1.Short
title; table of contents
(a)This Act may be cited
as the Medicare and Medicaid Extension
Act of 2008
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of
contents.
TITLE I—Medicare
Sec. 101. Extension of physician payment update.
Sec. 102. Extension of floor on Medicare work geographic
adjustment under the Medicare physician fee schedule.
Sec. 103. Extension of treatment of certain physician pathology
services under Medicare.
Sec. 104. Extension of exceptions process for Medicare therapy
caps.
Sec. 105. Extension of payment rule for brachytherapy and
therapeutic radiopharmaceuticals.
Sec. 106. Extension of accommodation of physicians ordered to
active duty in the Armed Services.
Sec. 107. Delay in and reform of Medicare DMEPOS competitive
acquisition program.
TITLE II—Medicaid
Sec. 201. Extension of qualifying individual (QI)
program.
Sec. 202. Extension of transitional medical assistance (TMA)
and abstinence education program.
Sec. 203. Medicaid
DSH extension.
TITLE III—Contingency
Sec. 301. Contingency.
<enum>I</enum><header>Medicare</header>
<section id="H0BD1C61FECC54F2CBF2D0300354D2323"><enum>101.</enum><header>Extension of
physician payment update</header>
<subsection display-inline="no-display-inline" id="H7CA36F83D2F64EA696C5CA4D3140B6"><enum>(a)</enum><header>In
general</header><text>Section 1848(d)(8) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1395w–4(d)(8)),
as added by section 101 of the Medicare, Medicaid, and SCHIP Extension Act of
2007 (Public Law 110–173), is amended—</text>
<paragraph display-inline="no-display-inline" id="id4378EF4B4B3F433D99414879183393D7"><enum>(1)</enum><text>in subparagraph
(A), by striking <quote>June 30, 2008</quote> and inserting <quote>July 31,
2008</quote>; and</text>
</paragraph><paragraph display-inline="no-display-inline" id="id3AEFE2EB47EA42B5907BABD3546F5A31"><enum>(2)</enum><text>in subparagraph
(B), by striking <quote>July 1, 2008</quote> and inserting <quote>August 1,
2008</quote>.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id8E17FB1A5B28431C8220238D86ADD32C"><enum>(b)</enum><header>Revision of the
Physician Assistance and Quality Initiative Fund</header><text>Section
1848(l)(2)(A)(i) of the Social Security Act (42 U.S.C. 1395w–4(l)(2)(A)(i)), as
amended by section 101(a)(2) of the Medicare, Medicaid, and SCHIP Extension Act
of 2007 (Public Law 110–173) and by section 7002(c) of the Supplemental
Appropriations Act, 2008, is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="idC5F01BE09C3E41A88035313502B97EF1"><enum>(1)</enum><text>in subclause
(III), by inserting <quote> reduced by $600,000,000</quote> before the period
at the end; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HC96AAFD10A004E9EAD40E8DBFF080025"><enum>(2)</enum><text>in subclause (IV),
by inserting <quote> increased by $220,000,000</quote> before the period at the
end.</text>
</paragraph></subsection><subsection display-inline="no-display-inline" id="idAA47C31FEFB94A99932643FDC0A1214B"><enum>(c)</enum><header>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 such provisions and amendments, there are appropriated to the
Centers for Medicare & Medicaid Services Program Management Account, out of
any money in the Treasury not otherwise appropriated, $20,000,000.</text>
</subsection></section><section id="H7C6BF9A6A0954ACFA38C097EE3AD5E5D"><enum>102.</enum><header>Extension of
floor on Medicare work geographic adjustment under the Medicare physician fee
schedule</header>
<subsection id="id960E5AB96414472CB5F5D6395B908988"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 1848(e)(1)(E)
of the Social Security Act (42 U.S.C. 1395w–4(e)(1)(E)), as amended by section
103 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law
110–173), is amended by striking <quote>before July 1, 2008</quote> and
inserting <quote>before August 1, 2008</quote>.</text>
</subsection><subsection commented="no" id="id2870635DB8294F4F97241E18548B58E3"><enum>(b)</enum><header>Technical
correction</header><text>Section 602(1) of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2301)
is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="idC104AA6A53884FCC97474CD38A16D3FA" style="OLC">
<paragraph commented="no" id="id69D926D14B4E43988CBC901B48712FC4"><enum>(1)</enum><text>in subparagraph
(A), by striking <quote>subparagraphs (B), (C), and (E)</quote> and inserting
<quote>subparagraphs (B), (C), (E), and (G)</quote>;
and</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="IDB4F6FB08B8FB4763AF28883C6819D5F2"><enum>103.</enum><header>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 Public Law 106–554), as amended by section 732 of the
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (42
U.S.C. 1395w–4 note), section 104 of division B of the Tax Relief and Health
Care Act of 2006 (42 U.S.C. 1395w–4 note), and section 104 of the Medicare,
Medicaid, and SCHIP Extension Act of 2007 (Public Law 110–173), is amended by
striking <quote>the first 6 months of 2008</quote> and inserting <quote>the
first 7 months of 2008</quote>.</text>
</section><section display-inline="no-display-inline" id="H172B88F80D3C4EBAA72700E719AF66E4"><enum>104.</enum><header>Extension of
exceptions process for Medicare therapy caps</header><text display-inline="no-display-inline">Section 1833(g)(5) of the Social Security
Act (42 U.S.C. 1395l(g)(5)), as amended by section 105 of the Medicare,
Medicaid, and SCHIP Extension Act of 2007 (Public Law 110–173), is amended by
striking <quote>June 30, 2008</quote> and inserting <quote>July 31,
2008</quote>.</text>
</section><section id="idD31A9507CD944285B702653BAF1D7057"><enum>105.</enum><header>Extension of
payment rule for brachytherapy and therapeutic
radiopharmaceuticals</header><text display-inline="no-display-inline">Section
1833(t)(16)(C) of the Social Security Act (42 U.S.C. 1395l(t)(16)(C)), as
amended by section 106 of the Medicare, Medicaid, and SCHIP Extension Act of
2007 (Public Law 110–173), is amended by striking <quote>July 1, 2008</quote>
each place it appears and inserting <quote>August 1, 2008</quote>.</text>
</section><section display-inline="no-display-inline" id="H81CEF34DA978412996712F389B380465" section-type="subsequent-section"><enum>106.</enum><header>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395u">42 U.S.C. 1395u(b)(6)(D)(iii)</external-xref>), as
amended by section 116 of the Medicare, Medicaid, and SCHIP Extension Act of
2007 (Public Law 110–173), is amended by striking <quote>July 1, 2008</quote>
and inserting <quote>August 1, 2008</quote>.</text>
</section><section id="HA9740FD5279F4B4FBC18BB90DDB6C96" section-type="subsequent-section"><enum>107.</enum><header>Delay in and reform
of Medicare DMEPOS competitive acquisition program</header>
<subsection id="H6AF0642E6F38480789BE58F4E2226704"><enum>(a)</enum><header>Temporary delay
and reform</header>
<paragraph id="H5B1A5E8B9AE64E8CA4DE05C2B2CD7A8"><enum>(1)</enum><header>In
general</header><text>Section 1847(a) of the Social Security Act (42 U.S.C.
