<num style="-uslm-dtd:enum" value="I">TITLE I—</num><heading style="-uslm-dtd:header">MEDICARE </heading> <elided style="-uslm-dtd:omitted-text">* * * * * * *</elided> <section style="-uslm-dtd:section" identifier="/us/sComp/110/173/tI/s114" styleType="OLC"> <num style="-uslm-dtd:enum" value="114">SEC. 114. </num><heading style="-uslm-dtd:header">LONG-TERM CARE HOSPITALS. </heading> <subsection style="-uslm-dtd:subsection" identifier="/us/sComp/110/173/tI/s114/a" styleType="OLC"> <num style="-uslm-dtd:enum" value="a">(a) </num><content style="-uslm-dtd:text"> <elided style="-uslm-dtd:omitted-text">* * *</elided> </content> </subsection> <subsection style="-uslm-dtd:subsection" identifier="/us/sComp/110/173/tI/s114/b" styleType="OLC"> <num style="-uslm-dtd:enum" value="b">(b) </num><heading style="-uslm-dtd:header">Study and Report on Long-Term Care Hospital Facility and Patient Criteria.—</heading> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/b/1" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">The Secretary of Health and Human Services (in this section referred to as the “<quotedText style="-uslm-dtd:quote">Secretary</quotedText>”) 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.</content> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/b/2" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><heading style="-uslm-dtd:header">Report.—</heading><content style="-uslm-dtd:text">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.</content> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/b/3" styleType="OLC"> <num style="-uslm-dtd:enum" value="3">(3) </num><heading style="-uslm-dtd:header">Considerations.—</heading><chapeau style="-uslm-dtd:text">In conducting the study and preparing the report under this subsection, the Secretary shall consider—</chapeau> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/b/3/A" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">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</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/b/3/B" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">ongoing work by the Secretary to evaluate and determine the feasibility of such recommendations.</content> </subparagraph> </paragraph> </subsection> <subsection style="-uslm-dtd:subsection" identifier="/us/sComp/110/173/tI/s114/c" styleType="OLC"> <num style="-uslm-dtd:enum" value="c">(c) </num><editorialNote style="-uslm-dtd:usc-reference" role="uscRef">[<ref href="/us/usc/t42/s1395ww">42 U.S.C. 1395ww note</ref>] </editorialNote><heading style="-uslm-dtd:header">Payment for Long-Term Care Hospital Services.—</heading> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/c/1" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><heading style="-uslm-dtd:header">Delay in application of 25 percent patient threshold payment adjustment.—</heading><chapeau style="-uslm-dtd:text">The Secretary shall not apply, for cost reporting periods beginning on or after July 1, 2007,—<ref style="-uslm-dtd:footnote-ref" idref="ID1A60606588A84A9B8CC50191A36BF4C2" class="footnoteRef">1</ref></chapeau><footnote id="ID1A60606588A84A9B8CC50191A36BF4C2" style="-uslm-dtd:footnote">1The comma followed by the em dash, in the matter preceding subparagraph (A), is so in law. See amendment made by section 1206(b)(1)(B)(i) of division B of Public Law 113–67.</footnote> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/c/1/A" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">through June 30, 2016, and for discharges occurring on or after October 1, 2016, and before October 1, 2017, section 412.536 of title 42, Code of Federal Regulations, or any similar provision, to freestanding long-term care hospitals or to a long-termcare hospital, or satellite facility, that as of December29, 2007, was co-located with an entity that is a provider-based, off-campus location of a subsection (d) hospital whichdid not provide services payable under section 1886(d) ofthe Social Security Act at the off-campus location; and</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/c/1/B" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">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 (Public Law 105–33).</content> </subparagraph> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/c/2" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><heading style="-uslm-dtd:header">Payment for hospitals-within-hospitals.—</heading> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/c/2/A" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">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 section 412.534 of title 42, Code of Federal Regulations, or any similar provision, 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.</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/c/2/B" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><heading style="-uslm-dtd:header">Co-located long-term care hospitals and satellite facilities.—</heading> <clause style="-uslm-dtd:clause" identifier="/us/sComp/110/173/tI/s114/c/2/B/i" styleType="OLC"> <num style="-uslm-dtd:enum" value="i">(i) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">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 section 412.534 of title 42, Code of Federal Regulations, or any similar provision, 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.</content> </clause> <clause style="-uslm-dtd:clause" identifier="/us/sComp/110/173/tI/s114/c/2/B/ii" styleType="OLC"> <num style="-uslm-dtd:enum" value="ii">(ii) </num><heading style="-uslm-dtd:header">Applicable long-term care hospital or satellite facility defined.—</heading><content style="-uslm-dtd:text">In this paragraph, the term “<term style="-uslm-dtd:term">applicable long-term care hospital or satellite facility</term>” means a hospital or satellite facility that is subject to the transition rules under section 412.534(g) of title 42, Code of Federal Regulations, or any similar provision, or that is described in section 412.22(h)(3)(i) of such title.</content> </clause> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/c/2/C" styleType="OLC"> <num style="-uslm-dtd:enum" value="C">(C) </num><heading style="-uslm-dtd:header">Effective date.