall not be subject to any payment adjustment under such section
			 if no more than 75 percent of the hospital’s Medicare discharges (other than
			 discharges described in paragraph (d)(2) or (e)(3) of such section) are
			 admitted from a co-located hospital.</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8F6BF489EAD94438B84F863B77CEE161"><enum>(B)</enum><header display-inline="yes-display-inline">Co-located long-term care hospitals and
			 satellite facilities</header>
							<clause commented="no" display-inline="no-display-inline" id="HC17DE4A28D3F4813A4A90520E100D1AB"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Payment to an applicable long-term care
			 hospital or satellite facility which is co-located with another hospital shall
			 not be subject to any payment adjustment under <external-xref legal-doc="usc" parsable-cite="usc/42/412">section 412.534</external-xref> of title 42,
			 Code of Federal Regulations, if no more than 50 percent of the hospital’s
			 Medicare discharges (other than discharges described in paragraph (c)(3) of
			 such section) are admitted from a co-located hospital.</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="H0A93015504B34D4FB44D65501C95BB91"><enum>(ii)</enum><header display-inline="yes-display-inline">Applicable long-term care hospital or
			 satellite facility defined</header><text display-inline="yes-display-inline">In
			 this paragraph, the term <term>applicable long-term care hospital or satellite
			 facility</term> means a hospital or satellite facility that is subject to the
			 transition rules under <external-xref legal-doc="usc" parsable-cite="usc/42/412">section 412.534(g)</external-xref> of title 42, Code of Federal
			 Regulations.</text>
							</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H33F79B5742DE4634914592A53CCB003B"><enum>(C)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">Subparagraphs (A) and
			 (B) shall apply to cost reporting periods beginning on or after the date of the
			 enactment of this Act for a 3-year period.</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF96E5D45B8834D4AAD713C1096890099"><enum>(3)</enum><header display-inline="yes-display-inline">No application of very short-stay outlier
			 policy</header><text display-inline="yes-display-inline">The Secretary shall
			 not apply, for the 3-year period beginning on the date of the enactment of this
			 Act, the amendments finalized on May 11, 2007 (72 Federal Register 26904,
			 26992) made to the short-stay outlier payment provision for long-term care
			 hospitals contained in <external-xref legal-doc="usc" parsable-cite="usc/42/412">section 412.529(c)(3)(i)</external-xref> of title 42, Code of Federal
			 Regulations, or any similar provision.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5FBE81B7D53944DFABA30024158D3807"><enum>(4)</enum><header display-inline="yes-display-inline">No application of one-time adjustment to
			 standard amount</header><text display-inline="yes-display-inline">The Secretary
			 shall not, for the 3-year period beginning on the date of the enactment of this
			 Act, make the one-time prospective adjustment to long-term care hospital
			 prospective payment rates provided for in <external-xref legal-doc="usc" parsable-cite="usc/42/412">section 412.523(d)(3)</external-xref> of title 42,
			 Code of Federal Regulations, or any similar provision.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H72AB97378FF449C9BA16A17C7CA6E35F"><enum>(d)</enum><header display-inline="yes-display-inline">Moratorium on the establishment of
			 long-term care hospitals, long-term care satellite facilities and on the
			 increase of long-term care hospital beds in existing long-term care hospitals
			 or satellite facilities</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H9F48ECD06FD44A33A6DAB5CE9CC85010"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">During the 3-year period beginning on the
			 date of the enactment of this Act, the Secretary shall impose a moratorium for
			 purposes of the Medicare program under title XVIII of the Social Security
			 Act—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="H0DFA3698482D43E187945BBFA6B57143"><enum>(A)</enum><text display-inline="yes-display-inline">subject to paragraph (2), on the
			 establishment and classification of a long-term care hospital or satellite
			 facility, other than an existing long-term care hospital or facility;
			 and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H032065B0CDEC4C6C80BCD32D6F0526F4"><enum>(B)</enum><text display-inline="yes-display-inline">subject to paragraph (3), on an increase of
			 long-term care hospital beds in existing long-term care hospitals or satellite
			 facilities.</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HCA79A27E3B2B4FDC95C2E155D98702C7"><enum>(2)</enum><header display-inline="yes-display-inline">Exception for Certain Long-Term Care
			 Hospitals</header><text display-inline="yes-display-inline">The moratorium
			 under paragraph (1)(A) shall not apply to a long-term care hospital that as of
			 the date of the enactment of this Act—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HEDB6DBE3C054403999A3E804AE0617D5"><enum>(A)</enum><text display-inline="yes-display-inline">began its qualifying period for payment as
			 a long-term care hospital under <external-xref legal-doc="usc" parsable-cite="usc/42/412">section 412.23(e)</external-xref> of title 42, Code of Federal
			 Regulations, on or before the date of the enactment of this Act;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H89E8C0BA0BE54D51B232426D5E7658C3"><enum>(B)</enum><text display-inline="yes-display-inline">has a binding written agreement with an
			 outside, unrelated party for the actual construction, renovation, lease, or
			 demolition for a long-term care hospital, and has expended, before the date of
			 the enactment of this Act, at least 10 percent of the estimated cost of the
			 project (or, if less, $2,500,000); or</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H4A3079DC4A00489E9D2BF66EB31FEFBD"><enum>(C)</enum><text display-inline="yes-display-inline">has obtained an approved certificate of
			 need in a State where one is required on or before the date of the enactment of
			 this Act.</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H9C5C3537D96041E29840B05127F1400"><enum>(3)</enum><header display-inline="yes-display-inline">Exception for bed increases during
			 moratorium</header>
						<subparagraph commented="no" display-inline="no-display-inline" id="id288FBA64F32D472685AFEA56223C6511"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subject to subparagraph (B), the moratorium
			 under paragraph (1)(B) shall not apply to an increase in beds in an existing
			 hospital or satellite facility if the hospital or facility—</text>
							<clause commented="no" display-inline="no-display-inline" id="H3E5FA520756B49ACB2DABC6C43F8B72E"><enum>(i)</enum><text display-inline="yes-display-inline">is located in a State where there is only
			 one other long-term care hospital; and</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="HC76340D3A513473188762CBD6CD6BBA"><enum>(ii)</enum><text display-inline="yes-display-inline">requests an increase in beds following the
			 closure or the decrease in the number of beds of another long-term care
			 hospital in the State.</text>
							</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id2AC831F091554FDE82390210C579897F"><enum>(B)</enum><header display-inline="yes-display-inline">No effect on certain
			 limitation</header><text display-inline="yes-display-inline">The exception
			 under subparagraph (A) shall not effect the limitation on increasing beds under
			 sections <external-xref legal-doc="usc" parsable-cite="usc/42/412">412.22(h)(3)</external-xref> and <external-xref legal-doc="usc" parsable-cite="usc/42/412">412.22(f)</external-xref> of title 42, Code of Federal
			 Regulations.</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HBC3A915585D746D28D8E94032E920011"><enum>(4)</enum><header display-inline="yes-display-inline">Existing hospital or satellite facility
			 defined</header><text display-inline="yes-display-inline">For purposes of this
			 subsection, the term <quote>existing</quote> means, with respect to a hospital
			 or satellite facility, a hospital or satellite facility that received payment
			 under the provisions of subpart O of part 412 of title 42, Code of Federal
			 Regulations, as of the date of the enactment of this Act.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idEBB781AE49A84A4785B0FA11CD7CA363"><enum>(5)</enum><header display-inline="yes-display-inline">Judicial review</header><text display-inline="yes-display-inline">There shall be no administrative or
			 judicial review under section 1869 of the Social Security Act (42 U.S.C.