1395w–3(a)) is amended—</text>
<subparagraph id="H310D01BA2A484D78AF82841337F8C4B7"><enum>(A)</enum><text>in paragraph
(1)—</text>
<clause id="HE76664DF253A42168C76576832155255"><enum>(i)</enum><text>in
subparagraph (B)(i), in the matter before subclause (I), by inserting
<quote>consistent with subparagraph (D)</quote> after <quote>in a
manner</quote>;</text>
</clause><clause id="HA23F852A46A84D3AB6CB4CA352F2CCB3"><enum>(ii)</enum><text>in
subparagraph (B)(i)(II), by striking <quote>80 </quote> and <quote>in
2009</quote> and inserting <quote>an additional 70</quote> and <quote>in
2011</quote>, respectively;</text>
</clause><clause id="HC6663C31FA734A7FBF52D17779956BF3"><enum>(iii)</enum><text>in
subparagraph (B)(i)(III), by striking <quote>after 2009</quote> and inserting
<quote>after 2011 (or, in the case of national mail order for items and
services, after 2010)</quote>; and</text>
</clause><clause id="HE673D3C155A04562AC63148D005DD038"><enum>(iv)</enum><text>by
adding at the end the following new subparagraphs:</text>
<quoted-block display-inline="no-display-inline" id="HB71E9C1283C14593A563393C92DF75A5" style="OLC">
<subparagraph id="HE152DC5C66314A338600847BBEC723F8"><enum>(D)</enum><header>Changes in
competitive acquisition programs</header>
<clause id="H51DFB96897E749039D7E4040936D9868"><enum>(i)</enum><header>Round 1 of
competitive acquisition program</header><text>Notwithstanding subparagraph
(B)(i)(I) and in implementing the first round of the competitive acquisition
programs under this section—</text>
<subclause id="HFE79FEDEEA834A99A4AFEF006F826534"><enum>(I)</enum><text display-inline="yes-display-inline">the contracts awarded under this section
before the date of the enactment of this subparagraph are terminated, no
payment shall be made under this title on or after the date of the enactment of
this subparagraph based on such a contract, and, to the extent that any damages
may be applicable as a result of the termination of such contracts, such
damages shall be payable from the Federal Supplementary Medical Insurance Trust
Fund under section 1841;</text>
</subclause><subclause id="HA02FB736ECEE425D9F5DF315B686F987"><enum>(II)</enum><text display-inline="yes-display-inline">the Secretary shall conduct the competition
for such round in a manner so that it occurs in 2009 with respect to the same
items and services and the same areas, except as provided in subclauses (III)
and (IV);</text>
</subclause><subclause id="H479AAFDF66924444BE0066F3A3ADC861"><enum>(III)</enum><text display-inline="yes-display-inline">the Secretary shall exclude Puerto Rico so
that such round of competition covers 9, instead of 10, of the largest
metropolitan statistical areas; and</text>
</subclause><subclause id="H11A89709A8D5446E8965EC8CB3CA841"><enum>(IV)</enum><text>there shall be
excluded negative pressure wound therapy items and services.</text>
</subclause><continuation-text continuation-text-level="clause">Nothing in
subclause (I) shall be construed to provide an independent cause of action or
right to administrative or judicial review with regard to the termination
provided under such subclause.</continuation-text></clause><clause id="H80E00EDA13144E19A6726D7618CADEEC"><enum>(ii)</enum><header>Round 2 of
competitive acquisition program</header><text display-inline="yes-display-inline">In implementing the second round of the
competitive acquisition programs under this section described in subparagraph
(B)(i)(II)—</text>
<subclause id="HE0EE55FAD13745F9836E4343928692BA"><enum>(I)</enum><text>the metropolitan
statistical areas to be included shall be those metropolitan statistical areas
selected by the Secretary for such round as of June 1, 2008; and</text>
</subclause><subclause id="HC41B65805243409DA4F72F97A0C87746"><enum>(II)</enum><text>the Secretary may
subdivide metropolitan statistical areas with populations (based upon the most
recent data from the Census Bureau) of at least 8,000,000 into separate areas
for competitive acquisition purposes.</text>
</subclause></clause><clause id="H200339EA07214054B7FFB2C7D9D588FB"><enum>(iii)</enum><header>Exclusion of
certain areas in subsequent rounds of competitive acquisition
programs</header><text display-inline="yes-display-inline">In implementing
subsequent rounds of the competitive acquisition programs under this section,
including under subparagraph (B)(i)(III), for competitions occurring before
2015, the Secretary shall exempt from the competitive acquisition program
(other than national mail order) the following:</text>
<subclause id="HCC2209595F7249E4A9E2A4FBDF8A4AF"><enum>(I)</enum><text>Rural areas.</text>
</subclause><subclause id="H5C4743B68275431293A2E1EE04C1A903"><enum>(II)</enum><text>Metropolitan
statistical areas not selected under round 1 or round 2 with a population of
less than 250,000.</text>
</subclause><subclause id="H6F9AA4B5D44647A587D229DCB45BB17"><enum>(III)</enum><text>Areas with a low
population density within a metropolitan statistical area that is otherwise
selected, as determined for purposes of paragraph (3)(A).</text>
</subclause></clause></subparagraph><subparagraph id="HCF7FBE0E6556485AB46D59C9AEC545B0"><enum>(E)</enum><header>Verification by
OIG</header><text display-inline="yes-display-inline">The Inspector General of
the Department of Health and Human Services shall, through post-award audit,
survey, or otherwise, assess the process used by the Centers for Medicare &
Medicaid Services to conduct competitive bidding and subsequent pricing
determinations under this section that are the basis for pivotal bid amounts
and single payment amounts for items and services in competitive bidding areas
under rounds 1 and 2 of the competitive acquisition programs under this section
and may continue to verify such calculations for subsequent rounds of such
programs.</text>
</subparagraph><subparagraph id="H36A38BA9029A4E6F8762D7DE688A1A0"><enum>(F)</enum><header>Supplier feedback
