[Congressional Record Volume 156, Number 104 (Wednesday, July 14, 2010)]
[House]
[Pages H5563-H5565]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




VETERANS', SENIORS', AND CHILDREN'S HEALTH TECHNICAL CORRECTIONS ACT OF 
                                  2010

  Mr. STARK. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 5712) to provide for certain clarifications and extensions under 
Medicare, Medicaid, and the Children's Health Insurance Program.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 5712

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Veterans', Seniors', and 
     Children's Health Technical Corrections Act of 2010''.

     SEC. 2. CLARIFICATION OF EFFECTIVE DATE OF PART B SPECIAL 
                   ENROLLMENT PERIOD FOR DISABLED TRICARE 
                   BENEFICIARIES.

       Effective as if included in the enactment of Public Law 
     111-148, section 3110(a)(2) of such Act is amended to read as 
     follows:
       ``(2) Effective date.--The amendment made by paragraph (1) 
     shall apply to elections made on and after the date of the 
     enactment of this Act.''.

     SEC. 3. REPEAL OF DELAY OF RUG-IV.

       Effective as if included in the enactment of Public Law 
     111-148, section 10325 of such Act is repealed.

     SEC. 4. CLARIFICATION FOR AFFILIATED HOSPITALS FOR 
                   DISTRIBUTION OF ADDITIONAL RESIDENCY POSITIONS.

       Effective as if included in the enactment of section 
     5503(a) of Public Law 111-148, section 1886(h)(8) of the 
     Social Security Act (42 U.S.C. 1395ww(h)(8)), as added by 
     such section 5503(a), is amended by adding at the end the 
     following new subparagraph:
       ``(I) Affiliation.--The provisions of this paragraph shall 
     be applied to hospitals which are members of the same 
     affiliated group (as defined by the Secretary under paragraph 
     (4)(H)(ii)) and the reference resident level for each such 
     hospital shall be the reference resident level with respect 
     to the cost reporting period that results in the smallest 
     difference between the reference resident level and the 
     otherwise applicable resident limit.''.

     SEC. 5. CONTINUED INCLUSION OF ORPHAN DRUGS IN DEFINITION OF 
                   COVERED OUTPATIENT DRUGS WITH RESPECT TO 
                   CHILDREN'S HOSPITALS UNDER THE 340B DRUG 
                   DISCOUNT PROGRAM.

       (a) Definition of Covered Outpatient Drug.--
       (1) Amendment.--Subsection (e) of section 340B of the 
     Public Health Service Act (42 U.S.C. 256b) is amended by 
     striking ``covered entities described in subparagraph (M)'' 
     and inserting ``covered entities described in subparagraph 
     (M) (other than a children's hospital described in 
     subparagraph (M))''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall take effect as if included in the enactment of section 
     2302 of the Health Care and Education Reconciliation Act of 
     2010 (Public Law 111-152).
       (b) Technical Amendment.--Subparagraph (B) of section 
     1927(a)(5) of the Social Security Act (42 U.S.C. 1396r-
     8(a)(5)) is amended by striking ``and a children's hospital'' 
     and all that follows through the end of the subparagraph and 
     inserting a period.

     SEC. 6. MEDICAID AND CHIP TECHNICAL CORRECTIONS.

       (a) Repeal of Exclusion of Certain Individuals and Entities 
     From Medicaid.--Section 6502 of Public Law 111-148 is 
     repealed and the provisions of law amended by such section 
     are restored as if such section had never been enacted. 
     Nothing in the previous sentence shall affect the execution 
     or placement of the insertion made by section 6503 of such 
     Act.
       (b) Income Level for Certain Children Under Medicaid.--
     Effective as if included in the enactment of Public Law 111-
     148, section 2001(a)(5)(B) of such Act is amended by striking 
     all that follows ``is amended'' and inserting the following: 
     ``by inserting after `100 percent' the following: `(or, 
     beginning January 1, 2014, 133 percent)'.''.
       (c) Calculation and Publication of Payment Error Rate 
     Measurement for Certain Years.--Section 601(b) of the 
     Children's Health Insurance Program Reauthorization Act of 
     2009 (Public Law 111-3) is amended by adding at the end the 
     following: ``The Secretary is not required under this 
     subsection to calculate or publish a national or a State-

