[House Report 110-285]
[From the U.S. Government Publishing Office]



110th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 1st Session                                                    110-285

======================================================================

 
  PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 3162) TO AMEND TITLES 
 XVIII, XIX, AND XXI OF THE SOCIAL SECURITY ACT TO EXTEND AND IMPROVE 
    THE CHILDREN'S HEALTH INSURANCE PROGRAM, TO IMPROVE BENEFICIARY 
PROTECTIONS UNDER THE MEDICARE, MEDICAID, AND THE CHIP PROGRAM, AND FOR 
                             OTHER PURPOSES

                                _______
                                

  August 1, 2007 (legislative day of July 31, 2007).--Referred to the 
                House Calendar and ordered to be printed

                                _______
                                

    Mr. Castor, from the Committee on Rules, submitted the following

                              R E P O R T

                       [To accompany H. Res. 594]

    The Committee on Rules, having had under consideration 
House Resolution 594, by a record vote of 8 to 4, report the 
same to the House with the recommendation that the resolution 
be adopted.

                SUMMARY OF PROVISIONS OF THE RESOLUTION

    The resolution provides for consideration H.R. 3162, the 
Children's Health and Medicare Protection Act of 2007, under a 
closed rule providing two hours of general debate in the House, 
with one hour to be equally divided and controlled by the 
chairman and ranking minority member of the Committee on Ways & 
Means and one hour to be equally divided and controlled by the 
chairman and ranking minority member of the Committee on Energy 
and Commerce.
    The rule waives all points of order against consideration 
of the bill except for clauses 9 and 10 of Rule XXI. The 
amendment in the nature of a substitute recommended by the 
Committee on Ways & Means now printed in the bill, modified by 
the amendment printed in this report, shall be considered as 
adopted. The rule waives all points of order against provisions 
in the bill as amended and provides that the bill, as amended, 
shall be considered as read. The rule provides one motion to 
recommit with or without instructions. Finally, the rule 
provides that the Chair may postpone further consideration of 
the bill to a time designated by the Speaker.

                         EXPLANATION OF WAIVERS

    The waiver of all points of order against consideration of 
the bill (except for clauses 9 and 10 of Rule XXI) includes the 
following: a waiver of Rule XIII, clause 4(a), requiring a 
three-day layover of the committee report and a waiver of Rule 
XIII, clause 3(e), requiring the inclusion of a comparative 
print of any part of the bill or joint resolution proposing to 
amend the statute and of the statute or part thereof proposed 
to be amended. Although the rule waives all points of order 
against provisions in the bill, as amended, the committee is 
not aware of any points of order against the bill, as amended. 
The waiver is prophylactic in nature.

                            COMMITTEE VOTES

    The results of each record vote on an amendment or motion 
to report, together with the names of those voting for and 
against, are printed below:

Rules Committee record vote No. 273

    Date: August 1, 2007 (legislative day of July 31, 2007).
    Measure: H.R. 3162.
    Motion by: Mr. Dreier.
    Summary of motion: To grant an open rule.
    Results: Defeated 4-8.
    Vote by Members: McGovern--Nay; Hastings (FL)--Nay; 
Cardoza--Nay; Welch--Nay; Castor--Nay; Arcuri--Nay; Sutton--
Nay; Dreier--Yea; Diaz-Balart--Yea; Hastings (WA)--Yea; 
Sessions--Yea; Slaughter--Nay.

Rules Committee record vote No. 274

    Date: August 1, 2007 (legislative day of July 31, 2007).
    Measure: H.R. 3162.
    Motion by: Mr. Dreier.
    Summary of motion: To grant a modified open rule.
    Results: Defeated 4-8.
    Vote by Members: McGovern--Nay; Hastings (FL)--Nay; 
Cardoza--Nay; Welch--Nay; Castor--Nay; Arcuri--Nay; Sutton--
Nay; Dreier--Yea; Diaz-Balart--Yea; Hastings (WA)--Yea; 
Sessions--Yea; Slaughter--Nay.

Rules Committee record vote No. 275

    Date: August 1, 2007 (legislative day of July 31, 2007).
    Measure: H.R. 3162.
    Motion by: Mr. Diaz-Balart.
    Summary of motion: To make in order en bloc and provide 
appropriate waivers for all 43 amendments submitted to Rules on 
H.R. 3162.
    Results: Defeated 4-8.
    Vote by Members: McGovern--Nay; Hastings (FL)--Nay; 
Cardoza--Nay; Welch--Nay; Castor--Nay; Arcuri--Nay; Sutton--
Nay; Dreier--Yea; Diaz-Balart--Yea; Hastings (WA)--Yea; 
Sessions--Yea; Slaughter--Nay.

Rules Committee record vote No. 276

    Date: August 1, 2007 (legislative day of July 31, 2007).
    Measure: H.R. 3162.
    Motion by: Mr. Sessions.
    Summary of motion: To make in order en bloc and provide 
appropriate waivers for amendments #8, 9, 10, and 11 by Rep. 
Burgess to prohibit the Secretary of Health and Human Services 
from approving future state waivers that would cover adults 
other than pregnant adults under the State Children's Health 
Insurance Program; to modify Title III of HR 3162 that 
addresses Medicare physician reimbursement; to modify section 
704 of HR 3162 that would require the Secretary of HHS to 
develop a plan to implement for never events; and to require a 
State submitting a SCHIP waiver request to the Secretary of 
Health and Human Services to certify that children in that 
state have access to an adequate level of pediatricians, 
pediatric specialists and pediatric sub-specialists for 
targeted low-income children covered under the State's child 
health plan.
    Results: Defeated 4-8.
    Vote by Members: McGovern--Nay; Hastings (FL)--Nay; 
Cardoza--Nay; Welch--Nay; Castor--Nay; Arcuri--Nay; Sutton--
Nay; Dreier--Yea; Diaz-Balart--Yea; Hastings (WA)--Yea; 
Sessions--Yea; Slaughter--Nay.

Rules Committee record vote No. 277

    Date: August 1, 2007 (legislative day of July 31, 2007).
    Measure: H.R. 3162.
    Motion by: Mr. Sessions.
    Summary of motion: To make in order en bloc and provide 
appropriate waivers for amendments #25, 26, 27, and 28 by Rep. 
Blackburn, to strike Section 902 from the bill, which repeals 
the trigger provision; to prevent employers within a State from 
dropping the option to have employer-sponsored health insurance 
coverage for their employees' children; to prohibit SCHIP 
eligibility for adults for consecutive years; and to prohibit 
adults convicted of a ``drug-related'' crime from SCHIP 
eligibility.
    Results: Defeated 4-8.
    Vote by Members: McGovern--Nay; Hastings (FL)--Nay; 
Cardoza--Nay; Welch--Nay; Castor--Nay; Arcuri--Nay; Sutton--
Nay; Dreier--Yea; Diaz-Balart--Yea; Hastings (WA)--Yea; 
Sessions--Yea; Slaughter--Nay.

