[Congressional Record (Bound Edition), Volume 153 (2007), Part 27]
[House]
[Pages 36194-36208]
[From the U.S. Government Publishing Office, www.gpo.gov]




          MEDICARE, MEDICAID, AND SCHIP EXTENSION ACT OF 2007

  Mr. PALLONE. Madam Speaker, I move to suspend the rules and pass the 
Senate bill (S. 2499) to amend titles XVIII, XIX, and XXI of the Social 
Security Act to extend provisions under the Medicare, Medicaid, and 
SCHIP programs, and for other purposes.
  The Clerk read the title of the Senate bill.
  The text of the Senate bill is as follows:

                                S. 2499

       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) In General.--This Act may be cited as the ``Medicare, 
     Medicaid, and SCHIP Extension Act of 2007''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.

                           TITLE I--MEDICARE

Sec. 101. Increase in physician payment update; extension of the 
              physician quality reporting system.
Sec. 102. Extension of Medicare incentive payment program for physician 
              scarcity areas.
Sec. 103. Extension of floor on work geographic adjustment under the 
              Medicare physician fee schedule.
Sec. 104. Extension of treatment of certain physician pathology 
              services under Medicare.
Sec. 105. Extension of exceptions process for Medicare therapy caps.
Sec. 106. Extension of payment rule for brachytherapy; extension to 
              therapeutic radiopharmaceuticals.
Sec. 107. Extension of Medicare reasonable costs payments for certain 
              clinical diagnostic laboratory tests furnished to 
              hospital patients in certain rural areas.
Sec. 108. Extension of authority of specialized Medicare Advantage 
              plans for special needs individuals to restrict 
              enrollment.
Sec. 109. Extension of deadline for application of limitation on 
              extension or renewal of Medicare reasonable cost contract 
              plans.
Sec. 110. Adjustment to the Medicare Advantage stabilization fund.
Sec. 111. Medicare secondary payor.
Sec. 112. Payment for part B drugs.
Sec. 113. Payment rate for certain diagnostic laboratory tests.
Sec. 114. Long-term care hospitals.
Sec. 115. Payment for inpatient rehabilitation facility (IRF) services.
Sec. 116. Extension of accommodation of physicians ordered to active 
              duty in the Armed Services.
Sec. 117. Treatment of certain hospitals.
Sec. 118. Additional Funding for State Health Insurance Assistance 
              Programs, Area Agencies on Aging, and Aging and 
              Disability Resource Centers.

                      TITLE II--MEDICAID AND SCHIP

Sec. 201. Extending SCHIP funding through March 31, 2009.
Sec. 202. Extension of transitional medical assistance (TMA) and 
              abstinence education program.
Sec. 203. Extension of qualifying individual (QI) program.
Sec. 204. Medicaid DSH extension.
Sec. 205. Improving data collection.
Sec. 206. Moratorium on certain payment restrictions.

                        TITLE III--MISCELLANEOUS

Sec. 301. Medicare Payment Advisory Commission status.
Sec. 302. Special Diabetes Programs for Type I Diabetes and Indians.

                           TITLE I--MEDICARE

     SEC. 101. INCREASE IN PHYSICIAN PAYMENT UPDATE; EXTENSION OF 
                   THE PHYSICIAN QUALITY REPORTING SYSTEM.

       (a) Increase in Physician Payment Update.--
       (1) In general.--Section 1848(d) of the Social Security Act 
     (42 U.S.C. 1395w-4(d)) is amended--
       (A) in paragraph (4)(B), by striking ``and paragraphs (5) 
     and (6)'' and inserting ``and the succeeding paragraphs of 
     this subsection''; and
       (B) by adding at the end the following new paragraph:
       ``(8) Update for a portion of 2008.--
       ``(A) In general.--Subject to paragraph (7)(B), in lieu of 
     the update to the single conversion factor established in 
     paragraph (1)(C) that would otherwise apply for 2008, for the 
     period beginning on January 1, 2008, and ending on June 30, 
     2008, the update to the single conversion factor shall be 0.5 
     percent.
       ``(B) No effect on computation of conversion factor for the 
     remaining portion of 2008 and 2009.--The conversion factor 
     under this subsection shall be computed under paragraph 
     (1)(A) for the period beginning on July 1, 2008, and ending 
     on December 31, 2008, and for 2009 and subsequent years as if 
     subparagraph (A) had never applied.''.
       (2) Revision of the physician assistance and quality 
     initiative fund.--
       (A) Revision.--Section 1848(l)(2) of the Social Security 
     Act (42 U.S.C. 1395w-4(l)(2)) is amended--
       (i) by striking subparagraph (A) and inserting the 
     following:
       ``(A) Amount available.--
       ``(i) In general.--Subject to clause (ii), there shall be 
     available to the Fund the following amounts:

       ``(I) For expenditures during 2008, an amount equal to 
     $150,500,000.
       ``(II) For expenditures during 2009, an amount equal to 
     $24,500,000.
       ``(III) For expenditures during 2013, an amount equal to 
     $4,960,000,000.

       ``(ii) Limitations on expenditures.--

       ``(I) 2008.--The amount available for expenditures during 
     2008 shall be reduced as provided by subparagraph (A) of 
     section 225(c)(1) and section 524 of the Departments of 
     Labor, Health and Human Services, and Education, and Related 
     Agencies Appropriations Act, 2008 (division G of the 
     Consolidated Appropriations Act, 2008).
       ``(II) 2009.--The amount available for expenditures during 
     2009 shall be reduced as provided by subparagraph (B) of such 
     section 225(c)(1).
       ``(III) 2013.--The amount available for expenditures during 
     2013 shall only be available for an adjustment to the update 
     of the conversion factor under subsection (d) for that 
     year.''; and

       (ii) in subparagraph (B), by striking ``entire amount 
     specified in the first sentence of subparagraph (A)'' and all 
     that follows and inserting the following: ``entire amount 
     available for expenditures, after application of subparagraph 
     (A)(ii), during--
       ``(i) 2008 for payment with respect to physicians' services 
     furnished during 2008;
       ``(ii) 2009 for payment with respect to physicians' 
     services furnished during 2009; and
       ``(iii) 2013 for payment with respect to physicians' 
     services furnished during 2013.''.
       (B) Effective date.--
       (i) In general.--Subject to clause (ii), the amendments 
     made by subparagraph (A) shall take effect on the date of the 
     enactment of this Act.
       (ii) Special rule for coordination with consolidated 
     appropriations act, 2008.--If the date of the enactment of 
     the Consolidated Appropriations Act, 2008, occurs on or after 
     the date described in clause (i), the amendments made by 
     subparagraph (A) shall be deemed to be made on the day after 
     the effective date of sections 225(c)(1) and 524 of the 
     Departments of Labor, Health and Human Services, and 
     Education, and Related Agencies Appropriations Act, 2008 
     (division G of the Consolidated Appropriations Act, 2008).
       (C) Transfer of funds to part b trust fund.--Amounts that 
     would have been available to the Physician Assistance and 
     Quality Initiative Fund under section 1848(l)(2) of the 
     Social Security Act (42 U.S.C. 1395w-4(l)(2)) for payment 
     with respect to physicians' services furnished prior to 
     January 1, 2013, but for the amendments made by subparagraph 
     (A), shall be deposited into, and made available for 
     expenditures from, the Federal Supplementary Medical 
     Insurance Trust Fund under section 1841 of such Act (42 
     U.S.C. 1395t).
       (b) Extension of the Physician Quality Reporting System.--
       (1) System.--Section 1848(k)(2)(B) of the Social Security 
     Act (42 U.S.C. 1395w-4(k)(2)(B)) is amended--
       (A) in the heading, by inserting ``and 2009'' after 
     ``2008'';

[[Page 36195]]

       (B) in clause (i), by inserting ``and 2009'' after 
     ``2008''; and
       (C) in each of clauses (ii) and (iii)--
       (i) by striking ``, 2007'' and inserting ``of each of 2007 
     and 2008''; and
       (ii) by inserting ``or 2009, as applicable'' after 
     ``2008''.
       (2) Reporting.--Section 101(c) of division B of the Tax 
     Relief and Health Care Act of 2006 (42 U.S.C. 1395w-4 note) 
     is amended--
       (A) in the heading, by inserting ``and 2008'' after 
     ``2007'';
       (B) in paragraph (5), by adding at the end the following:
       ``(F) Extension.--For 2008 and 2009, paragraph (3) shall 
     not apply, and the Secretary shall establish alternative 
     criteria for satisfactorily reporting under paragraph (2) and 
     alternative reporting periods under paragraph (6)(C) for 
     reporting groups of measures under paragraph (2)(B) of 
     section 1848(k) of the Social Security Act (42 U.S.C. 1395w-
     4(k)) and for reporting using the method specified in 
     paragraph (4) of such section.''; and
       (C) in paragraph (6), by striking subparagraph (C) and 
     inserting the following new subparagraph:
       ``(C) Reporting period.--The term `reporting period' 
     means--
       ``(i) for 2007, the period beginning on July 1, 2007, and 
     ending on December 31, 2007; and
       ``(ii) for 2008, all of 2008.''.
       (c) Implementation.--For purposes of carrying out the 
     provisions of, and amendments made by subsections (a) and 
     (b), in addition to any amounts otherwise provided in this 
     title, there are appropriated to the Centers for Medicare & 
     Medicaid Services Program Management Account, out of any 
     money in the Treasury not otherwise appropriated, $25,000,000 
     for the period of fiscal years 2008 and 2009.

     SEC. 102. EXTENSION OF MEDICARE INCENTIVE PAYMENT PROGRAM FOR 
                   PHYSICIAN SCARCITY AREAS.

       Section 1833(u) of the Social Security Act (42 U.S.C. 
     1395l(u)) is amended--
       (1) in paragraph (1), by striking ``before January 1, 
     2008'' and inserting ``before July 1, 2008''; and
       (2) in paragraph (4)--
       (A) by redesignating subparagraph (D) as subparagraph (E); 
     and
       (B) by inserting after subparagraph (C) the following new 
     subparagraph:
       ``(D) Special rule.--With respect to physicians' services 
     furnished on or after January 1, 2008, and before July 1, 
     2008, for purposes of this subsection, the Secretary shall 
     use the primary care scarcity counties and the specialty care 
     scarcity counties (as identified under the preceding 
     provisions of this paragraph) that the Secretary was using 
     under this subsection with respect to physicians' services 
     furnished on December 31, 2007.''.

     SEC. 103. EXTENSION OF FLOOR ON WORK GEOGRAPHIC ADJUSTMENT 
                   UNDER THE MEDICARE PHYSICIAN FEE SCHEDULE.

       Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 
     1395w-4(e)(1)(E)), as amended by section 102 of division B of 
     the Tax Relief and Health Care Act of 2006, is amended by 
     striking ``before January 1, 2008'' and inserting ``before 
     July 1, 2008''.

     SEC. 104. EXTENSION OF TREATMENT OF CERTAIN PHYSICIAN 
                   PATHOLOGY SERVICES UNDER MEDICARE.

       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) and section 104 of division B of the Tax Relief and 
     Health Care Act of 2006 (42 U.S.C. 1395w-4 note), is amended 
     by striking ``and 2007'' and inserting ``2007, and the first 
     6 months of 2008''.

     SEC. 105. EXTENSION OF EXCEPTIONS PROCESS FOR MEDICARE 
                   THERAPY CAPS.

       Section 1833(g)(5) of the Social Security Act (42 U.S.C. 
     1395l(g)(5)) is amended by striking ``December 31, 2007'' and 
     inserting ``June 30, 2008''.

     SEC. 106. EXTENSION OF PAYMENT RULE FOR BRACHYTHERAPY; 
                   EXTENSION TO THERAPEUTIC RADIOPHARMACEUTICALS.

       (a) Extension of Payment Rule for Brachytherapy.--Section 
     1833(t)(16)(C) of the Social Security Act (42 U.S.C. 
     1395l(t)(16)(C)), as amended by section 107(a) of division B 
     of the Tax Relief and Health Care Act of 2006, is amended by 
     striking ``January 1, 2008'' and inserting ``July 1, 2008''.
       (b) Payment for Therapeutic Radiopharmaceuticals.--Section 
     1833(t)(16)(C) of the Social Security Act (42 U.S.C. 
     1395l(t)(16)(C)), as amended by subsection (a), is amended--
       (1) in the heading, by inserting ``and therapeutic 
     radiopharmaceuticals'' before ``at charges'';
       (2) in the first sentence--
       (A) by inserting ``and for therapeutic radiopharmaceuticals 
     furnished on or after January 1, 2008, and before July 1, 
     2008,'' after ``July 1, 2008,'';
       (B) by inserting ``or therapeutic radiopharmaceutical'' 
     after ``the device''; and
       (C) by inserting ``or therapeutic radiopharmaceutical'' 
     after ``each device''; and
       (3) in the second sentence, by inserting ``or therapeutic 
     radiopharmaceuticals'' after ``such devices''.

     SEC. 107. EXTENSION OF MEDICARE REASONABLE COSTS PAYMENTS FOR 
                   CERTAIN CLINICAL DIAGNOSTIC LABORATORY TESTS 
                   FURNISHED TO HOSPITAL PATIENTS IN CERTAIN RURAL 
                   AREAS.

       Section 416(b) of the Medicare Prescription Drug, 
     Improvement, and Modernization Act of 2003 (42 U.S.C. 1395l-
     4), as amended by section 105 of division B of the Tax Relief 
     and Health Care Act of 2006 (42 U.S.C. 1395l note), is 
     amended by striking ``the 3-year period beginning on July 1, 
     2004'' and inserting ``the period beginning on July 1, 2004, 
     and ending on June 30, 2008''.

     SEC. 108. EXTENSION OF AUTHORITY OF SPECIALIZED MEDICARE 
                   ADVANTAGE PLANS FOR SPECIAL NEEDS INDIVIDUALS 
                   TO RESTRICT ENROLLMENT.