on missing financial documentation</header>
<clause id="HAC0CEEA7D313456A8F8000C54569E622"><enum>(i)</enum><header>In
general</header><text display-inline="yes-display-inline">In the case of a bid
where one or more covered documents in connection with such bid have been
submitted not later than the covered document review date specified in clause
(ii), the Secretary—</text>
<subclause id="H08CF749622F24C939B8F10EED6000F9"><enum>(I)</enum><text display-inline="yes-display-inline">shall provide, by not later than 45 days
(in the case of the first round of the competitive acquisition programs as
described in subparagraph (B)(i)(I)) or 90 days (in the case of a subsequent
round of such programs) after the covered document review date, for notice to
the bidder of all such documents that are missing as of the covered document
review date; and</text>
</subclause><subclause id="HF80F84003BCA47BE9F95FF6B49179E98"><enum>(II)</enum><text>may not reject
the bid on the basis that any covered document is missing or has not been
submitted on a timely basis, if all such missing documents identified in the
notice provided to the bidder under subclause (I) are submitted to the
Secretary not later than 10 business days after the date of such notice.</text>
</subclause></clause><clause id="H0BBB99E78D274799B519D7D302D4D3B1"><enum>(ii)</enum><header>Covered
document review date</header><text>The covered document review date specified
in this clause with respect to a competitive acquisition program is the later
of—</text>
<subclause id="H0A2410D220724DD48D1100EE33899EE2"><enum>(I)</enum><text>the date that is
30 days before the final date specified by the Secretary for submission of bids
under such program; or</text>
</subclause><subclause id="H8D1CE8AD619D427EA8B1EADCAB348A4"><enum>(II)</enum><text display-inline="yes-display-inline">the date that is 30 days after the first
date specified by the Secretary for submission of bids under such
program.</text>
</subclause></clause><clause id="HC4DE432512294476A98C9B2288F686FE"><enum>(iii)</enum><header>Limitations of
process</header><text>The process provided under this subparagraph—</text>
<subclause id="H70F5815745CF487F90F106A6CE3106C"><enum>(I)</enum><text>applies only to the
timely submission of covered documents;</text>
</subclause><subclause id="HE302C5CA70AF43199D1C159E7775106B"><enum>(II)</enum><text>does not apply to
any determination as to the accuracy or completeness of covered documents
submitted or whether such documents meet applicable requirements;</text>
</subclause><subclause id="H5EAF0EAA01A64DA600E00420E85FAAE8"><enum>(III)</enum><text>shall not
prevent the Secretary from rejecting a bid based on any basis not described in
clause (i)(II); and</text>
</subclause><subclause id="HC29ED84343FA4F25B88E8912DD13B800"><enum>(IV)</enum><text>shall not be
construed as permitting a bidder to change bidding amounts or to make other
changes in a bid submission.</text>
</subclause></clause><clause id="H7DF328D0204745E8A5B318A867F3398C"><enum>(iv)</enum><header>Covered
document defined</header><text>In this subparagraph, the term <quote>covered
document</quote> means a financial, tax, or other document required to be
submitted by a bidder as part of an original bid submission under a competitive
acquisition program in order to meet required financial standards. Such term
does not include other documents, such as the bid itself or accreditation
documentation.</text>
</clause></subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="H5A079BDB5CA941979750EDA862EC1DE"><enum>(B)</enum><text>in paragraph
(2)(A), by inserting before the period at the end the following: <quote>and
excluding certain complex rehabilitative power wheelchairs recognized by the
Secretary as classified within group 3 or higher (and related accessories when
furnished in connection with such wheelchairs)</quote>.</text>
</subparagraph></paragraph><paragraph id="HE271711DB1E54DA3009B271B6B61F4EB"><enum>(2)</enum><header>Budget neutral
offset</header>
<subparagraph id="HCD62FDCDA2E34A68BB877CDEAC111A6"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 1834(a)(14)
of such Act (42 U.S.C. 1395m(a)(14)) is amended—</text>
<clause id="H0A4972CCFC4843FDA4840543667C95C6"><enum>(i)</enum><text>by
striking <quote>and</quote> at the end of subparagraphs (H) and (I);</text>
</clause><clause id="H04269FC508E7441F80805CC86E9E78CC"><enum>(ii)</enum><text>by
redesignating subparagraph (J) as subparagraph (M); and</text>
</clause><clause id="HA2C1057C6BD04B9BB5BCC3C0223B3DCB"><enum>(iii)</enum><text>by
inserting after subparagraph (I) the following new subparagraphs:</text>
<quoted-block display-inline="no-display-inline" id="HEFFF02C5A11D47B8A31ECD53357B7E0" style="OLC">
<subparagraph id="H748FC778C77E4FEE94BF01C6C12D25A9"><enum>(J)</enum><text display-inline="yes-display-inline">for 2009—</text>
<clause id="HBBDFA7BA4513432CB8766330B3E01DD"><enum>(i)</enum><text display-inline="yes-display-inline">in the case of items and services furnished
in any geographic area, if such items or services were selected for competitive
acquisition in any area under the competitive acquisition program under section
1847(a)(1)(B)(i)(I) before July 1, 2008, including related accessories but only
if furnished with such items and services selected for such competition and
diabetic supplies but only if furnished through mail order, - 9.5 percent;
or</text>
</clause><clause id="HFE745D94783E42E9AA488988DB6F8B6"><enum>(ii)</enum><text display-inline="yes-display-inline">in the case of other items and services,
the percentage increase in the consumer price index for all urban consumers
(U.S. urban average) for the 12-month period ending with June 2008;</text>
</clause></subparagraph><subparagraph id="HA9C235F6479A422190D263CAD8D9F5B8"><enum>(K)</enum><text display-inline="yes-display-inline">for 2010, 2011, 2012, and 2013, the
percentage increase in the consumer price index for all urban consumers (U.S.