[[Page H5564]]

     specific error rate for fiscal year 2009 or fiscal year 
     2010.''.
       (d) Corrections to Exceptions to Exclusion of Children of 
     Certain Employees.--Section 2110(b)(6) of the Social Security 
     Act (42 U.S.C. 1397jj(b)(6)) is amended--
       (1) in subparagraph (B)--
       (A) by striking ``per person'' in the heading; and
       (B) by striking ``each employee'' and inserting 
     ``employees''; and
       (2) in subparagraph (C), by striking ``, on a case-by-case 
     basis,''.
       (e) Electronic Health Records.--Effective as if included in 
     the enactment of section 4201(a)(2) of the American Recovery 
     and Reinvestment Act of 2009 (Public Law 111-5), section 
     1903(t) of the Social Security Act (42 U.S.C. 1396b(t)) is 
     amended--
       (1) in paragraph (3)(E), by striking ``reduced by any 
     payment that is made to such Medicaid provider from any other 
     source (other than under this subsection or by a State or 
     local government)'' and inserting ``reduced by the average 
     payment the Secretary estimates will be made to such Medicaid 
     providers (determined on a percentage or other basis for such 
     classes or types of providers as the Secretary may specify) 
     from other sources (other than under this subsection, or by 
     the Federal government or a State or local government)''; and
       (2) in paragraph (6)(B), by inserting before the period the 
     following: ``and shall be determined to have met such 
     responsibility to the extent that the payment to the Medicaid 
     provider is not in excess of 85 percent of the net average 
     allowable cost''.
       (f) Corrections of Designations.--
       (1) Section 1902 of the Social Security Act (42 U.S.C. 
     1396a) is amended--
       (A) in subsection (a)(10), in the matter following 
     subparagraph (G), by striking ``and'' before ``(XVI) the 
     medical'' and by striking ``(XVI) if'' and inserting ``(XVII) 
     if''; and
       (B) in subsection (ii)(2), by striking ``(XV)'' and 
     inserting ``(XVI)''.
       (2) Section 2107(e)(1) of the Social Security Act (42 
     U.S.C. 1397gg(e)(1)) is amended by redesignating the 
     subparagraph (N) of that section added by 2101(e) of Public 
     Law 111-148 as subparagraph (O).

     SEC. 7. FUNDING FOR CLAIMS REPROCESSING.

       For purposes of carrying out the provisions of, and 
     amendments made by, this Act that relate to title XVIII of 
     the Social Security Act, and other provisions relating to 
     such title that involve reprocessing of claims, there are 
     appropriated to the Secretary of Health and Human Services 
     for the Centers for Medicare & Medicaid Services Program 
     Management Account, from amounts in the general fund of the 
     Treasury not otherwise appropriated, $95,000,000. Amounts 
     appropriated under the preceding sentence shall remain 
     available until expended.

     SEC. 8. EXTENSION OF SECTION 508 RECLASSIFICATIONS.

       (a) In General.--Section 106(a) of division B of the Tax 
     Relief and Health Care Act of 2006 (42 U.S.C. 1395 note), as 
     amended by section 117 of the Medicare, Medicaid, and SCHIP 
     Extension Act of 2007 (Public Law 110-173), section 124 of 
     the Medicare Improvements for Patients and Providers Act of 
     2008 (Public Law 110-275), and sections 3137(a) and 10317 of 
     Public Law 111-148, is amended by striking ``September 30, 
     2010'' and inserting ``September 30, 2011''.
       (b) Conforming Amendment.--Section 117(a)(3) of the 
     Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public 
     Law 110-173), is amended by inserting ``in fiscal years 2008 
     and 2009'' after ``For purposes of implementation of this 
     subsection''.

     SEC. 9. REVISION TO THE MEDICARE IMPROVEMENT FUND.

       Section 1898(b)(1) of the Social Security Act (42 U.S.C. 
     1395iii(b)(1)) is amended by striking subparagraphs (A) and 
     (B) and inserting the following subparagraphs:
       ``(A) fiscal year 2015, $0;
       ``(B) fiscal year 2016, $125,000,000; and''.

     SEC. 10. PAYGO COMPLIANCE.

       The budgetary effects of this Act, for the purpose of 
     complying with the Statutory Pay-As-You-Go Act of 2010, shall 
     be determined by reference to the latest statement titled 
     ``Budgetary Effects of PAYGO Legislation'' for this Act, 
     submitted for printing in the Congressional Record by the 
     Chairman of the House Budget Committee, provided that such 
     statement has been submitted prior to the vote on passage.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Stark) and the gentleman from California (Mr. Herger) 
each will control 20 minutes.
  The Chair recognizes the gentleman from California (Mr. Stark).