       (a) Extension of Authority To Restrict Enrollment.--Section 
     1859(f) of the Social Security Act (42 U.S.C. 1395w-28(f)) is 
     amended by striking ``2009'' and inserting ``2010''.
       (b) Moratorium.--
       (1) Authority to designate other plans as specialized ma 
     plans.--During the period beginning on January 1, 2008, and 
     ending on December 31, 2009, the Secretary of Health and 
     Human Services shall not exercise the authority provided 
     under section 231(d) of the Medicare Prescription Drug, 
     Improvement, and Modernization Act of 2003 (42 U.S.C. 1395w-
     21 note) to designate other plans as specialized MA plans for 
     special needs individuals under part C of title XVIII of the 
     Social Security Act. The preceding sentence shall not apply 
     to plans designated as specialized MA plans for special needs 
     individuals under such authority prior to January 1, 2008.
       (2) Enrollment in new plans.--During the period beginning 
     on January 1, 2008, and ending on December 31, 2009, the 
     Secretary of Health and Human Services shall not permit 
     enrollment of any individual residing in an area in a 
     specialized Medicare Advantage plan for special needs 
     individuals under part C of title XVIII of the Social 
     Security Act to take effect unless that specialized Medicare 
     Advantage plan for special needs individuals was available 
     for enrollment for individuals residing in that area on 
     January 1, 2008.

     SEC. 109. EXTENSION OF DEADLINE FOR APPLICATION OF LIMITATION 
                   ON EXTENSION OR RENEWAL OF MEDICARE REASONABLE 
                   COST CONTRACT PLANS.

       Section 1876(h)(5)(C)(ii) of the Social Security Act (42 
     U.S.C. 1395mm(h)(5)(C)(ii)), in the matter preceding 
     subclause (I), is amended by striking ``January 1, 2008'' and 
     inserting ``January 1, 2009''.

     SEC. 110. ADJUSTMENT TO THE MEDICARE ADVANTAGE STABILIZATION 
                   FUND.

       Section 1858(e)(2)(A)(i) of the Social Security Act (42 
     U.S.C. 1395w-27a(e)(2)(A)(i)), as amended by section 3 of 
     Public Law 110-48, is amended by striking ``the Fund'' and 
     all that follows and inserting ``the Fund during 2013, 
     $1,790,000,000.''

     SEC. 111. MEDICARE SECONDARY PAYOR.

       (a) In General.--Section 1862(b) of the Social Security Act 
     (42 U.S.C. 1395y(b)) is amended by adding at the end the 
     following new paragraphs:
       ``(7) Required submission of information by group health 
     plans.--
       ``(A) Requirement.--On and after the first day of the first 
     calendar quarter beginning after the date that is 1 year 
     after the date of the enactment of this paragraph, an entity 
     serving as an insurer or third party administrator for a 
     group health plan, as defined in paragraph (1)(A)(v), and, in 
     the case of a group health plan that is self-insured and 
     self-administered, a plan administrator or fiduciary, shall--
       ``(i) secure from the plan sponsor and plan participants 
     such information as the Secretary shall specify for the 
     purpose of identifying situations where the group health plan 
     is or has been a primary plan to the program under this 
     title; and
       ``(ii) submit such information to the Secretary in a form 
     and manner (including frequency) specified by the Secretary.
       ``(B) Enforcement.--
       ``(i) In general.--An entity, a plan administrator, or a 
     fiduciary described in subparagraph (A) that fails to comply 
     with the requirements under such subparagraph shall be 
     subject to a civil money penalty of $1,000 for each day of 
     noncompliance for each individual for which the information 
     under such subparagraph should have been submitted. The 
     provisions of subsections (e) and (k) of section 1128A shall 
     apply to a civil money penalty under the previous sentence in 
     the same manner as such provisions apply to a penalty or 
     proceeding under section 1128A(a). A civil money penalty 
     under this clause shall be in addition to any other penalties 
     prescribed by law and in addition to any Medicare secondary 
     payer claim under this title with respect to an individual.
       ``(ii) Deposit of amounts collected.--Any amounts collected 
     pursuant to clause (i) shall be deposited in the Federal 
     Hospital Insurance Trust Fund under section 1817.
       ``(C) Sharing of information.--Notwithstanding any other 
     provision of law, under terms and conditions established by 
     the Secretary, the Secretary--
       ``(i) shall share information on entitlement under Part A 
     and enrollment under Part B

[[Page 36196]]

     under this title with entities, plan administrators, and 
     fiduciaries described in subparagraph (A);
       ``(ii) may share the entitlement and enrollment information 
     described in clause (i) with entities and persons not 
     described in such clause; and
       ``(iii) may share information collected under this 
     paragraph as necessary for purposes of the proper 
     coordination of benefits.
       ``(D) Implementation.--Notwithstanding any other provision 
     of law, the Secretary may implement this paragraph by program 
     instruction or otherwise.
       ``(8) Required submission of information by or on behalf of 
     liability insurance (including self-insurance), no fault 
     insurance, and workers' compensation laws and plans.--
       ``(A) Requirement.--On and after the first day of the first 
     calendar quarter beginning after the date that is 18 months 
     after the date of the enactment of this paragraph, an 
     applicable plan shall--
       ``(i) determine whether a claimant (including an individual 
     whose claim is unresolved) is entitled to benefits under the 
     program under this title on any basis; and
       ``(ii) if the claimant is determined to be so entitled, 
     submit the information described in subparagraph (B) with 
     respect to the claimant to the Secretary in a form and manner 
     (including frequency) specified by the Secretary.
       ``(B) Required information.--The information described in 
     this subparagraph is--
       ``(i) the identity of the claimant for which the 
     determination under subparagraph (A) was made; and
       ``(ii) such other information as the Secretary shall 
     specify in order to enable the Secretary to make an 
     appropriate determination concerning coordination of 
     benefits, including any applicable recovery claim.
       ``(C) Timing.--Information shall be submitted under 
     subparagraph (A)(ii) within a time specified by the Secretary 
     after the claim is resolved through a settlement, judgment, 
     award, or other payment (regardless of whether or not there 
     is a determination or admission of liability).
       ``(D) Claimant.--For purposes of subparagraph (A), the term 
     `claimant' includes--
       ``(i) an individual filing a claim directly against the 
     applicable plan; and
       ``(ii) an individual filing a claim against an individual 
     or entity insured or covered by the applicable plan.
       ``(E) Enforcement.--
       ``(i) In general.--An applicable plan that fails to comply 
     with the requirements under subparagraph (A) with respect to 
     any claimant shall be subject to a civil money penalty of 
     $1,000 for each day of noncompliance with respect to each 
     claimant. The provisions of subsections (e) and (k) of 
     section 1128A shall apply to a civil money penalty under the 
     previous sentence in the same manner as such provisions apply 
     to a penalty or proceeding under section 1128A(a). A civil 
     money penalty under this clause shall be in addition to any 
     other penalties prescribed by law and in addition to any 
     Medicare secondary payer claim under this title with respect 
     to an individual.
       ``(ii) Deposit of amounts collected.--Any amounts collected 
     pursuant to clause (i) shall be deposited in the Federal 
     Hospital Insurance Trust Fund.
       ``(F) Applicable plan.--In this paragraph, the term 
     `applicable plan' means the following laws, plans, or other 
     arrangements, including the fiduciary or administrator for 
     such law, plan, or arrangement:
       ``(i) Liability insurance (including self-insurance).
       ``(ii) No fault insurance.
       ``(iii) Workers' compensation laws or plans.
       ``(G) Sharing of information.--The Secretary may share 
     information collected under this paragraph as necessary for 
     purposes of the proper coordination of benefits.
       ``(H) Implementation.--Notwithstanding any other provision 
     of law, the Secretary may implement this paragraph by program 
     instruction or otherwise.''.
       (b) Rule of Construction.--Nothing in the amendments made 
     by this section shall be construed to limit the authority of 
     the Secretary of Health and Human Services to collect 
     information to carry out Medicare secondary payer provisions 
     under title XVIII of the Social Security Act, including under 
     parts C and D of such title.
       (c) Implementation.--For purposes of implementing 
     paragraphs (7) and (8) of section 1862(b) of the Social 
     Security Act, as added by subsection (a), to ensure 
     appropriate payments under title XVIII of such Act, the 
     Secretary of Health and Human Services shall provide for the 
     transfer, from the Federal Hospital Insurance Trust Fund 
     established under section 1817 of the Social Security Act (42 
     U.S.C. 1395i) and the Federal Supplementary Medical Insurance 
     Trust Fund established under section 1841 of such Act (42 
     U.S.C. 1395t), in such proportions as the Secretary 
     determines appropriate, of $35,000,000 to the Centers for 
     Medicare & Medicaid Services Program Management Account for 
     the period of fiscal years 2008, 2009, and 2010.

     SEC. 112. PAYMENT FOR PART B DRUGS.

       (a) Application of Alternative Volume Weighting in 
     Computation of ASP.--Section 1847A(b) of the Social Security 
     Act (42 U.S.C. 1395w-3a(b)) is amended--
       (1) in paragraph (1)(A), by inserting ``for a multiple 
     source drug furnished before April 1, 2008, or 106 percent of 
     the amount determined under paragraph (6) for a multiple 
     source drug furnished on or after April 1, 2008'' after 
     ``paragraph (3)'';
       (2) in each of subparagraphs (A) and (B) of paragraph (4), 
     by inserting ``for single source drugs and biologicals 
     furnished before April 1, 2008, and using the methodology 
     applied under paragraph (6) for single source drugs and 
     biologicals furnished on or after April 1, 2008,'' after 
     ``paragraph (3)''; and
       (3) by adding at the end the following new paragraph:
       ``(6) Use of volume-weighted average sales prices in 
     calculation of average sales price.--
       ``(A) In general.--For all drug products included within 
     the same multiple source drug billing and payment code, the 
     amount specified in this paragraph is the volume-weighted 
     average of the average sales prices reported under section 
     1927(b)(3)(A)(iii) determined by--
       ``(i) computing the sum of the products (for each National 
     Drug Code assigned to such drug products) of--

       ``(I) the manufacturer's average sales price (as defined in 
     subsection (c)), determined by the Secretary without dividing 
     such price by the total number of billing units for the 
     National Drug Code for the billing and payment code; and
       ``(II) the total number of units specified under paragraph 
     (2) sold; and

       ``(ii) dividing the sum determined under clause (i) by the 
     sum of the products (for each National Drug Code assigned to 
     such drug products) of--

       ``(I) the total number of units specified under paragraph 
     (2) sold; and
       ``(II) the total number of billing units for the National 
     Drug Code for the billing and payment code.

       ``(B) Billing unit defined.--For purposes of this 
     subsection, the term `billing unit' means the identifiable 
     quantity associated with a billing and payment code, as 
     established by the Secretary.''.
       (b) Treatment of Certain Drugs.--Section 1847A(b) of the 
     Social Security Act (42 U.S.C. 1395w-3a(b)), as amended by 
     subsection (a), is amended--
       (1) in paragraph (1), by inserting ``paragraph (7) and'' 
     after ``Subject to''; and
       (2) by adding at the end the following new paragraph:
       ``(7) Special rule.--Beginning with April 1, 2008, the 
     payment amount for--
       ``(A) each single source drug or biological described in 
     section 1842(o)(1)(G) that is treated as a multiple source 
     drug because of the application of subsection (c)(6)(C)(ii) 
     is the lower of--
       ``(i) the payment amount that would be determined for such 
     drug or biological applying such subsection; or
       ``(ii) the payment amount that would have been determined 
     for such drug or biological if such subsection were not 
     applied; and
       ``(B) a multiple source drug described in section 
     1842(o)(1)(G) (excluding a drug or biological that is treated 
     as a multiple source drug because of the application of such 
     subsection) is the lower of--
       ``(i) the payment amount that would be determined for such 
     drug or biological taking into account the application of 
     such subsection; or
       ``(ii) the payment amount that would have been determined 
     for such drug or biological if such subsection were not 
     applied.''.

     SEC. 113. PAYMENT RATE FOR CERTAIN DIAGNOSTIC LABORATORY 
                   TESTS.

       Section 1833(h) of the Social Security Act (42 U.S.C. 
     1395l(h)) is amended by adding at the end the following new 
     paragraph:
       ``(9) Notwithstanding any other provision in this part, in 
     the case of any diagnostic laboratory test for HbA1c that is 
     labeled by the Food and Drug Administration for home use and 
     is furnished on or after April 1, 2008, the payment rate for 
     such test shall be the payment rate established under this 
     part for a glycated hemoglobin test (identified as of October 
     1, 2007, by HCPCS code 83036 (and any succeeding codes)).''.

     SEC. 114. LONG-TERM CARE HOSPITALS.