Rules Committee record vote No. 278

    Date: August 1, 2007 (legislative day of July 31, 2007).
    Measure: H.R. 3162.
    Motion by: Mr. Sessions.
    Summary of motion: To strike Section 651 regarding 
specialty hospitals.
    Results: Defeated 4-8.
    Vote by Members: McGovern--Nay; Hastings (FL)--Nay; 
Cardoza--Nay; Welch--Nay; Castor--Nay; Arcuri--Nay; Sutton--
Nay; Dreier--Yea; Diaz-Balart--Yea; Hastings (WA)--Yea; 
Sessions--Yea; Slaughter--Nay.

Rules Committee record vote No. 279

    Date: August 1, 2007 (legislative day of July 31, 2007).
    Measure: H.R. 3162.
    Motion by: Mr. Hastings (WA).
    Summary of motion: To make in order and provide appropriate 
waivers for an amendment offered by Rep. Hastings (WA) #29 to 
strike clause (i) of subparagraph (D) in subsection (i)(l) 
added by section 651 (a)(3).
    Results: Defeated 4-8.
    Vote by Members: McGovern--Nay; Hastings (FL)--Nay; 
Cardoza--Nay; Welch--Nay; Castor--Nay; Arcuri--Nay; Sutton--
Nay; Dreier--Yea; Diaz-Balart--Yea; Hastings (WA)--Yea; 
Sessions--Yea; Slaughter--Nay.

Rules Committee record vote No. 280

    Date: August 1, 2007 (legislative day of July 31,2007).
    Measure: H.R. 3162.
    Motion by: Mr. Hastings (WA).
    Summary of motion: To extend general debate to four hours.
    Results: Defeated 4-8.
    Vote by Members: McGovern--Nay; Hastings (FL)--Nay; 
Cardoza--Nay; Welch--Nay; Castor--Nay; Arcuri--Nay; Sutton--
Nay; Dreier--Yea; Diaz-Balert--Yea; Hastings (WA)--Yea; 
Sessions--Yea; Slaughter--Nay.

Rules Committee record vote No. 281

    Date: August 1, 2007 (legislative day of July 31, 2007).
    Measure: H.R. 3162.
    Motion by: Mr. McGovern.
    Summary of motion: To report the rule.
    Results: Adopted 8-4.
    Vote by Members: McGovern--Yea; Hastings (FL)--Yea; 
Cardoza--Yea; Welch--Yea; Castor--Yea; Arcuri--Yea; Sutton--
Yea; Dreier--Nay; Diaz-Balart--Nay; Hastings (WA)--Nay; 
Sessions--Nay; Slaughter--Yea.

               SUMMARY OF AMENDMENT CONSIDERED AS ADOPTED

    The following changes are reflected in the amendment.

       Amendments to Title I--Children's Health Insurance Program

    8. Amends Sec. 104 to increase the percentage of CHIP 
allotment ``qualifying States'' may spend from 30 percent to 
100 percent.
    9. Adds section 115 to require States with Separate State 
CHIP programs to provide 12 months of continuous eligibility 
for targeted low income children in families with incomes under 
200% of the federal poverty level under XXI.
    10. Amends section 111(a)(3)(A) to sunset the outreach 
performance bonus at the end of FY 2013 and require a GAO study 
of the effectiveness of the outreach bonus at enrolling 
eligible but uninsured children.
    11. Amends section 131 to allow for coverage of children 
under CHIP to age 21.
    12. Adds a new section 135 to make clear that nothing in 
the act allows Federal payment for individuals who are not 
legal residents.
    13. Adds a new section 136 to require audits to enforce 
citizenship restrictions on eligibility for Medicaid and CHIP 
benefits. This replaces the previous audit requirement in 
section 143.
    14. Amends 151(a)(2)(B) to require the new pediatric health 
quality measurement program to collect data on efforts to 
reduce hospitalization rate of premature infants.

       Amendments to Title II--Medicare Beneficiary Improvements

    8. Amends section 211(a)(2)(D) by changing the indexing of 
the asset test from $1000 and $2000 per year to the consumer 
price index.
    9. Amends section 213(a) to clarify applicants' ability to 
self-certify income and resources for purposes of qualifying 
for the Part D low-income subsidy. Also clarifies that SSA can 
verify eligibility with existing data, but without the need for 
additional documentation from applicants, except in 
extraordinary circumstances. Also makes required technical 
changes to account for this clarification.
    10. Amends section 213(d) to clarify that SSA will provide 
beneficiaries with a simplified application form and will 
accept and deliver these applications to the states.
    11. Amends section 217 to increase the cost-sharing 
limitation from 2.5 percent of annual income to 5 percent of 
annual income.
    12. Amends effective date of section 223.
    13. Changes paragraph (c)(3) of section 231 to clarify the 
definition of future patient record systems; adds a new 
subparagraph (f)(2)(E) to facilitate the collection of racial 
and ethnicity data.
    14. Amends section 233 to clarify the scope of the 
demonstration.

      Amendments to Title III--Physicians' Service Payment Reform

    Amends section 301 by clarifying the formula for excluding 
services not covered under the physician fee schedule from the 
target growth rates, changing the allowable growth rate for the 
primary care and preventive services category from three 
percent to two-and-a-half percent, and by freezing the update 
in years after 2012. Amends section 304 to clarify the 
definition of efficient areas; conforms language in section 309 
to reflect changes made in the bill as reported by the 
Committee on Ways and Means; adds language in section 905 
directing CMS to report on the specific needs of communities 
serving vulnerable populations;

           Amendments to Title IV--Medicare Advantage Reform

    4. Amends section 431 by adding authority for Severe and 
Disabling Chronic Condition Special Needs Plans (SDCC-SNPs). 
Provides that SDCC-SNPS must enroll 90% beneficiaries with 
specific chronic conditions as indicated by MA risk adjustment 
data; serve beneficiaries with one or more of six specific 
severe chronic conditions; have an average risk score of 1.35 
or greater; manage a MA chronic care improvement program that 
excels such programs in regular MA plans; and maintain a 
network of providers to meet the needs of enrollees with severe 
and disabling conditions.
    5. Amends section 431 to clarify a provision referring to 
Medicare-Medicaid demonstration programs in Massachusetts, 
Minnesota and Wisconsin.
    6. Amends section 411(h) to clarify a provision that 
provides financial support for State Health Insurance 
Assistance Programs.