			 1395ff), section 1878 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395oo">42 U.S.C. 1395oo</external-xref>), or otherwise, of the
			 application of this subsection by the Secretary.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HE3EE8C9E8A7F435185F38700E597C36"><enum>(e)</enum><header display-inline="yes-display-inline">Long-term care hospital payment
			 update</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H345071E4078048538BD8996CE34E3BAB"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1886 of the
			 <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww</external-xref>)
			 is amended by adding at the end the following new subsection:</text>
						<quoted-block act-name="Social" display-inline="no-display-inline" id="HA51DD8A937604B4191632E0845FE478" style="OLC">
							<subsection commented="no" display-inline="no-display-inline" id="H57B7A24F4BDC4D4FB9D1668F8F556D7E"><enum>(m)</enum><header display-inline="yes-display-inline">Prospective payment for long-term care
				hospitals</header>
								<paragraph commented="no" display-inline="no-display-inline" id="H40526E59CF13449CA7F2C1B32712521F"><enum>(1)</enum><header display-inline="yes-display-inline">Reference to establishment and
				implementation of system</header><text display-inline="yes-display-inline">For
				provisions related to the establishment and implementation of a prospective
				payment system for payments under this title for inpatient hospital services
				furnished by a long-term care hospital described in subsection (d)(1)(B)(iv),
				see section 123 of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement
				Act of 1999 and section 307(b) of the Medicare, Medicaid, and SCHIP Benefits
				Improvement and Protection Act of 2000.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H84C82E8C86F24D9AA953B0B990D3D119"><enum>(2)</enum><header display-inline="yes-display-inline">Update for rate year 2008</header><text display-inline="yes-display-inline">In implementing the system described in
				paragraph (1) for discharges occurring during the rate year ending in 2008 for
				a hospital, the base rate for such discharges for the hospital shall be the
				same as the base rate for discharges for the hospital occurring during the rate
				year ending in
				2007.</text>
								</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H9C5CCFB069B54FF8B845A3BF7DB95B53"><enum>(2)</enum><header display-inline="yes-display-inline">Delayed effective date</header><text display-inline="yes-display-inline">Subsection (m)(2) of section 1886 of the
			 Social Security Act, as added by paragraph (1), shall not apply to discharges
			 occurring on or after July 1, 2007, and before April 1, 2008.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H38A40FCD51424BACAE007B1C78AC9247"><enum>(f)</enum><header display-inline="yes-display-inline">Expanded review of medical
			 necessity</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H8C1CC2A9601A4416BBAB536FBE922D02"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services
			 shall provide, under contracts with one or more appropriate fiscal
			 intermediaries or medicare administrative contractors under section
			 1874A(a)(4)(G) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395kk-1">42 U.S.C. 1395kk–1(a)(4)(G)</external-xref>), for
			 reviews of the medical necessity of admissions to long-term care hospitals
			 (described in section 1886(d)(1)(B)(iv) of such Act) and continued stay at such
			 hospitals, of individuals entitled to, or enrolled for, benefits under part A
			 of title XVIII of such Act consistent with this subsection. Such reviews shall
			 be made for discharges occurring on or after October 1, 2007.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H34C2FBFE9CD945BFB87DC44585B1D063"><enum>(2)</enum><header display-inline="yes-display-inline">Review methodology</header><text display-inline="yes-display-inline">The medical necessity reviews under
			 paragraph (1) shall be conducted on an annual basis in accordance with rules
			 specified by the Secretary. Such reviews shall—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HDB0EBD56C0B341828CCA504611B3D4F3"><enum>(A)</enum><text display-inline="yes-display-inline">provide for a statistically valid and
			 representative sample of admissions of such individuals sufficient to provide
			 results at a 95 percent confidence interval; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H7B012C54D0B043828E1700B500B3B062"><enum>(B)</enum><text display-inline="yes-display-inline">guarantee that at least 75 percent of
			 overpayments received by long-term care hospitals for medically unnecessary
			 admissions and continued stays of individuals in long-term care hospitals will
			 be identified and recovered and that related days of care will not be counted
			 toward the length of stay requirement contained in section 1886(d)(1)(B)(iv) of
			 the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(d)(1)(B)(iv)</external-xref>).</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HEACECFAC34AE4BED92A500A71CFAC03F"><enum>(3)</enum><header display-inline="yes-display-inline">Continuation of reviews</header><text display-inline="yes-display-inline">Under contracts under this subsection, the
			 Secretary shall establish an error rate with respect to such reviews that could
			 require further review of the medical necessity of admissions and continued
			 stay in the hospital involved and other actions as determined by the
			 Secretary.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB2340057DFAE4E4A00C148965CA0FE36"><enum>(4)</enum><header display-inline="yes-display-inline">Termination of required reviews</header>
						<subparagraph commented="no" display-inline="no-display-inline" id="HCF3EA967B1754C9DB596F4879F3D795F"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subject to subparagraph (B), the previous
			 provisions of this subsection shall cease to apply for discharges occurring on
			 or after October 1, 2010.</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H62FA1E7E58D949749FF711CD46030058"><enum>(B)</enum><header display-inline="yes-display-inline">Continuation</header><text display-inline="yes-display-inline">As of the date specified in subparagraph
			 (A), the Secretary shall determine whether to continue to guarantee, through
			 continued medical review and sampling under this paragraph, recovery of at
			 least 75 percent of overpayments received by long-term care hospitals due to
			 medically unnecessary admissions and continued stays.</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H7B3835A6D4F54DBE9434D395CDE9699F"><enum>(5)</enum><header display-inline="yes-display-inline">Funding</header><text display-inline="yes-display-inline">The costs to fiscal intermediaries or
			 medicare administrative contractors conducting the medical necessity reviews
			 under paragraph (1) shall be funded from the aggregate overpayments recouped by
			 the Secretary of Health and Human Services from long-term care hospitals due to
			 medically unnecessary admissions and continued stays. The Secretary may use an
			 amount not in excess of 40 percent of the overpayments recouped under this
			 paragraph to compensate the fiscal intermediaries or Medicare administrative
			 contractors for the costs of services performed.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idAA47C31FEFB94A99932643FDC0A1214B"><enum>(g)</enum><header display-inline="yes-display-inline">Implementation</header><text display-inline="yes-display-inline">For purposes of carrying out the provisions
			 of, and amendments made by, this title, in addition to any amounts otherwise
			 provided in this title, there are appropriated to the Centers for Medicare
			 &amp; Medicaid Services Program Management Account, out of any money in the
			 Treasury not otherwise appropriated, $35,000,000 for the period of fiscal years
			 2008 and 2009.</text>
				</subsection></section><section commented="no" display-inline="no-display-inline" id="HCB928EAB5E7941EEAAF065316364AA1E" section-type="subsequent-section"><enum>115.</enum><header display-inline="yes-display-inline">Payment for inpatient rehabilitation
			 facility (IRF) services</header>