       (a) Definition of Long-Term Care Hospital.--Section 1861 of 
     the Social Security Act (42 U.S.C. 1395x) is amended by 
     adding at the end the following new subsection:

                       ``Long-Term Care Hospital

       ``(ccc) The term `long-term care hospital' means a hospital 
     which--
       ``(1) is primarily engaged in providing inpatient services, 
     by or under the supervision of a physician, to Medicare 
     beneficiaries whose medically complex conditions require a 
     long hospital stay and programs of care provided by a long-
     term care hospital;
       ``(2) has an average inpatient length of stay (as 
     determined by the Secretary) of greater than 25 days, or 
     meets the requirements of clause (II) of section 
     1886(d)(1)(B)(iv);
       ``(3) satisfies the requirements of subsection (e); and
       ``(4) meets the following facility criteria:
       ``(A) the institution has a patient review process, 
     documented in the patient medical record, that screens 
     patients prior to admission for appropriateness of admission 
     to a long-term care hospital, validates within 48 hours of 
     admission that patients meet admission criteria for long-term 
     care hospitals,

[[Page 36197]]

     regularly evaluates patients throughout their stay for 
     continuation of care in a long-term care hospital, and 
     assesses the available discharge options when patients no 
     longer meet such continued stay criteria;
       ``(B) the institution has active physician involvement with 
     patients during their treatment through an organized medical 
     staff, physician-directed treatment with physician on-site 
     availability on a daily basis to review patient progress, and 
     consulting physicians on call and capable of being at the 
     patient's side within a moderate period of time, as 
     determined by the Secretary; and
       ``(C) the institution has interdisciplinary team treatment 
     for patients, requiring interdisciplinary teams of health 
     care professionals, including physicians, to prepare and 
     carry out an individualized treatment plan for each 
     patient.''.
       (b) Study and Report on Long-Term Care Hospital Facility 
     and Patient Criteria.--
       (1) In general.--The Secretary of Health and Human Services 
     (in this section referred to as the ``Secretary'') 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.
       (2) Report.--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.
       (3) Considerations.--In conducting the study and preparing 
     the report under this subsection, the Secretary shall 
     consider--
       (A) 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
       (B) ongoing work by the Secretary to evaluate and determine 
     the feasibility of such recommendations.
       (c) Payment for Long-Term Care Hospital Services.--
       (1) No application of 25 percent patient threshold payment 
     adjustment to freestanding and grandfathered ltchs.--The 
     Secretary shall not apply, for cost reporting periods 
     beginning on or after the date of the enactment of this Act 
     for a 3-year period--
       (A) section 412.536 of title 42, Code of Federal 
     Regulations, or any similar provision, to freestanding long-
     term care hospitals; and
       (B) 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).
       (2) Payment for hospitals-within-hospitals.--
       (A) In general.--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, 
     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.
       (B) Co-located long-term care hospitals and satellite 
     facilities.--
       (i) In general.--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, 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.
       (ii) Applicable long-term care hospital or satellite 
     facility defined.--In this paragraph, the term ``applicable 
     long-term care hospital or satellite facility'' 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.
       (C) Effective date.--Subparagraphs (A) and (B) shall apply 
     to cost reporting periods beginning on or after the date of 
     the enactment of this Act for a 3-year period.
       (3) No application of very short-stay outlier policy.--The 
     Secretary shall not apply, for the 3-year period beginning on 
     the date of the enactment of this Act, the amendments 
     finalized on May 11, 2007 (72 Federal Register 26904, 26992) 
     made to the short-stay outlier payment provision for long-
     term care hospitals contained in section 412.529(c)(3)(i) of 
     title 42, Code of Federal Regulations, or any similar 
     provision.
       (4) No application of one-time adjustment to standard 
     amount.--The Secretary shall not, for the 3-year period 
     beginning on the date of the enactment of this Act, make the 
     one-time prospective adjustment to long-term care hospital 
     prospective payment rates provided for in section 
     412.523(d)(3) of title 42, Code of Federal Regulations, or 
     any similar provision.
       (d) 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.--
       (1) In general.--During the 3-year period beginning on the 
     date of the enactment of this Act, the Secretary shall impose 
     a moratorium for purposes of the Medicare program under title 
     XVIII of the Social Security Act--
       (A) 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
       (B) subject to paragraph (3), on an increase of long-term 
     care hospital beds in existing long-term care hospitals or 
     satellite facilities.
       (2) Exception for certain long-term care hospitals.--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--
       (A) 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;
       (B) 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
       (C) 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.
       (3) Exception for bed increases during moratorium.--
       (A) In general.--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--
       (i) is located in a State where there is only one other 
     long-term care hospital; and
       (ii) 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.
       (B) No effect on certain limitation.--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.
       (4) Existing hospital or satellite facility defined.--For 
     purposes of this subsection, the term ``existing'' 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.
       (5) Judicial review.--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.
       (e) Long-Term Care Hospital Payment Update.--
       (1) In general.--Section 1886 of the Social Security Act 
     (42 U.S.C. 1395ww) is amended by adding at the end the 
     following new subsection:
       ``(m) Prospective Payment for Long-Term Care Hospitals.--
       ``(1) Reference to establishment and implementation of 
     system.--For provisions related to the establishment and 
     implementation of a prospective payment system for payments 
     under this title for inpatient hospital services furnished by 
     a long-term care hospital described in subsection 
     (d)(1)(B)(iv), see section 123 of the Medicare, Medicaid, and 
     SCHIP Balanced Budget Refinement Act of 1999 and section 
     307(b) of the Medicare, Medicaid, and SCHIP Benefits 
     Improvement and Protection Act of 2000.
       ``(2) Update for rate year 2008.--In implementing the 
     system described in paragraph (1) for discharges occurring 
     during the rate year ending in 2008 for a hospital, the base 
     rate for such discharges for the hospital shall be the same 
     as the base rate for discharges for the hospital occurring 
     during the rate year ending in 2007.''.
       (2) Delayed effective date.--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.
       (f) Expanded Review of Medical Necessity.--
       (1) In general.--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.

[[Page 36198]]

     Such reviews shall be made for discharges occurring on or 
     after October 1, 2007.
       (2) Review methodology.--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--
       (A) provide for a statistically valid and representative 
     sample of admissions of such individuals sufficient to 
     provide results at a 95 percent confidence interval; and
       (B) 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)).
       (3) Continuation of reviews.--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.
       (4) Termination of required reviews.--
       (A) In general.--Subject to subparagraph (B), the previous 
     provisions of this subsection shall cease to apply for 
     discharges occurring on or after October 1, 2010.
       (B) Continuation.--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.
       (5) Funding.--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.
       (g) Implementation.--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.

     SEC. 115. PAYMENT FOR INPATIENT REHABILITATION FACILITY (IRF) 
                   SERVICES.

       (a) Payment Update.--
       (1) In general.--Section 1886(j)(3)(C) of the Social 
     Security Act (42 U.S.C. 1395ww(j)(3)(C)) is amended by adding 
     at the end the following: ``The increase factor to be applied 
     under this subparagraph for each of fiscal years 2008 and 
     2009 shall be 0 percent.''.
       (2) Delayed effective date.--The amendment made by 
     paragraph (1) shall not apply to payment units occurring 
     before April 1, 2008.
       (b) Inpatient Rehabilitation Facility Classification 
     Criteria.--
       (1) In general.--Section 5005 of the Deficit Reduction Act 
     of 2005 (Public Law 109-171; 42 U.S.C. 1395ww note) is 
     amended--
       (A) in subsection (a), by striking ``apply the applicable 
     percent specified in subsection (b)'' and inserting ``require 
     a compliance rate that is no greater than the 60 percent 
     compliance rate that became effective for cost reporting 
     periods beginning on or after July 1, 2006,''; and
       (B) by amending subsection (b) to read as follows:
       ``(b) Continued Use of Comorbidities.--For cost reporting 
     periods beginning on or after July 1, 2007, the Secretary 
     shall include patients with comorbidities as described in 
     section 412.23(b)(2)(i) of title 42, Code of Federal 
     Regulations (as in effect as of January 1, 2007), in the 
     inpatient population that counts toward the percent specified 
     in subsection (a).''.
       (2) Effective date.--The amendment made by paragraph (1)(A) 
     shall apply for cost reporting periods beginning on or after 
     July 1, 2007.
       (c) Recommendations for Classifying Inpatient 
     Rehabilitation Hospitals and Units.--
       (1) Report to congress.--Not later than 18 months after the 
     date of the enactment of this Act, the Secretary of Health 
     and Human Services, in consultation with physicians 
     (including geriatricians and physiatrists), administrators of 
     inpatient rehabilitation, acute care hospitals, skilled 
     nursing facilities, and other settings providing 
     rehabilitation services, Medicare beneficiaries, trade 
     organizations representing inpatient rehabilitation hospitals 
     and units and skilled nursing facilities, and the Medicare 
     Payment Advisory Commission, shall submit to the Committee on 
     Ways and Means of the House of Representatives and the 
     Committee on Finance of the Senate a report that includes the 
     following:
       (A) An analysis of Medicare beneficiaries' access to 
     medically necessary rehabilitation services, including the 
     potential effect of the 75 percent rule (as defined in 
     paragraph (2)) on access to care.
       (B) An analysis of alternatives or refinements to the 75 
     percent rule policy for determining criteria for inpatient 
     rehabilitation hospital and unit designation under the 
     Medicare program, including alternative criteria which would 
     consider a patient's functional status, diagnosis, co-
     morbidities, and other relevant factors.
       (C) An analysis of the conditions for which individuals are 
     commonly admitted to inpatient rehabilitation hospitals that 
     are not included as a condition described in section 
     412.23(b)(2)(iii) of title 42, Code of Federal Regulations, 
     to determine the appropriate setting of care, and any 
     variation in patient outcomes and costs, across settings of 
     care, for treatment of such conditions.
       (2) 75 percent rule defined.--For purposes of this 
     subsection, the term ``75 percent rule'' means the 
     requirement of section 412.23(b)(2) of title 42, Code of 
     Federal Regulations, that 75 percent of the patients of a 
     rehabilitation hospital or converted rehabilitation unit are 
     in 1 or more of 13 listed treatment categories.

     SEC. 116. EXTENSION OF ACCOMMODATION OF PHYSICIANS ORDERED TO 
                   ACTIVE DUTY IN THE ARMED SERVICES.

       Section 1842(b)(6)(D)(iii) of the Social Security Act (42 
     U.S.C. 1395u(b)(6)(D)(iii)), as amended by Public Law 110-54 
     (121 Stat. 551) is amended by striking ``January 1, 2008'' 
     and inserting ``July 1, 2008''.

     SEC. 117. TREATMENT OF CERTAIN HOSPITALS.

       (a) Extending Certain Medicare Hospital Wage Index 
     Reclassifications Through Fiscal Year 2008.--
       (1) In general.--Section 106(a) of division B of the Tax 
     Relief and Health Care Act of 2006 (42 U.S.C. 1395 note) is 
     amended by striking ``September 30, 2007'' and inserting 
     ``September 30, 2008''.
       (2) Special exception reclassifications.--The Secretary of 
     Health and Human Services shall extend for discharges 
     occurring through September 30, 2008, the special exception 
     reclassifications made under the authority of section 
     1886(d)(5)(I)(i) of the Social Security Act (42 U.S.C. 
     1395ww(d)(5)(I)(i)) and contained in the final rule 
     promulgated by the Secretary in the Federal Register on 
     August 11, 2004 (69 Fed. Reg. 49105, 49107).
       (3) Use of particular wage index.--For purposes of 
     implementation of this subsection, the Secretary shall use 
     the hospital wage index that was promulgated by the Secretary 
     in the Federal Register on October 10, 2007 (72 Fed. Reg. 
     57634), and any subsequent corrections.
       (b) Disregarding Section 508 Hospital Reclassifications for 
     Purposes of Group Reclassifications.--Section 508 of the 
     Medicare Prescription Drug, Improvement, and Modernization 
     Act of 2003 (Public Law 108-173, 42 U.S.C. 1395ww note) is 
     amended by adding at the end the following new subsection:
       ``(g) Disregarding Hospital Reclassifications for Purposes 
     of Group Reclassifications.--For purposes of the 
     reclassification of a group of hospitals in a geographic area 
     under section 1886(d) of the Social Security Act for purposes 
     of discharges occurring during fiscal year 2008, a hospital 
     reclassified under this section (including any such 
     reclassification which is extended under section 106(a) of 
     the Medicare Improvements and Extension Act of 2006) shall 
     not be taken into account and shall not prevent the other 
     hospitals in such area from continuing such a group for such 
     purpose.''.
       (c) Correction of Application of Wage Index During Tax 
     Relief and Health Care Act Extension.--In the case of a 
     subsection (d) hospital (as defined for purposes of section 
     1886 of the Social Security Act (42 U.S.C. 1395ww)) with 
     respect to which--
       (1) a reclassification of its wage index for purposes of 
     such section was extended for the period beginning on April 
     1, 2007, and ending on September 30, 2007, pursuant to 
     subsection (a) of section 106 of division B of the Tax Relief 
     and Health Care Act of 2006 (42 U.S.C. 1395 note); and
       (2) the wage index applicable for such hospital during such 
     period was lower than the wage index applicable for such 
     hospital during the period beginning on October 1, 2006, and 
     ending on March 31, 2007,
     the Secretary shall apply the higher wage index that was 
     applicable for such hospital during the period beginning on 
     October 1, 2006, and ending on March 31, 2007, for the entire 
     fiscal year 2007. If the Secretary determines that the 
     application of the preceding sentence to a hospital will 
     result in a hospital being owed additional reimbursement, the 
     Secretary shall make such payments within 90 days after the 
     settlement of the applicable cost report.

     SEC. 118. ADDITIONAL FUNDING FOR STATE HEALTH INSURANCE 
                   ASSISTANCE PROGRAMS, AREA AGENCIES ON AGING, 
                   AND AGING AND DISABILITY RESOURCE CENTERS.

       (a) State Health Insurance Assistance Programs.--
       (1) In general.--The Secretary of Health and Human Services 
     shall use amounts made available under paragraph (2) to make 
     grants to States for State health insurance assistance 
     programs receiving assistance under

[[Page 36199]]

     section 4360 of the Omnibus Budget Reconciliation Act of 
     1990.
       (2) Funding.--For purposes of making grants under this 
     subsection, the Secretary shall provide for the transfer, 
     from the Federal Hospital Insurance Trust Fund under section 
     1817 of the Social Security Act (42 U.S.C. 1395i) and the 
     Federal Supplementary Medical Insurance Trust Fund under 
     section 1841 of such Act (42 U.S.C. 1395t), in the same 
     proportion as the Secretary determines under section 1853(f) 
     of such Act (42 U.S.C. 1395w-23(f)), of $15,000,000 to the 
     Centers for Medicare & Medicaid Services Program Management 
     Account for fiscal year 2008.
       (b) Area Agencies on Aging and Aging and Disability 
     Resource Centers.--
       (1) In general.--The Secretary of Health and Human Services 
     shall use amounts made available under paragraph (2) to make 
     grants--
       (A) to States for area agencies on aging (as defined in 
     section 102 of the Older Americans Act of 1965 (42 U.S.C. 
     3002)); and
       (B) to Aging and Disability Resource Centers under the 
     Aging and Disability Resource Center grant program.
       (2) Funding.--For purposes of making grants under this 
     subsection, the Secretary shall provide for the transfer, 
     from the Federal Hospital Insurance Trust Fund under section 
     1817 of the Social Security Act (42 U.S.C. 1395i) and the 
     Federal Supplementary Medical Insurance Trust Fund under 
     section 1841 of such Act (42 U.S.C. 1395t), in the same 
     proportion as the Secretary determines under section 1853(f) 
     of such Act (42 U.S.C. 1395w-23(f)), of $5,000,000 to the 
     Centers for Medicare & Medicaid Services Program Management 
     Account for the period of fiscal years 2008 through 2009.

