[Congressional Record (Bound Edition), Volume 156 (2010), Part 8]
[House]
[Pages 11712-11725]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  1640
                 AFFORDABLE HEALTH CARE FOR AMERICA ACT

  Mr. LEVIN. Mr. Speaker, I move to suspend the rules and concur in the 
Senate amendments to the bill (H.R. 3962) to provide affordable, 
quality health care for all Americans and reduce the growth in health 
care spending, and for other purposes.
  The Clerk read the title of the bill.
  The text of the Senate amendments is as follows:

       Senate amendments:
       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Preservation of Access to 
     Care for Medicare Beneficiaries and Pension Relief Act of 
     2010''.

                       TITLE I--HEALTH PROVISIONS

     SEC. 101. PHYSICIAN PAYMENT UPDATE.

       (a) In General.--Section 1848(d) of the Social Security Act 
     (42 U.S.C. 1395w-4(d)) is amended--
       (1) in paragraph (10), in the heading, by striking 
     ``portion'' and inserting ``January through may ''; and
       (2) by adding at the end the following new paragraph:
       ``(11) Update for june through november of 2010.--
       ``(A) In general.--Subject to paragraphs (7)(B), (8)(B), 
     (9)(B), and (10)(B), in lieu of the update to the single 
     conversion factor established in paragraph (1)(C) that would 
     otherwise apply for 2010 for the period beginning on June 1, 
     2010, and ending on November 30, 2010, the update to the 
     single conversion factor shall be 2.2 percent.
       ``(B) No effect on computation of conversion factor for 
     remaining portion of 2010 and subsequent years.--The 
     conversion factor under this subsection shall be computed 
     under paragraph (1)(A) for the period beginning on December 
     1, 2010, and ending on December 31, 2010, and for 2011 and 
     subsequent years as if subparagraph (A) had never applied.''.
       (b) Statutory Paygo.--The budgetary effects of this Act, 
     for the purpose of complying with the Statutory Pay-As-You-Go 
     Act of 2010, shall be determined by reference to the latest 
     statement titled ``Budgetary Effects of PAYGO Legislation'' 
     for this Act, jointly submitted for printing in the 
     Congressional Record by the Chairmen of the House and Senate 
     Budget Committees, provided that such statement has been 
     submitted prior to the vote on passage in the House acting 
     first on this conference report or amendment between the 
     Houses.

     SEC. 102. CLARIFICATION OF 3-DAY PAYMENT WINDOW.

       (a) In General.--Section 1886 of the Social Security Act 
     (42 U.S.C. 1395ww) is amended--
       (1) by adding at the end of subsection (a)(4) the following 
     new sentence: ``In applying the first sentence of this 
     paragraph, the term `other services related to the admission' 
     includes all services that are not diagnostic services (other 
     than ambulance and maintenance renal dialysis services) for 
     which payment may be made under this title that are provided 
     by a hospital (or an entity wholly owned or operated by the 
     hospital) to a patient--
       ``(A) on the date of the patient's inpatient admission; or
       ``(B) during the 3 days (or, in the case of a hospital that 
     is not a subsection (d) hospital, during the 1 day) 
     immediately preceding the date of such admission unless the 
     hospital demonstrates (in a form and manner, and at a time, 
     specified by the Secretary) that such services are not 
     related (as determined by the Secretary) to such 
     admission.''; and
       (2) in subsection (d)(7)--
       (A) in subparagraph (A), by striking ``and'' at the end;
       (B) in subparagraph (B), by striking the period and 
     inserting ``, and''; and
       (C) by adding at the end the following new subparagraph:
       ``(C) the determination of whether services provided prior 
     to a patient's inpatient admission are related to the 
     admission (as described in subsection (a)(4)).''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall apply to services furnished on or after the date of the 
     enactment of this Act.
       (c) No Reopening of Previously Bundled Claims.--
       (1) In general.--The Secretary of Health and Human Services 
     may not reopen a claim, adjust a claim, or make a payment 
     pursuant to any request for payment under title XVIII of the 
     Social Security Act, submitted by an entity (including a 
     hospital or an entity wholly owned or operated by the 
     hospital) for services described in paragraph (2) for 
     purposes of treating, as unrelated to a patient's inpatient 
     admission, services provided during the 3 days (or, in the 
     case of a hospital that is not a subsection (d) hospital, 
     during the 1 day) immediately preceding the date of the 
     patient's inpatient admission.
       (2) Services described.--For purposes of paragraph (1), the 
     services described in this paragraph are other services 
     related to the admission (as described in section 1886(a)(4) 
     of the Social Security Act (42 U.S.C. 1395ww(a)(4)), as 
     amended by subsection (a)) which were previously included on 
     a claim or request for payment submitted under part A of 
     title XVIII of such Act for which a reopening, adjustment, or 
     request for payment under part B of such title, was not 
     submitted prior to the date of the enactment of this Act.
       (d) Implementation.--Notwithstanding any other provision of 
     law, the Secretary of Health and Human Services may implement 
     the provisions of this section (and amendments made by this 
     section) by program instruction or otherwise.
       (e) Rule of Construction.--Nothing in the amendments made 
     by this section shall be construed as changing the policy 
     described in section 1886(a)(4) of the Social Security Act 
     (42 U.S.C. 1395ww(a)(4)), as applied by the Secretary of 
     Health and Human Services before the date of the enactment of 
     this Act, with respect to diagnostic services.

     SEC. 103. ESTABLISH A CMS-IRS DATA MATCH TO IDENTIFY 
                   FRAUDULENT PROVIDERS.

       (a) Authority To Disclose Return Information Concerning 
     Outstanding Tax Debts for Purposes of Enhancing Medicare 
     Program Integrity.--
       (1) In general.--Section 6103(l) of the Internal Revenue 
     Code of 1986 is amended by adding at the end the following 
     new paragraph:
       ``(22) Disclosure of return information to department of 
     health and human services for purposes of enhancing medicare 
     program integrity.--
       ``(A) In general.--The Secretary shall, upon written 
     request from the Secretary of Health and Human Services, 
     disclose to officers and employees of the Department of 
     Health and Human Services return information with respect to 
     a taxpayer who has applied to enroll, or reenroll, as a 
     provider of services or supplier under the Medicare program 
     under title XVIII of the Social Security Act. Such return 
     information shall be limited to--
       ``(i) the taxpayer identity information with respect to 
     such taxpayer;
       ``(ii) the amount of the delinquent tax debt owed by that 
     taxpayer; and
       ``(iii) the taxable year to which the delinquent tax debt 
     pertains.
       ``(B) Restriction on disclosure.--Return information 
     disclosed under subparagraph (A) may be used by officers and 
     employees of the Department of Health and Human Services for 
     the purposes of, and to the extent necessary in, establishing 
     the taxpayer's eligibility for enrollment or reenrollment in 
     the Medicare program, or in any administrative or judicial 
     proceeding relating to, or arising from, a denial of such 
     enrollment or reenrollment, or in determining the level of 
     enhanced oversight to be applied with respect to such 
     taxpayer pursuant to section 1866(j)(3) of the Social 
     Security Act.
       ``(C) Delinquent tax debt.--For purposes of this paragraph, 
     the term `delinquent tax debt' means an outstanding debt 
     under this title for which a notice of lien has been filed 
     pursuant to section 6323, but the term does not include a 
     debt that is being paid in a timely manner pursuant to an 
     agreement under section 6159 or 7122, or a debt with respect 
     to which a collection due process hearing under section 6330 
     is requested, pending, or completed and no payment is 
     required.''.
       (2) Conforming amendments.--Section 6103(p)(4) of such 
     Code, as amended by sections 1414 and 3308 of Public Law 111-
     148, in the matter preceding subparagraph (A) and in 
     subparagraph (F)(ii), is amended by striking ``or (17)'' and 
     inserting ``(17), or (22)'' each place it appears.
       (b) Secretary's Authority To Use Information From the 
     Department of Treasury in Medicare Enrollments and 
     Reenrollments.--Section 1866(j)(2) of the Social Security Act 
     (42 U.S.C. 1395cc(j)), as inserted by section 6401(a) of 
     Public Law 111-148, is further amended--
       (1) by redesignating subparagraph (E) as subparagraph (F); 
     and
       (2) by inserting after subparagraph (D) the following new 
     subparagraph:
       ``(E) Use of information from the department of treasury 
     concerning tax debts.--In reviewing the application of a 
     provider of services or supplier to enroll or reenroll under 
     the program under this title, the Secretary shall take into 
     account the information supplied by the Secretary of the 
     Treasury pursuant to section 6103(l)(22) of the Internal 
     Revenue Code of 1986, in determining whether to deny such 
     application or to apply enhanced oversight to such provider 
     of services or supplier pursuant to paragraph (3) if the 
     Secretary determines such provider of services or supplier 
     owes such a debt.''.
       (c) Authority To Adjust Payments of Providers of Services 
     and Suppliers With the

[[Page 11713]]

     Same Tax Identification Number for Medicare Obligations.--
     Section 1866(j)(6) of the Social Security Act (42 U.S.C. 
     1395cc(j)(6)), as inserted by section 6401(a) of Public Law 
     111-148 and as redesignated by section 1304 of Public Law 
     111-152, is amended--
       (1) in the paragraph heading, by striking ``past-due'' and 
     inserting ``medicare'';
       (2) in subparagraph (A), by striking ``past-due obligations 
     described in subparagraph (B)(ii) of an'' and inserting 
     ``amount described in subparagraph (B)(ii) due from such''; 
     and
       (3) in subparagraph (B)(ii), by striking ``a past-due 
     obligation'' and inserting ``an amount that is more than the 
     amount required to be paid''.

                    TITLE II--PENSION FUNDING RELIEF

                   Subtitle A--Single Employer Plans

     SEC. 201. EXTENDED PERIOD FOR SINGLE-EMPLOYER DEFINED BENEFIT 
                   PLANS TO AMORTIZE CERTAIN SHORTFALL 
                   AMORTIZATION BASES.

       (a) Amendments to ERISA.--
       (1) In general.--Paragraph (2) of section 303(c) of the 
     Employee Retirement Income Security Act of 1974 (29 U.S.C. 
     1083(c)) is amended by adding at the end the following 
     subparagraph:
       ``(D) Special election for eligible plan years.--
       ``(i) In general.--If a plan sponsor elects to apply this 
     subparagraph with respect to the shortfall amortization base 
     of a plan for any eligible plan year (in this subparagraph 
     and paragraph (7) referred to as an `election year'), then, 
     notwithstanding subparagraphs (A) and (B)--

       ``(I) the shortfall amortization installments with respect 
     to such base shall be determined under clause (ii) or (iii), 
     whichever is specified in the election, and
       ``(II) the shortfall amortization installment for any plan 
     year in the 9-plan-year period described in clause (ii) or 
     the 15-plan-year period described in clause (iii), 
     respectively, with respect to such shortfall amortization 
     base is the annual installment determined under the 
     applicable clause for that year for that base.

       ``(ii) 2 plus 7 amortization schedule.--The shortfall 
     amortization installments determined under this clause are--

       ``(I) in the case of the first 2 plan years in the 9-plan-
     year period beginning with the election year, interest on the 
     shortfall amortization base of the plan for the election year 
     (determined using the effective interest rate for the plan 
     for the election year), and
       ``(II) in the case of the last 7 plan years in such 9-plan-
     year period, the amounts necessary to amortize the remaining 
     balance of the shortfall amortization base of the plan for 
     the election year in level annual installments over such last 
     7 plan years (using the segment rates under subparagraph (C) 
     for the election year).

       ``(iii) 15-year amortization.--The shortfall amortization 
     installments determined under this subparagraph are the 
     amounts necessary to amortize the shortfall amortization base 
     of the plan for the election year in level annual 
     installments over the 15-plan-year period beginning with the 
     election year (using the segment rates under subparagraph (C) 
     for the election year).
       ``(iv) Election.--

       ``(I) In general.--The plan sponsor of a plan may elect to 
     have this subparagraph apply to not more than 2 eligible plan 
     years with respect to the plan, except that in the case of a 
     plan described in section 106 of the Pension Protection Act 
     of 2006, the plan sponsor may only elect to have this 
     subparagraph apply to a plan year beginning in 2011.
       ``(II) Amortization schedule.--Such election shall specify 
     whether the amortization schedule under clause (ii) or (iii) 
     shall apply to an election year, except that if a plan 
     sponsor elects to have this subparagraph apply to 2 eligible 
     plan years, the plan sponsor must elect the same schedule for 
     both years.
       ``(III) Other rules.--Such election shall be made at such 
     time, and in such form and manner, as shall be prescribed by 
     the Secretary of the Treasury, and may be revoked only with 
     the consent of the Secretary of the Treasury. The Secretary 
     of the Treasury shall, before granting a revocation request, 
     provide the Pension Benefit Guaranty Corporation an 
     opportunity to comment on the conditions applicable to the 
     treatment of any portion of the election year shortfall 
     amortization base that remains unamortized as of the 
     revocation date.

       ``(v) Eligible plan year.--For purposes of this 
     subparagraph, the term `eligible plan year' means any plan 
     year beginning in 2008, 2009, 2010, or 2011, except that a 
     plan year shall only be treated as an eligible plan year if 
     the due date under subsection (j)(1) for the payment of the 
     minimum required contribution for such plan year occurs on or 
     after the date of the enactment of this subparagraph.
       ``(vi) Reporting.--A plan sponsor of a plan who makes an 
     election under clause (i) shall--

       ``(I) give notice of the election to participants and 
     beneficiaries of the plan, and
       ``(II) inform the Pension Benefit Guaranty Corporation of 
     such election in such form and manner as the Director of the 
     Pension Benefit Guaranty Corporation may prescribe.