				<subsection commented="no" display-inline="no-display-inline" id="H21E290C7BC91462EBEA9459FE0AC8F73"><enum>(a)</enum><header display-inline="yes-display-inline">Payment update</header>
					<paragraph commented="no" display-inline="no-display-inline" id="HADE2230E75314A2FA3B003774773D78"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1886(j)(3)(C) of the Social
			 Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(j)(3)(C)</external-xref>) is amended by adding at the end the
			 following: <quote>The increase factor to be applied under this subparagraph for
			 each of fiscal years 2008 and 2009 shall be 0 percent.</quote>.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD4589C7847FF4BB2886D00C0DFFC2E15"><enum>(2)</enum><header display-inline="yes-display-inline">Delayed effective date</header><text display-inline="yes-display-inline">The amendment made by paragraph (1) shall
			 not apply to payment units occurring before April 1, 2008.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H1AE57FE3459D43E3BD3D2F137D1343F7"><enum>(b)</enum><header display-inline="yes-display-inline">Inpatient rehabilitation facility
			 classification criteria</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H7B1981F6A9F142C48B2DE2118EEA8D1D"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 5005 of the Deficit Reduction Act
			 of 2005 (<external-xref legal-doc="public-law" parsable-cite="pl/109/171">Public Law 109–171</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww</external-xref> note) is amended—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HF9DDC8CFD0D74493A75668A844A9FA3"><enum>(A)</enum><text display-inline="yes-display-inline">in subsection (a), by striking <quote>apply
			 the applicable percent specified in subsection (b)</quote> and inserting
			 <quote>require a compliance rate that is no greater than the 60 percent
			 compliance rate that became effective for cost reporting periods beginning on
			 or after July 1, 2006,</quote>; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3120481BABC3468DAD2BD84AC2B4E4B"><enum>(B)</enum><text display-inline="yes-display-inline">by amending subsection (b) to read as
			 follows:</text>
							<quoted-block display-inline="no-display-inline" id="H47405E4AB5FD42D68BBA2D9D9E951731" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="H178331B0537C45B1BC66AA0093947C08"><enum>(b)</enum><header display-inline="yes-display-inline">Continued Use of
				Comorbidities</header><text display-inline="yes-display-inline">For cost
				reporting periods beginning on or after July 1, 2007, the Secretary shall
				include patients with comorbidities as described in section 412.23(b)(2)(i) of
				title 42, Code of Federal Regulations (as in effect as of January 1, 2007), in
				the inpatient population that counts toward the percent specified in subsection
				(a).</text>
								</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3E3F0C577A4A41D6A520CB35B3021FE9"><enum>(2)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendment made by
			 paragraph (1)(A) shall apply for cost reporting periods beginning on or after
			 July 1, 2007.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H233CB833E7894166A629318093CD1F3F"><enum>(c)</enum><header display-inline="yes-display-inline">Recommendations for classifying inpatient
			 rehabilitation hospitals and units</header>
					<paragraph commented="no" display-inline="no-display-inline" id="HF57B47A58C7B4D4A89BED0052851BDDD"><enum>(1)</enum><header display-inline="yes-display-inline">Report to congress</header><text display-inline="yes-display-inline">Not later than 18 months after the date of
			 the enactment of this Act, the Secretary of Health and Human Services, in
			 consultation with physicians (including geriatricians and physiatrists),
			 administrators of inpatient rehabilitation, acute care hospitals, skilled
			 nursing facilities, and other settings providing rehabilitation services,
			 Medicare beneficiaries, trade organizations representing inpatient
			 rehabilitation hospitals and units and skilled nursing facilities, and the
			 Medicare Payment Advisory Commission, shall submit to the Committee on Ways and
			 Means of the House of Representatives and the Committee on Finance of the
			 Senate a report that includes the following:</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HD2DE0DE480DA4534BCE49734F45F7E9"><enum>(A)</enum><text display-inline="yes-display-inline">An analysis of Medicare beneficiaries’
			 access to medically necessary rehabilitation services, including the potential
			 effect of the 75 percent rule (as defined in paragraph (2)) on access to
			 care.</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8FF75635CE8F46AEB91849F800003159"><enum>(B)</enum><text display-inline="yes-display-inline">An analysis of alternatives or refinements
			 to the 75 percent rule policy for determining criteria for inpatient
			 rehabilitation hospital and unit designation under the Medicare program,
			 including alternative criteria which would consider a patient’s functional
			 status, diagnosis, co-morbidities, and other relevant factors.</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0E9B3724C88546DDADE8393FF4E872F8"><enum>(C)</enum><text display-inline="yes-display-inline">An analysis of the conditions for which
			 individuals are commonly admitted to inpatient rehabilitation hospitals that
			 are not included as a condition described in section 412.23(b)(2)(iii) of title
			 42, Code of Federal Regulations, to determine the appropriate setting of care,
			 and any variation in patient outcomes and costs, across settings of care, for
			 treatment of such conditions.</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H50766491273D487FA200C04FCA693567"><enum>(2)</enum><header display-inline="yes-display-inline">75 percent rule defined</header><text display-inline="yes-display-inline">For purposes of this subsection, the term
			 <term>75 percent rule</term> means the requirement of section 412.23(b)(2) of
			 title 42, Code of Federal Regulations, that 75 percent of the patients of a
			 rehabilitation hospital or converted rehabilitation unit are in 1 or more of 13
			 listed treatment categories.</text>
					</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H81CEF34DA978412996712F389B380465" section-type="subsequent-section"><enum>116.</enum><header display-inline="yes-display-inline">Extension of accommodation of physicians
			 ordered to active duty in the Armed Services</header><text display-inline="no-display-inline">Section 1842(b)(6)(D)(iii) of the Social
			 Security Act (42
			 U.S.C. 1395u(b)(6)(D)(iii)), as amended by <external-xref legal-doc="public-law" parsable-cite="pl/110/54">Public Law 110–54</external-xref>
			 (121 Stat. 551) is amended by striking <quote>January 1, 2008</quote> and
			 inserting <quote>July 1, 2008</quote>.</text>
			</section><section commented="no" display-inline="no-display-inline" id="H0B0550F964294956A8A58550F28C16F" section-type="subsequent-section"><enum>117.</enum><header display-inline="yes-display-inline">Treatment of certain hospitals</header>
				<subsection commented="no" display-inline="no-display-inline" id="H1520D931B09A4444A4E056DA165FFAFE"><enum>(a)</enum><header display-inline="yes-display-inline">Extending certain Medicare hospital wage
			 index reclassifications through fiscal year 2008</header>
					<paragraph commented="no" display-inline="no-display-inline" id="HFE1C47316B8D4A4CB4FD25C49C1C8F53"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 106(a) of division B of the Tax
			 Relief and Health Care Act of 2006 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395</external-xref> note) is amended by striking
			 <quote>September 30, 2007</quote> and inserting <quote>September 30,
			 2008</quote>.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H6A08E24392FB4A2E8DD3D1DDFA6CA4D9"><enum>(2)</enum><header display-inline="yes-display-inline">Special exception
			 reclassifications</header><text display-inline="yes-display-inline">The
			 Secretary of Health and Human Services shall extend for discharges occurring
			 through September 30, 2008, the special exception reclassifications made under
			 the authority of section 1886(d)(5)(I)(i) of the Social Security Act (42 U.S.C.