     Amendments to Title V--Provisions Relating to Medicare Part A

    5. Amends section 503(c) to clarify the treatment of 
satellites facilities for long-stay cancer hospitals. Modifies 
the title for the section setting forth Medicare payments for 
long-stay cancer hospitals.
    6. Amends section 504 to modify the formula for 
disproportionate share hospital payments for hospitals located 
in Puerto Rico.
    7. Amends section 505(b) to streamline language pertaining 
to one PPS-exempt cancer hospital.
    8. Amends section 508(c) to streamline language pertaining 
to geographic reclassifications and to allow for geographic 
reclassification of certain hospitals.

  Amendments to Title VI--Other Provisions Relating to Medicare Part B

    4. Amends sections 608(b) and 609(c) to extend the date by 
which contracts entered into under the competitive acquisition 
program are exempt from these sections. The date for the 
exemption is extended to October 1, 2007.
    5. Amends section 612(c) to clarify that certain inhalation 
drugs are appropriately reimbursed. Specifically, the amendment 
clarifies that generic albuterol be reimbursed at the lower of 
its current or historic level, and that brand name levalbuterol 
be reimbursed at the lower of its current or historic level.
    6. Amends section 612(b) to clarify that Competitive 
Acquisition Program vendors may deliver drugs to a main office 
or satellite office as designated by the prescribing physician, 
and that physicians may be allowed to transport drugs to the 
site of administration if all applicable laws and regulations 
are followed.

 Amendments to Title VII--Provisions Relating to Medicare Parts A and B

    4. Amends section 705 to modify criteria for reallocation 
of graduate medical education residency slots from hospital 
closures and provision of additional residency slots.
    5. Adds section 706 providing for a study of the effect of 
home health remote monitoring on patient outcomes.
    6. Adds section 707 providing for a demonstration project 
testing effectiveness of home health telemonitoring and other 
telehealth technologies.

                   Amendments to Title VIII--Medicaid

    5. Amends section 801(a)(1) to extend the TMA program until 
2011, rather than 2009.
    6. Amends section 812(a) to change the applicable 
percentage to 22.1.
    7. Strikes section 812(b).
    8. Adds a new section 812 to extend the automated web-based 
asset verification demonstration to Medicaid, in the States in 
which the demonstration is operating.

                 Amendments to Title IX--Miscellaneous

    5. Amends section 904(a) to clarify the number of members 
and their terms of appointment on the Comparative Effectiveness 
Research Commission, and to clarify the terms of appointment of 
the members of the Coordinating Council for Health Services 
Research.
    6. Amends section 904(b) to clarify that the term 
`specified health insurance policy' does not include any 
insurance if substantially all of its coverage is of excepted 
benefits described in section 9832(c).
    7. Adds a new section 909 to the act allowing Congressional 
Support Agencies (MedPAC, GAO, and CBO) to obtain from CMS 
necessary data about the Medicare Part D program.
    8. Adds a new section 910 to reauthorize the Title V Social 
Security Act abstinence education programs with provisions to 
ensure that medically or scientifically accurate information is 
provided; that States have the flexibility to teach abstinence-
only education programs OR abstinence-plus education programs; 
and that funded programs are proven effective at decreasing 
teen pregnancy rates and rates of STDs and HIV/AIDS.

                TEXT OF AMENDMENTS CONSIDERED AS ADOPTED

  In the matter inserted by section 104, strike ``30 percent'' 
and insert ``100 percent''.
  Add at the end of subtitle B of title I the following:

SEC. 115. CONTINUOUS COVERAGE UNDER CHIP.

  (a) In General.--Section 2102(b) of the Social Security Act 
(42 U.S.C. 1397bb(b)) is amended by adding at the end the 
following new paragraph:
          ``(5) 12-months continuous eligibility.--In the case 
        of a State child health plan that provides child health 
        assistance under this title through a means other than 
        described in section 2101(a)(2), the plan shall provide 
        for implementation under this title of the 12-months 
        continuous eligibility option described in section 
        1902(e)(12) for targeted low-income children whose 
        family income is below 200 percent of the poverty 
        line.''.
  (b) Effective Date.--The amendment made by subsection (a) 
shall apply to determinations (and redeterminations) of 
eligibility made on or after January 1, 2008.
  In the paragraph (3)(A) added by section 111, insert ``and 
ending with fiscal year 2013'' after ``beginning with fiscal 
year 2008''.
  In section 111, insert ``(a) In General.--'' before ``Section 
2105(a)'', and add at the end the following:
  (b) GAO Study.--
          (1) In general.--The Comptroller General of the 
        United States shall conduct a study on the 
        effectiveness of the performance bonus payment program 
        under the amendment made by subsection (a) on the 
        enrollment and retention of eligible children under the 
        Medicaid and CHIP programs and in reducing the rate of 
        uninsurance among such children.
          (2) Report.--Not later than January 1, 2013, the 
        Comptroller General shall submit a report to Congress 
        on such study and shall include in such report such 
        recommendations for extending or modifying such program 
        as the Comptroller General determines appropriate.
  Amend section 131 to read as follows:

SEC. 131. OPTIONAL COVERAGE OF CHILDREN UP TO AGE 21 UNDER CHIP.

  (a) In General.--Section 2110(c)(1) of the Social Security 
Act (42 U.S.C. 1397jj(c)(1)) is amended by inserting ``(or, at 
the option of the State, under 20 or 21 years of age)'' after 
``19 years of age''.
  (b) Effective Date.--The amendment made by subsection (a) 
shall take effect on January 1, 2008.
  Add at the end of subtitle D of title I the following (and in 
section 143(a), strike paragraph (2) and redesignate paragraph 
(3) as paragraph (2)):

SEC. 135. NO FEDERAL FUNDING FOR ILLEGAL ALIENS.

  Nothing in this Act allows Federal payment for individuals 
who are not legal residents.

SEC. 136. AUDITING REQUIREMENT TO ENFORCE CITIZENSHIP RESTRICTIONS ON 
                    ELIGIBILITY FOR MEDICAID AND CHIP BENEFITS.