       ``(vii) Increases in required installments in certain 
     cases.--For increases in required contributions in cases of 
     excess compensation or extraordinary dividends or stock 
     redemptions, see paragraph (7).''.
       (2) Increases in required installments in certain cases.--
     Section 303(c) of the Employee Retirement Income Security Act 
     of 1974 (29 U.S.C. 1083(c)) is amended by adding at the end 
     the following paragraph:
       ``(7) Increases in alternate required installments in cases 
     of excess compensation or extraordinary dividends or stock 
     redemptions.--
       ``(A) In general.--If there is an installment acceleration 
     amount with respect to a plan for any plan year in the 
     restriction period with respect to an election year under 
     paragraph (2)(D), then the shortfall amortization installment 
     otherwise determined and payable under such paragraph for 
     such plan year shall, subject to the limitation under 
     subparagraph (B), be increased by such amount.
       ``(B) Total installments limited to shortfall base.--
     Subject to rules prescribed by the Secretary of the Treasury, 
     if a shortfall amortization installment with respect to any 
     shortfall amortization base for an election year is required 
     to be increased for any plan year under subparagraph (A)--
       ``(i) such increase shall not result in the amount of such 
     installment exceeding the present value of such installment 
     and all succeeding installments with respect to such base 
     (determined without regard to such increase but after 
     application of clause (ii)), and
       ``(ii) subsequent shortfall amortization installments with 
     respect to such base shall, in reverse order of the otherwise 
     required installments, be reduced to the extent necessary to 
     limit the present value of such subsequent shortfall 
     amortization installments (after application of this 
     paragraph) to the present value of the remaining unamortized 
     shortfall amortization base.
       ``(C) Installment acceleration amount.--For purposes of 
     this paragraph--
       ``(i) In general.--The term `installment acceleration 
     amount' means, with respect to any plan year in a restriction 
     period with respect to an election year, the sum of--

       ``(I) the aggregate amount of excess employee compensation 
     determined under subparagraph (D) with respect to all 
     employees for the plan year, plus
       ``(II) the aggregate amount of extraordinary dividends and 
     redemptions determined under subparagraph (E) for the plan 
     year.

       ``(ii) Annual limitation.--The installment acceleration 
     amount for any plan year shall not exceed the excess (if any) 
     of--

       ``(I) the sum of the shortfall amortization installments 
     for the plan year and all preceding plan years in the 
     amortization period elected under paragraph (2)(D) with 
     respect to the shortfall amortization base with respect to an 
     election year, determined without regard to paragraph (2)(D) 
     and this paragraph, over
       ``(II) the sum of the shortfall amortization installments 
     for such plan year and all such preceding plan years, 
     determined after application of paragraph (2)(D) (and in the 
     case of any preceding plan year, after application of this 
     paragraph).

       ``(iii) Carryover of excess installment acceleration 
     amounts.--

       ``(I) In general.--If the installment acceleration amount 
     for any plan year (determined without regard to clause (ii)) 
     exceeds the limitation under clause (ii), then, subject to 
     subclause (II), such excess shall be treated as an 
     installment acceleration amount with respect to the 
     succeeding plan year.
       ``(II) Cap to apply.--If any amount treated as an 
     installment acceleration amount under subclause (I) or this 
     subclause with respect any succeeding plan year, when added 
     to other installment acceleration amounts (determined without 
     regard to clause (ii)) with respect to the plan year, exceeds 
     the limitation under clause (ii), the portion of such amount 
     representing such excess shall be treated as an installment 
     acceleration amount with respect to the next succeeding plan 
     year.
       ``(III) Limitation on years to which amounts carried for.--
     No amount shall be carried under subclause (I) or (II) to a 
     plan year which begins after the first plan year following 
     the last plan year in the restriction period (or after the 
     second plan year following such last plan year in the case of 
     an election year with respect to which 15-year amortization 
     was elected under paragraph (2)(D)).
       ``(IV) Ordering rules.--For purposes of applying subclause 
     (II), installment acceleration amounts for the plan year 
     (determined without regard to any carryover under this 
     clause) shall be applied first against the limitation under 
     clause (ii) and then carryovers to such plan year shall be 
     applied against such limitation on a first-in, first-out 
     basis.

       ``(D) Excess employee compensation.--For purposes of this 
     paragraph--
       ``(i) In general.--The term `excess employee compensation' 
     means, with respect to any employee for any plan year, the 
     excess (if any) of--

       ``(I) the aggregate amount includible in income under 
     chapter 1 of the Internal Revenue Code of 1986 for 
     remuneration during the calendar year in which such plan year 
     begins for services performed by the employee for the plan 
     sponsor (whether or not performed during such calendar year), 
     over
       ``(II) $1,000,000.

       ``(ii) Amounts set aside for nonqualified deferred 
     compensation.--If during any calendar year assets are set 
     aside or reserved (directly or indirectly) in a trust (or 
     other arrangement as determined by the Secretary of the 
     Treasury), or transferred to such a trust or other 
     arrangement, by a plan sponsor for purposes of paying 
     deferred compensation of an employee under a nonqualified 
     deferred compensation plan (as defined in section 409A of 
     such Code) of the plan sponsor, then, for purposes of clause 
     (i), the amount of such assets shall be treated as 
     remuneration of the employee includible in income for the 
     calendar year unless such

[[Page 11714]]

     amount is otherwise includible in income for such year. An 
     amount to which the preceding sentence applies shall not be 
     taken into account under this paragraph for any subsequent 
     calendar year.
       ``(iii) Only remuneration for certain post-2009 services 
     counted.--Remuneration shall be taken into account under 
     clause (i) only to the extent attributable to services 
     performed by the employee for the plan sponsor after February 
     28, 2010.
       ``(iv) Exception for certain equity payments.--

       ``(I) In general.--There shall not be taken into account 
     under clause (i)(I) any amount includible in income with 
     respect to the granting after February 28, 2010, of service 
     recipient stock (within the meaning of section 409A of the 
     Internal Revenue Code of 1986) that, upon such grant, is 
     subject to a substantial risk of forfeiture (as defined under 
     section 83(c)(1) of such Code) for at least 5 years from the 
     date of such grant.
       ``(II) Secretarial authority.--The Secretary of the 
     Treasury may by regulation provide for the application of 
     this clause in the case of a person other than a corporation.

       ``(v) Other exceptions.--The following amounts includible 
     in income shall not be taken into account under clause 
     (i)(I):

       ``(I) Commissions.--Any remuneration payable on a 
     commission basis solely on account of income directly 
     generated by the individual performance of the individual to 
     whom such remuneration is payable.

       ``(II) Certain payments under existing contracts.--Any 
     remuneration consisting of nonqualified deferred 
     compensation, restricted stock, stock options, or stock 
     appreciation rights payable or granted under a written 
     binding contract that was in effect on March 1, 2010, and 
     which was not modified in any material respect before such 
     remuneration is paid.

       ``(vi) Self-employed individual treated as employee.--The 
     term `employee' includes, with respect to a calendar year, a 
     self-employed individual who is treated as an employee under 
     section 401(c) of such Code for the taxable year ending 
     during such calendar year, and the term `compensation' shall 
     include earned income of such individual with respect to such 
     self-employment.
       ``(vii) Indexing of amount.--In the case of any calendar 
     year beginning after 2010, the dollar amount under clause 
     (i)(II) shall be increased by an amount equal to--

       ``(I) such dollar amount, multiplied by
       ``(II) the cost-of-living adjustment determined under 
     section 1(f)(3) of such Code for the calendar year, 
     determined by substituting `calendar year 2009' for `calendar 
     year 1992' in subparagraph (B) thereof.

     If the amount of any increase under clause (i) is not a 
     multiple of $1,000, such increase shall be rounded to the 
     next lowest multiple of $1,000.
       ``(E) Extraordinary dividends and redemptions.--
       ``(i) In general.--The amount determined under this 
     subparagraph for any plan year is the excess (if any) of the 
     sum of the dividends declared during the plan year by the 
     plan sponsor plus the aggregate amount paid for the 
     redemption of stock of the plan sponsor redeemed during the 
     plan year over the greater of--

       ``(I) the adjusted net income (within the meaning of 
     section 4043) of the plan sponsor for the preceding plan 
     year, determined without regard to any reduction by reason of 
     interest, taxes, depreciation, or amortization, or
       ``(II) in the case of a plan sponsor that determined and 
     declared dividends in the same manner for at least 5 
     consecutive years immediately preceding such plan year, the 
     aggregate amount of dividends determined and declared for 
     such plan year using such manner.

       ``(ii) Only certain post-2009 dividends and redemptions 
     counted.--For purposes of clause (i), there shall only be 
     taken into account dividends declared, and redemptions 
     occurring, after February 28, 2010.
       ``(iii) Exception for intra-group dividends.--Dividends 
     paid by one member of a controlled group (as defined in 
     section 302(d)(3)) to another member of such group shall not 
     be taken into account under clause (i).
       ``(iv) Exception for certain redemptions.--Redemptions that 
     are made pursuant to a plan maintained with respect to 
     employees, or that are made on account of the death, 
     disability, or termination of employment of an employee or 
     shareholder, shall not be taken into account under clause 
     (i).
       ``(v) Exception for certain preferred stock.--

       ``(I) In general.--Dividends and redemptions with respect 
     to applicable preferred stock shall not be taken into account 
     under clause (i) to the extent that dividends accrue with 
     respect to such stock at a specified rate in all events and 
     without regard to the plan sponsor's income, and interest 
     accrues on any unpaid dividends with respect to such stock.
       ``(II) Applicable preferred stock.--For purposes of 
     subclause (I), the term `applicable preferred stock' means 
     preferred stock which was issued before March 1, 2010 (or 
     which was issued after such date and is held by an employee 
     benefit plan subject to the provisions of this title).

       ``(F) Other definitions and rules.--For purposes of this 
     paragraph--
       ``(i) Plan sponsor.--The term ` plan sponsor' includes any 
     member of the plan sponsor's controlled group (as defined in 
     section 302(d)(3)).
       ``(ii) Restriction period.--The term `restriction period' 
     means, with respect to any election year--

       ``(I) except as provided in subclause (II), the 3-year 
     period beginning with the election year (or, if later, the 
     first plan year beginning after December 31, 2009), and
       ``(II) if the plan sponsor elects 15-year amortization for 
     the shortfall amortization base for the election year, the 5-
     year period beginning with the election year (or, if later, 
     the first plan year beginning after December 31, 2009).

       ``(iii) Elections for multiple plans.--If a plan sponsor 
     makes elections under paragraph (2)(D) with respect to 2 or 
     more plans, the Secretary of the Treasury shall provide rules 
     for the application of this paragraph to such plans, 
     including rules for the ratable allocation of any installment 
     acceleration amount among such plans on the basis of each 
     plan's relative reduction in the plan's shortfall 
     amortization installment for the first plan year in the 
     amortization period described in subparagraph (A) (determined 
     without regard to this paragraph).
       ``(iv) Mergers and acquisitions.--The Secretary of the 
     Treasury shall prescribe rules for the application of 
     paragraph (2)(D) and this paragraph in any case where there 
     is a merger or acquisition involving a plan sponsor making 
     the election under paragraph (2)(D).''.
       (3) Conforming amendments.--Section 303 of such Act (29 
     U.S.C. 1083) is amended--
       (A) in subsection (c)(1), by striking ``the shortfall 
     amortization bases for such plan year and each of the 6 
     preceding plan years'' and inserting ``any shortfall 
     amortization base which has not been fully amortized under 
     this subsection'', and
       (B) in subsection (j)(3), by adding at the end the 
     following:
       ``(F) Quarterly contributions not to include certain 
     increased contributions.--Subparagraph (D) shall be applied 
     without regard to any increase under subsection (c)(7).''.
       (b) Amendments to Internal Revenue Code of 1986.--
       (1) In general.--Paragraph (2) of section 430(c) is amended 
     by adding at the end the following subparagraph:
       ``(D) Special election for eligible plan years.--
       ``(i) In general.--If a plan sponsor elects to apply this 
     subparagraph with respect to the shortfall amortization base 
     of a plan for any eligible plan year (in this subparagraph 
     and paragraph (7) referred to as an `election year'), then, 
     notwithstanding subparagraphs (A) and (B)--

       ``(I) the shortfall amortization installments with respect 
     to such base shall be determined under clause (ii) or (iii), 
     whichever is specified in the election, and
       ``(II) the shortfall amortization installment for any plan 
     year in the 9-plan-year period described in clause (ii) or 
     the 15-plan-year period described in clause (iii), 
     respectively, with respect to such shortfall amortization 
     base is the annual installment determined under the 
     applicable clause for that year for that base.

       ``(ii) 2 plus 7 amortization schedule.--The shortfall 
     amortization installments determined under this clause are--

       ``(I) in the case of the first 2 plan years in the 9-plan-
     year period beginning with the election year, interest on the 
     shortfall amortization base of the plan for the election year 
     (determined using the effective interest rate for the plan 
     for the election year), and
       ``(II) in the case of the last 7 plan years in such 9-plan-
     year period, the amounts necessary to amortize the remaining 
     balance of the shortfall amortization base of the plan for 
     the election year in level annual installments over such last 
     7 plan years (using the segment rates under subparagraph (C) 
     for the election year).