urban average) for the 12-month period ending with June of the previous
year;</text>
</subparagraph><subparagraph id="H59F266E43F1D4DF583095753006F8094"><enum>(L)</enum><text>for 2014—</text>
<clause id="H8C9CCCADD2034673B09C537BE0B62900"><enum>(i)</enum><text display-inline="yes-display-inline">in the case of items and services described
in subparagraph (J)(i) for which a payment adjustment has not been made under
subsection (a)(1)(F)(ii) in any previous year, the percentage increase in the
consumer price index for all urban consumers (U.S. urban average) for the
12-month period ending with June 2013, plus 2.0 percentage points; or</text>
</clause><clause id="HC4A26F9DB17E4EFF95B862FEC3C81D82"><enum>(ii)</enum><text>in the case of
other items and services, the percentage increase in the consumer price index
for all urban consumers (U.S. urban average) for the 12-month period ending
with June 2013;
and</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="H7AED8D1CC15F4C65934F051F9E00CF42"><enum>(B)</enum><header>Conforming
treatment for certain items and services</header><text>The second sentence of
section 1842(s)(1) of such Act (42 U.S.C. 1395u(s)(1)) is amended by striking
<quote>except that</quote> and all that follows and inserting the
following:</text>
<quoted-block display-inline="yes-display-inline" id="H20FE1948E72C4261BF69D88E12A68D57" style="OLC">
<text>except that for items and services
described in paragraph (2)(D)—</text><subparagraph id="H393C50D73A734F0881AB8FA0AF298973" indent="up1"><enum>(A)</enum><text display-inline="yes-display-inline">for 2009 section 1834(a)(14)(J)(i) shall
apply under this paragraph instead of the percentage increase otherwise
applicable; and</text>
</subparagraph><subparagraph id="H04D5A1A5F8304C65A49ED6343CA3CFCD" indent="up1"><enum>(B)</enum><text>for 2014, if subparagraph (A) is
applied to the items and services and there has not been a payment adjustment
under paragraph (3)(B) for the items and services for any previous year, the
percentage increase computed under section 1834(a)(14)(L)(i) shall apply
instead of the percentage increase otherwise
applicable.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HCE3577AFE39740E1A08F248CA43EEC54"><enum>(3)</enum><header>Conforming
delay</header><text>Subsections (a)(1)(F) and (h)(1)(H) of section 1834 of the
Social Security Act (42 U.S.C. 1395m) are each amended by striking
<quote>January 1, 2009</quote> and inserting <quote>January 1,
2011</quote>.</text>
</paragraph><paragraph id="H1499960983C04900BA68EB5E6B485924"><enum>(4)</enum><header>Considerations
in application</header><text display-inline="yes-display-inline">Section 1834
of such Act (42 U.S.C. 1395m) is amended—</text>
<subparagraph id="HBFA69DD00A0D41F6898066729F695E9C"><enum>(A)</enum><text>in subsection
(a)(1)—</text>
<clause id="HD5E6C0E7609F4AD7B2F12007A6525094"><enum>(i)</enum><text>in
subparagraph (F), by inserting <quote>subject to subparagraph (G),</quote>
before <quote>that are included</quote>; and</text>
</clause><clause id="H6B33E7F3798B4F2D911CB8E505C3B900"><enum>(ii)</enum><text>by
adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H2866CE3BAF73428E8E478F125EC94CAE" style="OLC">
<subparagraph id="H11E89F6992EB418C92BDEE2F4855CBCD"><enum>(G)</enum><header>Use of
information on competitive bid rates</header><text display-inline="yes-display-inline">The Secretary shall specify by regulation
the methodology to be used in applying the provisions of subparagraph (F)(ii)
and subsection (h)(1)(H)(ii). In promulgating such regulation, the Secretary
shall consider the costs of items and services in areas in which such
provisions would be applied compared to the payment rates for such items and
services in competitive acquisition
areas.</text>
</subparagraph><after-quoted-block>; and
</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="HA998A8F435794F49B972E8392C9B76CB"><enum>(B)</enum><text display-inline="yes-display-inline">in subsection (h)(1)(H), by inserting
<quote>subject to subsection (a)(1)(G),</quote> before <quote>that are
included</quote>.</text>
</subparagraph></paragraph></subsection><subsection id="H02D84DC2FF2B4A8A9E5226AE55779982"><enum>(b)</enum><header>Quality
standards</header>
<paragraph id="HC3BE1A7BE18D48C0BF162E009058DFA2"><enum>(1)</enum><header>Application of
accreditation requirement</header>
<subparagraph id="H1F7799D35E4B41E3931D008343CDEA77"><enum>(A)</enum><header>In
general</header><text>Section 1834(a)(20) of the Social Security Act (42 U.S.C.