  Section 1903(x) of the Social Security Act (as amended by 
section 405(c)(1)(A) of division B of the Tax Relief and Health 
Care Act of 2006 (Public Law 109-432)) is amended by adding at 
the end the following new paragraph:
  ``(4)(A) Each State shall audit a statistically-based sample 
of cases of individuals whose eligibility for medical 
assistance (or child health assistance) is determined under 
section 1902(a)(46)(B) or under subsection (v)(4)(A) in order 
to demonstrate to the satisfaction of the Secretary that 
Federal funds under this title or title XXI are not unlawfully 
spent for benefits for individuals who are not legal residents. 
In conducting such audits, a State may rely on case reviews 
regularly conducted pursuant to its Medicaid Quality Control or 
Payment Error Rate Measurement (PERM) eligibility reviews under 
subsection (u) and the provisions of subsection (e) of section 
1137 shall apply under this paragraph in the same manner as 
they apply under subsection (b) of such section.
  ``(B) The State shall remit to the Secretary the Federal 
share of any unlawful expenditures for benefits, for aliens who 
are not legal residents, which are identified under an audit 
conducted under subparagraph (A).''.
  In section 151(a)(2)(B), insert after clause (vi) the 
following new clause:
                          (vii) Data on State efforts to reduce 
                        hospitalization rate of premature 
                        infants under the age of 12 months who 
                        were born prior to 35 weeks.
  In the subclause (IV) inserted by section 211(a)(2)(D), 
strike ``increased by $1,000 (or $2,000 in the case of the 
combined value referred to in subclause (III))'' and insert 
``increased by the annual percentage increase in the consumer 
price index (all items; U.S. city average) as of September of 
such previous year''.
  In section 211(a)(2), strike ``and'' at the end of 
subparagraph (C), strike the last period at the end of the 
matter inserted by subparagraph (D) and insert ``; and'', and 
add at the end the following:
                  (E) in the last sentence, by inserting ``or 
                (IV)'' after ``subclause (II)''.
  Amend subsection (a) of section 213 to read as follows:
  (a) Administrative Verification of Income and Resources Under 
the Low-Income Subsidy Program.--Clause (iii) of section 1860D-
14(a)(3)(E) of the Social Security Act (42 U.S.C. 1395w-
114(a)(3)(E)) is amended to read as follows:
                          ``(iii) Certification of income and 
                        resources.--For purposes of applying 
                        this section--
                                  ``(I) an individual shall be 
                                permitted to apply on the basis 
                                of self-certification of income 
                                and resources; and
                                  ``(II) matters attested to in 
                                the application shall be 
                                subject to appropriate methods 
                                of verification without the 
                                need of the individual to 
                                provide additional 
                                documentation, except in 
                                extraordinary situations as 
                                determined by the 
                                Commissioner.''.
  In section 213(b), strike ``, as amended by subsection (a), 
is further amended'' and insert ``is amended'' and redesignate 
the subparagraph added by such section as subparagraph (G).
  In the paragraph (7) added by section 213(c), strike 
``clauses (iii) and (iv) of section 1860D-14(a)(3)(C)'' and 
inserting ``subparagraphs (C)(iii) and (G) of section 1860D-
14(a)(3)''.
  In the subsection (c)(1)(B) added by section 213(d), strike 
``an application form'' and insert ``a simplified application 
form''.
  In the subsection (c)(3) added by section 213(d), strike 
``completed'' in the heading and ``completed'' in the text.
  In the clause added by section 217(a)(1) and in the 
subparagraph added by section 217(a)(2), strike ``2.5 percent'' 
and insert ``5 percent''.
  In section 223(b), strike ``January 1, 2009'' and insert 
``January 1, 2013''.
  In section 231(c)(3), insert after ``systems'' the following: 
``, including electronic health records, electronic medical 
records and patient health records,''.
  In section 231(f)(2), strike ``and'' at the end of 
subparagraph (C), strike the period at the end of subparagraph 
(D) and insert ``; and'', and add at the end the following new 
subparagraph:
                  (E) provide for the revision of existing 
                HIPAA claims-related code sets to mandate the 
                collection of racial and ethnicity data, and to 
                provide a code set for primary language.
  In section 233(a), strike ``limited English proficient'' and 
insert ``living in communities where racial and ethnic 
minorities, including populations that face language barriers, 
are underserved with respect to such services''.
  In the matter inserted by section 301(c)(1), strike ``and 
(8)'' and insert ``(8), and (9)''.
  In the paragraph (8) added by section 301(c)(4), in the 
heading insert ``and ending with 2012'' after ``beginning with 
2008'' and in the matter in subparagraph (A) before clause (i), 
insert ``and ending with 2012'' after ``beginning with 2008''.
  In the paragraph (8)(B) added by section 301(c)(4), amend 
clause (i) to read as follows:
                          ``(i) For 2008.--For 2008:
                                  ``(I) Total 2007 allowed 
                                expenditures for all services 
                                included in sgr computation.--
                                Compute total allowed 
                                expenditures for physicians' 
                                services (as defined in 
                                subsection (f)(4)(A)) for 2007 
                                that would otherwise be 
                                calculated under subsection (d) 
                                but for this paragraph.
                                  ``(II) Total 2007 allowed 
                                expenditures for physician fee 
                                schedule services.--Compute 
                                total allowed expenditures for 
                                services furnished under the 
                                physician fee schedule for 2007 
                                by subtracting, from the total 
                                allowed expenditures computed 
                                under subclause (I), the 
                                Secretary's estimate of the 
                                amount of the actual 
                                expenditures for 2007 for 
                                services included in such 
                                subclause for which payment is 
                                not made under the fee schedule 
                                established pursuant to this 
                                section.
                                  ``(III) Allocation of 2007 
                                allowed expenditures to service 
                                category.--Compute allowed 
                                expenditures for the service 
                                category involved for 2007 by 
                                multiplying the total allowed 
                                expenditures computed under 
                                subclause (II) by the overhang 
                                allocation factor for the 
                                service category (as defined in 
                                subparagraph (C)(iii)).
                                  ``(IV) Increase by growth 
                                rate to obtain 2008 allowed 
                                expenditures for service 
                                category.--Compute allowed 
                                expenditures for the service 
                                category for 2008 by increasing 
                                the allowed expenditures for 
                                the service category for 2007 
                                computed under subclause (III) 
                                by the target growth rate for 
                                such service category under 
                                subsection (f) for 2008.
  In the paragraph (8)(D) added by section 301(c)(4), strike 
``Floor for updates'' and insert ``Updates'' and strike ``not 
less than'' and insert ``equal to''.
  In the matter added by section 301(c)(4), add at the end the 
following:
          ``(9) No update for service categories beginning with 
        2013.--The update to the conversion factor for each of 
        the service categories established under paragraph (8) 
        for 2013 and each succeeding year shall be 0 
        percent.''.
  In the paragraph (5)(B) added by section 301(d)(1), strike 
``0.03'' and insert ``0.025''.
  In the subsection (v)(2)(A) added by section 304, insert 
before the period at the end the following: ``as standardized 
to eliminate the effect of geographic adjustments in payment 
rates''.
  In the  subsection (m)(4) inserted by section 309(a)(2), in 
subparagraph (F) strike ``(n)(3)(G)'' and insert ``(n)'' and 
strike subparagraph (B) and redesignate succeeding 
subparagraphs accordingly.
  In section 411(h)(2), add ``and'' at the end of subparagraph 
(A), strike ``; and'' at the end of subparagraph (B) and insert 
a period, and strike subparagraph (C).
  Amend the clause (ii) inserted by section 431(b)(1)(A) to 
read as follows:
                          ``(ii) as of January 1, 2009--
                                  ``(I) at least 90 percent of 
                                the enrollees in which are 
                                described in subparagraph 
                                (B)(i), as determined under 
                                regulations in effect as of 
                                July 1, 2007;
                                  ``(II) at least 90 percent of 
                                the enrollees in which are 
                                described in subparagraph 
                                (B)(ii) and are full-benefit 
                                dual eligible individuals (as 
                                defined in section 1935(c)(6)) 
                                or qualified medicare 
                                beneficiaries (as defined in 
                                section 1905(p)(1)); or
                                  ``(III) at least 90 percent 
                                of the enrollees in which have 
                                a severe or disabling chronic 
                                condition of the type that the 
                                plan is committed to serve as 
                                indicated by the data submitted 
                                for the risk-adjustment of plan 
                                payments; and''.
  In section 431(b)(1), add ``and'' at the end of subparagraph 
(A), strike subparagraph (B), and redesignate subparagraph (C) 
as subparagraph (B).
  At the end of the paragraphs added by section 
431(b)(1)(B)(iii), as so redesignated, add the following 