			 1395ww(d)(5)(I)(i)) and contained in the final rule promulgated by the
			 Secretary in the Federal Register on August 11, 2004 (69 Fed. Reg. 49105,
			 49107).</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3D54641ED1DD4E2F9900781BD611E4C7"><enum>(3)</enum><header display-inline="yes-display-inline">Use of particular wage index</header><text display-inline="yes-display-inline">For purposes of implementation of this
			 subsection, the Secretary shall use the hospital wage index that was
			 promulgated by the Secretary in the Federal Register on October 10, 2007 (72
			 Fed. Reg. 57634), and any subsequent corrections.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H339A578150594D2F938D2544A1730157"><enum>(b)</enum><header display-inline="yes-display-inline">Disregarding section 508 hospital
			 reclassifications for purposes of group reclassifications</header><text display-inline="yes-display-inline">Section 508 of the Medicare Prescription
			 Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>, 42 U.S.C.
			 1395ww note) is amended by adding at the end the following new
			 subsection:</text>
					<quoted-block display-inline="no-display-inline" id="H413F2E4CBA914F0CB844398438FF51DC" style="OLC">
						<subsection commented="no" display-inline="no-display-inline" id="H80161AFC5F79443A8648F89D7FA1C970"><enum>(g)</enum><header display-inline="yes-display-inline">Disregarding hospital reclassifications for
				purposes of group reclassifications</header><text display-inline="yes-display-inline">For purposes of the reclassification of a
				group of hospitals in a geographic area under section 1886(d) of the Social
				Security Act for purposes of discharges occurring during fiscal year 2008, a
				hospital reclassified under this section (including any such reclassification
				which is extended under section 106(a) of the Medicare Improvements and
				Extension Act of 2006) shall not be taken into account and shall not prevent
				the other hospitals in such area from continuing such a group for such
				purpose.</text>
						</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="H0296C4CB11E24006BF8170320004A619"><enum>(c)</enum><header display-inline="yes-display-inline">Correction of application of wage index
			 during Tax Relief and Health Care Act extension</header><text display-inline="yes-display-inline">In the case of a subsection (d) hospital
			 (as defined for purposes of section 1886 of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww</external-xref>)) with
			 respect to which—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="H4A1F14E1B08F4E49BEBAC63773431840"><enum>(1)</enum><text display-inline="yes-display-inline">a reclassification of its wage index for
			 purposes of such section was extended for the period beginning on April 1,
			 2007, and ending on September 30, 2007, pursuant to subsection (a) of section
			 106 of division B of the Tax Relief and Health Care Act of 2006 (42 U.S.C. 1395
			 note); and</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0039BD6496E9437889DC8EC07980264"><enum>(2)</enum><text display-inline="yes-display-inline">the wage index applicable for such hospital
			 during such period was lower than the wage index applicable for such hospital
			 during the period beginning on October 1, 2006, and ending on March 31,
			 2007,</text>
					</paragraph><continuation-text commented="no" continuation-text-level="subsection">the Secretary shall apply the higher
			 wage index that was applicable for such hospital during the period beginning on
			 October 1, 2006, and ending on March 31, 2007, for the entire fiscal year 2007.
			 If the Secretary determines that the application of the preceding sentence to a
			 hospital will result in a hospital being owed additional reimbursement, the
			 Secretary shall make such payments within 90 days after the settlement of the
			 applicable cost report.</continuation-text></subsection></section><section commented="no" display-inline="no-display-inline" id="idD50A6D5D1CF54775BF79942B33013F1D" section-type="subsequent-section"><enum>118.</enum><header display-inline="yes-display-inline">Additional Funding for State Health
			 Insurance Assistance Programs, Area Agencies on Aging, and Aging and Disability
			 Resource Centers</header>
				<subsection commented="no" display-inline="no-display-inline" id="idBF5B5344C4CF459ABCDFDA3596DDB626"><enum>(a)</enum><header display-inline="yes-display-inline">State Health Insurance Assistance
			 Programs</header>
					<paragraph commented="no" display-inline="no-display-inline" id="idE4A22B5057264B088C3C47401527F036"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services
			 shall use amounts made available under paragraph (2) to make grants to States
			 for State health insurance assistance programs receiving assistance under
			 section 4360 of the Omnibus Budget Reconciliation Act of 1990.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF0FCE4DACF37422F82463972D8618581"><enum>(2)</enum><header display-inline="yes-display-inline">Funding</header><text display-inline="yes-display-inline">For purposes of making grants under this
			 subsection, the Secretary shall provide for the transfer, from the Federal
			 Hospital Insurance Trust Fund under section 1817 of the Social Security Act (42
			 U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund under
			 section 1841 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395t">42 U.S.C. 1395t</external-xref>), in the same proportion as the
			 Secretary determines under section 1853(f) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-23">42 U.S.C. 1395w–23(f)</external-xref>),
			 of $15,000,000 to the Centers for Medicare &amp; Medicaid Services Program
			 Management Account for fiscal year 2008.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id934FCD8E6D6F42348FBB6178E1800B3E"><enum>(b)</enum><header display-inline="yes-display-inline">Area Agencies on Aging and Aging and
			 Disability Resource Centers</header>
					<paragraph commented="no" display-inline="no-display-inline" id="idECCA30F4130040ABB86EB3B8601E562E"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services
			 shall use amounts made available under paragraph (2) to make grants—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="id0A38EA7AC1F4459D82C8FD9224304143"><enum>(A)</enum><text display-inline="yes-display-inline">to States for area agencies on aging (as
			 defined in section 102 of the Older Americans Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/42/3002">42 U.S.C. 3002</external-xref>));
			 and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id208A5285673A4439B0786D099D89DEC9"><enum>(B)</enum><text display-inline="yes-display-inline">to Aging and Disability Resource Centers
			 under the Aging and Disability Resource Center grant program.</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id8F5BC6B1548A4F0396ACC86A643816C1"><enum>(2)</enum><header display-inline="yes-display-inline">Funding</header><text display-inline="yes-display-inline">For purposes of making grants under this
			 subsection, the Secretary shall provide for the transfer, from the Federal
			 Hospital Insurance Trust Fund under section 1817 of the Social Security Act (42
			 U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund under
			 section 1841 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395t">42 U.S.C. 1395t</external-xref>), in the same proportion as the
			 Secretary determines under section 1853(f) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-23">42 U.S.C. 1395w–23(f)</external-xref>),
			 of $5,000,000 to the Centers for Medicare &amp; Medicaid Services Program
			 Management Account for the period of fiscal years 2008 through 2009.</text>
					</paragraph></subsection></section></title><title commented="no" id="id6C7184B6049C4A1EBE83927118204214" level-type="subsequent"><enum>II</enum><header display-inline="yes-display-inline">Medicaid and SCHIP</header>
			<section commented="no" display-inline="no-display-inline" id="H32C280AEFA5A416F8FCCC4D842C3C542" section-type="subsequent-section"><enum>201.</enum><header display-inline="yes-display-inline">Extending SCHIP funding through March 31,
			 2009</header>
				<subsection commented="no" display-inline="no-display-inline" id="HC2131501C1964DA4B8AC339DEE678651"><enum>(a)</enum><header display-inline="yes-display-inline">Through the second quarter of fiscal year