1395m(a)(20)) is amended—</text>
<clause id="HA918BCB35C8C4D088889815D30A1EF89"><enum>(i)</enum><text>in
subparagraph (E), by inserting <quote>including subparagraph (F),</quote> after
<quote>under this paragraph,</quote>; and</text>
</clause><clause id="H3EC61BF820C043FC98139504F34119D3"><enum>(ii)</enum><text>by
adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H6340A381758F4D3DB2FC14C94A8305" style="OLC">
<subparagraph id="H8E2FAC6263524AA19C182FF1B2C1A3BD"><enum>(F)</enum><header>Application of
accreditation requirement</header><text display-inline="yes-display-inline">In
implementing quality standards under this paragraph—</text>
<clause id="HE06AA8757EF948B29405002DB09C04E3"><enum>(i)</enum><text>subject to clause
(ii), the Secretary shall require suppliers furnishing items and services
described in subparagraph (D) on or after October 1, 2009, directly or as a
subcontractor for another entity, to have submitted to the Secretary evidence
of accreditation by an accreditation organization designated under subparagraph
(B) as meeting applicable quality standards; and</text>
</clause><clause id="HADDE4753FB834FE7A3B03DCD197A2B2"><enum>(ii)</enum><text>in
applying such standards and the accreditation requirement of clause (i) with
respect to eligible professionals (as defined in section 1848(k)(3)(B)), and
including such other persons, such as orthotists and prosthetists, as specified
by the Secretary, furnishing such items and services—</text>
<subclause id="H7ACF168A1AD442D389C46B26D62ECE6"><enum>(I)</enum><text display-inline="yes-display-inline">such standards and accreditation
requirement shall not apply to such professionals and persons unless the
Secretary determines that the standards being applied are designed specifically
to be applied to such professionals and persons; and</text>
</subclause><subclause id="H5D3E438E701E4C3C976FCA2B5D6D42FD"><enum>(II)</enum><text display-inline="yes-display-inline">the Secretary may exempt such professionals
and persons from such standards and requirement if the Secretary determines
that licensing, accreditation, or other mandatory quality requirements apply to
such professionals and persons with respect to the furnishing of such items and
services.</text>
</subclause></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="H4C643C4D5A264B47B3E17F94B4D17BF8"><enum>(B)</enum><header>Construction</header><text>Section
1834(a)(20)(F)(ii) of the Social Security Act, as added by subparagraph (A),
shall not be construed as preventing the Secretary of Health and Human Services
from implementing the first round of competition under section 1847 of such Act
on a timely basis.</text>
</subparagraph></paragraph><paragraph id="HD07D6D649F4C499685C9D38716548940"><enum>(2)</enum><header>Disclosure of
subcontractors under competitive acquisition program</header><text>Section
1847(b)(3) of such Act (42 U.S.C. 1395w–3(b)(3)) is amended by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H5422DFAC38A5449CBD8DF73427D00C0" style="OLC">
<subparagraph id="H9102A07EC2874E24A1310142A116BF15"><enum>(C)</enum><header>Disclosure of
subcontractors</header>
<clause id="HC622AD42C40C475F8DC06BC000C9B722"><enum>(i)</enum><header>Initial
disclosure</header><text display-inline="yes-display-inline">Not later than 10
days after the date a supplier enters into a contract with the Secretary under
this section, such supplier shall disclose to the Secretary, in a form and
manner specified by the Secretary, the information on—</text>
<subclause display-inline="no-display-inline" id="HAC4A4BC044594507B4A9A00BC7DF085"><enum>(I)</enum><text>each subcontracting
relationship that such supplier has in furnishing items and services under the
contract; and</text>
</subclause><subclause id="HC7236F138E694AF09F03E7C0B3D98200"><enum>(II)</enum><text>whether each such
subcontractor meets the requirement of section 1834(a)(20)(F)(i), if applicable
to such subcontractor.</text>
</subclause></clause><clause id="H145196B182004D98A99015A000E5062D"><enum>(ii)</enum><header>Subsequent
disclosure</header><text>Not later than 10 days after such a supplier
subsequently enters into a subcontracting relationship described in clause
(i)(II), such supplier shall disclose to the Secretary, in such form and
manner, the information described in subclauses (I) and (II) of clause
(i).</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HE922D19375FD480B9DEACBF0BDC3E2E9"><enum>(3)</enum><header>Competitive
acquisition ombudsman</header><text>Section 1847 of such Act (42 U.S.C.