       ``(iii) 15-year amortization.--The shortfall amortization 
     installments determined under this subparagraph are the 
     amounts necessary to amortize the shortfall amortization base 
     of the plan for the election year in level annual 
     installments over the 15-plan-year period beginning with the 
     election year (using the segment rates under subparagraph (C) 
     for the election year).
       ``(iv) Election.--

       ``(I) In general.--The plan sponsor of a plan may elect to 
     have this subparagraph apply to not more than 2 eligible plan 
     years with respect to the plan, except that in the case of a 
     plan described in section 106 of the Pension Protection Act 
     of 2006, the plan sponsor may only elect to have this 
     subparagraph apply to a plan year beginning in 2011.
       ``(II) Amortization schedule.--Such election shall specify 
     whether the amortization schedule under clause (ii) or (iii) 
     shall apply to an election year, except that if a plan 
     sponsor elects to have this subparagraph apply to 2 eligible 
     plan years, the plan sponsor must elect the same schedule for 
     both years.
       ``(III) Other rules.--Such election shall be made at such 
     time, and in such form and manner, as shall be prescribed by 
     the Secretary, and may be revoked only with the consent of 
     the Secretary. The Secretary shall, before granting a 
     revocation request, provide the Pension Benefit Guaranty 
     Corporation an opportunity to comment on the conditions 
     applicable to the treatment of any portion of the election 
     year shortfall amortization base that remains unamortized as 
     of the revocation date.

       ``(v) Eligible plan year.--For purposes of this 
     subparagraph, the term `eligible plan year' means any plan 
     year beginning in 2008, 2009, 2010, or 2011, except that a 
     plan year shall only be treated as an eligible plan year if 
     the due date under subsection (j)(1) for the payment of the 
     minimum required contribution for such plan year occurs on or 
     after the date of the enactment of this subparagraph.
       ``(vi) Reporting.--A plan sponsor of a plan who makes an 
     election under clause (i) shall--

[[Page 11715]]

       ``(I) give notice of the election to participants and 
     beneficiaries of the plan, and
       ``(II) inform the Pension Benefit Guaranty Corporation of 
     such election in such form and manner as the Director of the 
     Pension Benefit Guaranty Corporation may prescribe.

       ``(vii) Increases in required installments in certain 
     cases.--For increases in required contributions in cases of 
     excess compensation or extraordinary dividends or stock 
     redemptions, see paragraph (7).''.
       (2) Increases in required contributions if excess 
     compensation paid.--Section 430(c) is amended by adding at 
     the end the following paragraph:
       ``(7) Increases in alternate required installments in cases 
     of excess compensation or extraordinary dividends or stock 
     redemptions.--
       ``(A) In general.--If there is an installment acceleration 
     amount with respect to a plan for any plan year in the 
     restriction period with respect to an election year under 
     paragraph (2)(D), then the shortfall amortization installment 
     otherwise determined and payable under such paragraph for 
     such plan year shall, subject to the limitation under 
     subparagraph (B), be increased by such amount.
       ``(B) Total installments limited to shortfall base.--
     Subject to rules prescribed by the Secretary, if a shortfall 
     amortization installment with respect to any shortfall 
     amortization base for an election year is required to be 
     increased for any plan year under subparagraph (A)--
       ``(i) such increase shall not result in the amount of such 
     installment exceeding the present value of such installment 
     and all succeeding installments with respect to such base 
     (determined without regard to such increase but after 
     application of clause (ii)), and
       ``(ii) subsequent shortfall amortization installments with 
     respect to such base shall, in reverse order of the otherwise 
     required installments, be reduced to the extent necessary to 
     limit the present value of such subsequent shortfall 
     amortization installments (after application of this 
     paragraph) to the present value of the remaining unamortized 
     shortfall amortization base.
       ``(C) Installment acceleration amount.--For purposes of 
     this paragraph--
       ``(i) In general.--The term `installment acceleration 
     amount' means, with respect to any plan year in a restriction 
     period with respect to an election year, the sum of--

       ``(I) the aggregate amount of excess employee compensation 
     determined under subparagraph (D) with respect to all 
     employees for the plan year, plus
       ``(II) the aggregate amount of extraordinary dividends and 
     redemptions determined under subparagraph (E) for the plan 
     year.

       ``(ii) Annual limitation.--The installment acceleration 
     amount for any plan year shall not exceed the excess (if any) 
     of--

       ``(I) the sum of the shortfall amortization installments 
     for the plan year and all preceding plan years in the 
     amortization period elected under paragraph (2)(D) with 
     respect to the shortfall amortization base with respect to an 
     election year, determined without regard to paragraph (2)(D) 
     and this paragraph, over
       ``(II) the sum of the shortfall amortization installments 
     for such plan year and all such preceding plan years, 
     determined after application of paragraph (2)(D) (and in the 
     case of any preceding plan year, after application of this 
     paragraph).

       ``(iii) Carryover of excess installment acceleration 
     amounts.--

       ``(I) In general.--If the installment acceleration amount 
     for any plan year (determined without regard to clause (ii)) 
     exceeds the limitation under clause (ii), then, subject to 
     subclause (II), such excess shall be treated as an 
     installment acceleration amount with respect to the 
     succeeding plan year.
       ``(II) Cap to apply.--If any amount treated as an 
     installment acceleration amount under subclause (I) or this 
     subclause with respect any succeeding plan year, when added 
     to other installment acceleration amounts (determined without 
     regard to clause (ii)) with respect to the plan year, exceeds 
     the limitation under clause (ii), the portion of such amount 
     representing such excess shall be treated as an installment 
     acceleration amount with respect to the next succeeding plan 
     year.
       ``(III) Limitation on years to which amounts carried for.--
     No amount shall be carried under subclause (I) or (II) to a 
     plan year which begins after the first plan year following 
     the last plan year in the restriction period (or after the 
     second plan year following such last plan year in the case of 
     an election year with respect to which 15-year amortization 
     was elected under paragraph (2)(D)).
       ``(IV) Ordering rules.--For purposes of applying subclause 
     (II), installment acceleration amounts for the plan year 
     (determined without regard to any carryover under this 
     clause) shall be applied first against the limitation under 
     clause (ii) and then carryovers to such plan year shall be 
     applied against such limitation on a first-in, first-out 
     basis.

       ``(D) Excess employee compensation.--For purposes of this 
     paragraph--
       ``(i) In general.--The term `excess employee compensation' 
     means, with respect to any employee for any plan year, the 
     excess (if any) of--

       ``(I) the aggregate amount includible in income under this 
     chapter for remuneration during the calendar year in which 
     such plan year begins for services performed by the employee 
     for the plan sponsor (whether or not performed during such 
     calendar year), over
       ``(II) $1,000,000.

       ``(ii) Amounts set aside for nonqualified deferred 
     compensation.--If during any calendar year assets are set 
     aside or reserved (directly or indirectly) in a trust (or 
     other arrangement as determined by the Secretary), or 
     transferred to such a trust or other arrangement, by a plan 
     sponsor for purposes of paying deferred compensation of an 
     employee under a nonqualified deferred compensation plan (as 
     defined in section 409A) of the plan sponsor, then, for 
     purposes of clause (i), the amount of such assets shall be 
     treated as remuneration of the employee includible in income 
     for the calendar year unless such amount is otherwise 
     includible in income for such year. An amount to which the 
     preceding sentence applies shall not be taken into account 
     under this paragraph for any subsequent calendar year.
       ``(iii) Only remuneration for certain post-2009 services 
     counted.--Remuneration shall be taken into account under 
     clause (i) only to the extent attributable to services 
     performed by the employee for the plan sponsor after February 
     28, 2010.
       ``(iv) Exception for certain equity payments.--

       ``(I) In general.--There shall not be taken into account 
     under clause (i)(I) any amount includible in income with 
     respect to the granting after February 28, 2010, of service 
     recipient stock (within the meaning of section 409A) that, 
     upon such grant, is subject to a substantial risk of 
     forfeiture (as defined under section 83(c)(1)) for at least 5 
     years from the date of such grant.
       ``(II) Secretarial authority.--The Secretary may by 
     regulation provide for the application of this clause in the 
     case of a person other than a corporation.

       ``(v) Other exceptions.--The following amounts includible 
     in income shall not be taken into account under clause 
     (i)(I):

       ``(I) Commissions.--Any remuneration payable on a 
     commission basis solely on account of income directly 
     generated by the individual performance of the individual to 
     whom such remuneration is payable.
       ``(II) Certain payments under existing contracts.--Any 
     remuneration consisting of nonqualified deferred 
     compensation, restricted stock, stock options, or stock 
     appreciation rights payable or granted under a written 
     binding contract that was in effect on March 1, 2010, and 
     which was not modified in any material respect before such 
     remuneration is paid.

       ``(vi) Self-employed individual treated as employee.--The 
     term `employee' includes, with respect to a calendar year, a 
     self-employed individual who is treated as an employee under 
     section 401(c) for the taxable year ending during such 
     calendar year, and the term `compensation' shall include 
     earned income of such individual with respect to such self-
     employment.
       ``(vii) Indexing of amount.--In the case of any calendar 
     year beginning after 2010, the dollar amount under clause 
     (i)(II) shall be increased by an amount equal to--

       ``(I) such dollar amount, multiplied by
       ``(II) the cost-of-living adjustment determined under 
     section 1(f)(3) for the calendar year, determined by 
     substituting `calendar year 2009' for `calendar year 1992' in 
     subparagraph (B) thereof.

     If the amount of any increase under clause (i) is not a 
     multiple of $1,000, such increase shall be rounded to the 
     next lowest multiple of $1,000.
       ``(E) Extraordinary dividends and redemptions.--
       ``(i) In general.--The amount determined under this 
     subparagraph for any plan year is the excess (if any) of the 
     sum of the dividends declared during the plan year by the 
     plan sponsor plus the aggregate amount paid for the 
     redemption of stock of the plan sponsor redeemed during the 
     plan year over the greater of--

       ``(I) the adjusted net income (within the meaning of 
     section 4043 of the Employee Retirement Income Security Act 
     of 1974) of the plan sponsor for the preceding plan year, 
     determined without regard to any reduction by reason of 
     interest, taxes, depreciation, or amortization, or
       ``(II) in the case of a plan sponsor that determined and 
     declared dividends in the same manner for at least 5 
     consecutive years immediately preceding such plan year, the 
     aggregate amount of dividends determined and declared for 
     such plan year using such manner.

       ``(ii) Only certain post-2009 dividends and redemptions 
     counted.--For purposes of clause (i), there shall only be 
     taken into account dividends declared, and redemptions 
     occurring, after February 28, 2010.
       ``(iii) Exception for intra-group dividends.--Dividends 
     paid by one member of a controlled group (as defined in 
     section 412(d)(3)) to another member of such group shall not 
     be taken into account under clause (i).
       ``(iv) Exception for certain redemptions.--Redemptions that 
     are made pursuant to a plan maintained with respect to 
     employees, or that are made on account of the death, 
     disability, or termination of employment of an employee or 
     shareholder, shall not be taken into account under clause 
     (i).
       ``(v) Exception for certain preferred stock.--

       ``(I) In general.--Dividends and redemptions with respect 
     to applicable preferred stock shall not be taken into account 
     under clause (i) to the extent that dividends accrue with 
     respect to such stock at a specified rate in all events and 
     without regard to the plan sponsor's income, and interest 
     accrues on any unpaid dividends with respect to such stock.
       ``(II) Applicable preferred stock.--For purposes of 
     subclause (I), the term `applicable

[[Page 11716]]

     preferred stock' means preferred stock which was issued 
     before March 1, 2010 (or which was issued after such date and 
     is held by an employee benefit plan subject to the provisions 
     of title I of Employee Retirement Income Security Act of 
     1974).

       ``(F) Other definitions and rules.--For purposes of this 
     paragraph--
       ``(i) Plan sponsor.--The term ` plan sponsor' includes any 
     member of the plan sponsor's controlled group (as defined in 
     section 412(d)(3)).
       ``(ii) Restriction period.--The term `restriction period' 
     means, with respect to any election year--

       ``(I) except as provided in subclause (II), the 3-year 
     period beginning with the election year (or, if later, the 
     first plan year beginning after December 31, 2009), and
       ``(II) if the plan sponsor elects 15-year amortization for 
     the shortfall amortization base for the election year, the 5-
     year period beginning with the election year (or, if later, 
     the first plan year beginning after December 31, 2009).

       ``(iii) Elections for multiple plans.--If a plan sponsor 
     makes elections under paragraph (2)(D) with respect to 2 or 
     more plans, the Secretary shall provide rules for the 
     application of this paragraph to such plans, including rules 
     for the ratable allocation of any installment acceleration 
     amount among such plans on the basis of each plan's relative 
     reduction in the plan's shortfall amortization installment 
     for the first plan year in the amortization period described 
     in subparagraph (A) (determined without regard to this 
     paragraph).
       ``(iv) Mergers and acquisitions.--The Secretary shall 
     prescribe rules for the application of paragraph (2)(D) and 
     this paragraph in any case where there is a merger or 
     acquisition involving a plan sponsor making the election 
     under paragraph (2)(D).''.
       (3) Conforming amendments.--Section 430 is amended--
       (A) in subsection (c)(1), by striking ``the shortfall 
     amortization bases for such plan year and each of the 6 
     preceding plan years'' and inserting ``any shortfall 
     amortization base which has not been fully amortized under 
     this subsection'', and
       (B) in subsection (j)(3), by adding at the end the 
     following:
       ``(F) Quarterly contributions not to include certain 
     increased contributions.--Subparagraph (D) shall be applied 
     without regard to any increase under subsection (c)(7).''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to plan years beginning after December 31, 2007.

     SEC. 202. APPLICATION OF EXTENDED AMORTIZATION PERIOD TO 
                   PLANS SUBJECT TO PRIOR LAW FUNDING RULES.

       (a) In General.--Title I of the Pension Protection Act of 
     2006 is amended by redesignating section 107 as section 108 
     and by inserting the following after section 106:

     ``SEC. 107. APPLICATION OF EXTENDED AMORTIZATION PERIODS TO 
                   PLANS WITH DELAYED EFFECTIVE DATE.