                      TITLE II--MEDICAID AND SCHIP

     SEC. 201. EXTENDING SCHIP FUNDING THROUGH MARCH 31, 2009.

       (a) Through the Second Quarter of Fiscal Year 2009.--
       (1) In general.--Section 2104 of the Social Security Act 
     (42 U.S.C. 1397dd) is amended--
       (A) in subsection (a)--
       (i) by striking ``and'' at the end of paragraph (9);
       (ii) by striking the period at the end of paragraph (10) 
     and inserting ``; and''; and
       (iii) by adding at the end the following new paragraph:
       ``(11) for each of fiscal years 2008 and 2009, 
     $5,000,000,000.''; and
       (B) in subsection (c)(4)(B), by striking ``for fiscal year 
     2007'' and inserting ``for each of fiscal years 2007 through 
     2009''.
       (2) Availability of extended funding.--Funds made available 
     from any allotment made from funds appropriated under 
     subsection (a)(11) or (c)(4)(B) of section 2104 of the Social 
     Security Act (42 U.S.C. 1397dd) for fiscal year 2008 or 2009 
     shall not be available for child health assistance for items 
     and services furnished after March 31, 2009, or, if earlier, 
     the date of the enactment of an Act that provides funding for 
     fiscal years 2008 and 2009, and for one or more subsequent 
     fiscal years for the State Children's Health Insurance 
     Program under title XXI of the Social Security Act.
       (3) End of funding under continuing resolution.--Section 
     136(a)(2) of Public Law 110-92 is amended by striking ``after 
     the termination date'' and all that follows and inserting 
     ``after the date of the enactment of the Medicare, Medicaid, 
     and SCHIP Extension Act of 2007.''.
       (4) Clarification of application of funding under 
     continuing resolution.--Section 107 of Public Law 110-92 
     shall apply with respect to expenditures made pursuant to 
     section 136(a)(1) of such Public Law.
       (b) Extension of Treatment of Qualifying States; Rules on 
     Redistribution of Unspent Fiscal Year 2005 Allotments Made 
     Permanent.--
       (1) In general.--Section 2105(g)(1)(A) of the Social 
     Security Act (42 U.S.C. 1397ee(g)(1)(A)), as amended by 
     subsection (d) of section 136 of Public Law 110-92, is 
     amended by striking ``or 2008'' and inserting ``2008, or 
     2009''.
       (2) Applicability.--The amendment made by paragraph (1) 
     shall be in effect through March 31, 2009.
       (3) Certain rules made permanent.--Subsection (e) of 
     section 136 of Public Law 110-92 is repealed.
       (c) Additional Allotments To Eliminate Remaining Funding 
     Shortfalls Through March 31, 2009.--
       (1) In general.--Section 2104 of the Social Security Act 
     (42 U.S.C. 1397dd) is amended by adding at the end the 
     following new subsections:
       ``(j) Additional Allotments To Eliminate Funding Shortfalls 
     for Fiscal Year 2008.--
       ``(1) Appropriation; allotment authority.--For the purpose 
     of providing additional allotments described in subparagraphs 
     (A) and (B) of paragraph (3), there is appropriated, out of 
     any money in the Treasury not otherwise appropriated, such 
     sums as may be necessary, not to exceed $1,600,000,000 for 
     fiscal year 2008.
       ``(2) Shortfall states described.--For purposes of 
     paragraph (3), a shortfall State described in this paragraph 
     is a State with a State child health plan approved under this 
     title for which the Secretary estimates, on the basis of the 
     most recent data available to the Secretary as of November 
     30, 2007, that the Federal share amount of the projected 
     expenditures under such plan for such State for fiscal year 
     2008 will exceed the sum of--
       ``(A) the amount of the State's allotments for each of 
     fiscal years 2006 and 2007 that will not be expended by the 
     end of fiscal year 2007;
       ``(B) the amount, if any, that is to be redistributed to 
     the State during fiscal year 2008 in accordance with 
     subsection (i); and
       ``(C) the amount of the State's allotment for fiscal year 
     2008.
       ``(3) Allotments.--In addition to the allotments provided 
     under subsections (b) and (c), subject to paragraph (4), of 
     the amount available for the additional allotments under 
     paragraph (1) for fiscal year 2008, the Secretary shall 
     allot--
       ``(A) to each shortfall State described in paragraph (2) 
     not described in subparagraph (B), such amount as the 
     Secretary determines will eliminate the estimated shortfall 
     described in such paragraph for the State; and
       ``(B) to each commonwealth or territory described in 
     subsection (c)(3), an amount equal to the percentage 
     specified in subsection (c)(2) for the commonwealth or 
     territory multiplied by 1.05 percent of the sum of the 
     amounts determined for each shortfall State under 
     subparagraph (A).
       ``(4) Proration rule.--If the amounts available for 
     additional allotments under paragraph (1) are less than the 
     total of the amounts determined under subparagraphs (A) and 
     (B) of paragraph (3), the amounts computed under such 
     subparagraphs shall be reduced proportionally.
       ``(5) Retrospective adjustment.--The Secretary may adjust 
     the estimates and determinations made to carry out this 
     subsection as necessary on the basis of the amounts reported 
     by States not later than November 30, 2008, on CMS Form 64 or 
     CMS Form 21, as the case may be, and as approved by the 
     Secretary.
       ``(6) One-year availability; no redistribution of 
     unexpended additional allotments.--Notwithstanding 
     subsections (e) and (f), amounts allotted to a State pursuant 
     to this subsection for fiscal year 2008, subject to paragraph 
     (5), shall only remain available for expenditure by the State 
     through September 30, 2008. Any amounts of such allotments 
     that remain unexpended as of such date shall not be subject 
     to redistribution under subsection (f).
       ``(k) Redistribution of Unused Fiscal Year 2006 Allotments 
     to States With Estimated Funding Shortfalls During the First 
     2 Quarters of Fiscal Year 2009.--
       ``(1) In general.--Notwithstanding subsection (f) and 
     subject to paragraphs (3) and (4), with respect to months 
     beginning during the first 2 quarters of fiscal year 2009, 
     the Secretary shall provide for a redistribution under such 
     subsection from the allotments for fiscal year 2006 under 
     subsection (b) that are not expended by the end of fiscal 
     year 2008, to a fiscal year 2009 shortfall State described in 
     paragraph (2), such amount as the Secretary determines will 
     eliminate the estimated shortfall described in such paragraph 
     for such State for the month.
       ``(2) Fiscal year 2009 shortfall state described.--A fiscal 
     year 2009 shortfall State described in this paragraph is a 
     State with a State child health plan approved under this 
     title for which the Secretary estimates, on a monthly basis 
     using the most recent data available to the Secretary as of 
     such month, that the Federal share amount of the projected 
     expenditures under such plan for such State for the first 2 
     quarters of fiscal year 2009 will exceed the sum of--
       ``(A) the amount of the State's allotments for each of 
     fiscal years 2007 and 2008 that was not expended by the end 
     of fiscal year 2008; and
       ``(B) the amount of the State's allotment for fiscal year 
     2009.
       ``(3) Funds redistributed in the order in which states 
     realize funding shortfalls.--The Secretary shall redistribute 
     the amounts available for redistribution under paragraph (1) 
     to fiscal year 2009 shortfall States described in paragraph 
     (2) in the order in which such States realize monthly funding 
     shortfalls under this title for fiscal year 2009. The 
     Secretary shall only make redistributions under this 
     subsection to the extent that there are unexpended fiscal 
     year 2006 allotments under subsection (b) available for such 
     redistributions.
       ``(4) Proration rule.--If the amounts available for 
     redistribution under paragraph (1) are less than the total 
     amounts of the estimated shortfalls determined for the month 
     under that paragraph, the amount computed under such 
     paragraph for each fiscal year 2009 shortfall State for the 
     month shall be reduced proportionally.
       ``(5) Retrospective adjustment.--The Secretary may adjust 
     the estimates and determinations made to carry out this 
     subsection as necessary on the basis of the amounts reported 
     by States not later than May 31, 2009, on CMS Form 64 or CMS 
     Form 21, as the case may be, and as approved by the 
     Secretary.
       ``(6) Availability; no further redistribution.--
     Notwithstanding subsections (e) and (f), amounts 
     redistributed to a State pursuant to this subsection for the 
     first 2 quarters of fiscal year 2009 shall only remain 
     available for expenditure by the State through

[[Page 36200]]

     March 31, 2009, and any amounts of such redistributions that 
     remain unexpended as of such date, shall not be subject to 
     redistribution under subsection (f).
       ``(l) Additional Allotments To Eliminate Funding Shortfalls 
     for the First 2 Quarters of Fiscal Year 2009.--
       ``(1) Appropriation; allotment authority.--For the purpose 
     of providing additional allotments described in subparagraphs 
     (A) and (B) of paragraph (3), there is appropriated, out of 
     any money in the Treasury not otherwise appropriated, such 
     sums as may be necessary, not to exceed $275,000,000 for the 
     first 2 quarters of fiscal year 2009.
       ``(2) Shortfall states described.--For purposes of 
     paragraph (3), a shortfall State described in this paragraph 
     is a State with a State child health plan approved under this 
     title for which the Secretary estimates, on the basis of the 
     most recent data available to the Secretary, that the Federal 
     share amount of the projected expenditures under such plan 
     for such State for the first 2 quarters of fiscal year 2009 
     will exceed the sum of--
       ``(A) the amount of the State's allotments for each of 
     fiscal years 2007 and 2008 that will not be expended by the 
     end of fiscal year 2008;
       ``(B) the amount, if any, that is to be redistributed to 
     the State during fiscal year 2009 in accordance with 
     subsection (k); and
       ``(C) the amount of the State's allotment for fiscal year 
     2009.
       ``(3) Allotments.--In addition to the allotments provided 
     under subsections (b) and (c), subject to paragraph (4), of 
     the amount available for the additional allotments under 
     paragraph (1) for the first 2 quarters of fiscal year 2009, 
     the Secretary shall allot--
       ``(A) to each shortfall State described in paragraph (2) 
     not described in subparagraph (B) such amount as the 
     Secretary determines will eliminate the estimated shortfall 
     described in such paragraph for the State; and
       ``(B) to each commonwealth or territory described in 
     subsection (c)(3), an amount equal to the percentage 
     specified in subsection (c)(2) for the commonwealth or 
     territory multiplied by 1.05 percent of the sum of the 
     amounts determined for each shortfall State under 
     subparagraph (A).
       ``(4) Proration rule.--If the amounts available for 
     additional allotments under paragraph (1) are less than the 
     total of the amounts determined under subparagraphs (A) and 
     (B) of paragraph (3), the amounts computed under such 
     subparagraphs shall be reduced proportionally.
       ``(5) Retrospective adjustment.--The Secretary may adjust 
     the estimates and determinations made to carry out this 
     subsection as necessary on the basis of the amounts reported 
     by States not later than May 31, 2009, on CMS Form 64 or CMS 
     Form 21, as the case may be, and as approved by the 
     Secretary.
       ``(6) Availability; no redistribution of unexpended 
     additional allotments.--Notwithstanding subsections (e) and 
     (f), amounts allotted to a State pursuant to this subsection 
     for fiscal year 2009, subject to paragraph (5), shall only 
     remain available for expenditure by the State through March 
     31, 2009. Any amounts of such allotments that remain 
     unexpended as of such date shall not be subject to 
     redistribution under subsection (f).''.

     SEC. 202. EXTENSION OF TRANSITIONAL MEDICAL ASSISTANCE (TMA) 
                   AND ABSTINENCE EDUCATION PROGRAM.

       Section 401 of division B of the Tax Relief and Health Care 
     Act of 2006 (Public Law 109-432, 120 Stat. 2994), as amended 
     by section 1 of Public Law 110-48 (121 Stat. 244) and section 
     2 of the TMA, Abstinence, Education, and QI Programs 
     Extension Act of 2007 (Public Law 110-90, 121 Stat. 984), is 
     amended--
       (1) by striking ``December 31, 2007'' and inserting ``June 
     30, 2008''; and
       (2) by striking ``first quarter'' and inserting ``third 
     quarter'' each place it appears.

     SEC. 203. EXTENSION OF QUALIFYING INDIVIDUAL (QI) PROGRAM.

       (a) Extension.--Section 1902(a)(10)(E)(iv) of the Social 
     Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended by 
     striking ``December 2007'' and inserting ``June 2008''.
       (b) Extending Total Amount Available for Allocation.--
     Section 1933(g)(2) of the Social Security Act (42 U.S.C. 
     1396u-3(g)(2)) is amended--
       (1) in subparagraph (G), by striking ``and'' at the end;
       (2) in subparagraph (H), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following new subparagraph:
       ``(I) for the period that begins on January 1, 2008, and 
     ends on June 30, 2008, the total allocation amount is 
     $200,000,000.''.

     SEC. 204. MEDICAID DSH EXTENSION.