—</heading><content style="-uslm-dtd:text">Subparagraphs (A) and (B) shall apply to cost reporting periods beginning on or after October 1, 2007 (or July 1, 2007, in the case of a satellite facility described in section 412.22(h)(3)(i) of title 42, Code of Federal Regulations) through June 30, 2016, and for discharges occurring on or after October 1, 2016, and before October 1, 2017.</content> </subparagraph> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/c/3" styleType="OLC"> <num style="-uslm-dtd:enum" value="3">(3) </num><heading style="-uslm-dtd:header">No application of very short-stay outlier policy.—</heading><content style="-uslm-dtd:text">The Secretary shall not apply, for the 5-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 section 412.529(c)(3)(i) of title 42, Code of Federal Regulations, or any similar provision.</content> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/c/4" styleType="OLC"> <num style="-uslm-dtd:enum" value="4">(4) </num><heading style="-uslm-dtd:header">No application of one-time adjustment to standard amount.—</heading><content style="-uslm-dtd:text">The Secretary shall not, for the 5-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 section 412.523(d)(3) of title 42, Code of Federal Regulations, or any similar provision.</content> </paragraph> </subsection> <subsection style="-uslm-dtd:subsection" identifier="/us/sComp/110/173/tI/s114/d" styleType="OLC"> <num style="-uslm-dtd:enum" value="d">(d) </num><editorialNote style="-uslm-dtd:usc-reference" role="uscRef">[<ref href="/us/usc/t42/s1395ww">42 U.S.C. 1395ww note</ref>] </editorialNote><heading style="-uslm-dtd:header">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.—</heading> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/d/1" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><heading style="-uslm-dtd:header">In general.—</heading><chapeau style="-uslm-dtd:text">During the 5-year period (and for the period beginning on the date of the enactment of paragraph (7) of this subsection and ending September 30, 2017) 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—</chapeau> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/1/A" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">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</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/1/B" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">subject to paragraph (3), on an increase of long-term care hospital beds in existing long-term care hospitals or satellite facilities.</content> </subparagraph> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/d/2" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><heading style="-uslm-dtd:header">Exception for certain long-term care hospitals.—</heading><chapeau style="-uslm-dtd:text">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—</chapeau> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/2/A" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">began its qualifying period for payment as a long-term care hospital under section 412.23(e) of title 42, Code of Federal Regulations, on or before the date of the enactment of this Act;</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/2/B" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">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</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/2/C" styleType="OLC"> <num style="-uslm-dtd:enum" value="C">(C) </num><content style="-uslm-dtd:text">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.</content> </subparagraph> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/d/3" styleType="OLC"> <num style="-uslm-dtd:enum" value="3">(3) </num><heading style="-uslm-dtd:header">Exception for bed increases during moratorium.—</heading> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/3/A" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><heading style="-uslm-dtd:header">In general.—</heading><chapeau style="-uslm-dtd:text">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 obtained a certificate of need for an increase in beds that is in a State for which such certificate of need is required and that was issued on or after April 1, 2005, and before December 29, 2007, or if the hospital or facility—</chapeau> <clause style="-uslm-dtd:clause" identifier="/us/sComp/110/173/tI/s114/d/3/A/i" styleType="OLC"> <num style="-uslm-dtd:enum" value="i">(i) </num><content style="-uslm-dtd:text">is located in a State where there is only one other long-term care hospital; and</content> </clause> <clause style="-uslm-dtd:clause" identifier="/us/sComp/110/173/tI/s114/d/3/A/ii" styleType="OLC"> <num style="-uslm-dtd:enum" value="ii">(ii) </num><content style="-uslm-dtd:text">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.</content> </clause> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/3/B" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><heading style="-uslm-dtd:header">No effect on certain limitation.—</heading><content style="-uslm-dtd:text">The exception under subparagraph (A) shall not effect the limitation on increasing beds under sections 412.22(h)(3) and 412.22(f) of title 42, Code of Federal Regulations.</content> </subparagraph> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/d/4" styleType="OLC"> <num style="-uslm-dtd:enum" value="4">(4) </num><heading style="-uslm-dtd:header">Existing hospital or satellite facility defined.—</heading><content style="-uslm-dtd:text">For purposes of this subsection, the term “<term style="-uslm-dtd:term">existing</term>” 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.</content> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/d/5" styleType="OLC"> <num style="-uslm-dtd:enum" value="5">(5) </num><heading style="-uslm-dtd:header">Judicial review.—</heading><content style="-uslm-dtd:text">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 (42 U.S.C. 1395oo), or otherwise, of the application of this subsection by the Secretary.</content> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/d/6" styleType="OLC"> <num style="-uslm-dtd:enum" value="6">(6) </num><heading style="-uslm-dtd:header">Limitation on application of exceptions.