       ``(a) In General.--If the plan sponsor of a plan to which 
     section 104, 105, or 106 of this Act applies elects to have 
     this section apply for any eligible plan year (in this 
     section referred to as an `election year'), section 302 of 
     the Employee Retirement Income Security Act of 1974 and 
     section 412 of the Internal Revenue Code of 1986 (as in 
     effect before the amendments made by this subtitle and 
     subtitle B) shall apply to such year in the manner described 
     in subsection (b) or (c), whichever is specified in the 
     election. All references in this section to `such Act' or 
     `such Code' shall be to such Act or such Code as in effect 
     before the amendments made by this subtitle and subtitle B.
       ``(b) Application of 2 and 7 Rule.--In the case of an 
     election year to which this subsection applies--
       ``(1) 2-year lookback for determining deficit reduction 
     contributions for certain plans.--For purposes of applying 
     section 302(d)(9) of such Act and section 412(l)(9) of such 
     Code, the funded current liability percentage (as defined in 
     subparagraph (C) thereof) for such plan for such plan year 
     shall be such funded current liability percentage of such 
     plan for the second plan year preceding the first election 
     year of such plan.
       ``(2) Calculation of deficit reduction contribution.--For 
     purposes of applying section 302(d) of such Act and section 
     412(l) of such Code to a plan to which such sections apply 
     (after taking into account paragraph (1))--
       ``(A) in the case of the increased unfunded new liability 
     of the plan, the applicable percentage described in section 
     302(d)(4)(C) of such Act and section 412(l)(4)(C) of such 
     Code shall be the third segment rate described in sections 
     104(b), 105(b), and 106(b) of this Act, and
       ``(B) in the case of the excess of the unfunded new 
     liability over the increased unfunded new liability, such 
     applicable percentage shall be determined without regard to 
     this section.
       ``(c) Application of 15-year Amortization.--In the case of 
     an election year to which this subsection applies, for 
     purposes of applying section 302(d) of such Act and section 
     412(l) of such Code--
       ``(1) in the case of the increased unfunded new liability 
     of the plan, the applicable percentage described in section 
     302(d)(4)(C) of such Act and section 412(l)(4)(C) of such 
     Code for any pre-effective date plan year beginning with or 
     after the first election year shall be the ratio of--
       ``(A) the annual installments payable in each year if the 
     increased unfunded new liability for such plan year were 
     amortized over 15 years, using an interest rate equal to the 
     third segment rate described in sections 104(b), 105(b), and 
     106(b) of this Act, to
       ``(B) the increased unfunded new liability for such plan 
     year, and
       ``(2) in the case of the excess of the unfunded new 
     liability over the increased unfunded new liability, such 
     applicable percentage shall be determined without regard to 
     this section.
       ``(d) Election.--
       ``(1) In general.--The plan sponsor of a plan may elect to 
     have this section apply to not more than 2 eligible plan 
     years with respect to the plan, except that in the case of a 
     plan to which section 106 of this Act applies, the plan 
     sponsor may only elect to have this section apply to 1 
     eligible plan year.
       ``(2) Amortization schedule.--Such election shall specify 
     whether the rules under subsection (b) or (c) shall apply to 
     an election year, except that if a plan sponsor elects to 
     have this section apply to 2 eligible plan years, the plan 
     sponsor must elect the same rule for both years.
       ``(3) Other rules.--Such election shall be made at such 
     time, and in such form and manner, as shall be prescribed by 
     the Secretary of the Treasury, and may be revoked only with 
     the consent of the Secretary of the Treasury.
       ``(e) Definitions.--For purposes of this section--
       ``(1) Eligible plan year.--For purposes of this 
     subparagraph, the term `eligible plan year' means any plan 
     year beginning in 2008, 2009, 2010, or 2011, except that a 
     plan year beginning in 2008 shall only be treated as an 
     eligible plan year if the due date for the payment of the 
     minimum required contribution for such plan year occurs on or 
     after the date of the enactment of this clause.
       ``(2) Pre-effective date plan year.--The term `pre-
     effective date plan year' means, with respect to a plan, any 
     plan year prior to the first year in which the amendments 
     made by this subtitle and subtitle B apply to the plan.
       ``(3) Increased unfunded new liability.--The term 
     `increased unfunded new liability' means, with respect to a 
     year, the excess (if any) of the unfunded new liability over 
     the amount of unfunded new liability determined as if the 
     value of the plan's assets determined under subsection 
     302(c)(2) of such Act and section 412(c)(2) of such Code 
     equaled the product of the current liability of the plan for 
     the year multiplied by the funded current liability 
     percentage (as defined in section 302(d)(8)(B) of such Act 
     and 412(l)(8)(B) of such Code) of the plan for the second 
     plan year preceding the first election year of such plan.
       ``(4) Other definitions.--The terms `unfunded new 
     liability' and `current liability' shall have the meanings 
     set forth in section 302(d) of such Act and section 412(l) of 
     such Code.''.
       (b) Eligible Charity Plans.--Section 104 of the Pension 
     Protection Act of 2006 is amended--
       (1) by striking ``eligible cooperative plan'' wherever it 
     appears in subsections (a) and (b) and inserting ``eligible 
     cooperative plan or an eligible charity plan'', and
       (2) by adding at the end the following new subsection:
       ``(d) Eligible Charity Plan Defined.--For purposes of this 
     section, a plan shall be treated as an eligible charity plan 
     for a plan year if the plan is maintained by more than one 
     employer (determined without regard to section 414(c) of the 
     Internal Revenue Code) and 100 percent of the employers are 
     described in section 501(c)(3) of such Code.''.
       (c) Effective Date.--
       (1) In general.--The amendment made by subsection (a) shall 
     take effect as if included in the Pension Protection Act of 
     2006.
       (2) Eligible charity plan.--The amendments made by 
     subsection (b) shall apply to plan years beginning after 
     December 31, 2007, except that a plan sponsor may elect to 
     apply such amendments to plan years beginning after December 
     31, 2008. Any such election shall be made at such time, and 
     in such form and manner, as shall be prescribed by the 
     Secretary of the Treasury, and may be revoked only with the 
     consent of the Secretary of the Treasury.

     SEC. 203. LOOKBACK FOR CERTAIN BENEFIT RESTRICTIONS.

       (a) In General.--
       (1) Amendment to erisa.--Section 206(g)(9) of the Employee 
     Retirement Income Security Act of 1974 is amended by adding 
     at the end the following:
       ``(D) Special rule for certain years.--Solely for purposes 
     of any applicable provision--
       ``(i) In general.--For plan years beginning on or after 
     October 1, 2008, and before October 1, 2010, the adjusted 
     funding target attainment percentage of a plan shall be the 
     greater of--

       ``(I) such percentage, as determined without regard to this 
     subparagraph, or
       ``(II) the adjusted funding target attainment percentage 
     for such plan for the plan year beginning after October 1, 
     2007, and before October 1, 2008, as determined under rules 
     prescribed by the Secretary of the Treasury.

       ``(ii) Special rule.--In the case of a plan for which the 
     valuation date is not the first day of the plan year--

       ``(I) clause (i) shall apply to plan years beginning after 
     December 31, 2007, and before January 1, 2010, and
       ``(II) clause (i)(II) shall apply based on the last plan 
     year beginning before November 1, 2007, as determined under 
     rules prescribed by the Secretary of the Treasury.

       ``(iii) Applicable provision.--For purposes of this 
     subparagraph, the term `applicable provision' means--

       ``(I) paragraph (3), but only for purposes of applying such 
     paragraph to a payment which,

[[Page 11717]]

     as determined under rules prescribed by the Secretary of the 
     Treasury, is a payment under a social security leveling 
     option which accelerates payments under the plan before, and 
     reduces payments after, a participant starts receiving social 
     security benefits in order to provide substantially similar 
     aggregate payments both before and after such benefits are 
     received, and
       ``(II) paragraph (4).''.

       (2) Amendment to internal revenue code of 1986.--Section 
     436(j) of the Internal Revenue Code of 1986 is amended by 
     adding at the end the following:
       ``(3) Special rule for certain years.--Solely for purposes 
     of any applicable provision--
       ``(A) In general.--For plan years beginning on or after 
     October 1, 2008, and before October 1, 2010, the adjusted 
     funding target attainment percentage of a plan shall be the 
     greater of--
       ``(i) such percentage, as determined without regard to this 
     paragraph, or
       ``(ii) the adjusted funding target attainment percentage 
     for such plan for the plan year beginning after October 1, 
     2007, and before October 1, 2008, as determined under rules 
     prescribed by the Secretary.
       ``(B) Special rule.--In the case of a plan for which the 
     valuation date is not the first day of the plan year--
       ``(i) subparagraph (A) shall apply to plan years beginning 
     after December 31, 2007, and before January 1, 2010, and
       ``(ii) subparagraph (A)(ii) shall apply based on the last 
     plan year beginning before November 1, 2007, as determined 
     under rules prescribed by the Secretary.
       ``(C) Applicable provision.--For purposes of this 
     paragraph, the term `applicable provision' means--
       ``(i) subsection (d), but only for purposes of applying 
     such paragraph to a payment which, as determined under rules 
     prescribed by the Secretary, is a payment under a social 
     security leveling option which accelerates payments under the 
     plan before, and reduces payments after, a participant starts 
     receiving social security benefits in order to provide 
     substantially similar aggregate payments both before and 
     after such benefits are received, and
       ``(ii) subsection (e).''.
       (b) Interaction With Wrera Rule.--Section 203 of the 
     Worker, Retiree, and Employer Recovery Act of 2008 shall 
     apply to a plan for any plan year in lieu of the amendments 
     made by this section applying to sections 206(g)(4) of the 
     Employee Retirement Income Security Act of 1974 and 436(e) of 
     the Internal Revenue Code of 1986 only to the extent that 
     such section produces a higher adjusted funding target 
     attainment percentage for such plan for such year.
       (c) Effective Date.--
       (1) In general.--Except as provided in paragraph (2), the 
     amendments made by this section shall apply to plan years 
     beginning on or after October 1, 2008.
       (2) Special rule.--In the case of a plan for which the 
     valuation date is not the first day of the plan year, the 
     amendments made by this section shall apply to plan years 
     beginning after December 31, 2007.

     SEC. 204. LOOKBACK FOR CREDIT BALANCE RULE FOR PLANS 
                   MAINTAINED BY CHARITIES.

       (a) Amendment to Erisa.--Paragraph (3) of section 303(f) of 
     the Employee Retirement Income Security Act of 1974 is 
     amended by adding the following at the end thereof:
       ``(D) Special rule for certain years of plans maintained by 
     charities.--
       ``(i) In general.--For purposes of applying subparagraph 
     (C) for plan years beginning after August 31, 2009, and 
     before September 1, 2011, the ratio determined under such 
     subparagraph for the preceding plan year shall be the greater 
     of--

       ``(I) such ratio, as determined without regard to this 
     subparagraph, or
       ``(II) the ratio for such plan for the plan year beginning 
     after August 31, 2007, and before September 1, 2008, as 
     determined under rules prescribed by the Secretary of the 
     Treasury.

       ``(ii) Special rule.--In the case of a plan for which the 
     valuation date is not the first day of the plan year--

       ``(I) clause (i) shall apply to plan years beginning after 
     December 31, 2008, and before January 1, 2011, and
       ``(II) clause (i)(II) shall apply based on the last plan 
     year beginning before September 1, 2007, as determined under 
     rules prescribed by the Secretary of the Treasury.

       ``(iii) Limitation to charities.--This subparagraph shall 
     not apply to any plan unless such plan is maintained 
     exclusively by one or more organizations described in section 
     501(c)(3) of the Internal Revenue Code of 1986.''.
       (b) Amendment to Internal Revenue Code of 1986.--Paragraph 
     (3) of section 430(f) of the Internal Revenue Code of 1986 is 
     amended by adding the following at the end thereof:
       ``(D) Special rule for certain years of plans maintained by 
     charities.--
       ``(i) In general.--For purposes of applying subparagraph 
     (C) for plan years beginning after August 31, 2009, and 
     before September 1, 2011, the ratio determined under such 
     subparagraph for the preceding plan year of a plan shall be 
     the greater of--

       ``(I) such ratio, as determined without regard to this 
     subsection, or
       ``(II) the ratio for such plan for the plan year beginning 
     after August 31, 2007 and before September 1, 2008, as 
     determined under rules prescribed by the Secretary.

       ``(ii) Special rule.--In the case of a plan for which the 
     valuation date is not the first day of the plan year--

       ``(I) clause (i) shall apply to plan years beginning after 
     December 31, 2007, and before January 1, 2010, and
       ``(II) clause (i)(II) shall apply based on the last plan 
     year beginning before September 1, 2007, as determined under 
     rules prescribed by the Secretary.

       ``(iii) Limitation to charities.--This subparagraph shall 
     not apply to any plan unless such plan is maintained 
     exclusively by one or more organizations described in section 
     501(c)(3).''.
       (c) Effective Date.--
       (1) In general.--Except as provided in paragraph (2), the 
     amendments made by this section shall apply to plan years 
     beginning after August 31, 2009.
       (2) Special rule.--In the case of a plan for which the 
     valuation date is not the first day of the plan year, the 
     amendments made by this section shall apply to plan years 
     beginning after December 31, 2008.

                    Subtitle B--Multiemployer Plans

     SEC. 211. ADJUSTMENTS TO FUNDING STANDARD ACCOUNT RULES.

       (a) Adjustments.--
       (1) Amendment to erisa.--Section 304(b) of the Employee 
     Retirement Income Security Act of 1974 (29 U.S.C. 1084(b)) is 
     amended by adding at the end the following new paragraph:
       ``(8) Special relief rules.--Notwithstanding any other 
     provision of this subsection--
       ``(A) Amortization of net investment losses.--
       ``(i) In general.--A multiemployer plan with respect to 
     which the solvency test under subparagraph (C) is met may 
     treat the portion of any experience loss or gain attributable 
     to net investment losses incurred in either or both of the 
     first two plan years ending after August 31, 2008, as an item 
     separate from other experience losses, to be amortized in 
     equal annual installments (until fully amortized) over the 
     period --

       ``(I) beginning with the plan year in which such portion is 
     first recognized in the actuarial value of assets, and
       ``(II) ending with the last plan year in the 30-plan year 
     period beginning with the plan year in which such net 
     investment loss was incurred.