1395w–3) is amended by adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="HF146DECB628A4D2A94FB75FFC0065D9" style="OLC">
<subsection id="HB86D99A257B74E659846A5685FFD64DD"><enum>(f)</enum><header>Competitive
acquisition ombudsman</header><text display-inline="yes-display-inline">The
Secretary shall provide for a competitive acquisition ombudsman within the
Centers for Medicare & Medicaid Services in order to respond to complaints
and inquiries made by suppliers and individuals relating to the application of
the competitive acquisition program under this section. The ombudsman may be
within the office of the Medicare Beneficiary Ombudsman appointed under section
1808(c). The ombudsman shall submit to Congress an annual report on the
activities under this subsection, which report shall be coordinated with the
report provided under section
1808(c)(2)(C).</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HDF5410F7E8F6463EA210324D2F26E768"><enum>(c)</enum><header>Change in
reports and deadlines</header>
<paragraph id="H1DE87D358A3145188C6595FB90228B56"><enum>(1)</enum><header>GAO
report</header><text>Section 302(b)(3) of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (Public Law 108-173) is
amended—</text>
<subparagraph id="HB7FF07339E5D415A920075A72FA71305"><enum>(A)</enum><text>in subparagraph
(A)—</text>
<clause id="HF1C42922904F47418D6FEA1F6CDAC257"><enum>(i)</enum><text>by
inserting <quote>and as amended by section 2 of the Medicare DMEPOS Competitive
Acquisition Reform Act of 2008</quote> after <quote>as amended by paragraph
(1)</quote>; and</text>
</clause><clause id="H1D39E8F4651F42B2B900BE1492901600"><enum>(ii)</enum><text>by
inserting before the period at the end the following: <quote>and the topics
specified in subparagraph (C)</quote>;</text>
</clause></subparagraph><subparagraph id="HDD743C84571D4DA3B798C78433D041C"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking <quote>Not
later than January 1, 2009,</quote> and inserting <quote>Not later than 1 year
after the first date that payments are made under section 1847 of the Social
Security Act,</quote>; and</text>
</subparagraph><subparagraph id="HC775A3F9DB03472086E2B7EDD223D07"><enum>(C)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="HF991AA290E4346E0943FC08672690975" style="OLC">
<subparagraph id="H8EFD03478CB34E51925165AEECE1087"><enum>(C)</enum><header>Topics</header><text display-inline="yes-display-inline">The topics specified in this subparagraph,
for the study under subparagraph (A) concerning the competitive acquisition
program, are the following:</text>
<clause id="H4FABEB2363444C99AF85D9F3E2F4001D"><enum>(i)</enum><text display-inline="yes-display-inline">Beneficiary access to items and services
under the program, including the impact on such access of awarding contracts to
bidders that—</text>
<subclause id="HD639673332B746B68F2E2CBDC1DE2CF4"><enum>(I)</enum><text>did not have a
physical presence in an area where they received a contract; or</text>
</subclause><subclause id="H369050E1BF6F49FE9BD6D23BB5B8AA08"><enum>(II)</enum><text>had no previous
experience providing the product category they were contracted to
provide.</text>
</subclause></clause><clause id="H5F6BA051D5F7428184C9B3657D1E9C1B"><enum>(ii)</enum><text>Beneficiary
satisfaction with the program and cost savings to beneficiaries under the
program.</text>
</clause><clause id="H81EC4ACDB8184060956FA22E00C89978"><enum>(iii)</enum><text>Costs to
suppliers of participating in the program and recommendations about ways to
reduce those costs without compromising quality standards or savings to the
Medicare program.</text>
</clause><clause id="HBDBA2D52972942D0B6F6E012F46844BA"><enum>(iv)</enum><text>Impact of the
program on small business suppliers.</text>
</clause><clause id="H82A366EFE4FC4420003DEEEDC758B234"><enum>(v)</enum><text display-inline="yes-display-inline">Analysis of the impact on utilization of
different items and services paid within the same Healthcare Common Procedure
Coding System (HCPCS) code.</text>
</clause><clause id="H80DFA964F3C14D5FB18257031C56F7EC"><enum>(vi)</enum><text>Costs to the
Centers for Medicare & Medicaid Services, including payments made to
contractors, for administering the program compared with administration of a
fee schedule, in comparison with the relative savings of the program.</text>
</clause><clause id="H9082B25106474785B037376611E3D3AB"><enum>(vii)</enum><text display-inline="yes-display-inline">Impact on access, Medicare spending, and
beneficiary spending of any difference in treatment for diabetic testing
supplies depending on how such supplies are furnished.</text>
</clause><clause id="HFC008D3F86FC43C6BE02F4DBBFAEE5E"><enum>(viii)</enum><text>Such other
topics as the Comptroller General determines to be
appropriate.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H309345773AA542E9B4665C07F9BA50F5"><enum>(2)</enum><header>Delay in other
deadlines</header>
<subparagraph id="H64940F8209C4483EABE906003FA4E90"><enum>(A)</enum><header>Program Advisory
and Oversight Committee</header><text>Section 1847(c)(5) of the Social Security
Act (42 U.S.C. 1395w–3(c)(5)) is amended by striking <quote>December 31,
2009</quote> and inserting <quote>December 31, 2011</quote>.</text>
</subparagraph><subparagraph id="H97875B2879004FACA7E17C1400B11B58"><enum>(B)</enum><header>Secretarial
report</header><text display-inline="yes-display-inline">Section 1847(d) of
such Act (42 U.S.C. 1395w–3(d)) is amended by striking <quote>July 1,
2009</quote> and inserting <quote>July 1, 2011</quote>.</text>
</subparagraph><subparagraph id="HC89AB89D24B84E82A5CCB593933DE51D"><enum>(C)</enum><header>IG
report</header><text display-inline="yes-display-inline">Section 302(e) of the
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public
Law 108-173) is amended by striking <quote>July 1, 2009</quote> and inserting
<quote>July 1, 2011</quote>.</text>
</subparagraph></paragraph><paragraph id="HBC35B2F135984368B8FBDBCC2183C9D0"><enum>(3)</enum><header>Evaluation of
certain code</header><text display-inline="yes-display-inline">The Secretary of
Health and Human Services shall evaluate the existing Health Care Common
Procedure Coding System (HCPCS) codes for negative pressure wound therapy to
ensure accurate reporting and billing for items and services under such codes.