			 2009</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H069E4DF445EF4AF18143B32EC8CC5DFF"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 2104 of the Social Security Act (42
			 U.S.C. 1397dd) is amended—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="H51503342AF174218AFE68E4637F8F41C"><enum>(A)</enum><text display-inline="yes-display-inline">in subsection (a)—</text>
							<clause commented="no" display-inline="no-display-inline" id="HCFF0DB2B9821411D9B00B097593BFF8D"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>and</quote> at the end
			 of paragraph (9);</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="H7BEFE44DCF3346318DD657C72D786D92"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking the period at the end of
			 paragraph (10) and inserting <quote>; and</quote>; and</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="HAEEEB4DDD0E6457B96700075764C1BEF"><enum>(iii)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 paragraph:</text>
								<quoted-block display-inline="no-display-inline" id="HFDE1C429AD1E423700DE2D7E8EAEF63F" style="OLC">
									<paragraph commented="no" display-inline="no-display-inline" id="H23E311AC4885428496FBA8FD9BA8B51"><enum>(11)</enum><text display-inline="yes-display-inline">for each of fiscal years 2008 and 2009,
				$5,000,000,000.</text>
									</paragraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD3A36F714C2E4842A793ED65BD2F0136"><enum>(B)</enum><text display-inline="yes-display-inline">in subsection (c)(4)(B), by striking
			 <quote>for fiscal year 2007</quote> and inserting <quote>for each of fiscal
			 years 2007 through 2009</quote>.</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H8C428F1AE92E43AC8D1D00A35C628C1F"><enum>(2)</enum><header display-inline="yes-display-inline">Availability of extended
			 funding</header><text display-inline="yes-display-inline">Funds made available
			 from any allotment made from funds appropriated under subsection (a)(11) or
			 (c)(4)(B) of section 2104 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397dd">42 U.S.C. 1397dd</external-xref>) for
			 fiscal year 2008 or 2009 shall not be available for child health assistance for
			 items and services furnished after March 31, 2009, or, if earlier, the date of
			 the enactment of an Act that provides funding for fiscal years 2008 and 2009,
			 and for one or more subsequent fiscal years for the State Children's Health
			 Insurance Program under title XXI of the Social Security Act.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3AF3837A0A7F416D94D5F5CAC9522DE9"><enum>(3)</enum><header display-inline="yes-display-inline">End of funding under continuing
			 resolution</header><text display-inline="yes-display-inline">Section 136(a)(2)
			 of <external-xref legal-doc="public-law" parsable-cite="pl/110/92">Public Law 110–92</external-xref> is amended by striking <quote>after the termination
			 date</quote> and all that follows and inserting <quote>after the date of the
			 enactment of the <short-title>Medicare, Medicaid, and
			 SCHIP Extension Act of 2007</short-title>.</quote>.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H978F934BA6A347F2B816A85357867157"><enum>(4)</enum><header display-inline="yes-display-inline">Clarification of application of funding
			 under continuing resolution</header><text display-inline="yes-display-inline">Section 107 of <external-xref legal-doc="public-law" parsable-cite="pl/110/92">Public Law 110–92</external-xref> shall
			 apply with respect to expenditures made pursuant to section 136(a)(1) of such
			 Public Law.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H62173388096247A0A8CCDF1BD662B00"><enum>(b)</enum><header display-inline="yes-display-inline">Extension of treatment of qualifying
			 States; rules on redistribution of unspent fiscal year 2005 allotments made
			 permanent</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H2256D2BFC46C4239925E3F837E09007D"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 2105(g)(1)(A) of the Social
			 Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ee">42 U.S.C. 1397ee(g)(1)(A)</external-xref>), as amended by subsection (d) of
			 section 136 of <external-xref legal-doc="public-law" parsable-cite="pl/110/92">Public Law 110–92</external-xref>, is amended by striking <quote>or 2008</quote>
			 and inserting <quote>2008, or 2009</quote>.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF6CA8106F05141AE863336BF2E9B7196"><enum>(2)</enum><header display-inline="yes-display-inline">Applicability</header><text display-inline="yes-display-inline">The amendment made by paragraph (1) shall
			 be in effect through March 31, 2009.</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB20E66B1C86643E59690E01E57D752E2"><enum>(3)</enum><header display-inline="yes-display-inline">Certain rules made permanent</header><text display-inline="yes-display-inline">Subsection (e) of section 136 of Public Law
			 110–92 is repealed.</text>
					</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HBDA823183247462BBC90EC49A6BA00E9"><enum>(c)</enum><header display-inline="yes-display-inline">Additional allotments To eliminate
			 remaining funding shortfalls through March 31, 2009</header>
					<paragraph commented="no" display-inline="no-display-inline" id="H6D8A1393A67D455EA3CF956ADFD9FC6"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 2104 of the Social Security Act (42
			 U.S.C. 1397dd) is amended by adding at the end the following new
			 subsections:</text>
						<quoted-block display-inline="no-display-inline" id="H59422DBAF44C49EBB19858C0E14BD000" style="OLC">
							<subsection commented="no" display-inline="no-display-inline" id="H32C1C61434E64EC79CE76CD9C200D360"><enum>(j)</enum><header display-inline="yes-display-inline">Additional allotments To eliminate funding
				shortfalls for fiscal year 2008</header>
								<paragraph commented="no" display-inline="no-display-inline" id="HC99ADF4928CA45C0A9A30002C85F605E"><enum>(1)</enum><header display-inline="yes-display-inline">Appropriation; allotment
				authority</header><text display-inline="yes-display-inline">For the purpose of
				providing additional allotments described in subparagraphs (A) and (B) of
				paragraph (3), there is appropriated, out of any money in the Treasury not
				otherwise appropriated, such sums as may be necessary, not to exceed
				$1,600,000,000 for fiscal year 2008.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HFF53FC0CBD0F4899A1C25093E969E508"><enum>(2)</enum><header display-inline="yes-display-inline">Shortfall states described</header><text display-inline="yes-display-inline">For purposes of paragraph (3), a shortfall
				State described in this paragraph is a State with a State child health plan
				approved under this title for which the Secretary estimates, on the basis of
				the most recent data available to the Secretary as of November 30, 2007, that
				the Federal share amount of the projected expenditures under such plan for such
				State for fiscal year 2008 will exceed the sum of—</text>
									<subparagraph commented="no" display-inline="no-display-inline" id="HA09D108B8A564960A8178D4C49AB2327"><enum>(A)</enum><text display-inline="yes-display-inline">the amount of the State's allotments for
				each of fiscal years 2006 and 2007 that will not be expended by the end of
				fiscal year 2007;</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H44999489AA67466490676200CD00027B"><enum>(B)</enum><text display-inline="yes-display-inline">the amount, if any, that is to be
				redistributed to the State during fiscal year 2008 in accordance with
				subsection (i); and</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5859B7D89EF64C60B780DEBC50804054"><enum>(C)</enum><text display-inline="yes-display-inline">the amount of the State's allotment for
				fiscal year 2008.</text>
									</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H646D0EE398854E7782EF8BE5E153FD3E"><enum>(3)</enum><header display-inline="yes-display-inline">Allotments</header><text display-inline="yes-display-inline">In addition to the allotments provided
				under subsections (b) and (c), subject to paragraph (4), of the amount
				available for the additional allotments under paragraph (1) for fiscal year
				2008, the Secretary shall allot—</text>