       ``(ii) Coordination with extensions.--If this subparagraph 
     applies for any plan year--

       ``(I) no extension of the amortization period under clause 
     (i) shall be allowed under subsection (d), and
       ``(II) if an extension was granted under subsection (d) for 
     any plan year before the election to have this subparagraph 
     apply to the plan year, such extension shall not result in 
     such amortization period exceeding 30 years.

       ``(iii) Net investment losses.--For purposes of this 
     subparagraph--

       ``(I) In general.--Net investment losses shall be 
     determined in the manner prescribed by the Secretary of the 
     Treasury on the basis of the difference between actual and 
     expected returns (including any difference attributable to 
     any criminally fraudulent investment arrangement).
       ``(II) Criminally fraudulent investment arrangements.--The 
     determination as to whether an arrangement is a criminally 
     fraudulent investment arrangement shall be made under rules 
     substantially similar to the rules prescribed by the 
     Secretary of the Treasury for purposes of section 165 of the 
     Internal Revenue Code of 1986.

       ``(B) Expanded smoothing period.--
       ``(i) In general.--A multiemployer plan with respect to 
     which the solvency test under subparagraph (C) is met may 
     change its asset valuation method in a manner which--

       ``(I) spreads the difference between expected and actual 
     returns for either or both of the first 2 plan years ending 
     after August 31, 2008, over a period of not more than 10 
     years,
       ``(II) provides that for either or both of the first 2 plan 
     years beginning after August 31, 2008, the value of plan 
     assets at any time shall not be less than 80 percent or 
     greater than 130 percent of the fair market value of such 
     assets at such time, or
       ``(III) makes both changes described in subclauses (I) and 
     (II) to such method.

       ``(ii) Asset valuation methods.--If this subparagraph 
     applies for any plan year--

       ``(I) the Secretary of the Treasury shall not treat the 
     asset valuation method of the plan as unreasonable solely 
     because of the changes in such method described in clause 
     (i), and
       ``(II) such changes shall be deemed approved by such 
     Secretary under section 302(d)(1) and section 412(d)(1) of 
     such Code.

       ``(iii) Amortization of reduction in unfunded accrued 
     liability.--If this subparagraph and subparagraph (A) both 
     apply for any plan year, the plan shall treat any reduction 
     in unfunded accrued liability resulting from the application 
     of this subparagraph as a separate experience amortization 
     base, to be amortized in equal annual installments (until 
     fully amortized) over a period of 30 plan years rather than 
     the period such liability would otherwise be amortized over.
       ``(C) Solvency test.--The solvency test under this 
     paragraph is met only if the plan actuary certifies that the 
     plan is projected to have sufficient assets to timely pay 
     expected benefits and anticipated expenditures over the 
     amortization period, taking into account the changes in the 
     funding standard account under this paragraph.
       ``(D) Restriction on benefit increases.--If subparagraph 
     (A) or (B) apply to a multiemployer plan for any plan year, 
     then, in addition to any other applicable restrictions on 
     benefit increases, a plan amendment increasing benefits may 
     not go into effect during either of the 2 plan years 
     immediately following such plan year unless--

[[Page 11718]]

       ``(i) the plan actuary certifies that--

       ``(I) any such increase is paid for out of additional 
     contributions not allocated to the plan immediately before 
     the application of this paragraph to the plan, and
       ``(II) the plan's funded percentage and projected credit 
     balances for such 2 plan years are reasonably expected to be 
     at least as high as such percentage and balances would have 
     been if the benefit increase had not been adopted, or

       ``(ii) the amendment is required as a condition of 
     qualification under part I of subchapter D of chapter 1 of 
     the Internal Revenue Code of 1986 or to comply with other 
     applicable law.
       ``(E) Reporting.--A plan sponsor of a plan to which this 
     paragraph applies shall--
       ``(i) give notice of such application to participants and 
     beneficiaries of the plan, and
       ``(ii) inform the Pension Benefit Guaranty Corporation of 
     such application in such form and manner as the Director of 
     the Pension Benefit Guaranty Corporation may prescribe.''.
       (2) Amendment to internal revenue code of 1986.--Section 
     431(b) is amended by adding at the end the following new 
     paragraph:
       ``(8) Special relief rules.--Notwithstanding any other 
     provision of this subsection--
       ``(A) Amortization of net investment losses.--
       ``(i) In general.--A multiemployer plan with respect to 
     which the solvency test under subparagraph (C) is met may 
     treat the portion of any experience loss or gain attributable 
     to net investment losses incurred in either or both of the 
     first two plan years ending after August 31, 2008, as an item 
     separate from other experience losses, to be amortized in 
     equal annual installments (until fully amortized) over the 
     period --

       ``(I) beginning with the plan year in which such portion is 
     first recognized in the actuarial value of assets, and
       ``(II) ending with the last plan year in the 30-plan year 
     period beginning with the plan year in which such net 
     investment loss was incurred.

       ``(ii) Coordination with extensions.--If this subparagraph 
     applies for any plan year--

       ``(I) no extension of the amortization period under clause 
     (i) shall be allowed under subsection (d), and
       ``(II) if an extension was granted under subsection (d) for 
     any plan year before the election to have this subparagraph 
     apply to the plan year, such extension shall not result in 
     such amortization period exceeding 30 years.

       ``(iii) Net investment losses.--For purposes of this 
     subparagraph--

       ``(I) In general.--Net investment losses shall be 
     determined in the manner prescribed by the Secretary on the 
     basis of the difference between actual and expected returns 
     (including any difference attributable to any criminally 
     fraudulent investment arrangement).
       ``(II) Criminally fraudulent investment arrangements.--The 
     determination as to whether an arrangement is a criminally 
     fraudulent investment arrangement shall be made under rules 
     substantially similar to the rules prescribed by the 
     Secretary for purposes of section 165.

       ``(B) Expanded smoothing period.--
       ``(i) In general.--A multiemployer plan with respect to 
     which the solvency test under subparagraph (C) is met may 
     change its asset valuation method in a manner which--

       ``(I) spreads the difference between expected and actual 
     returns for either or both of the first 2 plan years ending 
     after August 31, 2008, over a period of not more than 10 
     years,
       ``(II) provides that for either or both of the first 2 plan 
     years beginning after August 31, 2008, the value of plan 
     assets at any time shall not be less than 80 percent or 
     greater than 130 percent of the fair market value of such 
     assets at such time, or
       ``(III) makes both changes described in subclauses (I) and 
     (II) to such method.

       ``(ii) Asset valuation methods.--If this subparagraph 
     applies for any plan year--

       ``(I) the Secretary shall not treat the asset valuation 
     method of the plan as unreasonable solely because of the 
     changes in such method described in clause (i), and
       ``(II) such changes shall be deemed approved by the 
     Secretary under section 302(d)(1) of the Employee Retirement 
     Income Security Act of 1974 and section 412(d)(1).

       ``(iii) Amortization of reduction in unfunded accrued 
     liability.--If this subparagraph and subparagraph (A) both 
     apply for any plan year, the plan shall treat any reduction 
     in unfunded accrued liability resulting from the application 
     of this subparagraph as a separate experience amortization 
     base, to be amortized in equal annual installments (until 
     fully amortized) over a period of 30 plan years rather than 
     the period such liability would otherwise be amortized over.
       ``(C) Solvency test.--The solvency test under this 
     paragraph is met only if the plan actuary certifies that the 
     plan is projected to have sufficient assets to timely pay 
     expected benefits and anticipated expenditures over the 
     amortization period, taking into account the changes in the 
     funding standard account under this paragraph.
       ``(D) Restriction on benefit increases.--If subparagraph 
     (A) or (B) apply to a multiemployer plan for any plan year, 
     then, in addition to any other applicable restrictions on 
     benefit increases, a plan amendment increasing benefits may 
     not go into effect during either of the 2 plan years 
     immediately following such plan year unless--
       ``(i) the plan actuary certifies that--

       ``(I) any such increase is paid for out of additional 
     contributions not allocated to the plan immediately before 
     the application of this paragraph to the plan, and
       ``(II) the plan's funded percentage and projected credit 
     balances for such 2 plan years are reasonably expected to be 
     at least as high as such percentage and balances would have 
     been if the benefit increase had not been adopted, or

       ``(ii) the amendment is required as a condition of 
     qualification under part I of subchapter D or to comply with 
     other applicable law.
       ``(E) Reporting.--A plan sponsor of a plan to which this 
     paragraph applies shall--
       ``(i) give notice of such application to participants and 
     beneficiaries of the plan, and
       ``(ii) inform the Pension Benefit Guaranty Corporation of 
     such application in such form and manner as the Director of 
     the Pension Benefit Guaranty Corporation may prescribe.''.
       (b) Effective Dates.--
       (1) In general.--The amendments made by this section shall 
     take effect as of the first day of the first plan year ending 
     after August 31, 2008, except that any election a plan makes 
     pursuant to this section that affects the plan's funding 
     standard account for the first plan year beginning after 
     August 31, 2008, shall be disregarded for purposes of 
     applying the provisions of section 305 of the Employee 
     Retirement Income Security Act of 1974 and section 432 of the 
     Internal Revenue Code of 1986 to such plan year.
       (2) Restrictions on benefit increases.--Notwithstanding 
     paragraph (1), the restrictions on plan amendments increasing 
     benefits in sections 304(b)(8)(D) of such Act and 
     431(b)(8)(D) of such Code, as added by this section, shall 
     take effect on the date of enactment of this Act.

                    TITLE III--BUDGETARY PROVISIONS

     SEC. 301. BUDGETARY PROVISIONS.

       The budgetary effects of this Act, for the purpose of 
     complying with the Statutory Pay-As-You-Go-Act of 2010, shall 
     be determined by reference to the latest statement titled 
     ``Budgetary Effects of PAYGO Legislation'' for this Act, 
     submitted for printing in the Congressional Record by the 
     Chairman of the Senate Budget Committee, provided that such 
     statement has been submitted prior to the vote on passage.
       Amend the title so as to read: ``An Act to provide a 
     physician payment update, to provide pension funding relief, 
     and for other purposes.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Michigan (Mr. Levin) and the gentleman from California (Mr. Herger) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Michigan.
  Mr. LEVIN. Mr. Speaker, I ask unanimous consent that 10 minutes of my 
time be controlled by the gentleman from California (Mr. Waxman), the 
chairman of the Energy and Commerce Committee, on the Senate amendments 
to H.R. 3962.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Michigan?
  There was no objection.
  Mr. LEVIN. Mr. Speaker, I yield myself such time as I shall use.
  This is a flawed bill that we are now considering. We are forced to 
consider it because of the Republican filibuster of action on the jobs 
and tax bill now pending in the other body. This bill does not 
adequately address the need for a longer-term solution to avoid the 
disastrous cut in Medicare physician reimbursement that is currently 
impacting doctors and, most importantly, seniors and military 
servicemembers.
  Republicans in the other body have been stonewalling the basic bill, 
the jobs bill, week after week after week. Doing so, they have placed a 
hammerlock on the lives of millions of Americans. A much better course 
would be for Republicans in the other body to begin to side with the 
American people instead of stonewalling against them, and not with 
their party leaders nor the Tea Party, and allow a straight up-or-down 
vote on the comprehensive jobs bill pending in the other body.
  Instead, they are willing to put politics before people, and they are 
leaving millions of unemployed workers thrown out of work by this 
recession through no fault of their own without their unemployment 
insurance benefits. Instead, they seem willing to let loopholes that 
permit jobs to be shipped overseas continue to remain open. 
Republicans, in a word, are saying to the American people that they 
care more about their political futures than they do the daily lives of 
millions and millions of Americans.
  We will not let that stand. We will continue to stand on the side of 
seniors and the physicians who treat them, on the side of unemployed 
workers and their families, on the side of millions who are looking for 
jobs, on the side of youth seeking employment, and on the side of those 
who would benefit from