                             General Leave

  Mr. STARK. Mr. Speaker, I ask unanimous consent that all Members have 
5 legislative days to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. STARK. I reserve the balance of my time.
  Mr. HERGER. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, the majority is again bringing to the floor more fixes 
to the fatally flawed health care overhaul. The health care law was 
riddled with errors; some were oversights, the likes of which we are 
here today to address. However, the majority has failed to rectify the 
fundamentally flawed policies that threaten our economic stability and 
America's health care, all the while driving Federal and State budgets 
down a further unsustainable path.
  Mr. Speaker, where is the fix for the up to 117 million Americans 
with health insurance from their employers that, by the 
administration's own estimates, will not be able to keep the plan they 
have and like? That promise was repeatedly made by President Obama and 
the Democratic majority to assure to the American people that health 
care overhaul would not force them into a one-size-fits-all government-
approved insurance plan. Unfortunately, this has repeatedly proven to 
be false.
  Where is the fix for the millions of small businesses that will be 
forced to file 1099 tax forms for each business from which they 
purchase more than $600 worth of goods and services during this year? 
The National Federation of Independent Business, NFIB, describes these 
new requirements as crippling, and they will further divert investment 
away from jobs, which should be our number one concern.
  Mr. Speaker, where is the fix for seniors whose Medicare coverage is 
threatened by the health care overhaul? Medicare's own actuaries found 
that the $500 billion in Medicare cuts could jeopardize access to care 
for seniors. Furthermore, the actuaries predict millions of seniors 
will lose their Medicare plan because massive cuts to the program will 
result in ``about 50 percent'' of seniors no longer being in a plan.
  Unfortunately, the merits of today's legislation pale in comparison 
to the merits of addressing the needs of the millions of Americans 
losing the plan they have and like, the small businesses facing 
burdensome new costs and regulations, and seniors relying on Medicare. 
When will these pressing needs be addressed?
  Mr. Speaker, while I support the bill before us, it is not enough. We 
must move beyond mere technical corrections and fix the fundamental 
flaws of the Democrats' health care law by repealing it and replacing 
it with solutions that work.
  Mr. Speaker, I yield the balance of my time to the gentleman from 
Nebraska (Mr. Terry).
  The SPEAKER pro tempore. Without objection, the gentleman from 
Nebraska will control the time.
  There was no objection.
  Mr. TERRY. I reserve the balance of my time at this point.
  Mr. STARK. Mr. Speaker, I yield myself such time as I may consume.
  I rise today in support of H.R. 5712. It's a small but important 
bill. It's fully paid for and contains time-sensitive, mostly technical 
changes that strengthen the programs that care for the health of our 
Nation's veterans, senior citizens, and children. I appreciate the 
support of my distinguished ranking member for this bill.
  This bill is supported by the National Association of Children's 
Hospitals, the American Hospital Association, Federation of American 
Hospitals, and most of the health care groups. And we can proceed on 
issues concerning other matters at another time.
  At this point, I yield the balance of my time to the distinguished 
gentleman from California (Mr. Waxman).
  The SPEAKER pro tempore. Without objection, the gentleman from 
California will control the time.
  There was no objection.
  Mr. WAXMAN. Mr. Speaker, I reserve the balance of my time.
  Mr. TERRY. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I am pleased to announce, as a representative of the 
Energy and Commerce Committee, that we are not opposed to this bill and 
we're pleased with this these corrections. It is especially important 
that our veterans' access to care is not impeded or delayed and that 
these other corrections will improve the efficiency and effectiveness 
of some of the programs that our citizens depend on the most.
  This bill, as the gentleman from California mentioned, is budget 
neutral. In fact, there may even be as much as a $50 million savings if 
everything goes right here, which I think is important. It's a small 
number with regard to the trillion-dollar deficit that we've already 
hit by the end of June and the

[[Page H5565]]

$1.5 trillion deficit that we may experience for this year.
  I would like to see a budget where--I think we're missing an 
opportunity with items like this where we can save $50 million here, 
hopefully save $50 million here. If we had a budget, it could be part 
of a master plan to reduce our deficits and empower the private sector 
to create jobs.
  These are technical corrections that are necessary. But this is what 
happens when the majority works in secret, crafts legislation that 
doesn't receive the input from others, the minority side. And, frankly, 
I wouldn't be surprised that, after drastically altering the health 
care system so quickly, we'll have many more technical corrections 
necessary as time goes on.