									<subparagraph commented="no" display-inline="no-display-inline" id="H42D831F1789E47688B3753516D823692"><enum>(A)</enum><text display-inline="yes-display-inline">to each shortfall State described in
				paragraph (2) not described in subparagraph (B), such amount as the Secretary
				determines will eliminate the estimated shortfall described in such paragraph
				for the State; and</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0967BBD36DA044D080FDCBBD8B1353DE"><enum>(B)</enum><text display-inline="yes-display-inline">to each commonwealth or territory described
				in subsection (c)(3), an amount equal to the percentage specified in subsection
				(c)(2) for the commonwealth or territory multiplied by 1.05 percent of the sum
				of the amounts determined for each shortfall State under subparagraph
				(A).</text>
									</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0814B79E832541FE93ABE3E02D71B022"><enum>(4)</enum><header display-inline="yes-display-inline">Proration
				rule</header><text display-inline="yes-display-inline">If the amounts available
				for additional allotments under paragraph (1) are less than the total of the
				amounts determined under subparagraphs (A) and (B) of paragraph (3), the
				amounts computed under such subparagraphs shall be reduced
				proportionally.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HBDB30DBB6E2A4ABBA28BB76DAE79A610"><enum>(5)</enum><header display-inline="yes-display-inline">Retrospective adjustment</header><text display-inline="yes-display-inline">The Secretary may adjust the estimates and
				determinations made to carry out this subsection as necessary on the basis of
				the amounts reported by States not later than November 30, 2008, on CMS Form 64
				or CMS Form 21, as the case may be, and as approved by the Secretary.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H20B7A134D1AF4A3ABC26F861CD2EE363"><enum>(6)</enum><header display-inline="yes-display-inline">One-year availability; no redistribution of
				unexpended additional allotments</header><text display-inline="yes-display-inline">Notwithstanding subsections (e) and (f),
				amounts allotted to a State pursuant to this subsection for fiscal year 2008,
				subject to paragraph (5), shall only remain available for expenditure by the
				State through September 30, 2008. Any amounts of such allotments that remain
				unexpended as of such date shall not be subject to redistribution under
				subsection (f).</text>
								</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H88A8591FE2AD4483A961A2FAEC74293"><enum>(k)</enum><header display-inline="yes-display-inline">Redistribution of unused fiscal year 2006
				allotments to States with estimated funding shortfalls during the first 2
				quarters of fiscal year 2009</header>
								<paragraph commented="no" display-inline="no-display-inline" id="HCC6D1D4047BF43D280A294F05E7EF9EA"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Notwithstanding subsection (f) and subject
				to paragraphs (3) and (4), with respect to months beginning during the first 2
				quarters of fiscal year 2009, the Secretary shall provide for a redistribution
				under such subsection from the allotments for fiscal year 2006 under subsection
				(b) that are not expended by the end of fiscal year 2008, to a fiscal year 2009
				shortfall State described in paragraph (2), such amount as the Secretary
				determines will eliminate the estimated shortfall described in such paragraph
				for such State for the month.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H2E08F5E60E814F81A7DD7B9D741BBAD7"><enum>(2)</enum><header display-inline="yes-display-inline">Fiscal year 2009 shortfall State
				described</header><text display-inline="yes-display-inline">A fiscal year 2009
				shortfall State described in this paragraph is a State with a State child
				health plan approved under this title for which the Secretary estimates, on a
				monthly basis using the most recent data available to the Secretary as of such
				month, that the Federal share amount of the projected expenditures under such
				plan for such State for the first 2 quarters of fiscal year 2009 will exceed
				the sum of—</text>
									<subparagraph commented="no" display-inline="no-display-inline" id="HEDFEE1E7FD6340C3A755F584507503A5"><enum>(A)</enum><text display-inline="yes-display-inline">the amount of the State's allotments for
				each of fiscal years 2007 and 2008 that was not expended by the end of fiscal
				year 2008; and</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H960C6CC19CAF44E9A3756E33004DFC3F"><enum>(B)</enum><text display-inline="yes-display-inline">the amount of the State's allotment for
				fiscal year 2009.</text>
									</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H8C17CD97C79541DF9465D1B2CB975E72"><enum>(3)</enum><header display-inline="yes-display-inline">Funds redistributed in the order in which
				States realize funding shortfalls</header><text display-inline="yes-display-inline">The Secretary shall redistribute the
				amounts available for redistribution under paragraph (1) to fiscal year 2009
				shortfall States described in paragraph (2) in the order in which such States
				realize monthly funding shortfalls under this title for fiscal year 2009. The
				Secretary shall only make redistributions under this subsection to the extent
				that there are unexpended fiscal year 2006 allotments under subsection (b)
				available for such redistributions.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H9C030037541C46E4BD16C54E4D37B654"><enum>(4)</enum><header display-inline="yes-display-inline">Proration
				rule</header><text display-inline="yes-display-inline">If the amounts available
				for redistribution under paragraph (1) are less than the total amounts of the
				estimated shortfalls determined for the month under that paragraph, the amount
				computed under such paragraph for each fiscal year 2009 shortfall State for the
				month shall be reduced proportionally.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H11ECE81081C7434297D98B2600A2C3C4"><enum>(5)</enum><header display-inline="yes-display-inline">Retrospective adjustment</header><text display-inline="yes-display-inline">The Secretary may adjust the estimates and
				determinations made to carry out this subsection as necessary on the basis of
				the amounts reported by States not later than May 31, 2009, on CMS Form 64 or
				CMS Form 21, as the case may be, and as approved by the Secretary.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H85EDE32A21674626BC3921D7CB464B"><enum>(6)</enum><header display-inline="yes-display-inline">Availability; no further
				redistribution</header><text display-inline="yes-display-inline">Notwithstanding subsections (e) and (f),
				amounts redistributed to a State pursuant to this subsection for the first 2
				quarters of fiscal year 2009 shall only remain available for expenditure by the
				State through March 31, 2009, and any amounts of such redistributions that
				remain unexpended as of such date, shall not be subject to redistribution under
				subsection (f).</text>
								</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H2FE21ABE60A0487EB110BFBEDD7D703D"><enum>(l)</enum><header display-inline="yes-display-inline">Additional allotments To eliminate funding
				shortfalls for the first 2 quarters of fiscal year 2009</header>
								<paragraph commented="no" display-inline="no-display-inline" id="H2F2923C22A3F4DA28E221753CF045B5"><enum>(1)</enum><header display-inline="yes-display-inline">Appropriation; allotment
				authority</header><text display-inline="yes-display-inline">For the purpose of
				providing additional allotments described in subparagraphs (A) and (B) of
				paragraph (3), there is appropriated, out of any money in the Treasury not
				otherwise appropriated, such sums as may be necessary, not to exceed
				$275,000,000 for the first 2 quarters of fiscal year 2009.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF16157E91E734172A53DE138596C723C"><enum>(2)</enum><header display-inline="yes-display-inline">Shortfall states described</header><text display-inline="yes-display-inline">For purposes of paragraph (3), a shortfall
				State described in this paragraph is a State with a State child health plan
				approved under this title for which the Secretary estimates, on the basis of