additional paragraph:
          ``(4) Additional requirements for severe or disabling 
        chronic condition snps.--In the case of a specialized 
        MA plan for special needs individuals described in 
        subsection (b)(6)(A)(ii)(III), the applicable 
        requirements of this subsection are as follows:
                  ``(A) The plan is designated to serve, and 
                serves, Medicare beneficiaries with one or more 
                of the following specific severe or disabling 
                chronic conditions:
                          ``(i) Cardiovascular.
                          ``(ii) Cerebrovascular.
                          ``(iii) Congestive health failure.
                          ``(iv) Diabetes.
                          ``(v) Chronic obstructive pulmonary 
                        disease.
                          ``(vi) HIV/AIDS.
                  ``(B) The plan has an average risk score 
                under section 1853(a)(1)(C) of 1.35 or greater.
                  ``(C) The plan has established and actively 
                manages a chronic care improvement program 
                under section 1852(e)(2) for each of the 
                conditions that it serves under subparagraph 
                (A) that significantly exceeds the features and 
                results of such programs established and 
                managed by Medicare Part C plans that are not 
                specialized Medicare Part C plans for special 
                needs individuals of the type described in this 
                paragraph.
                  ``(D) The plan has a network of a sufficient 
                number of primary care and specialty 
                physicians, hospitals, and other health care 
                providers under contract to the plan so that 
                the plan can clearly meet the routine and 
                specialty needs of the severely ill and 
                disabled enrollees of the plan throughout the 
                service area of the plan.
                  ``(E) The plan reports to the Secretary 
                information on additional quality measures 
                specified by the Secretary under section 
                1852(e)(3)(D)(iv)(III) for such plans.''.
  In the matter inserted by section 431(b)(2)(A), strike ``or 
(3)'' and insert ``, (3), or (4)''.
  In the clause (iii) added by section 431(b)(2)(B), strike 
``and'' at the end of subclause (I), strike the period at the 
end of subclause (II) and insert ``; and'', and add at the end 
the following new subclause:
                                  ``(III) beneficiaries 
                                enrolled in specialized 
                                Medicare Part C plans for 
                                special needs individuals 
                                (described in section 
                                1859(b)(6)(A)(ii)(III)) that 
                                serve predominantly individuals 
                                with severe or disabling 
                                chronic conditions by measuring 
                                the special needs for care of 
                                such individuals.''.
  Amend subparagraph (A) of section 431(b)(3) to read as 
follows:
                  (A) to a Medicare Advantage plan with a 
                contract with a State Medicaid integrated 
                Medicare-Medicaid plan program that had been 
                approved by the Centers for Medicare & Medicaid 
                Services as of January 1, 2004; and
  Add at the end of section 431 the following:
  (c) Sunset of Additional Designation Authority.--
          (1) In general.--Subsection (d) of section 231 of the 
        Medicare Prescription Drug, Improvement, and 
        Modernization Act of 2003 (Public Law 108-173) is 
        repealed.
          (2) Effective date.--The repeal made by paragraph (1) 
        shall take effect on January 1, 2009, and shall apply 
        to plans offered on or after such date.
  In section 503(c)(4), strike ``Transition rule'' and insert 
``In general''.
  In section 503(c)(5), insert ``without regard to section 
412.22(h)(2)(i) of title 42, Code of Federal Regulations,'' 
after ``of this Act'' and strike ``of title 42, Code of Federal 
Regulations'' and insert ``of such title''.
  In section 504, insert ``(a) In General.--'' before ``Section 
1886(d)(5)(F)(xiv)'' and add at the end the following:
  (b) Special Rule in Computing Disproportionate Patient 
Percentage.--
          (1) In general.--Section 1886(d)(5)(F)(vi) of such 
        Act (42 U.S.C. 1395ww(d)(5)(F)(vi)) is amended by 
        adding at the end the following: ``In applying this 
        clause in the case of hospitals located in Puerto Rico, 
        the Secretary shall substitute for the fraction 
        described in subclause (I) one-half of the national 
        average of such fraction for all subsection (d) 
        hospitals, as estimated by the Secretary.''.
          (2) Effective date.--The amendment made by paragraph 
        (1) shall apply to discharges in cost reporting periods 
        of hospitals beginning on or after January 1, 2008.
  In the clause (vii) inserted by section 505(b)(1)(B), strike 
subclauses (I), (V), and (VIII) and redesignate subclauses 
(II), (III), (IV), (VI), and (VII) as subclauses (I) through 
(V), respectively, and in subclause (IV), as so redesignated, 
add ``and'' at the end and in subclause (V), as so 
redesignated, strike ``and'' at the end.
  In section 508, strike subsections (c) and (d).
  Redesignate subsection (e) of section 508 as subsection (c) 
and, in such subsection, in paragraph (3)(A), insert 
``greater'' after ``and no'', in paragraph (4), strike 
``Notwithstanding paragraph (6), in'' and insert ``In'' and 
strike ``of this section'' and insert ``of this paragraph'', 
and redesignate paragraph (8) as paragraph (13) and insert 
after paragraph (7) the following:
          (8) For purposes of making payment under section 
        1886(d) of the Social Security Act (42 U.S.C. 
        1395ww(d)), the Nashville-Davidson-Murfreesboro core 
        based statistical area is deemed to include Cumberland 
        County, Tennessee.
          (9) For purposes of making payment under section 
        1886(d) of the Social Security Act (42 U.S.C. 
        1395ww(d)), any hospital that is co-located in 
        Marinette, Wisconsin and the Menominee, Michigan is 
        deemed to be located in Chicago, Illinois.
          (10) In the case of a hospital located in 
        Massachusetts or Clinton County, New York, that is 
        reclassified based on wages under paragraph (8) or (10) 
        of section 1886(d) of the Social Security Act into an 
        area the area wage index for which is increased under 
        section 4410(a) of the Balanced Budget Act of 1997 
        (Public Law 105-33), such increased area wage index 
        shall also apply to such hospital under such section 
        1886(d).
          (11) For purposes of applying the area wage index 
        under section 1886(d) of the Social Security Act (42 
        U.S.C. 1395ww(d)), hospital provider numbers 360112 and 
        23005 shall be treated as located in the same urban 
        area as Ann Arbor, Michigan.
          (12) For purposes of making payment under section 
        1886(d) of the Social Security Act (42 U.S.C. 
        1395ww(d)), any hospital that is located in Columbia 
        County, New York, with less 250 beds is deemed to be 
        located in the New York-White Plains-Wayne, NY-NJ core 
        based statistical area.
  In sections 608(b)(2) and 609(b)(3), strike ``July 21, 2007'' 
and insert ``October 1, 2007''.
  In section 612(b), amend paragraph (2) to read as follows:
          (2) Permitting appropriate delivery and transport of 
        drugs.--Subsection (b)(4)(E) of such section is 
        amended--
                  (A) by striking ``or'' at the end of clause 
                (i);
                  (B) by striking the period at the end of 
                clause (ii) and inserting a semicolon; and
                  (C) by adding at the end the following new 
                clauses:
                          ``(iii) prevent a contractor from 
                        delivering drugs to a satellite office 
                        designated by the prescribing 
                        physician; or
                          ``(iv) prevent a contractor from 
                        allowing a selecting physician to 
                        transport drugs or biologicals to the 
                        site of administration consistent with 
                        State law and other applicable laws and 
                        regulations.''.
  In section 612(b)(4), insert before the period at the end the 
following: ``, except in the case of a contractor terminated as 
a result of the application of section 1847B(b)(2)(B) of such 
Act''.
  Amend the paragraph (6) added by section 612(c)(2) to read as 
follows:
          ``(6) Special rule.--Beginning with January 1, 2008, 
        the payment amount for--
                  ``(A) each single source drug or biological 
                described in section 1842(o)(1)(G) (including a 
                single source drug or biological that is 
                treated as a multiple source drug because of 
                the application of subsection (c)(6)(C)(ii)) is 
                the lower of--
                          ``(i) the payment amount that would 
                        be determined for such drug or 
                        biological applying such subsection; or
                          ``(ii) the payment amount that would 
                        have been determined for such drug or 
                        biological if such subsection were not 
                        applied; and
                  ``(B) a multiple source drug (excluding a 
                drug or biological that is treated as a 
                multiple source drug because of the application 
                of such subsection) is the lower of--
                          ``(i) the payment amount that would 
                        be determined for such drug or 
                        biological taking into account the 
                        application of such subsection; or
                          ``(ii) the payment amount that would 
                        have been determined for such drug or 
                        biological if such subsection were not 
                        applied.''.
  In the clause (v) added by section 705(a)(1), strike 
``division of the core based'' each place it appears before 
subclause (I) and insert after subclause (IV) the following:
                                  ``(V) The hospital maintains 
                                no more than 400 beds.
  In section 705(a)(1), strike ``the following new clause:'' 
and insert ``the following new clauses:'' and add after clause 
(v) (as added by such section, and after ``exceed 10.'' ) the 
following new clause:
                          ``(vi) Increase in residency slots.--
                        In the case of a hospital located in 
                        Peoria County, Illinois, that has more 
                        than 500 beds, the Secretary shall 
                        increase by two the otherwise 
                        applicable resident limit under 
                        subparagraph (F) for such hospital.''.
  At the end of title VII add the following:

SEC. 706. STUDIES RELATING TO HOME HEALTH.

  (a) In General.--The Medicare Payment Advisory Commission 
shall conduct a study of Medicare beneficiaries utilizing home 
health care services to determine--
          (1) the impact that remote monitoring equipment and 
        related services have on improving health care outcomes 
        in the home health care setting for beneficiaries with 
        chronic conditions;
          (2) the differences in the percentage of inpatient 
        hospital admissions and emergency room visits for 
        beneficiaries with a similar health care risk profile 
        who utilize remote monitoring equipment and services 
        compared to those who do not use such equipment and 
        services;
          (3) the percentage of Medicare beneficiaries 
        currently utilizing remote monitoring equipment and 
        related services;
          (4) the estimated reduction in aggregate expenditures 
        under parts A and B of title XVIII of the Social 
        Security Act expenditures if home health agencies 
        increased their utilization of remote monitoring 
        equipment and related services for patients with 
        chronic disease conditions; and
          (5) the variation of utilization of remote monitoring 
        equipment and related services within geographic 
        regions and by size of home health agency.
  (b) Data Collection.--As a condition of a home health 
agency's participation in the program under title XVIII of the 
Social Security Act, beginning no later than January 1, 2008, 
the Secretary of Health and Human Services shall require such 
agencies to collect, in a form and manner determined by the 
Secretary, the following data:
          (1) The extent of home health agency's usage of 
        remote monitoring equipment and related services for 
        beneficiaries with chronic conditions.
          (2) Whether such equipment and services are used to 
        monitor patients' with chronic conditions vital signs 
        on a daily basis.
          (3) Whether standing physician orders accompany the 
        use of remote monitoring equipment and services.
          (4) The costs of remote monitoring equipment and 
        related services.
  (c) Report to Congress.--Not later than June 1, 2010, the 
Commission shall report to Congress on its findings on the 
study conducted under subsection (a). Such report shall include 
recommendations regarding how Congress may enact reimbursement 
policies that increase the appropriate utilization of remote 
monitoring equipment and services under the home health program 
for Medicare beneficiaries with chronic conditions in a manner 
that facilitates health care outcomes and leads to the long-
term reduction of aggregate expenditures under the Medicare 
program.

SEC. 707. RURAL HOME HEALTH QUALITY DEMONSTRATION PROJECTS.