       Section 1923(f)(6) of the Social Security Act (42 U.S.C. 
     1396r-4(f)(6)) is amended--
       (1) in the heading, by inserting ``and portions of fiscal 
     year 2008'' after ``fiscal year 2007''; and
       (2) in subparagraph (A)--
       (A) in clause (i), by adding at the end (after and below 
     subclause (II)) the following:
     ``Only with respect to fiscal year 2008 for the period ending 
     on June 30, 2008, the DSH allotment for Tennessee for such 
     portion of the fiscal year, notwithstanding such table or 
     terms, shall be \3/4\ of the amount specified in the previous 
     sentence for fiscal year 2007.'';
       (B) in clause (ii)--
       (i) by inserting ``or for a period in fiscal year 2008 
     described in clause (i)'' after ``fiscal year 2007''; and
       (ii) by inserting ``or period'' after ``such fiscal year''; 
     and
       (C) in clause (iv)--
       (i) in the heading, by inserting ``and fiscal year 2008'' 
     after ``fiscal year 2007'';
       (ii) in subclause (I)--

       (I) by inserting ``or for a period in fiscal year 2008 
     described in clause (i)'' after ``fiscal year 2007''; and
       (II) by inserting ``or period'' after ``for such fiscal 
     year''; and

       (iii) in subclause (II)--

       (I) by inserting ``or for a period in fiscal year 2008 
     described in clause (i)'' after ``fiscal year 2007''; and
       (II) by inserting ``or period'' after ``such fiscal year'' 
     each place it appears; and

       (3) in subparagraph (B)(i), by adding at the end the 
     following: ``Only with respect to fiscal year 2008 for the 
     period ending on June 30, 2008, the DSH allotment for Hawaii 
     for such portion of the fiscal year, notwithstanding the 
     table set forth in paragraph (2), shall be $7,500,000.''.

     SEC. 205. IMPROVING DATA COLLECTION.

       Section 2109(b)(2) of the Social Security Act (42 U.S.C. 
     1397ii(b)(2)) is amended by inserting before the period at 
     the end the following ``(except that only with respect to 
     fiscal year 2008, there are appropriated $20,000,000 for the 
     purpose of carrying out this subsection, to remain available 
     until expended)''.

     SEC. 206. MORATORIUM ON CERTAIN PAYMENT RESTRICTIONS.

       Notwithstanding any other provision of law, the Secretary 
     of Health and Human Services shall not, prior to June 30, 
     2008, take any action (through promulgation of regulation, 
     issuance of regulatory guidance, use of Federal payment audit 
     procedures, or other administrative action, policy, or 
     practice, including a Medical Assistance Manual transmittal 
     or letter to State Medicaid directors) to impose any 
     restrictions relating to coverage or payment under title XIX 
     of the Social Security Act for rehabilitation services or 
     school-based administration and school-based transportation 
     if such restrictions are more restrictive in any aspect than 
     those applied to such areas as of July 1, 2007.

                        TITLE III--MISCELLANEOUS

     SEC. 301. MEDICARE PAYMENT ADVISORY COMMISSION STATUS.

       Section 1805(a) of the Social Security Act (42 U.S.C. 
     1395b-6(a)) is amended by inserting ``as an agency of 
     Congress'' after ``established''.

     SEC. 302. SPECIAL DIABETES PROGRAMS FOR TYPE I DIABETES AND 
                   INDIANS.

       (a) Special Diabetes Programs for Type I Diabetes.--Section 
     330B(b)(2)(C) of the Public Health Service Act (42 U.S.C. 
     254c-2(b)(2)(C)) is amended by striking ``2008'' and 
     inserting ``2009''.
       (b) Special Diabetes Programs for Indians.--Section 
     330C(c)(2)(C) of the Public Health Service Act (42 U.S.C. 
     254c-3(c)(2)(C)) is amended by striking ``2008'' and 
     inserting ``2009''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Texas (Mr. Barton) each 
will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days to revise and extend their remarks and 
include extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Madam Speaker, I yield 10 minutes to the gentleman from 
California (Mr. Stark) and ask unanimous consent that he be allowed to 
control that time.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, when this Congress was first gaveled into session by 
Speaker Pelosi, she declared it the Children's Congress. With that in 
mind, we set out to enact an ambitious agenda that included legislation 
to provide health care to 10 million low-income American children. But 
we were forced to go it alone. Instead of working with us, the 
President and his Republican foot soldiers in Congress chose to fight 
us tooth and nail.
  We were not deterred by the President or the opposition that we faced 
from congressional Republicans. Earlier this summer, the House passed 
the

[[Page 36201]]

CHAMP Act, which would have strengthened the Children's Health 
Insurance Program, CHIP, and helped secure health care coverage for 10 
million American children, 4 million of which are presently uninsured 
and come from hardworking families.
  The CHAMP Act also included dramatic improvements for beneficiaries 
and providers under Medicare, which, if enacted, would have put the 
program on a more stable financial footing and ensured that seniors 
have access to the medical care they need and deserve. The CHAMP Act 
would have also protected Medicaid from harmful regulations which are 
now about to go into effect and will cut billions of dollars in 
critical services for low-income and disabled citizens of all ages.
  Now, some may see the defeat of the CHAMP Act this year as a great 
victory for the President and his Republican allies in Congress. But 
they may have succeeded in being nothing more than obstructionists. No 
one has gained anything from these actions by the President or my 
Republican colleagues, least of all the people who rely on these 
programs for their health care.
  This year, we had a chance to strengthen our Nation's health care 
safety net and improve the lives of our most vulnerable citizens, the 
elderly, the young, the poor and the disabled. Instead, both the 
administration and congressional Republicans are content on leaving 
here this year with doing the bare minimum on CHIP and Medicare when we 
could have accomplished so much more to improve the health of millions 
of Americans.
  So now, Madam Speaker, we are left with a package that addresses the 
most immediate concerns, but leaves any real health care improvements 
for another day, and I think that is very unfortunate. But with the 
current President and the current Senate, sadly, this is the best we 
can do. But I will say, Madam Speaker, the Democrats are determined in 
the next year to revive the CHAMP Act and the provisions that we care 
so much about, because we know that that is the best for the American 
people.
  Madam Speaker, I reserve the balance of my time.
  Mr. BARTON of Texas. Madam Speaker, I yield myself 2\1/2\ minutes.
  Madam Speaker, it is difficult to speak on this subject because we 
have debated it so many times in the last 1\1/2\ months. Suffice it to 
say that all is well that ends well, and today we have a bill before us 
that is going to temporarily fix the physician reimbursement issue. It 
is going to extend the SCHIP program through March of 2009. It is going 
to extend the special diabetes program for another year and a number of 
other things.
  These are all good things and people on both sides of the aisle 
support them. It shouldn't have taken all year to do these things, but 
it has.
  I want to speak very briefly about the SCHIP program. The language in 
the bill before us is essentially the Barton-Deal language, which 
Congressman Deal of Georgia, the ranking member of the Health 
Subcommittee, and myself introduced 7 or 8 months ago to extend the 
existing SCHIP program for 18 months, to make sure that all children 
currently receiving coverage continue to receive coverage, to have a 
slight increase in funding so that some new enrollments could occur. It 
is a commonsense approach to an issue while we debate with our friends 
on the majority side the extent to which we want to expand or change 
the program.
  We have had two Presidential vetoes. We have had enough speeches on 
the House floor and the other body to probably populate a national 
forest in terms of the amount of paper that has been used to cover 
those speeches. And yet we are here today doing what we could have done 
11 months ago.
  I am very pleased that the SCHIP program is going to be extended. I 
am very pleased that no State is going to lose funding. I am very 
pleased that we are going to continue to cover the children that have 
been covered. And I look forward in the next year to the same offer 
that Congressman Deal and Mr. McCrery and Mr. Camp and I have made to 
our friends on the majority, let's have some hearings.
  We now have 15 months. We could hold regular hearings. We could 
introduce draft bills. We could circulate those bills. We could have a 
bipartisan dialogue. We could have an actual open, transparent 
committee markup in both the Ways and Means Committee and the Energy 
and Commerce Committee. It is still possible in this Congress to have 
the meetings of the mind on SCHIP in terms of changes to the program, 
and I hope, Madam Speaker, that that occurs in the next 12 months.

                              {time}  1045

  Mr. STARK. Madam Speaker, I yield myself such time as I may consume.
  I wish I could say I was pleased to be here today to support this 
important legislation, but you can't say that about this bill the 
Republicans have brought us.
  Last July we sent to the Senate the CHAMP Act, a strong bill that 
preserved and improved both the Medicare and SCHIP program. The CHAMP 
Act extended health coverage to 10 million children nationwide. This 
bill doesn't even come close.
  This bill was designed by the Republicans to support their rich 
friends, the pharmaceutical industry, the for-profit insurance 
industry, and to destroy Medicare as millions of American seniors have 
known it, to harm children, and to cast blame at illegal immigrants and 
working single parents. It shows the Republicans in their truest form: 
Help the rich at the expense of the poor; to deny government services 
to anyone, and only help the profit industries who pay them so 
generously through their campaign contributions, which will be useless, 
because the public will realize that we don't need them anymore.
  The CHAMP Act provided Medicare benefits for all, and it increased 
protections for low-income beneficiaries. It extended the physicians' 
reimbursement above par for 2 years and it protected rural providers 
for those same periods of time. The CHAMP Act overwrote provisions 
enacted by the former Republican majority designed to end Medicare as 
an entitlement program. The CHAMP Act was paid for by reducing 
overpayments to the substandard private plans in Medicare, plans 
designed to privatize the program by Republicans.
  For this effort, House Members, five Republican Members and the 
Democrats, and our staffs are to be congratulated. They worked hard and 
took tough and reasoned positions. The Senate failed to act on our 
legislation and the irresponsible Republicans in the House of 
Representatives failed to help the children in this country as is their 
wont.
  What we have before us gives the lowest common denominator a bad 
name. The Senate has sent us a bill that extends otherwise expiring 
Medicare provisions by a mere 6 months, meaning that we will be back 
here next summer, next spring trying to fix a system which the 
Republicans consistently try and privatize and destroy. That is 
Medicare and SCHIP. For the next 6 months, the bill delays the 10 
percent physicians cut, prevents some therapy caps from going into 
effect, and protects rural providers by extending a host of particular 
provisions that would otherwise expire.
  There are some provisions that run longer. SCHIP will go for 15 
months, moving it forward in time when we have a new President, whom we 
hope will be willing to work with Congress to protect children's health 
and expand access to care. It also makes longer term reforms to 
Medicare payment policies for long-term care hospitals and rehab 
hospitals, two changes that are long overdue.
  What is wrong with the bill is what it fails to do. It flat out fails 
to address real improvements needed for Medicare beneficiaries, many of 
which we had addressed in the CHAMP Act. It lacks increased protections 
for low-income beneficiaries; it lacks Medicare mental health parity; 
it lacks overdue improvements in preventive benefits and nonpayment 
related reforms to the HMO program. It lacks limits on physician 
hospital ownership and self-referral. And the list goes on.

[[Page 36202]]

  Adding insult to injury, this legislation also lets HMOs in the 
insurance industry off virtually scot free, even though MedPAC, CBO, 
GAO, the Office of the Inspector General and even the administration's 
own actuaries confirm that we overpay these second-rate, for-profit 
plans relative to the rest of Medicare.
  I would hope that those of you learned, as I learned, that if you 
don't like the food, don't eat it, but don't complain about it.
  We still have a strong bill pending in the Senate, the CHAMP Act. The 
Senate must act early in 2008 so that we can reach a better outcome for 
Medicare. We just can't keep subsidizing the for-profit providers and 
failing to serve our own children and seniors. So we must proceed as 
best we can.
  I reserve the balance of my time.
  Mr. BARTON of Texas. Madam Speaker, may I inquire how much time I 
have remaining.
  The SPEAKER pro tempore. The gentleman from Texas has 17\1/2\ 
minutes.
  Mr. BARTON of Texas. Madam Speaker, I ask unanimous consent to yield 
10 minutes of that time to the gentleman from Louisiana (Mr. McCrery), 
the ranking member of the Ways and Means Committee, for him to control.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. McCRERY. Madam Speaker, I agree with some of the comments that 
have been made by the majority today, not all of them, of course, but 
some of them.
  I think it is a shame that we were not able to reach a bipartisan 
agreement on a longer term extension of the SCHIP program. As Ranking 
Member Barton has pointed out on more than one occasion, though, this 
process was pretty much doomed from the start because the majority 
failed to include the minority at all in the early stages of putting 
together legislation for this important program.
  And I understand, it is difficult being in the majority for the first 
time in 12 years and not really knowing how to get things done. It's 
tough to govern. It's tough to have the responsibility to actually pass 
legislation and make law. We did it for 12 years, and we had some 
troubles ourselves in the first year or so that we were in the 
majority. So I understand. But I hope the majority will learn from this 
experience.
  We have two choices, the majority has two choices, really, insofar as 
dealing with the SCHIP program. And that is, number one, next year they 
could do as Ranking Member Barton suggested and have hearings on the 
SCHIP program and work with the minority hand in hand to try to come up 
with a reasonable extension reauthorization of this important program.
  Number two, they could try the same thing next year that they did 
this year and get the same result, and then just wait until after the 
elections and hope that they would have a Democratic President, a 
Democratic majority, and can do what they want, maybe.
  I would submit that the better course is the former, and that is to 
work with the minority next year. We certainly made that offer this 
calendar year. I would extend it, at least from my committee's 
standpoint, that invitation again for next year. And I am hopeful that 
we can do that.
  This bill before us today covers a lot of other things besides the 
SCHIP program. As Chairman Stark said, we do have in here kind of a 
stalling of the cliff that physicians find themselves looking over as 
far as Medicare reimbursement. We only do that for 6 months. We do 
several other things for 6 months, including therapy caps which I think 
are very important. So we are under the gun, this Congress is under the 
gun, and I would submit that means both the majority and the minority 
early next year to get some things done in the Medicare field.
  Again, I certainly want to extend my hand to the majority and offer 
to work together to get these very important things that are only 
extended or only dealt with for 6 months in this bill, a more certain 
future with legislation next year.
  Madam Speaker, I reserve the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield 2 minutes to the gentlewoman from 
Colorado (Ms. DeGette).
  Ms. DeGETTE. Madam Speaker, December is a month of holidays, holidays 
about families; Hanukkah, the Festival of Lights; Kwanzaa about family 
traditions. At this time of year I always think about my children when 
they were little, their beautiful faces staring into the creche at the 
baby Jesus. But during this special time, the very best present we 
could give 4 million children in this country is the gift of health 
care.
  Every parent knows that quality health care is the foundation for a 
happy and successful life. Sadly, at this special time, Congress is 
denying this gift to 4 million children who are eligible right now 
under the SCHIP program but are not enrolled. Although the House and 
Senate passed great legislation that would have expanded the coverage 
to these children, the President has vetoed it twice. And so, 
reluctantly, I stand here today in full support of current law.
  The current SCHIP program is a great one that has worked for 10 
years, one that we should all stand up for and be proud of. It will 
guarantee that the 6 million kids currently enrolled will not lose 
their health insurance until March 2009.
  As the new year draws close though, Madam Speaker, we must recommit 
ourselves to ensuring that every child in this country who is eligible 
for SCHIP is enrolled. And that is why I ask the Speaker and my 
wonderful committee leadership to recommit ourselves to reauthorizing 
this program earlier than March 2009 so all these kids may be covered.
  In addition, Madam Speaker, this bill contains protections for 
seniors. But, again, it is only a start. There is much more to be done, 
and I am committed to working with my colleagues to develop a 
comprehensive bill that will do more than extend protections to doctors 
and seniors for only 6 months.
  Finally, Madam Speaker, I want to commend my colleagues for including 
extension of the special diabetes program in this bill. This will 
ensure cures for millions of Americans.
  Mr. BARTON of Texas. Madam Speaker, I yield 2\1/2\ minutes to the 
distinguished ranking member of the Health Subcommittee, Mr. Deal of 
Georgia, who has worked tirelessly on these issues this year.
  Mr. DEAL of Georgia. I thank the gentleman from Texas for yielding.
  Madam Speaker, I am pleased to rise today in support of S. 2499. This 
vital legislation will help preserve Medicare beneficiaries' access to 
their physicians' services, in addition to providing States certainty 
as to their ability to cover their SCHIP children for the next 13 
months and to continue to enroll eligible children in their programs.
  While this bill does not contain the needed reform of the sustainable 
growth rate formula in Medicare, it averts a payment cut for physicians 
which, I fear, would have dramatically impacted physician participation 
in Medicare. Moving forward, I hope that we would work in a bipartisan 
way to reform this SGR system rather than continuing these short fix 
programs that we have seen for the last several years. The physicians 
who serve this Nation's elderly population should not be subject to 
this annual uncertainty, constantly wondering whether or not they will 
be able to afford to see their Medicare patients.
  On the second subject, for months I have supported a long-term 
extension of the SCHIP program to ensure that children currently 
enrolled would continue to have health care services, and to allow 
States the certainty of funding so that they can continue to enroll 
eligible children.
  In the coming months there should be ample opportunity for SCHIP 
legislation to move through a regular legislative process without the 
pressures created by last-minute expiration of the program. I look 
forward to working with my colleagues on both sides of the aisle on 
this bill, which would help put and continue to put low-income children 
first, and continues the purpose of the original program: To serve the 
neediest children with health care. As