[[Page 11719]]

tax measures and bond measures that are supporting millions of jobs.
  I reserve the balance of my time.
  Mr. HERGER. Mr. Speaker, I yield myself such time as I may consume.
  For the fourth time in 6 months, Democrats' inability to properly 
manage the Medicare program is causing doctors to confront a 21 percent 
cut in their Medicare reimbursement rates. In fact, this cut went into 
effect on June 1, forcing Medicare to pay claims for physicians' 
services with the 21 percent cut. In practical terms, this means that 
for a standard office visit, physicians are now being paid $8 less than 
they received in 2007. This is unacceptable and irresponsible.
  As a result of the Democrats' failure to address this issue in a 
timely manner, tens of millions of taxpayer dollars will be required to 
reprocess these claims and send new checks to doctors, all because the 
majority Democrats could not finish their work on time.
  Physicians' practices, like most small businesses, are hurt by the 
dereliction of duty. Dr. Joel Bolen from Montgomery, Alabama, said 
about the delayed payments, quote, ``We have already eliminated one 
staff position, and that has resulted in a major reduction in some 
services.'' Dr. Jen Brull from Plainville, Kansas, had to juggle a 
$10,000 temporary drop in revenue while claims were held up when 
payments were delayed for 15 days in April of this year, a major stress 
on a small practice.
  Senior citizens have been hurt as well. Earlier this week, one of my 
constituents visited my office in Redding, California, to share his 
story. His doctor is not accepting any more Medicare patients until 
Congress deals with the 21 percent cut. As a result, he has been forced 
to postpone an essential surgery.
  The new president of the American Medical Association, Dr. Cecil 
Wilson, said, ``This is no way to run a major health coverage program. 
Already the instability caused by repeated short-term delays is taking 
its toll.'' The newspaper Politico declared that ``never before has 
Congress allowed such a deep Medicare cut to go into effect at this 
scale.''
  The legislation before us provides physicians with a 6-month reprieve 
of the 21 percent cut by providing them a 2.2 percent rate increase 
through November. But after November, the 21 percent cut returns. And 1 
month after that, the cut goes even deeper, totaling 26 percent in 
January. Perhaps my friends on the other side of the aisle believe this 
will be someone else's problem in December.
  Mr. Speaker, ironically, the bill before us today uses the same bill 
number as the Democrats' health bill that passed the House in November 
of last year. It's ironic, because Republicans argued for months that 
the Democrats should address the flawed Medicare physician payment 
formula in their health care overhaul. After all, if they could find 
more than one-half trillion dollars in cuts to Medicare, you would 
think they could find a couple dollars to fix the SGR; except, they 
didn't, allowing them to shield the true cost of their trillion-dollar 
government takeover of health care. It's one of the many reasons we 
should replace that flawed law with reform Americans can afford, and 
then we can address a true long-term fix for our doctors.
  Mr. Speaker, I reserve the balance of my time.
  Mr. WAXMAN. Mr. Speaker, I rise in support of this suspension, and I 
yield myself such time as I may consume.
  After all is said and done, no one can say this is a great bill. It's 
a disappointment. It's an embarrassment that we are here today to ask 
for only 5 months' extension for the doctors who take care of our 
Medicare patients to be paid for the work that they are doing. But it 
has come to this.
  Because of the dysfunctional rules in the United States Senate, they 
could not get a bill for jobs passed. They could not get FMAP to assist 
the States for their Medicaid payment. They couldn't get extension of 
unemployment insurance. People are losing their unemployment insurance, 
or if they lose their jobs, they won't have it available to them.
  What we have before us is one little piece. It is at least for 5 
months to extend the physician fee reimbursement. I can't say that we 
should be proud of this. This should have been fixed permanently. And 
this is the best we can do, so let's vote ``aye.''
  I reserve the balance of my time and urge my colleagues to support 
the suspension.
  Mr. HERGER. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Florida (Ms. Ginny Brown-Waite).

                              {time}  1650

  Ms. GINNY BROWN-WAITE of Florida. I thank the gentleman for yielding.
  Mr. Speaker, I rise today in support of the Preservation of Access to 
Care for Medicare Beneficiaries and Pension Relief Act that we have 
before us.
  For too long my Democrat colleagues have been playing games with the 
physician reimbursement fix. Playing chicken with the deadline time and 
time and time again and putting Medicare beneficiaries at risk while 
hurting small businesses across the country.
  I've the highest number of constituents on Medicare of any Member of 
Congress. Believe me, I have heard from them loud and clear that they 
are disgusted with how long it took because their doctors are indeed 
refusing to take patients.
  Whether it's the handling of the oil spill or their inability to put 
together a budget, it seems that even the basic responsibilities of 
running the government have become far too difficult for them. I'm glad 
to see this bill finally come before the House today, but I would 
remind all of our constituents that this could have been prevented. 
Months ago, my Republican colleagues and I offered and voted for a 
longer fix that would have been fully paid for.
  Americans are tired of the credit card mentality of Washington. This 
is a voting card, ladies and gentlemen. It is not a credit card.
  Mr. LEVIN. I yield 1 minute to the gentlewoman from Nevada (Ms. 
Berkley), a distinguished member of the Ways and Means Committee.
  Ms. BERKLEY. Thank you, Mr. Chairman, for your extraordinary work.
  Every day I receive calls from dedicated physicians who tell me that 
if this 21 percent cut goes through they are no longer going to be able 
to continue to treat their Medicare patients. They're not threatening 
me when they say it. They're talking the truth. They simply can no 
longer afford to treat their senior patients.
  Doctors are small business people. They've got payrolls to make and 
rent to pay, utilities, just like the rest of us; but time is long past 
due to permanently fix the way doctors in this country get compensated 
for treating Medicare patients. We need to fix this SGR. We need to fix 
it permanently.
  We're playing a very dangerous political game with our seniors' 
health care, and we are forcing doctors to make unspeakable choices. I 
am supporting this 6-month fix to keep the doctors working and to give 
seniors the health care that they deserve and that they are entitled 
to, but I would urge my Republican colleagues in the Senate that they 
should do what's right by the American people and let's get this thing 
permanently fixed.
  Mr. HERGER. I yield 1 minute to the gentleman from Tennessee (Mr. 
Roe), who is also a physician.
  Mr. ROE of Tennessee. I thank the gentleman for yielding.
  Why was this so hard? House Republicans have been saying for months 
that we'd be happy to support legislation ensuring seniors have access 
to doctors. They were warned to cut spending to stop the deficits from 
going any higher. Doctors and patients both are benefiting under this 
legislation, but today's headline should be this: bipartisan solutions 
are possible when the majority tries to meet the minority halfway.
  When we cut spending, we can address many of the critical problems 
facing our country. Hopefully, today's bill isn't the end of bipartisan 
cooperation. Our economy is still in dire straits, and Republicans can 
help Democrats get people back to work only if the majority lets us. 
Otherwise,

[[Page 11720]]

the job loss and exploding deficits we've seen for the past 18 months 
will only continue, and no one benefits from that.
  I can tell you as a physician three things will happen with these 
cuts: one, patients lose access to doctors; two, the quality of their 
care goes down; and, three, their costs will go up.
  I urge my colleagues to support this legislation.
  Mr. WAXMAN. Mr. Speaker, I yield 2 minutes to the gentleman from New 
Jersey (Mr. Pallone), distinguished chairman of the Health Subcommittee 
of Energy and Commerce.
  Mr. PALLONE. Thank you, Mr. Waxman.
  I'm listening to the debate on the other side of the aisle, and I 
just can't believe what I hear. We passed, the House Democrats, the 
majority, passed a comprehensive permanent fix to the SGR, and we only 
had one Republican vote on the other side.
  I heard the gentleman from California say it's not someone else's 
problem. That's true. It's also the Republican problem. You have a 
responsibility as Republicans to help us out, and you're not helping us 
out at all. When this jobs bill that included the SGR, and that was a 
2-year fix, passed a couple of weeks ago here in the House, we had just 
a handful of Republican votes; and that's what it's been all along, 
Republicans not willing to do anything for any kind of permanent fix 
for this SGR for the physicians' reimbursement rate or not voting for 2 
years. Now, we're down to 6 months because that's all we have left.
  And I don't like it anymore than anybody else, but I'm going to vote 
for it today; and I hope that all of you will join us in voting for it. 
When you talk about the fact we have a problem here, the problem is 
you're not willing to help us out.
  I heard the gentleman from Tennessee who is a physician say, well, 
it's got to be paid for. Well, where are the cuts that he's proposing 
to pay for it? In other social programs and other jobs? That's the 
problem here. We had a comprehensive jobs package that included this 
SGR. It would have had a summer jobs program. It had a lot of things to 
put Americans back to work, bring jobs back from overseas, tax cuts, 
and changes in the Tax Code that would have made a difference.
  But we don't get any Republican support. We don't get anything. All 
you do is sit there and say that you want to solve this problem, but 
don't put up any votes or come up with any solutions whatsoever. So 
we're forced today to deal with this and we're going to vote for it, 
but if I keep hearing more and more about permanent fix, there's no 
support on the other side of the aisle for permanent fix. Don't kid 
those doctors and make them believe that you're going to vote for some 
kind of permanent fix. You never have. I don't see it.
  I remember when you were in the majority and we kept kicking the can 
down the road. We inherited this mess from all of you. So don't sit 
here and talk about what you're going to do to make a difference. 
You're not helping at all. You're not solving the problem. You're part 
of the problem, not part of the solution.
  Mr. HERGER. Just in response, we as Republicans last November had a 
4-year fix that was paid for, and I might mention that the legislation 
that the gentleman was referring to that we opposed had a $200 billion 
deficit on it, and that's why we opposed it.
  Mr. Speaker, while I intend to support this bill and urge its 
passage, our work does not end here. We must find a long-term, stable 
and fiscally responsible solution to this problem.
  I yield the balance of my time to the gentleman from Illinois (Mr. 
Shimkus).
  The SPEAKER pro tempore. Without objection, the gentleman from 
Illinois will control the time.
  There was no objection.
  Mr. SHIMKUS. I yield such time as he may consume to the gentleman 
from Texas, Dr. Burgess.
  Mr. BURGESS. I thank the gentleman for yielding.
  Just as a historical note, I think I should point out when it comes 
to this issue, there's actually plenty of blame to go around because 
after all it was in 1988 when a Democratic Congress, voting under the 
Omnibus Budget Reconciliation Act of 1988, created this problem under 
the guise of the RVRBS, and it's gone through several names and several 
acronyms since then. But that's when it began.
  It was really a very predictable consequence of Congress' 
interference in the practice of medicine. Since 1988, there have been 
multiple Congresses; there have been multiple administrations, both 
Republican and Democratic. The opportunity to fix this thing has been 
there, but it has not been taken.
  Patching the payment system is extremely unsatisfactory, but the 
alternative is absolutely unthinkable. Let me tell you this for a 
minute what it means in a one- or two-doctor office practicing primary 
care when the head of CMS holds your paycheck for 1 week, 2 weeks, now 
3 weeks. Even if you're doing as little as 15 percent Medicare in your 
business, that cash flow that's disrupted across the counter means that 
that doctor's office is likely not going to be able to take a paycheck 
that month; and what's even worse, they may have to go out and borrow 
money for operational expenses.
  I know that never troubles this Congress to borrow money for 
operational expenses--we do it all the time--but when you're a small 
businessperson and you're borrowing for operational expenses, it's 
extremely frightening because you don't know when you're going to be 
able to make that up.
  Now, we have a bill that's retroactive to the first of the month so 
those checks will be reissued, and that's a good thing. Unfortunately, 
the expiration date on this bill is November 30. As was pointed out 
previously by the ranking member on the Ways and Means Health 
Subcommittee on December 31 of this year a 26 percent reduction occurs.
  What happens in early November of this year is that every private 
insurance company that pegs its reimbursement to Medicare is going to 
recalculate its reimbursement based on that 26 percent if we don't do 
something before then.

                              {time}  1700

  Let us commit, with this window of opportunity that we have given 
ourselves between now and November 30, that we are going to work on 
this problem.
  I've had a bill up there some time, H.R. 3693. Yes, it's problematic 
because of the cost, but it's not a real cost because we've already 
dispensed that money to the doctors; the doctors have already used that 
to run their practices. This is ``Bernie Madoff'' accounting that 
should make any one of us in this body ashamed to continue it.
  Let's recommit to fixing this problem. Let's redouble our efforts. 
Let's leave aside the partisanship. I will remind some of the speakers 
on the other side, I have voted with you on this issue in the past. I 
didn't like the policy you put forward. I thought it was very bad 
policy at the time, but it was worth it to me to get this issue solved 
because our Nation's seniors, our patients, our doctors depend upon 
this.
  Mr. LEVIN. Mr. Speaker, I yield myself 15 seconds.
  The gentleman acknowledges he voted for a permanent fix. He was the 
only one on the Republican side. There was nobody else. You have 
refused, on the Republican side, to vote for a permanent fix.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. LEVIN. I yield myself another 15 seconds.
  Instead, we're stuck with this bill because we could not get a single 
vote for a bill that is better than this in the Senate from a 
Republican. That's why we're here today.
  I now yield 1 minute to the gentleman from Georgia (Mr. Scott).
  Mr. SCOTT of Georgia. We have a unique opportunity today. I've heard 
from the other side, the Republicans, who are saying that they want to 
have a permanent fix. We on the Democratic side have shown that by 
pushing forward, we had a $68 billion bill that went over to the Senate 
that would do that.