                              {time}  1140

  The technical errors, however, are hardly the biggest problems facing 
this country's health care system. Far worse are the looming ill 
effects of the majority's basic policy mistakes. Who doesn't know the 
problems in that they refuse to exercise the fundamental responsibility 
of the House to conduct oversight hearings on how this is set up. And 
the grandfathering clause has already been very confusing. This is what 
we'll have to look out for as the health care bill proceeds.
  Now, just for the record, let's consider some of the problems that we 
face from this bill. The law will cut $575 billion out of Medicare. 
Concerning me equally as much is that it's with no direction from 
Congress, leaving these decisions to Health and Human Services and the 
Center for Medicare and Medicaid Services.
  In Nebraska, in my district, many of my seniors rely on Medicare 
Advantage as a program, but $145 billion will be taken from Medicare 
Advantage, reducing the enrollment, according to the nonpartisan 
estimates, by as much as 50 percent.
  It will raise spending nearly 90 percent for States in Medicaid 
programs, squeezing State taxpayers and crippling State budgets.
  Despite the claims that the bill would lower health care costs and 
deficits, the Chief Actuary of Medicine has since concluded that 
spending won't go down, it will actually go up, as many people 
believed.
  And remember the promise that if you like your coverage, you can keep 
it? With the new grandfathering rules that are being rolled out, it is 
now estimated that, and this is the administration's estimate, that as 
many as 66 percent of small businesses will not be eligible to keep 
what they have and will have to accept something from the exchange 
which will be pre-approved by HHS.
  We're also learning the recession might worsen now because employers 
are hesitant to expand. We're hearing from many employers, articles in 
the Wall Street Journal, that they're sitting on cash because they 
don't want to spend now, be hit with these higher costs, and then have 
to lay off later. So it's arresting investment and hiring of new 
workers because businesses don't know the costs of implementation of 
this health care bill.
  Now, the Democrats at every level are in hiding mode. They don't want 
a new public debate on this. We had a recess appointment of Donald 
Berwick, Dr. Donald Berwick, who is a great intellectual on medical 
savings, particularly in a British system that says that a rationing-
type of system relies on a mathematical formula of age, as well as 
comparative effectiveness. And the comparative effectiveness provision 
in this bill provides Dr. Berwick carte blanche to implement those type 
of British policies.
  This is probably--this won't be the last time that we hear about 
health care, but probably we won't hear about it until after November 
2. The American people know why. I can only hope that we choose to 
conduct oversight of the new health care law and fix its disastrous 
effects.
  Mr. Speaker, I have no further requests for time, and I yield back 
the balance of my time.
  Mr. WAXMAN. I yield myself such time as I may consume.
  Mr. Speaker and my colleagues, I rise to join everybody else who has 
spoken in favor of this bill and urge passage of H.R. 5712, the 
Veterans, Seniors and Children's Health Technical Corrections Act. It's 
a small set of noncontroversial changes to the law needed to provide 
for the smooth functioning of the Medicare, Medicaid, Child Health 
Insurance, or CHIP program, as well as the 340B program. The 
legislation has no cost.
  One provision ensures that a special enrollment period into Medicare 
part B does not exclude some of the veterans for whom the policy was 
intended.
  Another provision clarifies that the redistribution of unused 
Medicare-funded residency slots not inadvertently take slots away from 
hospitals that were cooperating with other hospitals to actually use 
these slots. This is a practice that occurs in 36 States, and they want 
this clarification.
  We also have a clarification that children's hospitals will continue 
to have access to discounts on orphan drugs through the 340B program 
tape.
  The bill would modify the payment system for nursing facilities in 
Medicare, ensuring smoother operations of that program.
  And virtually all of these provisions have been passed by the House 
at least once. Many of them have been passed by the Senate as well. 
This legislation needs to be enacted now because it modifies provisions 
of law that are coming into effect now, or will come into effect within 
the next few months.
  So the legislation is fully paid for, will not increase the deficit. 
It involves technical corrections only. It's a bipartisan bill, and I'd 
urge my colleagues to suspend the rules and pass this legislation.
  Mr. Speaker, I have no further requests for time, and I yield back 
the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Stark) that the House suspend the rules 
and pass the bill, H.R. 5712.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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