  (a) In General.--Not later than 180 days after the date of 
the enactment of this Act, the Secretary of Health and Human 
Services (in this section referred to as the ``Secretary'') 
shall make grants to eligible entities for demonstration 
projects to assist home health agencies to better serve their 
Medicare populations while aiming to reduce costs to the 
Medicare program through utilization of technologies, including 
telemonitoring and other telehealth technologies, health 
information technologies, and telecommunications technologies 
that--
          (1) implement procedures and standards that reduce 
        the need for inpatient hospital services and health 
        center visits; and
          (2) address the aims of safety, effectiveness, 
        patient- or community-centeredness, timeliness, 
        efficiency, and equity identified by the Institute of 
        Medicine of the National Academies in its report 
        entitled ``Crossing the Quality Chasm: A New Health 
        System for the 21st Century'' released on March 1, 
        2001, when determining when and what care is needed.
  (b) Eligible Entities.--In this section, the term ``eligible 
entity'' means a State that includes--
          (1) a rural academic medical center;
          (2) no urban regional medical center; and
          (3) a Medicare population whose enrollees in the 
        Medicare Part C program is less than 3 percent.
  (c) Consultation.--In developing the program for awarding 
grants under this section, the Secretary shall consult with the 
Administrator of the Centers for Medicare & Medicaid Services, 
home health agencies, rural health care researchers, and 
private and non-profit groups (including national associations) 
which are undertaking similar efforts.
  (d) Duration.--Each demonstration project under this section 
shall be for a period of 2 years.
  (e) Report.--Not later than one year after the conclusion of 
all of the demonstration projects funded under this section, 
the Secretary shall submit a report to the Congress on the 
results of such projects. The report shall include--
          (1) an evaluation of technologies utilized and 
        effects on patient access to home health care, patient 
        outcomes, and an analysis of the cost effectiveness of 
        each such project; and
          (2) recommendations on Federal legislation, 
        regulations, or administrative policies to enhance 
        rural home health quality and outcomes.
  (f) Funding.--Out of any funds in the Treasury not otherwise 
appropriated, there are appropriated to the Secretary for 
fiscal year 2008, $3,000,000 to carry out this section. Funds 
appropriated under this subsection shall remain available until 
expended.
  In section 801(a), strike ``Two-Year'' and insert ``Four-
Year'' and in the matter inserted by section 801(a)(1) strike 
``September 30, 2009'' and insert ``September 30, 2011''.
  In the subclause (VI) added by section 812(a)(3), strike 
``20.1 percent'' and insert ``22.1 percent''.
  In section 812, strike ``(a) Brand.--'' and strike subsection 
(b).
  At the end of subtitle B of title VIII, add the following:

SEC. 817. EXTENSION OF SSI WEB-BASED ASSET DEMONSTRATION PROJECT TO THE 
                    MEDICAID PROGRAM.

  (a) In General.--The Secretary of Health and Human Services 
shall provide for the application to asset eligibility 
determinations under the Medicaid program under title XIX of 
the Social Security Act of the automated, secure, web-based 
asset verification request and response process being applied 
for determining eligibility for benefits under the Supplemental 
Security Income (SSI) program under title XVI of such Act under 
a demonstration project conducted under the authority of 
section 1631(e)(1)(B)(ii) of such Act (42 U.S.C. 
1383(e)(1)(B)(ii)).
  (b) Limitation.--Such application shall only extend to those 
States in which such demonstration project is operating and 
only for the period in which such project is otherwise 
provided.
  (c) Rules of Application.--For purposes of carrying out 
subsection (a), notwithstanding any other provision of law, 
information obtained from a financial institution that is used 
for purposes of eligibility determinations under such 
demonstration project with respect to the Secretary of Health 
and Human Services under the SSI program may also be shared and 
used by States for purposes of eligibility determinations under 
the Medicaid program. In applying section 1631(e)(1)(B)(ii) of 
the Social Security Act under this subsection, references to 
the Commissioner of Social Security and benefits under title 
XVI of such Act shall be treated as including a reference to a 
State described in subsection (b) and medical assistance under 
title XIX of such Act provided by such a State.
  In the section 1822 added by section 904(a), in subsection 
(b)(3)(A)(iii) strike ``up to 15'' and insert ``15''; in 
subsection (b)(6)(B) strike ``10'' and ``9'' and insert ``8'' 
and ``7'', respectively; and in subsection (g)(2)(B)(ii) strike 
``8'' and ``7'' and insert ``10'' and ``9'', respectively.
  Amend paragraph (2) of the section 4375(c) added by section 
904(b)(2)(A) to read as follows:
          ``(2) Exemption for certain policies.--The term 
        `specified health insurance policy' does not include 
        any insurance if substantially all of its coverage is 
        of excepted benefits described in section 9832(c).
  At the end of title IX add the following:

SEC. 909. ACCESS TO DATA ON PRESCRIPTION DRUG PLANS AND MEDICARE 
                    ADVANTAGE PLANS.

  (a) In General.--Section 1875 of the Social Security Act (42 
U.S.C. 1395ll) is amended--
          (1) in the heading, by inserting ``to congress; 
        providing information to congressional support 
        agencies'' after ``and recommendations''; and
          (2) by adding at the end the following new 
        subsection:
  ``(c) Providing Information to Congressional Support 
Agencies.--
          ``(1) In general.--Notwithstanding any provision 
        under part D that limits the use of prescription drug 
        data collected under such part, upon the request of a 
        Congressional support agency, the Secretary shall 
        provide such agency with information submitted to, or 
        compiled by, the Secretary under part D (subject to the 
        restriction on disclosure under paragraph (2)), 
        including--
                  ``(A) only with respect to Congressional 
                support agencies that make official baseline 
                spending projections, conduct oversight studies 
                mandated by Congress, or make official 
                recommendations on the program under this title 
                to Congress--
                          ``(i) aggregate negotiated prices for 
                        drugs covered under prescription drug 
                        plans and MA-PD plans;
                          ``(ii) negotiated rebates, discounts, 
                        and other price concessions by drug and 
                        by contract or plan (as reported under 
                        section 1860D-2(d)(2));
                          ``(iii) bid information (described in 
                        section 1860D-11(b)(2)(C)) submitted by 
                        such plans;
                          ``(iv) data or a representative 
                        sample of data regarding drug claims 
                        and other data submitted under section 
                        1860D-15(c)(1)(C) (as determined 
                        necessary and appropriate by the 
                        Congressional support agency to carry 
                        out the legislatively mandated duties 
                        of the agency);
                          ``(v) the amount of reinsurance 
                        payments paid under section 1860D-
                        15(a)(2), provided at the plan level; 
                        and
                          ``(vi) the amount of any adjustments 
                        of payments made under subparagraph (B) 
                        or (C) of section 1860D-15(e)(2), 
                        provided at the plan level aggregate 
                        negotiated prices for drugs covered 
                        under prescription drug plans and MA-PD 
                        plans; and
                  ``(B) access to drug event data submitted by 
                such plans under section 1860D-15(d)(2)(A), 
                except, with respect to data that reveals 
                prices negotiated with drug manufacturers, such 
                data shall only be available to Congressional 
                support agencies that make official baseline 
                spending projections, conduct oversight studies 
                mandated by Congress, or make official 
                recommendations on the program under this title 
                to Congress.
          ``(2) Restriction on data disclosure.--
                  ``(A) In general.--Data provided to a 
                Congressional support agency under this 
                subsection shall not be disclosed, reported, or 
                released in identifiable form.
                  ``(B) Identifiable form.--For purposes of 
                subparagraph (A), the term `identifiable form' 
                means any representation of information that 
                permits identification of a specific 
                prescription drug plan, MA-PD plan, pharmacy 
                benefit manager, drug manufacturer, drug 
                wholesaler, or individual enrolled in a 
                prescription drug plan or an MA-PD plan under 
                part D.
          ``(3) Timing.--The Secretary shall release data under 
        this subsection in a timeframe that enables 
        Congressional support agencies to complete 
        congressional requests.
          ``(4) Use of the data provided.--Data provided to a 
        Congressional support agency under this subsection 
        shall only be used by such agency for carrying out the 
        functions and activities of the agency mandated by 
        Congress.
          ``(5) Confidentiality.--The Secretary shall establish 
        safeguards to protect the confidentiality of data 
        released under this subsection. Such safeguards shall 
        not provide for greater disclosure than is permitted 
        under any of the following:
                  ``(A) The Federal regulations (concerning the 
                privacy of individually identifiable health 
                information) promulgated under section 264(c) 
                of the Health Insurance Portability and 
                Accountability Act of 1996.
                  ``(B) Sections 552 or 552a of title 5, United 
                States Code, with regard to the privacy of 
                individually identifiable beneficiary health 
                information.
          ``(6) Definitions.--In this subsection:
                  ``(A) Congressional support agency.--The term 
                `Congressional support agency' means--
                          ``(i) the Medicare Payment Advisory 
                        Commission;
                          ``(ii) the Government Accountability 
                        Office; and
                          ``(iii) the Congressional Budget 
                        Office.
                  ``(B) Ma-pd plan.--The term `MA-PD plan' has 
                the meaning given such term in section 1860D-
                1(a)(3)(C).
                  ``(C) Prescription drug plan.--The term 
                `prescription drug plan' has the meaning given 
                such term in section 1860D-41(a)(14).''.
  (b) Conforming Amendment.--Section 1805(b)(2) of the Social 
Security Act (42 U.S.C. 1395b-6(b)(2)) is amended by adding at 
the end the following new subparagraph:
                  ``(D) Part d.--Specifically, the Commission 
                shall review payment policies with respect to 
                the Voluntary Prescription Drug Benefit Program 
                under part D, including--
                          ``(i) the factors affecting 
                        expenditures;
                          ``(ii) payment methodologies; and
                          ``(iii) their relationship to access 
                        and quality of care for Medicare 
                        beneficiaries.''.