[[Page 11721]]

  Now, ladies and gentlemen, people all across this Nation are paining, 
they are crying to see this House of Representatives work in a 
bipartisan way, and there is no more critical or important issue to 
show that than on this issue.
  The future of our health care system rests on the ability to be able 
to have our physicians to be able to receive payment for their 
services. I've talked to physicians--I talked to a group of them 
today--and many of them not only are refusing to serve Medicare 
patients now, but they're losing hope in the health care system.
  We've just passed a new health care bill. It's going to bring 37 
million more people on, many of them are going to be senior citizens. 
We're growing more senior citizens. Let's be fair to our physicians. 
Let's save our health care system. And let us come together as 
Democrats and Republicans this day and come back and get a permanent 
fix on this issue.
  Mr. SHIMKUS. Mr. Speaker, I reserve the balance of my time.
  Mr. WAXMAN. Mr. Speaker, I am pleased at this time to yield 1 minute 
to the chairman emeritus of the Energy and Commerce Committee, the 
gentleman from Michigan (Mr. Dingell).
  Mr. DINGELL. Mr. Speaker, we have before us a wonderful opportunity; 
we can begin to solve a problem that's going to destroy our medical 
care system in this country.
  Doctors are abandoning Medicare patients because they can no longer 
afford to serve them. And it is turning out that we are now finding 
that we are losing the capability of addressing one of the greatest 
health problems we've got, and that is seeing to it that physicians do 
take care of our people and that they have the necessary resources to 
do it.
  This is a proposal which has to be adopted today. I commend the 
gentleman from Texas who has urged the House to work together, and I 
commend him for having had the courage to say so, but it is something 
that we must do.
  We came close to having this issue solved with a permanent fix. The 
law of interest, compounded interest, tells us that we have a big 
problem. The numbers in this have grown to $210 billion, and they will 
grow more. It is time that the House resolves this question so we can 
assure that we take care of our people, we deal with their health, we 
preserve Medicare, and we do what is necessary to carry out our 
responsibility in a fiscally responsible way.
  We are, in good part, in this mess because of the United States 
Senate, which diligently disregards its responsibilities on all matters 
of this kind. And regrettably, as we look to see, we find that this is 
the best thing that we can do because they refuse to do better. They 
will tell us that because of their incompetence, we must therefore bow 
to them and do things the way they only can do them.
  I urge my colleagues to vote for this legislation. And then let us 
prepare to work together to try and resolve this matter because the 
time is wasting and the whole system is about to collapse because of 
our failure to properly address it.
  Mr. SHIMKUS. Mr. Speaker, I continue to reserve the balance of my 
time.
  Mr. LEVIN. Mr. Speaker, I yield 1 minute to the gentleman from New 
York (Mr. Maffei).
  Mr. MAFFEI. Mr. Speaker, many of the doctors in my Upstate New York 
district have started to turn away new Medicare patients because of the 
21 percent cut that has already started, and seniors are fearful that 
their physicians may soon drop out of Medicare altogether. Those 
doctors who still accept seniors have taken huge risks with their 
practice. At a time when we should be promoting improved access to 
physicians, a doctor payment cut of this magnitude will only decrease 
access, especially for our seniors, and sometimes with tragic results.
  Seniors and their doctors should not pay the price for partisan 
politics. They should have the peace of mind to know that the doctor of 
their choice will be available to see them. And physicians should know 
that the work they perform will be reimbursed fairly, without having to 
worry about cuts month after month.
  Now, Mr. Speaker, while it is clear that the Medicare payment system 
is broken and needs to be fixed permanently, there is an urgent need to 
provide an immediate and temporary solution. If you cannot cure the 
patient, at least find a treatment. If you cannot administer a long-
term treatment, at least stop the bleeding.
  Mr. Speaker, this band-aid is just that. It stops the bleeding 
temporarily. But lives and livelihoods are hanging in the balance. We 
have made a commitment to provide for our seniors, and I will stand 
with our seniors and our physicians.
  Mr. SHIMKUS. I continue to reserve the balance of my time.
  Mr. WAXMAN. Mr. Speaker, I am pleased to yield 1 minute to a very 
important member of our committee, the gentleman from Texas (Mr. Gene 
Green).
  Mr. GENE GREEN of Texas. I thank the chair of the full Energy and 
Commerce Committee for yielding.
  To my Republican colleagues, we make history on the floor of the 
House, and we did when we passed the health care bill, but you can't 
rewrite it. The House passed a bill, H.R. 3961, that only had one 
Member from the Republican Party who voted for that bill that was the 
permanent fix for this doctor situation so that our doctors wouldn't be 
cut 21 percent as of last week. One vote, and it was my colleague from 
Texas, Dr. Burgess. That's why this is so important today.
  We wish we could pass a better bill and a long-term fix, but we can't 
get it through the United States Senate; so we're going to November. 
You had a chance to step up and do it, but you didn't do it. We passed 
that bill with only one Republican vote.
  This legislation is so important because Medicare is so important. 
Our seniors need to be able to go to a doctor, and yet we're seeing 
doctors say they can't afford to treat them anymore because we didn't 
do the permanent fix. That's why this bill is so important today, to 
get us through November. Hopefully we will be able to then do a 
permanent fix so doctors will be able to see our senior citizens.
  Mr. Speaker, I rise today in support of Preservation of Access to 
Care for Medicare Beneficiaries and Pension Relief Act.
  This legislation will prevent a 21-percent cut in Medicare physician 
payment reimbursements through November 30, and makes the so-called doc 
fix retroactive to June 1, when a previous stop gap measure expired.
  While Congress enacted stop-gap measures for rate cuts scheduled for 
several months, yesterday CMS began mailing reimbursement checks to 
physicians who accept Medicare with the 21-percent reduction in their 
reimbursement.
  This legislation before us today is another temporary fix and amends 
the legislation we sent to the Senate, which would be a permanent fix 
to the Medicare physician payment system, but we need to ensure that 
our seniors will continue to have access to their physicians and 
doctors will continue to accept Medicare.
  It is clear that this current physician payment system contains some 
inherent flaws that must be addressed to ensure the long term viability 
of Medicare and access to beneficiaries.
  My hometown of Houston contains some of the world's best medical 
facilities, where the scope of care is unmatched.
  Yet, I meet physicians working in every medical specialty who say 
that this current Medicare physician payment system threatens our 
Medicare beneficiaries' access to the health care that they provide.
  I support the legislation today to ensure our physicians will not 
receive a 21-percent cut in their Medicare reimbursement rates, but in 
November we will need to revisit this issue and enact a permanent fix 
to the physician payment system.
  Mr. SHIMKUS. I continue to reserve the balance of my time.
  Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.
  Mr. WAXMAN. Mr. Speaker, I am pleased to yield 1 minute to the 
gentlewoman from the Virgin Islands (Mrs. Christensen).
  Mrs. CHRISTENSEN. Thank you for yielding, Mr. Chairman.
  Mr. Speaker, this is not what we should be doing. What is needed is a

[[Page 11722]]

permanent fix for the SGR. But I do urge my colleagues to vote for at 
least a short-term measure that would stop the 21 percent cut in 
physician reimbursement.
  As a family physician who had a practice that was at least one-third 
Medicare patients, I know how low the reimbursement is for the 
important work we do after long years of training. That cut and the one 
slated to follow would have cause many physicians to close their doors 
to some of the individuals who need it most. Even when I was in 
practice over 14 years ago, the fees were so low that I was one of a 
handful of doctors who saw Medicare patients. It has only gotten worse 
since then.
  And it is not that doctors don't want to take care of the elderly and 
disabled patients, it is what we went into the profession to do; but to 
be able to do that, we have to be able to meet our overhead, pay staff, 
purchase supplies, and take care of our families. The 2.2 percent 
increase is a start, but doctors need certainty and stability.

                              {time}  1710

  The other body and our colleagues on the other side of the aisle need 
to step up and support what Democrats tried to do during health care 
reform. We need to help doctors provide the care that they want to 
provide to our seniors. Let us fix the SGR once and for all, even if we 
have to do it as part of a supplemental. Ensuring the care of some of 
our most vulnerable is that important and that urgent.
  Mr. SHIMKUS. Mr. Speaker, I continue to reserve the balance of my 
time.


                             General Leave

  Mr. LEVIN. Mr. Speaker, I ask unanimous consent that all Members have 
5 legislative days in which to revise and extend their remarks and to 
include extraneous material on the Senate amendments to H.R. 3962.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Michigan?
  There was no objection.
  Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.
  Mr. WAXMAN. Mr. Speaker, I am pleased at this time to yield 1 minute 
to another important member of our committee, the gentleman from Texas 
(Mr. Gonzalez).
  Mr. GONZALEZ. Mr. Speaker, I rise in favor of this piece of 
legislation. As we only have about a minute, my observation, after 
listening to all of my colleagues and to my dear friends, is thank God 
physicians don't practice medicine the way we practice enacting 
legislation.
  Can you imagine if you were wheeled into the emergency room? You'd 
have five qualified physicians, and they'd all start arguing about, 
``How are we going to save the life of this particular patient?'' They 
don't come to any real conclusion. Some say, We need to do this 
immediately. Some of them say, We can wait 6 months. Others say, We can 
wait 2 years.
  It doesn't work. It doesn't work in that operating room, and it 
shouldn't work in this Chamber. We are all in agreement. We are all in 
agreement that it is broken, and now we have given the other side a 
chance to work with us.
  Last year, as it has already been pointed out, we had something that 
was for an extended period of time that was going to work on a solution 
which would give the doctors the kind of predictability they require in 
order to have practices where they can open their doors in the morning, 
but we only got one vote from the other side. You know, let's all put 
that aside today. Let's start working together. It's 6 months. It's not 
long enough. We acknowledge it. Let us just rededicate ourselves to 
making sure that doctors can practice medicine.
  Mr. SHIMKUS. Mr. Speaker, I continue to reserve the balance of my 
time.
  Mr. WAXMAN. Mr. Speaker, I am pleased at this time to yield 1 minute 
to the gentlewoman from Texas (Ms. Sheila Jackson Lee).
  Ms. JACKSON LEE of Texas. Mr. Speaker, I rise today to support the 
permanent fix for doctors. That's what we have been saying as Democrats 
for more than a year.
  I want to thank the leadership, who has taken the calls of Members 
who are representing their doctors and seniors and who are saying we 
have got to do this.
  So let me tell the doctors of America: Look at what your friends look 
like--Democrats, who have been fighting over and over again. I promised 
physicians in my area, the doctors who work in inner city 
neighborhoods, that we were not going to leave them without help.
  I hope the other body and my friends on the other side of the aisle, 
the Republicans, will really understand the facts. We have to join 
together. Doctors help save lives. They tend to our seniors. It is 
important that they have the reimbursement they need.
  We rise today to support the 6-month fix, but we rise today to say 
the Democrats have been fighting to get this right. We are going to get 
it right. We are going to provide for the physicians. We are going to 
stop this 21 percent cut, and we are going to provide doctors for 
Americans who are waiting for us to do our jobs.
  Support the legislation.
  Physicians, your friends are us.
  Mr. Speaker, I rise today in strong support of H.R. 3962, the 
``Preservation of Access to Care for Medicare Beneficiaries and Pension 
Relief Act of 2010,'' a provision that retroactively reverses the 21 
percent cut in Medicare payments to physicians scheduled for June 1, 
2010; and also provides a 2.2 percent status report to physician 
payments through November 30, 2010. This provision also protects 
TRICARE military families dedicated to the service of this nation.
  Mr. Speaker, I would like to pay special tribute to my good friend, 
Chairman Henry Waxman, for his lifetime of devoted service to the cause 
of affordable health care for all Americans. I also thank the 
Democratic leadership, led by Speaker Pelosi, making health care 
affordable for Medicare beneficiaries a central issue. Democrats 
promised to chart a new direction for America if given the chance to 
lead. Today, we take another giant step toward fulfilling that promise.
  For nearly a decade, Medicare patients and the doctors who treat them 
have been held hostage by short-term patches to an unworkable 
Sustainable Growth Rate (SGR) formula. In the months to come, I look 
forward to working with Members of Congress from both sides of the 
aisle to repeal the SGR formula and to replace it with a permanent 
physician payment system for Medicare that rewards value and ends the 
uncertainty for patients and providers alike. In addition, the bill 
provides enhanced Medicaid funding to states to assist them with the 
added costs of providing health coverage to underserved and 
underrepresented individuals and for home and community based services 
that must be extended.
  Under current law, all outpatient services provided within three days 
before an inpatient admission and are related to the inpatient 
admission must be included in the bundled payment for that admission. 
The provision closes a loophole that had allowed the unbundling of 
services and submission of adjustment claims seeking separate and 
additional Medicare payments. This provision provides temporary, 
targeted funding relief for single employer and multiemployer pension 
plans that suffered significant losses in asset value due to the steep 
market slide in 2008. Employers that elect the relief would be required 
to make additional contributions to the plan if they pay compensation 
to any employee in excess of $1 million, pay extraordinary dividends, 
or engage in extraordinary stock buybacks during the first part of the 
relief period. Additional relief is available to certain plans 
sponsored by charitable organizations.
  Mr. Speaker, this provision will provide much needed fiscal relief to 
the states and to unemployed individuals.
  Although this fix is for 6 months, I am committed to working with my 
colleagues to deliver a permanent fix for our nation's physicians, and 
I am committed to fight for critical job-creating measures, on behalf 
of all of the American people and to strengthen our economy, as well as 
such vital provisions as extending unemployment benefits for the 
millions who have lost their jobs through no fault of their own.
  We must uphold our responsibility to the seniors and persons with 
disabilities who depend upon the Medicare program and the military 
families who depend upon the TRICARE program. The 21 percent cut in 
fees that physicians are seeing now is jeopardizing the relationship 
between Medicare and TRICARE patients and their doctors, and we cannot