In carrying out such evaluation, the Secretary shall use an existing process,
administered by the Durable Medical Equipment Medicare Administrative
Contractors, for the consideration of coding changes and consider all relevant
studies and information furnished pursuant to such process.</text>
</paragraph></subsection><subsection id="H2BB3D01A79BB44A791F323209FBCDE2"><enum>(d)</enum><header>Other
provisions</header>
<paragraph id="H3C65F24640A74BA6A2CC1F07A6F4DAD"><enum>(1)</enum><header>Exemption from
competitive acquisition for certain off-the-shelf orthotics</header><text display-inline="yes-display-inline">Section 1847(a) of the Social Security Act
(42 U.S.C. 1395w–3(a)) is amended by adding at the end the following new
paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H60233BED848C42D2B64EF895DD68A9FB" style="OLC">
<paragraph id="H26CFA8A1071F426794AA4C68D711CBB"><enum>(7)</enum><header>Exemption from
competitive acquisition</header><text display-inline="yes-display-inline">The
programs under this section shall not apply to the following:</text>
<subparagraph id="HD624AEB14F574B5BAA545E00ECC53CDE"><enum>(A)</enum><header>Certain
off-the-shelf orthotics</header><text display-inline="yes-display-inline">Items
and services described in paragraph (2)(C) if furnished—</text>
<clause id="H652F24852A1C43C68EE16295400E971"><enum>(i)</enum><text display-inline="yes-display-inline">by a physician or other practitioner (as
defined by the Secretary) to the physician’s or practitioner’s own patients as
part of the physician’s or practitioner’s professional service; or</text>
</clause><clause id="H679F06B1D3154BDCA783C2C41CDBFF37"><enum>(ii)</enum><text display-inline="yes-display-inline">by a hospital to the hospital’s own
patients during an admission or on the date of discharge.</text>
</clause></subparagraph><subparagraph id="H121640B6DC234AE09B64BC23E1113BB5"><enum>(B)</enum><header>Certain durable
medical equipment</header><text display-inline="yes-display-inline">Those items
and services described in paragraph (2)(A)—</text>
<clause id="H4DCDE046238B4407ABA76743124D1FD2"><enum>(i)</enum><text>that are furnished
by a hospital to the hospital’s own patients during an admission or on the date
of discharge; and</text>
</clause><clause id="H5D3C7B90C48544A1923C2B00AC4B6224"><enum>(ii)</enum><text>to which such
programs would not apply, as specified by the Secretary, if furnished by a
physician to the physician’s own patients as part of the physician’s
professional
service.</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HF8EFCE1DC4A2468A87E9DDACE37B479D"><enum>(2)</enum><header>Correction in
face-to-face examination requirement</header><text>Section 1834(a)(1)(E)(ii) of
such Act (42 U.S.C. 1395m(a)(1)(E)(ii)) is amended by striking
<quote>1861(r)(1)</quote> and inserting <quote>1861(r)</quote>.</text>
</paragraph><paragraph id="H8025C675D4854C968378297C30261300"><enum>(3)</enum><header>Special rule in
case of national mail-order competition for diabetic testing
strips</header><text display-inline="yes-display-inline">Section 1847(b) of
such Act (42 U.S.C. 1395w–3(b)) is amended—</text>
<subparagraph id="H2772EFC53703446DA4E2EEB68B488B6B"><enum>(A)</enum><text display-inline="yes-display-inline">by redesignating paragraph (10) as
paragraph (11); and</text>
</subparagraph><subparagraph id="H851E9D7D450B41BCB5EAE78D677DB200"><enum>(B)</enum><text>by inserting after
paragraph (9) the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H02D3573C03D544A2A8BC1E07AD7BF42" style="OLC">
<paragraph id="H83B8911B334049D591EC83618800DD26"><enum>(10)</enum><header>Special rule in
case of competition for diabetic testing strips</header>
<subparagraph id="HFC3D225A52E649988EACE8BC60FAB0AF"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">With respect to the
competitive acquisition program for diabetic testing strips conducted after the
first round of the competitive acquisition programs, if an entity does not
demonstrate to the Secretary that its bid covers types of diabetic testing
strip products that, in the aggregate and taking into account volume for the
different products, cover 50 percent (or such higher percentage as the
Secretary may specify) of all such types of products, the Secretary shall
reject such bid. The volume for such types of products may be determined in
accordance with such data (which may be market based data) as the Secretary
recognizes.</text>
</subparagraph><subparagraph id="H6D3A152690214A7CA259DA4DAC4C68E3"><enum>(B)</enum><header>Study of types
of testing strip products</header><text display-inline="yes-display-inline">Before 2011, the Inspector General of the
Department of Health and Human Services shall conduct a study to determine the
types of diabetic testing strip products by volume that could be used to make
determinations pursuant to subparagraph (A) for the first competition under the
competitive acquisition program described in such subparagraph and submit to
the Secretary a report on the results of the study. The Inspector General shall
also conduct such a study and submit such a report before the Secretary
conducts a subsequent competitive acquisition program described in subparagraph
(A).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H2D6AB6A52D1F49AC84526CB68EE5EF8D"><enum>(4)</enum><header>Other conforming
amendments</header><text display-inline="yes-display-inline">Section
1847(b)(11) of such Act, as redesignated by paragraph (3), is amended—</text>
<subparagraph id="H0FD2A640F10848088F1F54A3531C7450"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (C), by inserting
<quote>and the identification of areas under subsection (a)(1)(D)(iii)</quote>
after <quote>(a)(1)(A)</quote>;</text>
</subparagraph><subparagraph id="HD12B68B5BD044A75ACBC90976DF647B7"><enum>(B)</enum><text>in subparagraph
(D), by inserting <quote>and implementation of subsection (a)(1)(D)</quote>
after <quote>(a)(1)(B)</quote>;</text>
</subparagraph><subparagraph id="HB0565239DBEF4768A3A1F59CDF9FADBA"><enum>(C)</enum><text>in subparagraph