				the most recent data available to the Secretary, that the Federal share amount
				of the projected expenditures under such plan for such State for the first 2
				quarters of fiscal year 2009 will exceed the sum of—</text>
									<subparagraph commented="no" display-inline="no-display-inline" id="HF6F719A8BDC3407387B95C3EBA9FA11B"><enum>(A)</enum><text display-inline="yes-display-inline">the amount of the State's allotments for
				each of fiscal years 2007 and 2008 that will not be expended by the end of
				fiscal year 2008;</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0F5EE733F9D1464FA1D2C2B4FB36C3B8"><enum>(B)</enum><text display-inline="yes-display-inline">the amount, if any, that is to be
				redistributed to the State during fiscal year 2009 in accordance with
				subsection (k); and</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H162010CF117A4A8B831CCD02DDCD90B1"><enum>(C)</enum><text display-inline="yes-display-inline">the amount of the State's allotment for
				fiscal year 2009.</text>
									</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF2EB0E3301934ABF87C9EF606C835EE9"><enum>(3)</enum><header display-inline="yes-display-inline">Allotments</header><text display-inline="yes-display-inline">In addition to the allotments provided
				under subsections (b) and (c), subject to paragraph (4), of the amount
				available for the additional allotments under paragraph (1) for the first 2
				quarters of fiscal year 2009, the Secretary shall allot—</text>
									<subparagraph commented="no" display-inline="no-display-inline" id="H432CB11C01AD4E58B8186FFECE09339B"><enum>(A)</enum><text display-inline="yes-display-inline">to each shortfall State described in
				paragraph (2) not described in subparagraph (B) such amount as the Secretary
				determines will eliminate the estimated shortfall described in such paragraph
				for the State; and</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H18351225E6C847B79F5C34D5ECCB359E"><enum>(B)</enum><text display-inline="yes-display-inline">to each commonwealth or territory described
				in subsection (c)(3), an amount equal to the percentage specified in subsection
				(c)(2) for the commonwealth or territory multiplied by 1.05 percent of the sum
				of the amounts determined for each shortfall State under subparagraph
				(A).</text>
									</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H02B18B5FCD5748BA85C6B9077761A753"><enum>(4)</enum><header display-inline="yes-display-inline">Proration
				rule</header><text display-inline="yes-display-inline">If the amounts available
				for additional allotments under paragraph (1) are less than the total of the
				amounts determined under subparagraphs (A) and (B) of paragraph (3), the
				amounts computed under such subparagraphs shall be reduced
				proportionally.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H80F3A3546CF84ED993C94747222F9B3D"><enum>(5)</enum><header display-inline="yes-display-inline">Retrospective adjustment</header><text display-inline="yes-display-inline">The Secretary may adjust the estimates and
				determinations made to carry out this subsection as necessary on the basis of
				the amounts reported by States not later than May 31, 2009, on CMS Form 64 or
				CMS Form 21, as the case may be, and as approved by the Secretary.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H1F6C9F6C75074A498312068E4184A525"><enum>(6)</enum><header display-inline="yes-display-inline">Availability; no redistribution of
				unexpended additional allotments</header><text display-inline="yes-display-inline">Notwithstanding subsections (e) and (f),
				amounts allotted to a State pursuant to this subsection for fiscal year 2009,
				subject to paragraph (5), shall only remain available for expenditure by the
				State through March 31, 2009. Any amounts of such allotments that remain
				unexpended as of such date shall not be subject to redistribution under
				subsection
				(f).</text>
								</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H4308253E655749828F119CCDC65EC8FE" section-type="subsequent-section"><enum>202.</enum><header display-inline="yes-display-inline">Extension of transitional medical
			 assistance (TMA) and abstinence education program</header><text display-inline="no-display-inline">Section 401 of division B of the Tax Relief
			 and Health Care Act of 2006 (<external-xref legal-doc="public-law" parsable-cite="pl/109/432">Public Law 109–432</external-xref>, 120 Stat. 2994),
			 as amended by section 1 of <external-xref legal-doc="public-law" parsable-cite="pl/110/48">Public Law 110–48</external-xref> (121 Stat. 244) and section 2 of
			 the TMA, Abstinence, Education, and QI Programs Extension Act of 2007 (Public
			 Law 110–90, 121 Stat. 984), is amended—</text>
				<paragraph commented="no" display-inline="no-display-inline" id="H4DAA39614CBC4D7CB4B4E2F6375B3043"><enum>(1)</enum><text display-inline="yes-display-inline">by striking <quote>December 31,
			 2007</quote> and inserting <quote>June 30, 2008</quote>; and</text>
				</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id503476BE4E1F44D8B26F15B05FEADA51"><enum>(2)</enum><text display-inline="yes-display-inline">by striking <quote>first quarter</quote>
			 and inserting <quote>third quarter</quote> each place it appears.</text>
				</paragraph></section><section commented="no" display-inline="no-display-inline" id="H8C90C2499662434E84948B6959E24942" section-type="subsequent-section"><enum>203.</enum><header display-inline="yes-display-inline">Extension of qualifying individual (QI)
			 program</header>
				<subsection commented="no" display-inline="no-display-inline" id="id6321B670F2DE4C16853FDE49B19C0405"><enum>(a)</enum><header display-inline="yes-display-inline">Extension</header><text display-inline="yes-display-inline">Section 1902(a)(10)(E)(iv) of the
			 <act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
			 1396a(a)(10)(E)(iv)) is amended by striking <quote>December
			 2007</quote> and inserting <quote>June 2008</quote>.</text>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="H7BDAAA8F33C04F0687CB87190074399F"><enum>(b)</enum><header display-inline="yes-display-inline">Extending Total Amount Available for
			 Allocation</header><text display-inline="yes-display-inline">Section 1933(g)(2)
			 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396u-3">42 U.S.C. 1396u–3(g)(2)</external-xref>) is
			 amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="HDECEAAECDE254FC88DB1768BE564009F"><enum>(1)</enum><text display-inline="yes-display-inline">in subparagraph (G), by striking
			 <quote>and</quote> at the end;</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA089363A5FF944A282353FBD398D2DD8"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (H), by striking the period
			 at the end and inserting <quote>; and</quote>; and</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H46223AE7572049B2A33800444D72CC07"><enum>(3)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subparagraph:</text>
						<quoted-block display-inline="no-display-inline" id="idE402F084AD724881A373FCB4F4F214C4" style="OLC">
							<subparagraph commented="no" display-inline="no-display-inline" id="HA1F0D593A6FD4860BA7FED46CB29E795"><enum>(I)</enum><text display-inline="yes-display-inline">for the period that begins on January 1,
				2008, and ends on June 30, 2008, the total allocation amount is
				$200,000,000.</text>
							</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="HC8808302347C" section-type="subsequent-section"><enum>204.</enum><header display-inline="yes-display-inline">Medicaid DSH extension</header><text display-inline="no-display-inline">Section 1923(f)(6) of the Social Security
			 Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-4">42 U.S.C. 1396r–4(f)(6)</external-xref>) is amended—</text>
				<paragraph commented="no" display-inline="no-display-inline" id="H81B8C1A2127248D8B04EE680B58F00B6"><enum>(1)</enum><text display-inline="yes-display-inline">in the heading, by inserting
			 <quote><header-in-text level="paragraph" style="OLC">and portions of fiscal
			 year 2008</header-in-text></quote> after <quote><header-in-text level="paragraph" style="OLC">fiscal year 2007</header-in-text></quote>;
			 and</text>