—</heading><content style="-uslm-dtd:text">Paragraphs (2) and (3) shall not apply during the period beginning on the date of the enactment of paragraph (7) of this subsection and ending September 30, 2017.</content> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/d/7" styleType="OLC"> <num style="-uslm-dtd:enum" value="7">(7) </num><heading style="-uslm-dtd:header">Additional exception for certain long-term care hospitals.—</heading><chapeau style="-uslm-dtd:text">Any moratorium under paragraph (1) shall not apply to a long-term care hospital that—</chapeau> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/7/A" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">began its qualifying period for payment as a long-term care hospital under section 412.23(e) of title 42, Code of Federal Regulations, on or before the date of enactment of this paragraph;</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/7/B" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">has a binding written agreement as of the date of the enactment of this paragraph with an outside, unrelated party for the actual construction, renovation, lease, or demolition for a long-term care hospital, and has expended, before such date of enactment, at least 10 percent of the estimated cost of the project (or, if less, $2,500,000); or</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/d/7/C" styleType="OLC"> <num style="-uslm-dtd:enum" value="C">(C) </num><content style="-uslm-dtd:text">has obtained an approved certificate of need in a State where one is required on or before such date of enactment.</content> </subparagraph> </paragraph> </subsection> <subsection style="-uslm-dtd:subsection" identifier="/us/sComp/110/173/tI/s114/e" styleType="OLC"> <num style="-uslm-dtd:enum" value="e">(e) </num><heading style="-uslm-dtd:header">Long-Term Care Hospital Payment Update.—</heading> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/e/1" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text"> <elided style="-uslm-dtd:omitted-text">* * *</elided> </content> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/e/2" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><editorialNote style="-uslm-dtd:usc-reference" role="uscRef">[<ref href="/us/usc/t42/s1395ww">42 U.S.C. 1395ww note</ref>] </editorialNote><heading style="-uslm-dtd:header">Delayed effective date.—</heading><content style="-uslm-dtd:text">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.</content> </paragraph> </subsection> <subsection style="-uslm-dtd:subsection" identifier="/us/sComp/110/173/tI/s114/f" styleType="OLC"> <num style="-uslm-dtd:enum" value="f">(f) </num><editorialNote style="-uslm-dtd:usc-reference" role="uscRef">[<ref href="/us/usc/t42/s1395ww">42 U.S.C. 1395ww note</ref>] </editorialNote><heading style="-uslm-dtd:header">Expanded Review of Medical Necessity.—</heading> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/f/1" styleType="OLC"> <num style="-uslm-dtd:enum" value="1">(1) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">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 (42 U.S.C. 1395kk–1(a)(4)(G)), 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.</content> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/f/2" styleType="OLC"> <num style="-uslm-dtd:enum" value="2">(2) </num><heading style="-uslm-dtd:header">Review methodology.—</heading><chapeau style="-uslm-dtd:text">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—</chapeau> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/f/2/A" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><content style="-uslm-dtd:text">provide for a statistically valid and representative sample of admissions of such individuals sufficient to provide results at a 95 percent confidence interval; and</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/f/2/B" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><content style="-uslm-dtd:text">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 (42 U.S.C. 1395ww(d)(1)(B)(iv)).</content> </subparagraph> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/f/3" styleType="OLC"> <num style="-uslm-dtd:enum" value="3">(3) </num><heading style="-uslm-dtd:header">Continuation of reviews.—</heading><content style="-uslm-dtd:text">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.</content> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/f/4" styleType="OLC"> <num style="-uslm-dtd:enum" value="4">(4) </num><heading style="-uslm-dtd:header">Termination of required reviews.—</heading> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/f/4/A" styleType="OLC"> <num style="-uslm-dtd:enum" value="A">(A) </num><heading style="-uslm-dtd:header">In general.—</heading><content style="-uslm-dtd:text">Subject to subparagraph (B), the previous provisions of this subsection shall cease to apply for discharges occurring on or after October 1, 2010.</content> </subparagraph> <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/110/173/tI/s114/f/4/B" styleType="OLC"> <num style="-uslm-dtd:enum" value="B">(B) </num><heading style="-uslm-dtd:header">Continuation.—</heading><content style="-uslm-dtd:text">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.</content> </subparagraph> </paragraph> <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/110/173/tI/s114/f/5" styleType="OLC"> <num style="-uslm-dtd:enum" value="5">(5) </num><heading style="-uslm-dtd:header">Funding.—</heading><content style="-uslm-dtd:text">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.</content> </paragraph> </subsection> <subsection style="-uslm-dtd:subsection" identifier="/us/sComp/110/173/tI/s114/g" styleType="OLC"> <num style="-uslm-dtd:enum" value="g">(g) </num><heading style="-uslm-dtd:header">Implementation.—</heading><content style="-uslm-dtd:text">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 & 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.</content> <elided style="-uslm-dtd:omitted-text">* * * * * * *</elided> </subsection> </section>

AN ACTTo 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. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS. (a) [42 U.S.C. 1305 note] In General.—This Act may be cited as the “Medicare, Medicaid, and SCHIP Extension Act of 2007”. * * * * * * *