SEC. 910. ABSTINENCE EDUCATION.

  Section 510 of the Social Security Act (42 U.S.C. 710) is 
amended to read as follows:

``SEC. 510. SEPARATE PROGRAM FOR ABSTINENCE EDUCATION.

  ``(a) In General.--For the purpose described in subsection 
(b), the Secretary shall, for fiscal year 2008 and fiscal year 
2009, allot to each State which has transmitted an application 
for the fiscal year under section 505(a) an amount equal to the 
product of--
          ``(1) the amount appropriated in subsection (d) for 
        the fiscal year; and
          ``(2) the percentage determined for the State under 
        section 502(c)(1)(B)(ii).
  ``(b) Purpose of Allotment.--
          ``(1) Purpose.--The purpose of an allotment under 
        subsection (a) to a State is to enable the State to 
        provide abstinence education, and where appropriate, 
        mentoring, counseling, and adult supervision to promote 
        abstinence from sexual activity, with a focus on those 
        groups which are most likely to bear children out-of-
        wedlock.
          ``(2) Definition; state option.--For purposes of this 
        section, the term `abstinence education' has, at the 
        option of each State receiving an allotment under 
        subsection (a), the meaning given such term in 
        subparagraph (A), or the meaning given such term in 
        subparagraph (B), as follows:
                  ``(A) Such term means a medically and 
                scientifically accurate educational or 
                motivational program which--
                          ``(i) has as its exclusive purpose, 
                        teaching the social, psychological, and 
                        health gains to be realized by 
                        abstaining from sexual activity;
                          ``(ii) teaches abstinence from sexual 
                        activity outside marriage as the 
                        expected standard for all school age 
                        children;
                          ``(iii) teaches that abstinence from 
                        sexual activity is the only certain way 
                        to avoid out-of-wedlock pregnancy, 
                        sexually transmitted diseases, and 
                        other associated health problems;
                          ``(iv) teaches that a mutually 
                        faithful monogamous relationship in 
                        context of marriage is the expected 
                        standard of human sexual activity;
                          ``(v) teaches that sexual activity 
                        outside of the context of marriage is 
                        likely to have harmful psychological 
                        and physical effects;
                          ``(vi) teaches that bearing children 
                        out-of-wedlock is likely to have 
                        harmful consequences for the child, the 
                        child's parents, and society;
                          ``(vii) teaches young people how to 
                        reject sexual advances and how alcohol 
                        and drug use increases vulnerability to 
                        sexual advances; and
                          ``(viii) teaches the importance of 
                        attaining self-sufficiency before 
                        engaging in sexual activity.
                  ``(B) Such term means a medically and 
                scientifically accurate educational or 
                motivational program which promotes abstinence 
                and educates those who are currently sexually 
                active or at risk of sexual activity about 
                additional methods to prevent unintended 
                pregnancy or reduce other health risks.
          ``(3) Certain requirements.--
                  ``(A) Limitation regarding inaccurate 
                information.--None of the funds made available 
                under this section may be used to provide 
                abstinence education that includes information 
                that is medically and scientifically 
                inaccurate. For purposes of this section, the 
                term `medically and scientifically inaccurate' 
                means information that is unsupported or 
                contradicted by a preponderance of peer-
                reviewed research by leading medical, 
                psychological, psychiatric, and public health 
                publications, organizations and agencies.
                  ``(B) Effectiveness regarding certain 
                matters.--None of the funds made available 
                under this section may be used for a program 
                unless the program is based on a model that has 
                been demonstrated to be effective in preventing 
                unintended pregnancy, or in reducing the 
                transmission of a sexually transmitted disease, 
                including the human immunodeficiency virus. The 
                preceding sentence does not apply to any 
                program that was approved and funded under this 
                section on or before September 30, 2007.
  ``(c) Applicability of Certain Sections.--
          ``(1) Requirements.--Sections 503, 507, and 508 apply 
        to allotments under subsection (a) to the same extent 
        and in the same manner as such sections apply to 
        allotments under section 502(c).
          ``(2) Discretion of secretary.--Sections 505 and 506 
        apply to allotments under subsection (a) to the extent 
        determined by the Secretary to be appropriate.
  ``(d) Authorization of Appropriations.--For the purpose of 
allotments under subsection (a), there is authorized to be 
appropriated $50,000,000 for each of fiscal years 2008 and 
2009.''.
   In the matter proposed to be inserted by section 1001(d)(1), 
strike ``44.63 percent'' and insert ``40 percent (33 percent on 
cigars removed after December 31, 2007, and before October 1, 
2013)''.
  Conform the table of contents accordingly.

                                  
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