[[Page 36203]]

a supporter of the program, it is unfortunate to me that we have not 
been able to reauthorize it for a longer period of time, but this 
extension should give us the opportunity to do so in a thoughtful and 
appropriate process. I would hope to work on these issues in a 
bipartisan fashion next year, and I urge my colleagues to support this 
bill.
  Mr. STARK. Madam Speaker, I am delighted to yield 2 minutes to the 
distinguished gentleman from Illinois (Mr. Emanuel).
  Mr. EMANUEL. A lot of people have mentioned that in fact this 
extension will cover the children that presently are in the program. 
That is half true and half not true. Kids who are on the program will 
be covered. But if you live in 14 States in the United States, because 
of the President's executive order, if you live in California, 
Connecticut, Washington, D.C., Hawaii, Maryland, Massachusetts, 
Minnesota, Missouri, New Hampshire, New Jersey, Pennsylvania, Rhode 
Island, Vermont, or Washington, kids in those States will actually come 
off the rolls in August because of the President's executive order. And 
in those States, the Governors will have to begin to develop plans to 
notify those kids and their parents because of the President's 
executive order.
  So not all kids who are on the program will actually stay on the 
program. And that is just a consequence, after passing two bills to 
give 10 million children health care, two bills with 45 Republicans and 
220 plus Democrats here in the House, and 18 Republicans in the Senate 
and every Democrat in the Senate, we were unable, which is unique 
around here, but we were unable to get the President to sign this 
legislation. And so what we couldn't resolve, the American people will 
resolve in November.
  President Kennedy once said, to govern is to choose. We have made our 
choice, the President and some on your side made your choice, and in 
November the American people will make their choice. And that is how 
differences get resolved here. I think we should understand that.
  And so, as the President has said, a lot of children will have 
universal health care in this country because we have an emergency room 
in hospitals. A lot of kids will end up in emergency rooms that didn't 
need to go to emergency rooms.
  We did right in a bipartisan fashion to get a bill. In my own view, 
this will be the first thing that the new Democratic President will get 
done. We don't need March 9. It will get done within the first month. 
It will be a major accomplishment for a Democratic Congress, a 
Democratic Senate, and a Democratic President.

                              {time}  1100

  Starting this August in those 14 States, kids and their parents that 
did have health care will be notified they will no longer get health 
care. Now, there is a consequence to that, because August 2008 is 2 
months before the election. And I don't think that is a problem. As a 
matter of fact, we can't protect the American people from the 
consequences of the President's decision, and a number of Republicans 
stand by him. We did right. There was a bipartisan bill to resolve a 
major problem to give 10 million children health care. We didn't 
accomplish it. We will be back and we will get it done because the 
American people deserve and the kids deserve the same health care that 
their Members of Congress and their kids get. This is what that would 
have done.
  Mr. McCRERY. Madam Speaker, before I recognize the gentleman from 
Pennsylvania (Mr. English), I would just point out under the 
President's executive order, those States do have the option of 
covering the low-income children in their States first. If they do 
that, then they can certainly expand it to higher income children.
  At this time I yield 1 minute to the gentleman from Pennsylvania (Mr. 
English).
  Mr. ENGLISH of Pennsylvania. Thank goodness they are not going to 
have to wait a generation for a Democratic President.
  This bill, Madam Speaker, is a good resolution to a political impasse 
and a good solution to the hindering cuts that impede our Nation's 
physicians and would impact on the health care of our young people and 
our seniors.
  It makes a substantial adjustment for physicians who participate in 
the Medicare program, albeit only temporary. Although I would have 
liked to have seen a more permanent and comprehensive solution to a 
range of Medicare issues, we just couldn't wait and allow 10 percent 
cuts in payments to physicians to occur. I hope to work with my 
colleagues on both sides of the aisle on a more permanent solution in 
the upcoming year to this particularly thorny issue.
  The legislation before us also endorses important issues that I have 
fought hard to be involved with and to make progress on, including 
extending the exceptions process for therapy caps and a revision of the 
policy structure for long-term care hospitals. Those are legacy issues 
that we are going to have to take up sooner rather than later.
  I am glad we have a final resolution temporarily on SCHIP. Thank you. 
I urge a vote for the bill.
  Mr. PALLONE. Madam Speaker, I yield 2 minutes to the gentlewoman from 
California (Ms. Solis).
  Ms. SOLIS. Madam Speaker, I thank the gentleman for yielding me this 
time. Today I stand boldly in support of this Medicare, Medicaid and 
SCHIP Extension Act.
  Madam Speaker, 800,000 children, as you know, in the State of 
California are covered by this program. It is essential that we 
continue to provide that coverage. But many, many low-income and 
minority children will not be covered because previously this President 
vetoed our bill twice where we would have taken this farther. Instead 
of the 6 million that are currently in the program, it would have gone 
to 10 million children. But we can't talk about that now.
  But one thing is sure, our constituents, our seniors, are telling us 
we also need to provide a fix for our doctors because many of our 
seniors that are on low-income assistance now need to see their 
doctors, and we know how vitally important that is.
  Each and every one of us has an obligation to provide support for the 
very vulnerable in our communities. And I think there is a saying 
somewhere, maybe in the Bible, that says we will be judged by how we 
deal with those that are most vulnerable. And those are our frail, 
elderly and our children.
  I know we can do better. I also pray that we have better outcomes 
after 2008, because I do believe that our public, our constituents, are 
demanding that we step up to the plate on health care. That is the 
number one priority that we are reading about throughout this country, 
that we cannot stand behind and not speak up here on the House, on the 
floor and demand that we have better coverage for all of our 
populations. I speak not only as a Latina and as a woman representing a 
low-income community, but I think I speak for many millions of people 
who would like to hear their Congresspeople speaking out loud and 
shouting out loud about the need for better health care coverage. They 
are demanding it. Yes, as my former colleague said on the floor, we 
will probably see those results change once November 2008 arrives.
  Merry Christmas to the Congress.
  Mr. BARTON of Texas. Madam Speaker, I yield myself 15 seconds just to 
point out that the subregulatory deadline that Mr. Emanuel referred to 
requires States to show a good-faith effort to cover 95 percent of 
those children below 200 percent of poverty before they cover children 
above 250 percent of poverty.
  I yield 2 minutes to the gentlewoman from Tennessee (Mrs. Blackburn), 
a member of the committee.
  Mrs. BLACKBURN. Madam Speaker, I want to compliment Mr. Barton and 
Mr. Deal for the extraordinary amount of work they have done on this 
issue this entire year. I know that they are pleased that the 
congressional leadership has joined them in working to be certain that 
we take the politics out of this issue and we keep the focus on how we 
address the health care needs of our Nation's most vulnerable, our 
children and our elderly.
  A couple of things that we are going to see in this bill, as you have 
already

[[Page 36204]]

heard, the Medicare physician payment schedule, the cut that was to 
take place is not going to. They are going to see a half percent 
increase through June 2008. My hope is that we will be able to have the 
majority work with us to resolve this issue.
  I think it is just unconscionable that every single year this SGR 
gets revisited and we try to work it through. We know that this is 
something that we are going to be providing. It is a service. Health 
care is going to be provided for our Medicare enrollees. And, Madam 
Speaker, this needs to be dealt with and the problem needs to be 
solved.
  I am also pleased that SCHIP is going to be extended through March 
2009 and that we are keeping the focus there on standing in the gap 
between those children that are not eligible for Medicare and those 
that have the ability to afford private health insurance. This gets 
back to the original intent of that program to be certain that the 
children of the working poor are covered.
  I am also pleased that this contains the 6-month extension of 
critical funding for the Tennessee Medicaid DSH payments to our 
hospitals.
  Madam Speaker, there should be some lessons learned from the 1115 
waiver process that my State of Tennessee has been through and through 
the experiment of Hillary Clinton health care and the failures of that. 
As we move forward, I hope we look at those lessons learned.
  I appreciate this legislation does provide those DSH payments to 
these hospitals. I look forward to working with the majority.
  Mr. PALLONE. Madam Speaker, I yield 2 minutes to the gentlewoman from 
New York (Mrs. Lowey).
  Mrs. LOWEY. Madam Speaker, I rise in strong support of the Medicare, 
Medicaid and SCHIP Extension Act of 2007.
  This bill includes a provision based on legislation I introduced with 
Representatives Tanner, LoBiondo and Hulshof that would not only freeze 
compliance thresholds under the 75 percent rule at 60 percent, it would 
require CMS to consult rehabilitation facilities in developing 
recommendations on more appropriate criteria than the 75 percent rule 
for determining IRF admission policy.
  The legislation will stop CMS in its tracks from continuing to 
implement an out-of-date 75 percent rule that is 100 percent wrong for 
Americans, and ensure that millions of individuals will continue to 
have access to the critical care and medical services provided by 
rehabilitation facilities.
  There are a number of individuals I would like to thank for their 
tireless work on this legislation: Chairman Rangel and the entire Ways 
and Means staff, particularly Jon Sheiner, Cybele Bjorklund, and Janice 
Mays; my partners on this legislation, Representatives Tanner, 
LoBiondo, Hulshof, and their staffs, Vicki Walling, Dana Richter, and 
Erik Rasmussen; and my legislative director, Jean Doyle.
  And last but certainly not least, the key advocates from hospitals in 
my district in New York: Dr. Walsh from Burke Rehabilitation Center, 
Maggie Ramirez from Helen Hayes Hospital, and Keith Safian from Phelps 
Memorial Hospital.
  Your tireless work along with the support of Chairman Rangel and 
others in Congress helped us get to where we are today. I urge my 
colleagues to support this very important legislation.
  Mr. McCRERY. Madam Speaker, how much time remains on each side?
  The SPEAKER pro tempore. The gentleman from Louisiana (Mr. McCrery) 
has 6 minutes. The gentleman from New Jersey (Mr. Pallone) has 2 
minutes remaining. The gentleman from California has 2\1/2\ minutes 
remaining. The gentleman from Texas has 3\1/4\ minutes remaining.
  The Chair will recognize in reverse order the closing arguments, 
beginning with the gentleman from Louisiana (Mr. McCrery), the 
gentleman from California (Mr. Stark), the gentleman from Texas (Mr. 
Barton), and the gentleman from New Jersey (Mr. Pallone).
  Mr. McCRERY. Madam Speaker, at this time I recognize the 
distinguished ranking member of the Health Subcommittee of the Ways and 
Means Committee, the gentleman from Michigan (Mr. Camp), for 2 minutes.
  Mr. CAMP of Michigan. Madam Speaker, I appreciate the distinguished 
gentleman yielding me this time.
  I am glad we have the opportunity to vote on this legislation today 
which is critical to protecting doctors from receiving the 10 percent 
Medicare cut and providing certainty to the SCHIP program, the State 
Children's Health Insurance.
  But let's not kid ourselves. This is the bare minimum and we are 
capable of much more. It is disappointing that the majority would not 
work in a bipartisan fashion to craft at least a 1-year reprieve from 
the Medicare cuts for physicians, as Republicans were able to do in 
previous years. This 6-month extension is simply putting the problem 
off and not solving it. The majority knew this 10 percent cut was 
coming. So what did they do? They passed a CHAMP bill that was fraught 
with problems that cut home health, skilled nursing facilities, 
devastated Medicare Advantage and the individual care, and would have 
left 22 States without one senior receiving Medicare Advantage. That 
was nearly 6 months ago. And what has happened since then? Nothing.
  It is unfortunate that we could not come to a bipartisan compromise 
on SCHIP, which was and is within reach. A simple extension, while 
better than what the majority offered, and their offer was transforming 
a program to assist low-income children to an entitlement for families 
earning $80,000 a year, is much worse than what was possible.
  As I said before on this floor, I stand ready to work in a bipartisan 
fashion to address the looming cuts faced by physicians in Medicare. I 
hope we can see this legislation for the Band-Aid that it is and return 
next year with a commitment from leaders in both parties to enact real 
long-term Medicare payment reform.
  Mr. BARTON of Texas. Madam Speaker, I yield 1\1/4\ minutes to the 
gentleman from Alabama (Mr. Aderholt) who is one of the negotiators of 
an attempt at a compromise.
  Mr. ADERHOLT. Madam Speaker, I would like to thank every Member who 
has worked on this piece of legislation, and there has been a lot, 
especially Mr. Barton and Mr. Deal who have gone beyond the call of 
duty in their work. I have been in meetings with them for many hours, 
so I appreciate their work.
  I think we are all disappointed that it has taken so long to come up 
with a solution, but in the end we have arrived at a correct decision.
  When SCHIP was first brought to the floor in 1997, I was a new Member 
of Congress. It was a bipartisan bill that was enacted by a Republican 
House and Senate. And it was signed into law by a Democrat President.
  This year's process has been anything but bipartisan. I think it 
would be fair to say that the political rancor in the debate that has 
occurred over the last several months has surpassed anything that most 
of us have seen while we have been in Congress. But it is time to move 
forward and it is time that we remember what is important in this whole 
process, and that is the children that need health care in America, 
that are simply the poor in this country.
  In my home State of Alabama, SCHIP has been a tremendous success and 
has helped a new generation of children live happier and healthier 
lives.