				</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD329B314E1104785893EA18E41E9664B"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (A)—</text>
					<subparagraph commented="no" display-inline="no-display-inline" id="H26F9055821D64C7387D9B00732EF2A1"><enum>(A)</enum><text display-inline="yes-display-inline">in clause (i), by adding at the end (after
			 and below subclause (II)) the following:</text>
						<quoted-block display-inline="no-display-inline" id="H795D769BEAA44B94A9C651AEA0C6DF2" style="OLC">
							<quoted-block-continuation-text commented="no" quoted-block-continuation-text-level="clause">Only with respect to fiscal year 2008
				for the period ending on June 30, 2008, the DSH allotment for Tennessee for
				such portion of the fiscal year, notwithstanding such table or terms, shall be
				¾ of the amount specified in the previous sentence for fiscal year
				2007.</quoted-block-continuation-text><after-quoted-block>; </after-quoted-block></quoted-block>
					</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H55D729C36A684FFDAE3347155BA3CAEA"><enum>(B)</enum><text display-inline="yes-display-inline">in clause (ii)—</text>
						<clause commented="no" display-inline="no-display-inline" id="H985BA2475FA04C308D67000019D6E452"><enum>(i)</enum><text display-inline="yes-display-inline">by inserting <quote>or for a period in
			 fiscal year 2008 described in clause (i)</quote> after <quote>fiscal year
			 2007</quote>; and</text>
						</clause><clause commented="no" display-inline="no-display-inline" id="H8278750D42424C1798C83C6B8B006951"><enum>(ii)</enum><text display-inline="yes-display-inline">by inserting <quote>or period</quote> after
			 <quote>such fiscal year</quote>; and</text>
						</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H4CBCBB72DEF94AA094F0C9F790719895"><enum>(C)</enum><text display-inline="yes-display-inline">in clause (iv)—</text>
						<clause commented="no" display-inline="no-display-inline" id="H51C7B4EB70A54B6300A85E513F78EFFB"><enum>(i)</enum><text display-inline="yes-display-inline">in the heading, by inserting
			 <quote><header-in-text level="clause" style="OLC">and fiscal year
			 2008</header-in-text></quote> after <quote><header-in-text level="clause" style="OLC">fiscal year 2007</header-in-text></quote>;</text>
						</clause><clause commented="no" display-inline="no-display-inline" id="H88BBA4A4AE84473594637D5CAD78C931"><enum>(ii)</enum><text display-inline="yes-display-inline">in subclause (I)—</text>
							<subclause commented="no" display-inline="no-display-inline" id="id35A766BD3DFE4368B6F67A00CAA928A3"><enum>(I)</enum><text display-inline="yes-display-inline">by inserting <quote>or for a period in
			 fiscal year 2008 described in clause (i)</quote> after <quote>fiscal year
			 2007</quote>; and</text>
							</subclause><subclause commented="no" display-inline="no-display-inline" id="H74811300C82543499653C7D2004E94F7"><enum>(II)</enum><text display-inline="yes-display-inline">by inserting <quote>or period</quote> after
			 <quote>for such fiscal year</quote>; and</text>
							</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H51E3B4FEADE843DC82C387CD24A42CB8"><enum>(iii)</enum><text display-inline="yes-display-inline">in subclause (II)—</text>
							<subclause commented="no" display-inline="no-display-inline" id="id5D318BD82E194E178EFF169EF9FB2EE2"><enum>(I)</enum><text display-inline="yes-display-inline">by inserting <quote>or for a period in
			 fiscal year 2008 described in clause (i)</quote> after <quote>fiscal year
			 2007</quote>; and</text>
							</subclause><subclause commented="no" display-inline="no-display-inline" id="H6142F097F4724370A0FBA811A7E6E5E9"><enum>(II)</enum><text display-inline="yes-display-inline">by inserting <quote>or period</quote> after
			 <quote>such fiscal year</quote> each place it appears; and</text>
							</subclause></clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF27A046BF53B4D9B8877616F26B84FC1"><enum>(3)</enum><text display-inline="yes-display-inline">in subparagraph (B)(i), by adding at the
			 end the following: <quote>Only with respect to fiscal year 2008 for the period
			 ending on June 30, 2008, the DSH allotment for Hawaii for such portion of the
			 fiscal year, notwithstanding the table set forth in paragraph (2), shall be
			 $7,500,000. </quote>.</text>
				</paragraph></section><section commented="no" display-inline="no-display-inline" id="HB999D96FC99F421C8033239500FB1373" section-type="subsequent-section"><enum>205.</enum><header display-inline="yes-display-inline">Improving data collection</header><text display-inline="no-display-inline">Section 2109(b)(2) of the Social Security
			 Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397ii">42 U.S.C. 1397ii(b)(2)</external-xref>) is amended by inserting before the period at the
			 end the following <quote>(except that only with respect to fiscal year 2008,
			 there are appropriated $20,000,000 for the purpose of carrying out this
			 subsection, to remain available until expended)</quote>.</text>
			</section><section commented="no" display-inline="no-display-inline" id="HCEAF4191D3A64C0EAC9E445B010047D2" section-type="subsequent-section"><enum>206.</enum><header display-inline="yes-display-inline">Moratorium on certain payment
			 restrictions</header><text display-inline="no-display-inline">Notwithstanding
			 any other provision of law, the Secretary of Health and Human Services shall
			 not, prior to June 30, 2008, take any action (through promulgation of
			 regulation, issuance of regulatory guidance, use of Federal payment audit
			 procedures, or other administrative action, policy, or practice, including a
			 Medical Assistance Manual transmittal or letter to State Medicaid directors) to
			 impose any restrictions relating to coverage or payment under title XIX of the
			 Social Security Act for rehabilitation services or school-based administration
			 and school-based transportation if such restrictions are more restrictive in
			 any aspect than those applied to such areas as of July 1, 2007.</text>
			</section></title><title commented="no" id="id314BA201933142E9900066D7B1C2130F" level-type="subsequent"><enum>III</enum><header display-inline="yes-display-inline">Miscellaneous</header>
			<section commented="no" display-inline="no-display-inline" id="id3197D6A88EFC4DA8AB0E74160B1CCAB8" section-type="subsequent-section"><enum>301.</enum><header display-inline="yes-display-inline">Medicare Payment Advisory Commission
			 status</header><text display-inline="no-display-inline">Section 1805(a) of the
			 Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395b-6">42 U.S.C. 1395b–6(a)</external-xref>) is amended
			 by inserting <quote>as an agency of Congress</quote> after
			 <quote>established</quote>.</text>
			</section><section commented="no" display-inline="no-display-inline" id="IDE81560453319427CB39FA6E5A9EE8DC1" section-type="subsequent-section"><enum>302.</enum><header display-inline="yes-display-inline">Special Diabetes Programs for Type I
			 Diabetes and Indians</header>
				<subsection commented="no" display-inline="no-display-inline" id="ID33F3E9F19F25409DB1CD4E0712A7D026"><enum>(a)</enum><header display-inline="yes-display-inline">Special Diabetes Programs for Type I
			 Diabetes</header><text display-inline="yes-display-inline">Section
			 330B(b)(2)(C) of the <act-name parsable-cite="PHSA">Public Health Service
			 Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/254c-2">42 U.S.C. 254c–2(b)(2)(C)</external-xref>) is amended by striking
			 <quote>2008</quote> and inserting <quote>2009</quote>.</text>
				</subsection><subsection commented="no" display-inline="no-display-inline" id="ID5D81F36726F34E848C25F1E32B8782E7"><enum>(b)</enum><header display-inline="yes-display-inline">Special Diabetes Programs for
			 Indians</header><text display-inline="yes-display-inline">Section 330C(c)(2)(C)
			 of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42
			 U.S.C. 254c–3(c)(2)(C)) is amended by striking <quote>2008</quote> and
			 inserting <quote>2009</quote>.</text>
				</subsection></section></title></legis-body>
	<attestation>
		<attestation-group>
			<attestation-date chamber="Senate" date="20071218">Passed the Senate
			 December 18, 2007.</attestation-date>
			<attestor display="no"></attestor>
			<role>Secretary</role>
		</attestation-group>
	</attestation>
	<endorsement display="yes">
	</endorsement>
</bill>