(E), by striking <quote>or</quote> at the end;</text>
</subparagraph><subparagraph id="HB617602EF796448EB34DA9B42B7262EC"><enum>(D)</enum><text>in subparagraph
(F), by striking the period at the end and inserting <quote>; or</quote>;
and</text>
</subparagraph><subparagraph id="H0F4585282AE24D48A6DEC87017C7682F"><enum>(E)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H5DFC33D1FACF4802ADA76B124468F1D9" style="OLC">
<subparagraph id="H4D55293C44A64201BE6300006C075BD0"><enum>(G)</enum><text display-inline="yes-display-inline">the implementation of the special rule
described in paragraph
(10).</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H8AEBC32DC7FC4FBF91454205B7C8EA5D"><enum>(5)</enum><header>Funding for
implementation</header><text display-inline="yes-display-inline">In addition to
funds otherwise available, for purposes of implementing the provisions of, and
amendments made by, this section, other than the amendment made by subsection
(c)(1) and other than section 1847(a)(1)(E) of the Social Security Act, the
Secretary of Health and Human Services shall provide for the transfer from the
Federal Supplementary Medical Insurance Trust Fund established under section
1841 of the Social Security Act (42 U.S.C. 1395t) to the Centers for Medicare
& Medicaid Services Program Management Account of $20,000,000 for fiscal
year 2008, and $25,000,000 for each of fiscal years 2009 through 2012. Amounts
transferred under this paragraph for a fiscal year shall be available until
expended.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HF72EE3F47BBB48C4BCA7F99273F410D5"><enum>(e)</enum><header>Effective
date</header><text>The amendments made by this section shall take effect as of
June 30, 2008.</text>
</subsection></section><enum>II</enum><header>Medicaid</header>
<section id="id35CADA2D50A54183B3403DD0FD26EB0D"><enum>201.</enum><header>Extension of
qualifying individual (QI) program</header>
<subsection id="idB13AFDF5A97B4F5DB0FB42D1C9F70958"><enum>(a)</enum><header>Extension</header><text>Section
1902(a)(10)(E)(iv) of the <act-name parsable-cite="SSA">Social Security
Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42
U.S.C. 1396a(a)(10)(E)(iv)</external-xref>) is amended by striking
<quote>June</quote> and inserting <quote>July</quote>.</text>
</subsection><subsection id="id2EBEF6CA9AA24F5297EA5A61F3CCBA07"><enum>(b)</enum><header>Extending Total
Amount Available for Allocation</header><text>Section 1933(g)(2)(I) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396u-3">42 U.S.C.
1396u–3(g)(2)(I)</external-xref>) is amended—</text>
<paragraph id="id6BF4B2EB2E88467B82F5D81BFA2D46C2"><enum>(1)</enum><text>by striking
<quote>June 30</quote> and inserting <quote>July 31</quote>;</text>
</paragraph><paragraph id="id682CD383095B4610905C11DB42D065AA"><enum>(2)</enum><text>by striking
<quote>$200,000,000</quote> and inserting <quote>$250,000,000</quote>.</text>
</paragraph></subsection></section><section id="id4E0CDC99BC434ACBA08C4EB498A88ED7"><enum>202.</enum><header>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 Public Law
110–48 (121 Stat. 244), section 2 of the TMA, Abstinence, Education, and QI
Programs Extension Act of 2007 (Public Law 110–90, 121 Stat. 984), and section
202 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law
110–173), is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="id1BD221739F5C4AC49E129C87776D65CB"><enum>(1)</enum><text display-inline="yes-display-inline">by striking <quote>June 30</quote> and
inserting <quote>July 31</quote>;</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idE8CED65C75A648EF975DDBFAB3B7DD03"><enum>(2)</enum><text>by striking
<quote>the third quarter of fiscal year 2008</quote> and inserting <quote>July
31, 2008</quote>; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idCC61A8724B7B4DBCAB1B12A72A03DF40"><enum>(3)</enum><text display-inline="yes-display-inline">by striking <quote>the third quarter of
fiscal year 2007</quote> and inserting <quote>July 31, 2007</quote>.</text>
</paragraph></section><section commented="no" display-inline="no-display-inline" id="HC8808302347C" section-type="subsequent-section"><enum>203.</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 (42 U.S.C. 1396r–4(f)(6)) is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="HD329B314E1104785893EA18E41E9664B"><enum>(1)</enum><text display-inline="yes-display-inline">in subparagraph (A)(i), in the second
sentence—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="idD8F580C0EF644C799730E5C569ACC8AC"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>June 30</quote> and
inserting <quote>July 31</quote>; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id90A63F92F4B1459F8941272F19E809F5"><enum>(B)</enum><text>by striking
<quote>¾</quote> and inserting <quote><fraction>5/6</fraction></quote>;
and</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF27A046BF53B4D9B8877616F26B84FC1"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (B)(i)—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="id878EAEB6C3CC41B7B2B0AABBA496E7FC"><enum>(A)</enum><text display-inline="yes-display-inline">in the first sentence, by striking
<quote>June 30</quote> and inserting <quote>July 31</quote>; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id2C3B0DE6E7824AE997881E5468CC4C90"><enum>(B)</enum><text>by striking
<quote>$7,500,000</quote> and inserting <quote>$8,333,333</quote>.</text>
</subparagraph></paragraph></section><enum>III</enum><header>Contingency</header>
<section id="id41AC23EC2F9341C0B887865A4C408D7E"><enum>301.</enum><header>Contingency</header><text display-inline="no-display-inline">If a bill entitled the <quote>Medicare
Improvements for Patients and Providers Act of 2008</quote> is enacted, before,
on, or after the date of enactment of this Act, except for sections 101(c), the
provisions of, and amendments made by, this Act are repealed and any Act
amended by such amendments shall be administered as if such provisions and
amendments had not been enacted.</text>
</section>
July 11, 2008
Read the second time and placed on the
calendar