                              {time}  1115

  I'm pleased that this Congress has decided to extend this vital 
program into 2009 and provide a level of certainty to State health 
directors that did not exist under our previous resolutions. This is a 
good solution, and I encourage my colleagues to support it.
  Mr. McCRERY. Madam Speaker, I yield 1\1/2\ minutes to the gentleman 
from Texas, the ranking member of the Social Security Subcommittee of 
the Ways and Means Committee, Mr. Johnson.
  Mr. SAM JOHNSON of Texas. Madam Speaker, today we're considering a 
bill that does some important things. One,

[[Page 36205]]

it stops the 2008 physician cuts. Two, it extends the Children's Health 
Insurance Program past the politics of the Presidential election; and 
three, it helps physicians who are called up for active duty to serve 
their country. But in reality, this isn't the best bill Congress could 
have put together, and y'all need to know that.
  For the first time, physicians don't know what Medicare will pay them 
next year. In 6 short months, doctors will once again be facing more 
than a 10 percent cut in their reimbursements. That uncertainty is no 
help when you're trying to run a business.
  When it comes to physicians who are called up to serve their country 
and their community, this bill does deliver temporary relief.
  Earlier this year Congress moved in a bipartisan fashion to 
temporarily fix an oversight in Medicare. Previously, the law created a 
red tape nightmare for any Medicare physician who needed to leave his 
practice for more than 60 days at a time. The bill before us today 
continues this fix for just 6 months by allowing our Reservists to have 
one substitute doctor for their entire deployment.
  I look forward to working with my colleagues next year on a permanent 
fix for this problem. We need to support our troops and the docs that 
are called up.
  Mr. PALLONE. Madam Speaker, I just want to inquire if the other side 
is prepared to close or has any additional speakers.
  Mr. BARTON of Texas. Madam Speaker, I am the only speaker remaining 
for my portion of the time, so I am prepared to close.
  Mr. McCRERY. Madam Speaker, I have two remaining speakers.
  The SPEAKER pro tempore. The gentleman from Louisiana has 3 minutes 
remaining.
  Mr. McCRERY. Madam Speaker, I would yield 1\1/2\ minutes to the 
gentleman from Georgia (Mr. Gingrey).
  Mr. GINGREY. Madam Speaker, I appreciate the gentleman yielding. And 
I stand today in full support of this 18-month extension of the 
Children's Health Insurance Program, and also the 6-month mitigation of 
the payment cut to our physicians under Medicare.
  But, Madam Speaker, let me say in regard to that 6-month mitigation, 
we have done this the whole time that I've been in this Congress, the 
past 5 years, with a Band-Aid. We're literally doing it this time with 
a spot Band-Aid, and first thing you know we're going to do a 3-month 
mitigation and a month-to-month mitigation. It's time to end this 
flawed sustainable growth rate, just like it's time to end the 
alternative minimum tax that was not indexed for inflation. They're 
both flawed, and we need to strike both of them dead permanently.
  In regard to the Children's Health Insurance Program, Madam Speaker, 
the distinguished chairman of the Democratic Conference spoke a little 
earlier, talking about certain children are going to lose their 
coverage during this 18-month extension. Well, certain children should 
lose their coverage if their families make up to 300 percent of the 
Federal poverty level, which is about $65,000 a year, and it crowds out 
those children from needy families who are not being covered.
  So this extension, I want to commend my colleague from Georgia, 
Nathan Deal, and Ranking Member Barton. This is their bill, and this is 
exactly what we need to do. We need to make sure we have 90 percent 
coverage saturation and those children up to 250 percent of the poverty 
level before we consider anything else. I support this extension.
  Mr. McCRERY. Madam Speaker, I have two remaining speakers. I promise 
this will be the last time I will have two remaining speakers.
  At this time I would yield 30 seconds to the gentleman from Missouri, 
the distinguished minority whip, Mr. Blunt. And I believe my colleague, 
Mr. Barton, is going to also give him 30 seconds.
  Mr. BARTON of Texas. Madam Speaker, I would like to yield 30 of my 
seconds to the gentleman from Missouri (Mr. Blunt).
  The SPEAKER pro tempore. The gentleman from Missouri is recognized 
for 1 minute.
  Mr. BLUNT. Madam Speaker, I thank the gentlemen for yielding.
  I'm just here to say that I think this 18-month extension gives us 
the time we need to make SCHIP an even better program. It extends the 
current program. It increases funding for the current program. It helps 
the States that have a shortfall. It ensures that kids who don't have 
Medicaid, who are in that second 100 percentile, the families who are 
closest to the Medicaid number, get their coverage first, by not 
reversing the policies the administration has lately put in place on 
waivers. It does important things to ensure that the qualifying 
standards for SCHIP don't change. On those areas that extend Medicare 
payments to doctors, I would remind my friends here that we're paying 
for those, most of that, through the stabilization fund on the last big 
fight here we had. This was the fund we thought we might need to make 
part D addition to Medicare as a competitive and innovative addition to 
Medicare work. We didn't need that money because it's working on its 
own. The last fight we had this big on a health care issue, we kept 
hearing how terrible it would be for seniors. Eighty-seven percent of 
the seniors don't think it's terrible at all.
  I think we're going to see that this debate also leads to better 
results for SCHIP, not worse results for SCHIP. I'm glad to see this 
extension.
  The SPEAKER pro tempore. The gentleman from Louisiana has 1 minute 
remaining.
  Mr. McCRERY. Madam Speaker, I assume all managers of time have one 
remaining speaker?
  Mr. STARK. I have one.
  Madam Speaker, I would yield, at this point, 1\1/2\ minutes to the 
distinguished gentleman from Texas (Mr. Doggett).
  Mr. DOGGETT. Madam Speaker, this pathetic excuse for a Medicare bill 
is made necessary by a Republican refusal to tackle waste, fraud and 
abuse. To fulfill an ideological dream, taxpayers are compelled to 
continue wasting billions of dollars to fund abusive private Medicare 
Advantage plans run by Bush administration buddies, rather than less 
expensive, more effective traditional Medicare.
  And while doctors are rightly protected from a scheduled payment cut, 
how about the millions of poor seniors who are cut off from access to 
extra help for prescription drug coverage? As with so many battles in 
this Congress, where it is a contest between the poor and a well-
financed special interest, guess who gets knocked out?
  This shell of a bill actually means that millions of our youngest 
Americans will still be barred from access to the Children's Health 
Insurance Program, and, of course, it will enable my State, Texas, to 
maintain its dubious distinction of being number one, the number one 
State in the country with children who have no health insurance, due 
largely to the indifference of then Governor George Bush, now the 
``vetoer in chief'' when it comes to children's health insurance.
  This House had approved the CHAMP Act. Today, about all that remains 
of it, thanks to continued Republican obstructionism and one veto after 
another, is what could be called the CHUMP Act because it reeks of 
fiscal irresponsibility and social inequity. Something may be better 
than nothing, but this is barely something. In 18 months we'll correct 
it.
  Mr. McCRERY. Madam Speaker, I would yield 1 minute to the gentleman 
from Georgia (Mr. Price) and note that I still believe bipartisanship 
is the way to solving these problems, especially in the next year.
  Mr. PRICE of Georgia. I thank my friend for yielding and for his 
leadership.
  There's a recurrent theme that we've heard this month and that is 
from this majority party that continues to lament the work product of 
this 110th Congress. You'd think they weren't in the majority.
  But it's time to set the record straight about a couple of items. One 
is SCHIP. The reason that SCHIP hasn't moved forward in the way that 
they envisioned is because the American people didn't believe that over 
half of

[[Page 36206]]

the American children ought to be on a government-run system.
  Were there alternatives? Absolutely. The alternative that we put on 
the table was to reauthorize the program, provide premium assistance 
for families up to $63,000 and give States greater flexibility. That's 
a positive solution.
  In the area of SGR or the physician reimbursement in Medicare, it's 
important to appreciate that this 6-month extension is wrong. Medicare 
is woefully flawed. The 6-month extension is an insult to both patients 
and physicians.
  What we call for is for bipartisanship, for working together to solve 
the Medicare physician payment program that works well for patients and 
works for physicians and makes certain that patients and their families 
control health care, not government.
  Mr. STARK. Madam Speaker, I yield myself the balance of the time and 
agree with the gentleman from Georgia that the fix for the physicians 
is an abomination, but it was written by the Republicans in the Senate, 
and with concurrence with Republicans in the House. So I congratulate 
you for at least recognizing a lousy piece of legislation when it's 
drafted by Republicans.
  The distinguished gentleman from Texas (Mr. Barton) suggested that 
all's well that ends well, and that pretty much sums up the Republican 
philosophy. They've kept 4 million kids from getting health care. 
They've endangered the health care of many of the 6 million kids on 
SCHIP now, and they've protected the for-profit insurance industry and 
other special interests who fund their campaigns to the detriment of 
the children and the seniors in this country.
  You might call that all well, but the Democrats don't.
  Madam Speaker, I yield back the balance of my time.
  Mr. BARTON of Texas. Madam Speaker, I yield myself the remainder of 
my time.
  The SPEAKER pro tempore. The gentleman is recognized for 1\1/2\ 
minutes.
  Mr. BARTON of Texas. I want to compliment Congresswoman Lowey of New 
York for working to include the 60 percent fix for the rehabilitation 
hospitals. I wasn't aware that that was in the bill. I'm very pleased 
that that is.
  I would like to, I guess, compliment my friend from California, 
Chairman Stark, for at least agreeing that this bill is worthy of 
coming to the floor.
  I would like to point out that the whole purpose of SCHIP is to cover 
low- and moderate-income kids. That was the original intent. There are 
many of us on this side of the aisle that still think that should be 
the intent. If you want to go to some of the larger numbers of coverage 
of children that are currently not covered, you have to go above 250 
and, in some cases, above 300 percent of poverty.
  You also are covering right now six to 700,000 adults. There are 
those like myself that don't think adults need to be covered by SCHIP 
because those same adults can be covered by Medicaid, which is the 
coverage for low-income Americans, regardless of how old they are.
  I would like to point out the obvious. When you're in the minority, 
the only way you can get anything passed is to work with the majority. 
That's self-evident. When you're in the majority you can pass things in 
the House just by yourself, but if you want them to become law, you 
normally have to work with the minority. And I hope this debate on 
SCHIP has shown people on both sides of the aisle that we should be 
trying to legislate and work together instead of scoring political 
points for one particular side.
  With that, Madam Speaker, I yield back the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield myself such time as I may 
consume.
  The SPEAKER pro tempore. The gentleman from New Jersey is recognized 
for 2 minutes.
  Mr. PALLONE. Madam Speaker, this bill is the result of Republican 
intransigence. This is a Band-Aid. And I would remind my Republican 
colleagues who seem to think that this is good legislation, that every 
day that goes by, more kids are going to get off SCHIP.
  They put out that directive of August 17 that says that if a kid's 
parents lose their job, they would have to wait 1 year before they 
could get SCHIP coverage.
  So the bottom line is more kids are going to go off SCHIP. We're just 
barely paying for the kids that are on it now.
  They're not willing to do anything. They said that they were willing 
to negotiate. Well, we had negotiations, our majority leader said, for 
over 100 hours, and they still could not come up with an agreement.