[[Page 11723]]

allow that to stand. This is a matter of whether seniors will have 
access to care or whether that access to care will be diminished 
because doctors will no longer be able to afford to continue to sustain 
their businesses with the cuts under the SGR for Medicare. That is why 
I support passage of this legislation. Over the months we struggled 
with Republicans over this issue.
  I continuously spoke to doctors in my district to say, I would not 
forget this important issue. I worked with the leadership, voted for a 
permanent fix and continued to call on the Senate to move this bill. 
Now we have a temporary fix of 6 months.
  However, I will work for a permanent fix with the Democratic 
leadership in spite of those of my Republican colleagues who oppose it. 
I believe in bipartisanship to help doctors and patients including 
seniors, get reimbursed and get the care they need.
  I support this legislation.
  Mr. SHIMKUS. Mr. Speaker, I reserve the balance of my time.
  Mr. WAXMAN. Mr. Speaker, I yield 1 minute to the gentleman from New 
Jersey (Mr. Andrews).
  Mr. ANDREWS. I thank my friend for yielding.
  Mr. Speaker, a lot of Americans seem to have been misled that they 
are not going to be able to see their doctors under Medicare anymore 
because of some legislation that came out of here. This bill today 
makes it emphatically clear that that is emphatically not true.
  The bill today restores the full reimbursement rate for doctors and 
for other providers who see America's senior citizens. The majority of 
us wanted to make that a permanent fix last summer. Only one minority 
Member voted for that. Just a few weeks ago, the majority of us wanted 
to extend that far beyond this. Almost no one on the minority side 
voted for that. Today, I assume just about everybody is going to vote 
for this, and I'm glad, but let the record be clear: No one here is 
prepared to see a day when Medicare doctors turn their patients away. 
That is not the truth.
  Mr. SHIMKUS. Mr. Speaker, I yield myself the balance of my time.
  I appreciate the comments. I was going to be cool, calm, and 
collected, of course, as I normally am on the committee, Mr. Chairman, 
as you know. But of course, I am required to respond to just a couple 
of points.
  I agree with my colleague who just spoke that we want to get this 
fixed and that we want to do it now, and I'm going to talk about the 
importance of paying for it. Though, the public has to understand that 
we are 39 seats in the minority. The only bipartisan vote was the 
``no'' vote on the health care bill. For the protestations that, from 
the Republicans, there was only one vote, the reality is you could do 
whatever you want, but the bipartisan vote was ``no'' against the 
health care bill.
  Why? $500 billion cuts in Medicare--and we talked about this 
yesterday in committee--not on Medicare Advantage but on hospital cuts, 
on doc cuts across the board, and on tax increases. $1 trillion in new 
spending.
  You'd think, if you're going to spend $1 trillion more, you could fix 
this. In fact, you all promised it, but because of the policy and the 
politics, you had to accept the Senate bill that really didn't do it. 
The promises you made to some doctor organization you could not keep. 
That is why we are here again.
  We know the CBO and we know the CMS actuary say premiums are going to 
go up and that benefits are going to be cut. Our health care system is 
going to change because we are going to migrate away from the employer-
based health care system. Some of us believe that was the intent of the 
law that you passed. So there is an important part of this debate:
  First of all, we have a $13.5 trillion debt. Now, I'm not going to 
lay that all on my colleagues' shoulders, because a lot of it is our 
fault. We get it. We were put in the minority because of our frivolous, 
reckless spending, but I think you'd better be very, very careful that 
you're going down that same path. A $13.5 trillion debt makes the 
argument to the public today that we have to pay for things, that we 
have to pay for the services that we think are important.
  As for all of the other things on the spending side that this was 
connected to, we didn't pay for it all. I don't know about you and your 
districts, but my folks are saying, Stop going into debt. Stop 
obligating yourselves to things that we cannot pay for. Stop mortgaging 
our grandchildren's futures.
  So that's what this is about. That's why we support this bill, 
because you know what? It's paid for. Maybe we are getting the message. 
Maybe we are turning the corner. Maybe we realize now that, if it's 
important enough to have, it's important enough to pay for.
  This costs $6.4 billion. It is a 2.2 percent increase in 
reimbursement levels. If the bill is not passed, Medicare physicians 
will face a 20 percent reduction in reimbursement rates. We want them 
to see our seniors, and we want them to be paid for their services.
  It's curious. It ends in November. Things happen in November. 
December is not paid for. January is not paid for. In fact, as we went 
along this process, we had month extensions throughout this process 
instead of addressing the issue early on. I'll be honest, Mr. Speaker, 
we'll accept a lot of our blame for the position we're in.

                              {time}  1720

  But we're not in the majority now. And the public has changed, and 
they say, Start paying for the services that you think are important, 
whether it's discretionary or it's entitlement. And that's why we 
support this bill. The doctors need it.
  I appreciate my colleagues and their support in the debate.
  I yield back the balance of my time.
  Mr. WAXMAN. Mr. Speaker, in the 30 seconds I have left, let's pass 
this bill and go on to fix this problem. We owe it to the seniors who 
were promised Medicare coverage. And Medicare coverage means that they 
ought to have access to physicians who are paid for the care that they 
give those Medicare recipients.
  I urge an ``aye'' vote.
  I yield back the balance of my time.
  Mr. LEVIN. Mr. Speaker, I yield myself the balance of my time.
  I understand the Senate is about to vote--I think has begun its 
vote--on the comprehensive jobs bill, helping to pay for it, so that 
companies don't ship jobs overseas. So what we're doing now, in view of 
what seems inevitable in the Senate, is take up one piece of that bill. 
The SGR provision is in the bill now before the Senate, and that, I'm 
afraid, will be turned down. And what the fact is, we have to act 
because patients, military personnel, their physicians, need action. 
But it's the inaction of Republicans in the other House; it really is 
bringing us to this point.
  And despite efforts, and valiant efforts, by the majority leader in 
the Senate, in the other House, and the Finance chair in the other 
body, it now seems absolutely certain there won't be a single 
Republican vote for that comprehensive bill that has this piece in it.
  What the Democrats in the other body have faced is a Republican 
phalanx, without a single one on the minority side willing to step up 
and vote for a bill that this country needs. So I serve notice: We on 
this side will not give up. A million and half Americans today who are 
out of work, who are looking for work, have lost their benefits because 
of the phalanx in the other body. There's reference to turning the 
corner here. No. The minority in the other House, as was true here, 
have been turning their backs.
  So much is at stake. I mentioned just a few parts of that bill--the 
R&D tax credit; Build America Bonds that have helped put millions of 
people to work; provisions regarding housing; summer employment for 
300,000 young people who want to work, who need work. So because of 
this phalanx among Republicans in the other body, as was true here, we 
were faced with this alternative to pass this so-called fix now.
  And it's interesting. We tried some months ago to have a permanent 
resolution of this. And, as mentioned, only one Republican voted for 
it. In May, we had a 19-month provision in the jobs bill, and it just 
could not pass the Senate, apparently, and very, very few, if any, here 
on the Republican side supported it.
  So here we are. A Republican phalanx. So we're going to act on this 
bill.

[[Page 11724]]

And I assure you, we on this side will not give up on the basic 
interest of the American people.
  Mr. VAN HOLLEN. Mr. Speaker, I rise in support of legislation to 
retroactively reverse a 21 percent payment cut for doctors in Medicare 
and TRICARE and update the flawed Medicare physician payment formula.
  Rather than the 21 percent payment cut, physicians will see a 2.2 
percent update in their payment rates through November, 30, 2010. 
Though I would prefer a permanent, long-term solution to this problem, 
this legislation is necessary so that Medicare beneficiaries can 
continue to see their doctor of choice and access the care they need. 
The uncertainty of payments is causing difficulties for physicians who 
provide services under Medicare because their practices cannot 
adequately plan for the expenses they incur for treating Medicare 
beneficiaries.
  Congress needs to fix this problem in a permanent manner. The House 
has passed legislation this Congress that would have done exactly that. 
Unfortunately, it was blocked in the Senate.
  Mr. Speaker, while I urge my colleagues to support this bill before 
us, I also urge all my colleagues in both the House and Senate to 
recommit themselves to passing legislation that will permanently fix 
Medicare payments to physicians.
  Ms. WASSERMAN SCHULTZ. Mr. Speaker, I rise today in support of 
provisions contained in H.R. 3962, which will temporarily fix the 
Sustainable Growth Rate--or SGR--formula. This legislation will undo 
the twenty-one percent cut in Medicare reimbursements to physicians 
that took place on June 1st. Without prompt action, these cuts will do 
serious harm to physicians and patients alike.
  With a 21 percent cut, payments to physicians would be well below 
their overhead costs and could jeopardize continued access for Medicare 
beneficiaries to their physicians. We have a duty to our retirees to be 
there for them when they are in need, so I fully and enthusiastically 
support the provisions that restore Medicare reimbursement rates.
  However, I want to register my profound concern over a provision in 
H.R. 3962 that utilizes a new application of what's known as the ``72-
hour rule'' as an offset for the SGR temporary fix. This provision 
dictates how a hospital must bundle certain Medicare payments for 
reimbursement.
  My home state of Florida was among the states included in the first 
round of the Recovery Audit Contractors Program, overseeing the 72-hour 
rule. Some Florida hospitals that have undergone audits had either 
inadvertently overbilled or underbilled.
  Hospitals that inadvertently overbilled are obligated to repay the 
appropriate amount, and have already done so. But, hospitals that 
inadvertently underbilled, would be immediately precluded, if this 
passes, from resubmitting claims in compliance with existing 
regulations to recoup underpayments.
  It is my understanding that many hospitals are still reviewing a 
large number of possible underpayments for submittal. If they are 
precluded from resubmitting claims because of changes in this 
legislation, Florida hospitals could face $225 million in losses. This 
retroactive application constitutes changing the rules of the game 
after the services were provided, and is simply not fair to providers.
  We owe it to both our physicians and our hospitals to treat them 
fairly when they care for our seniors under Medicare. Assuming this 
legislation becomes law, I strongly encourage the Centers for Medicare 
and Medicaid Services to administer this new application of the 72-hour 
rule in the most equitable manner possible and limit the adverse 
impacts on hospitals to the greatest extent possible.
  Ms. SCHAKOWSKY. Mr. Speaker, this week, the first round of provider 
payments with a 21 percent cut was sent to physicians who treat 
Medicare beneficiaries.
  This drastic reduction in reimbursements is quite simply 
unacceptable. Doctors in my district who provide life-saving care to 
seniors and people with disabilities have called me to say they won't 
be able to see Medicare patients much longer. Patients have called 
begging that we prevent the cuts.
  I am a strong supporter of a permanent fix to the flawed sustainable 
growth rate that continues to create instability for providers and 
uncertainty for Medicare beneficiaries.
  H.R. 3961, which passed the House in November 2009, would have 
responsibly fixed the flawed formula--but Senate Republicans have 
refused to come to the table to negotiate a permanent solution. For 
that reason, while I will vote for this bill to stop the pay cuts, I 
think it falls far short of what is needed.
  Under the pay-go agreement, we had agreed to fix physician payments 
without taking money from other parts of Medicare until December 31, 
2011. I am disappointed that we have not stuck to this original 
agreement.
  Senate Amendments to H.R. 3962--also known as the physician payment 
fix--is not perfect legislation. But without action this cut will 
create a crisis for Medicare beneficiaries and providers. I simply 
cannot allow that to happen, and will vote in support of this bill.
  This bill will ensure that doctors who see Medicare patients over the 
next six months receive fair payments. It will ensure that senior 
citizens and persons with disabilities have access to their doctors. 
And it gives us time to permanently fix the flawed formula. It is not 
perfect, but it would be irresponsible not to act.
  Mr. RYAN of Wisconsin. Mr. Speaker, I voted for this legislation 
because it avoided deep reductions to Medicare physician pay but was 
offset to avoid any increase in the deficit. While I support this 
legislation, I have some concerns about where this leads us in the 
future.
  First, this legislation illustrates why we must fundamentally reform 
Medicare. Our Nation's physicians who treat Medicare beneficiaries 
currently face a 21 percent reduction. It is critically important that 
we correct this. Although this legislation provides a much-needed 
temporary solution, it makes the Medicare physician problem even 
greater when this short-term fix expires in six months, requiring a 26 
percent reduction to payment rates. That is completely untenable.
  Unfortunately, that is precisely the path that the health care bill 
enacted earlier this year puts us on. In addition to Medicare and 
Medicaid's obligations, that bill created two new health care 
entitlements. I think this legislation is the sign of things to come. 
We will increasingly face difficult reductions to medical providers or 
require that health care be rationed through government bureaucracies. 
We will be told that to avoid this we need to either run up the debt or 
raise taxes on the American people. I think that is a false choice and 
we should instead fundamentally reform these programs to put them on a 
sustainable path.
  Second, I have some concerns with the pension relief provisions of 
this bill. Companies are struggling to get by due to a stagnant 
economy. This legislation will provide temporary pension relief. Under 
our cash-based budget, these pension relief provisions produce savings 
over the next ten years. We do not have a full analysis of the long-
term consequences of the pension provisions, but it appears these 
savings are likely to be more than offset by greater federal 
obligations that will appear outside the ten year window we use to 
enforce the budget. While this pension relief may make sense in today's 
economic environment, we need to explore the budgetary impact of these 
pension provisions to get a better understanding of the full impact 
before we pursue this as an offset for future legislation.
  Mr. VISCLOSKY. Mr. Speaker, I rise today in support of Preservation 
of Access to Care for Medicare Beneficiaries and Pension Relief Act.
  This important legislation will ensure that Medicare and TRICARE 
beneficiaries will be able to keep their doctors by retroactively 
reversing a 21 percent decrease in physician reimbursement that 
occurred on June 1, 2010. Additionally, this measure would provide 
physicians a 2.2 percent increase in physician reimbursements through 
November 30, 2010.
  While I am pleased that the House is considering a 6 month fix, I 
continue to support a permanent solution. It is not fair to medical 
providers to face the continued uncertainty of temporary fixes. I am 
proud that I supported and the House passed a permanent fix last 
November, and would urge my colleagues in both the House and Senate to 
recommit themselves to passing legislation to permanently fix this 
problem.
  Mrs. MALONEY. Mr. Speaker, I rise in support of H.R. 3962, which will 
protect patient access to their doctors and prevent a 21 percent cut in 
Medicare payments to doctors, and also boost physician payments by 2.2 
percent through November 30.
  Congress has spent the last decade--under both Republican and 
Democratic leadership--overriding the Sustainable Growth Rate, SGR, 
formula to prevent America's doctors from facing pay cuts in Medicare 
and to ensure seniors can keep their doctor.
  Last November, the House passed H.R. 3961, the Medicare Physician 
Payment Reform Act, permanently fixing the SGR. Democrats have long 
recognized that this formula is fundamentally flawed and have been 
working to fix it only to be stymied by Republicans in the Senate. This 
bill, though necessary, will require Congress to review the formula 
again in December when the current fix expires.
  Temporary fixes are not the answer. We must have a permanent solution 
to this problem to protect our Medicare patients and retired military 
veterans.

[[Page 11725]]

  I urge my colleagues to work toward a permanent fix of the 
Sustainable Growth Rate.
  Mr. LEVIN. I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Michigan (Mr. Levin) that the House suspend the rules 
and concur in the Senate amendments to the bill, H.R. 3962.
  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. SHIMKUS. Mr. 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.

                          ____________________