                              {time}  1130

  The President refuses to fund anything. He won't pay through a 
tobacco increase, the only tax increase. The only thing he says he will 
do is cut programs to pay for expanded SCHIP that would even make it 
harder, like cutting Medicare.
  So the fact of the matter is we are stuck with this lousy bill that 
was negotiated between the White House and the Republicans in the 
Senate. We don't like it. It's simply a temporary measure, and we as 
Democrats are committed to the fact that in the beginning of next year 
we're going to take up SCHIP again. We're going to take up the issue of 
Medicare to try to prevent the privatization that takes place under the 
current program. We're determined to correct these programs.
  But it won't happen if the Republicans continue their intransigence, 
both at the White House and here in the House of Representatives. There 
is no reason to believe, based on what they've done in the last 6 
months, that this Republican minority wants to work with us to achieve 
a better result.
  So we are stuck with this bill today. It is a Band-Aid approach. We 
have to pass it so we can continue with the existing programs. But 
every day that goes by, Medicare suffers because fewer and fewer 
doctors are likely to take Medicare and fewer and fewer kids are going 
to get coverage because they're going to have to go to the emergency 
room because they can't see a doctor on a regular basis. That's not the 
way to operate. And I have to say that it's totally due to the fault, 
in my opinion, of the President and the Republicans here in the House 
of Representatives. I hope this changes in the next year.
  Mr. LEVIN. Madam Speaker, it has become clear, not only to my 
colleagues in Congress, but also to the American people, that the 
intransigence of President Bush and his supporters in the House and 
Senate have made it difficult to advance long-needed bills to improve 
Medicare and expand the Children's Health Insurance Program.
  The bill we are considering today in no way reflects negotiations 
with the Senate on the CHAMP Act that the House approved with a bi-
partisan majority on August 1st, and the Senate's Medicare and SCHIP 
priorities. Rather, it is a skinny health extenders package that 
generally extends some provisions in current law for only 6 months.
  Shoring up Medicare from years of neglect under the Republican 
Congress and expanding the Children's Health Insurance Program to cover 
10 million low-income children are top priorities for me and the New 
Democratic Majority in Congress. That is why the House approved the 
CHAMP Act of 2007 to eliminate the scheduled Medicare physician payment 
cuts for the next 2 years and expand the Children's Health Insurance 
Program to cover 10 million low-income children nationwide. The only 
reason that the legislation we approved in August to improve the 
Medicare and SCHIP programs has not been signed into law is because 
President Bush and his allies in Congress oppose it.
  There are several provisions of importance back home that I wish to 
recognize. We were able to keep in the health extenders bill a 
moratorium on cuts to school-based Medicaid services that the 
Administration has proposed. We have included a 6-month extension of a 
wage-reclassification program in the Medicare program, and have 
provided funding to extend the Special Diabetes Program for research, 
treatment and prevention of diabetes through September 30, 2009.
  Unfortunately, imperative improvements to the Medicare program have 
been dropped from the bill. Improvements approved in the House in 
August include mental health parity for seniors, making prevention more 
accessible by eliminating co-pays and deductibles

[[Page 36207]]

for preventative services like mammograms and colonoscopy screenings, 
and expanding programs that help low-income seniors pay for their 
health care and prescription drugs.
  The Children's Health Insurance expansion that has been dropped from 
the bill would have extended children's health insurance to enroll 6 
million kids that are currently eligible for the program and not yet 
enrolled. That's in addition to the 6 million low-income children 
already receiving health care under the SCHIP program nationwide, 
including 55,000 kids in my home state of Michigan whose parents make 
between $20,535 and $41,300 a year.
  I urge my colleagues to support the short-term extensions in the 
legislation before us today, and to join me in addressing long-needed 
reforms to Medicare and SCHIP in the new year.
  Ms. WOOLSEY. Madam Speaker, I support S. 2499, the Medicare, Medicaid 
and SCHIP Extension Act of 2007. It's important that Congress pass this 
legislation today to ensure that our Nation's poorest children retain 
their health insurance and doctors who take care of our seniors on 
Medicare do not receive a 10 percent cut in reimbursements.
  It's deeply disappointing that this bill doesn't address the issue of 
the Medicare physician geographic payment discrepancy that is faced by 
many areas in California and across the country. One of these areas is 
Sonoma County, in my District. This inconsistency has led to doctor's 
reimbursements being based upon their geographic location and not the 
true cost of providing services. Because of this discrepancy, doctors 
in Sonoma County receive a lower payment for the same services than 
doctors in next door Marin County and this discrepancy is causing 
doctors to leave Sonoma County. Congress needs to act to fix this 
discrepancy and ensure that physicians with Medicare patients can 
continue to afford to see their patients regardless of where their 
practice is located.
  Because of the Republican led efforts, the bill only delays a real 
solution to the Medicare physician payment cuts that all doctors are 
facing. We can and must do better for our seniors. When the Medicare 
extension expires in June, we owe it to our seniors and physicians to 
replace it with a permanent fix to the physician payment cuts and 
payment discrepancies.
  With this bill, the State Children's Health Insurance Program (SCHIP) 
will be extended and states will receive enough funding to keep all the 
children currently enrolled on SCHIP from being removed from the 
program. But, this bill doesn't help the millions more children whose 
families cannot afford health insurance and who should be covered under 
SCHIP. Earlier this year, Congress passed an SCHIP bill that would have 
given 4 million more children healthcare, for a total of 10 million 
children receiving healthcare on SCHIP. However, the Administration 
showed that its priorities are completely out of line with the rest of 
this country when it vetoed that legislation. We need to do better for 
our nation's children and provide all of them with the healthy start 
and security that SCHIP can provide.
  I urge my colleagues to support this bill and look forward to working 
with them to provide a permanent solution to the Medicare physician 
payment issues and in ensuring that every child in America is insured.
  Mr. LANGEVIN. Madam Speaker, I rise today to express my support for 
S. 2499, the Medicare, Medicaid and SCHIP Extension Act. This bill 
includes a number of provisions that are essential to the continued 
delivery of vital healthcare programs to our Nation's most vulnerable 
citizens.
  This measure offers much-needed relief to physicians that serve our 
Medicare population by providing a 6-month suspension of the 10-percent 
cut in Medicare payments scheduled to occur on January 1, providing 
instead a modest increase of 0.5 percent. It also extends important 
incentive payment programs that provide a 5-percent bonus to physicians 
serving areas with a shortage of doctors, while ensuring that Medicare 
beneficiaries have continued access to therapy services through June 
30, 2008.
  Also included in this bill is a vital extension for the State 
Children's Health Insurance Program (SCHIP) through March 31, 2009. 
Currently, 24,900 Rhode Islanders are enrolled in the SCHIP portion of 
Rhode Island's model RITE Care program. As a proud Representative of 
Rhode Island and a longtime supporter of SCHIP, I cannot stress enough 
how important this program is to the health and well-being of our 
children, expectant mothers and parents alike. Although this was not 
the outcome that I and many of my colleagues originally envisioned for 
SCHIP, this extension is crucial for States like Rhode Island that are 
facing tremendous budgetary shortfalls.
  Madam Speaker, access to quality, affordable healthcare is integral 
to the prosperity of every American. While I am pleased that this 
Congress was able to reach a compromise to provide temporary relief for 
our country's most important safety net programs, I believe that we 
have the potential to do so much more. Health care providers that have 
pledged to continue serving the aging, disabled, and low-income 
citizens deserve more than stopgap measures and temporary relief. This 
Congress has an obligation to take meaningful action to reform and 
stabilize the Medicare provider payment system, as well as to ensure 
the continued strength and success of our Medicaid and SCHIP programs. 
To that end, I will continue to work in a bipartisan manner with my 
colleagues in an effort to guarantee that these issues are properly 
addressed in this and future Congresses.
  Mr. ETHERIDGE. Madam Speaker, I rise in support of this legislation 
and the critical services provided by Medicare, Medicaid, and the State 
Children's Health Insurance Program (SCHIP). This legislation ensures 
continued access to our nation's health care system for our most 
vulnerable citizens--children, seniors, the poor, and the disabled. It 
also extends incentives that allow health care providers to maintain 
practices in rural areas. These federal efforts are critical to 
maintaining healthy and productive communities across the country, and 
particularly in North Carolina's 2nd District.
  North Carolina's citizens are at risk when reimbursements to 
physicians fall below the cost of providing care, and doctors must shut 
their doors or turn away patients because they cannot afford to attend 
to them. North Carolina's citizens are at risk when children go without 
care, and untreated illnesses or foregone preventative care reduces the 
health and productivity of those who will build our future. North 
Carolina's citizens are at risk when Congress fails to act to preserve 
benefits that they depend on.
  The health of Americans and the future health of America depend upon 
the availability of and access to health care. I applaud our leaders in 
the House and Senate for working in a bicameral, bipartisan manner to 
craft this legislation so that our doctors, hospitals, and other health 
care providers can continue their service to keep our citizens healthy.
  This legislation improves physician quality and access by averting 
the planned 10 percent cut in physician payments and extending the 
Medicare physician quality reporting system. It continues Medicare 
policy that provides a measure of fairness to the payment system for 
rural providers so that they can continue providing valuable services 
to individuals in rural parts of the 2nd District and across the 
country. I am hopeful that when Congress returns in 2008, we make 
extending these provisions on a long-term basis a priority so that 
providers can plan to remain in our communities for the long-term.
  As the only former State schools chief serving in Congress, my life's 
work has been to provide for a better future for the next generation, 
and health care is critically important to that effort. This 
legislation averts the threat that States will run out of funds for the 
State Children's Health Insurance Program, or SCHIP. North Carolina's 
Health Choice, which serves over 250,000 needy children, will now be 
able to plan enrollment for the next year, whereas without this 
legislation it would have run out of money next March. While I am 
disappointed that this legislation does not enable the coverage of 
additional children, we owe it to the children currently served by 
SCHIP to ensure that they are continuously covered and can get the 
health care they need when they need it. I look forward to working with 
my colleagues in the future to fulfill the vision of health access for 
all children.
  Madam Speaker, a lack of access to health care has impact beyond the 
individual who suffers a sickness without treatment. Untreated 
illnesses have long-term consequences, and ensuring access to health 
care contributes to a healthy and productive society and heads off 
expensive treatments down the road. This legislation is necessary to 
keep providers in our communities, and I urge my colleagues to join me 
in supporting it.
  Mr. SPACE. Madam Speaker, I rise today in support of the legislation 
before us that will help both seniors and children alike receive the 
health care that they deserve, and continue our national investment in 
combating chronic disease.
  I am particularly pleased to see that the legislation includes an 
extension of the Special Diabetes Program, which affords critical 
research funding to research into type one diabetes. Every year, 
thousands of parents receive the tragic news that their child will have 
to bear the burden of juvenile diabetes. With this news comes the 
realities of a life permanently changed by a disease for which we 
currently have no cure.

[[Page 36208]]

  As I have shared with the House before, I am one of these parents. 
Nearly a decade ago, my wife and I learned that my son Nick would have 
to face the challenge of type one diabetes. We have been blessed and 
fortunate that Nick has lived an active and normal life. His successes 
are in large part thanks to the insulin pump he wears and other 
innovations that help type one diabetes patients manage their disease.
  While Nick and so many other children have been able to manage their 
disease, they still worry about their future. It is the obligation of 
Congress to work towards finding a cure. The Special Diabetes Program 
provides the guarantee of continued, groundbreaking research into this 
disease. The yields of this research hold unquestioned promise for a 
better future.
  I am disappointed that the extension of the program prescribed in 
this legislation is only one year. An overwhelming bipartisan group of 
my colleague in both the House and Senate expressed support for a 
longer extension of the program. Unfortunately, those who carry the 
weight of type one diabetes were casualties of partisan warfare over 
other, unrelated issues.
  I look forward to working with my colleagues next year to ensure a 
longer renewal of this legislation. Congress has an obligation to lead 
the charge against this disease. I know that we can meet this challenge 
if we work together.
  Mr. CASTLE. Madam Speaker, I rise today in support of S. 2499, the 
Medicare, Medicaid, and State Children's Health Insurance Program 
Extension Act of 2007. The measure includes an important, albeit 
limited, delay of the scheduled 10 percent cut to Medicare's physician 
payment rates, which will help ensure quality care and access for 
Medicare patients without the cuts to vital Medicare programs I opposed 
previously. While not the expansion to reach an additional 4 million 
children I had hoped for, S. 2449 also extends the authorization for 
the State Children's Health Insurance Program until March 31, 2009, 
ensuring the needs of the 6 million children currently enrolled are 
met. I hope Congress will again forge ahead and continue negotiations 
to reach more of these eligible and uninsured children.
  As co-chair of the Congressional Diabetes Caucus, I was extremely 
pleased to see the reauthorization of the Special Diabetes Program to 
fund type 1 diabetes research and type 2 treatment and prevention 
programs for Native Americans and Alaska Natives included in S. 2449. I 
am the lead Republican sponsor, with my colleague Representative Diana 
DeGette, of legislation in the U.S. House of Representatives, H.R. 
2762, to reauthorize the Special Diabetes Program for Type I Research 
and the Special Diabetes Program for Indians for 5 years and to 
increase the authorized funding level to $200 million annually for each 
program. While a long-term extension is needed, in this difficult 
budget environment a short-term extension is a step in the right 
direction and I will continue to work next year with my colleagues to 
finish the job and secure a multi-year renewal so the critical long-
term projects supported by this program can continue.
  Since their creation in 1997, the Special Diabetes Programs have led 
to research breakthroughs through the Special Diabetes Program for Type 
1 Research and have increased diabetes treatment and prevention 
programs for Native Americans and Alaska Natives through the Special 
Diabetes Program for Indians. Before this time, efforts on both fronts 
were in short supply. The Special Diabetes Programs have been 
reauthorized twice and have enjoyed broad bipartisan support in both 
the House and Senate; and H.R. 2762 continues in this spirit with 225 
cosponsors.
  The reauthorization of the Special Diabetes Programs is vitally 
important and an extension to September 30, 2009 is welcome.
  With over 20 million adults and children in the U.S. affected by 
diabetes, the cost to the U.S. economy is estimated at $132 billion per 
year in direct and indirect medical costs alone. Continued funding of 
the Special Diabetes Programs will ensure that the Federal effort to 
combat diabetes remains strong, as we ardently work to ensure that 
accelerated diabetes research, treatment, and prevention efforts with 
on the ground results in improving the lives of millions of people 
burdened with diabetes continue. I will continue to push for a longer 
extension of the Special Diabetes Programs.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the Senate bill, S. 2499.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. BARTON of Texas. Madam Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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