| Home > 106th Congressional Bills > H.R. 3076 (ih) To provide for the assessment of civil penalties for aliens who illegally enter the United States and for persons smuggling aliens within the United States. [Introduced in House] ...
H.R. 3076 (ih) To provide for the assessment of civil penalties for aliens who illegally enter the United States and for persons smuggling aliens within the United States. [Introduced in House] ...
106th CONGRESS 1st Session H. R. 3075 _______________________________________________________________________ IN THE SENATE OF THE UNITED STATES November 8, 1999 Received November 19, 1999 Read twice and referred to the Committee on Finance _______________________________________________________________________ AN ACT To amend titles XVIII, XIX, and XXI of the Social Security Act to make corrections and refinements in the Medicare, Medicaid, and State children's health insurance programs, as revised by the Balanced Budget Act of 1997. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE; AMENDMENTS TO SOCIAL SECURITY ACT; REFERENCES TO BBA; TABLE OF CONTENTS. (a) Short Title.--This Act may be cited as the ``Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999''. (b) Amendments to Social Security Act.--Except as otherwise specifically provided, whenever in this title an amendment is expressed in terms of an amendment to or repeal of a section or other provision, the reference shall be considered to be made to that section or other provision of the Social Security Act. (c) References to Balanced Budget Act of 1997.--In this Act, the term ``BBA'' means the Balanced Budget Act of 1997 (Public Law 105-33). (d) Table of Contents.--The table of contents of this Act is as follows: Sec. 1. Short title; amendments to Social Security Act; references to BBA; table of contents. TITLE I--PROVISIONS RELATING TO PART A Subtitle A--PPS Hospitals Sec. 101. One-year delay in transition for indirect medical education (IME) percentage adjustment. Sec. 102. Decrease in reductions for disproportionate share hospitals; data collection requirements. Subtitle B--PPS Exempt Hospitals Sec. 111. Wage adjustment of percentile cap for PPS-exempt hospitals. Sec. 112. Enhanced payments for long-term care and psychiatric hospitals until development of prospective payment systems for those hospitals. Sec. 113. Per discharge prospective payment system for long-term care hospitals. Sec. 114. Per diem prospective payment system for psychiatric hospitals. Sec. 115. Refinement of prospective payment system for inpatient rehabilitation services. Subtitle C--Adjustments to PPS Payments for Skilled Nursing Facilities Sec. 121. Temporary increase in payment for certain high cost patients. Sec. 122. Market basket increase. Sec. 123. Authorizing facilities to elect immediate transition to Federal rate. Sec. 124. Part A pass-through payment for certain ambulance services, prostheses, and chemotherapy drugs. Sec. 125. Provision for part B add-ons for facilities participating in the NHCMQ demonstration project. Sec. 126. Special consideration for facilities serving specialized patient populations. Sec. 127. MedPAC study on special payment for facilities located in Hawaii and Alaska. Subtitle D--Other Sec. 131. Part A BBA technical corrections. TITLE II--PROVISIONS RELATING TO PART B Subtitle A--Adjustments to Physician Payment Updates Sec. 201. Modification of update adjustment factor provisions to reduce update oscillations and require estimate revisions. Sec. 202. Use of data collected by organizations and entities in determining practice expense relative values. Sec. 203. GAO study on resources required to provide safe and effective outpatient cancer therapy. Subtitle B--Hospital Outpatient Services Sec. 211. Outlier adjustment and transitional pass-through for certain medical devices, drugs, and biologicals. Sec. 212. Establishing a transitional corridor for application of OPD PPS. Sec. 213. Delay in application of prospective payment system to cancer center hospitals. Sec. 214. Limitation on outpatient hospital copayment for a procedure to the hospital deductible amount. Subtitle C--Other Sec. 221. Application of separate caps to physical and speech therapy services. Sec. 222. Transitional outlier payments for therapy services for certain high acuity patients. Sec. 223. Update in renal dialysis composite rate. Sec. 224. Temporary update in durable medical equipment and oxygen rates. Sec. 225. Requirement for new proposed rulemaking for implementation of inherent reasonableness policy. Sec. 226. Increase in reimbursement for pap smears. Sec. 227. Refinement of ambulance services demonstration project. Sec. 228. Phase-in of PPS for ambulatory surgical centers. Sec. 229. Extension of Medicare benefits for immunosuppressive drugs. Sec. 230. Additional studies. TITLE III--PROVISIONS RELATING TO PARTS A AND B Subtitle A--Home Health Services Sec. 301. Adjustment to reflect administrative costs not included in the interim payment system. Sec. 302. Delay in application of 15 percent reduction in payment rates for home health services until 1 year after implementation of prospective payment system. Sec. 303. Clarification of surety bond requirements. Sec. 304. Technical amendment clarifying applicable market basket increase for PPS. Subtitle B--Direct Graduate Medical Education Sec. 311. Use of national average payment methodology in computing direct graduate medical education (DGME) payments. Sec. 312. Initial residency period for child neurology residency training programs. Subtitle C--Other Sec. 321. GAO study on geographic reclassification. Sec. 322. MedPAC study on Medicare payment for non-physician health professional clinical training in hospitals. TITLE IV--RURAL PROVIDER PROVISIONS Sec. 401. Permitting reclassification of certain urban hospitals as rural hospitals. Sec. 402. Update of standards applied for geographic reclassification for certain hospitals. Sec. 403. Improvements in the critical access hospital (CAH) program. Sec. 404. Five-year extension of Medicare dependent hospital (MDH) program. Sec. 405. Rebasing for certain sole community hospitals. Sec. 406. Increased flexibility in providing graduate physician training in rural areas. Sec. 407. Elimination of certain restrictions with respect to hospital swing bed program. Sec. 408. Grant program for rural hospital transition to prospective payment. Sec. 409. MedPAC study of rural providers. Sec. 410. Expansion of access to paramedic intercept services in rural areas. TITLE V--PROVISIONS RELATING TO PART C (MEDICARE+CHOICE PROGRAM) Subtitle A--Medicare+Choice Sec. 501. Phase-in of new risk adjustment methodology. Sec. 502. Encouraging offering of Medicare+Choice plans in areas without plans. Sec. 503. Modification of 5-year re-entry rule for contract terminations. Sec. 504. Continued computation and publication of AAPCC data. Sec. 505. Changes in Medicare+Choice enrollment rules. Sec. 506. Allowing variation in premium waivers within a service area if Medicare+Choice payment rates vary within the area. Sec. 507. Delay in deadline for submission of adjusted community rates and related information. Sec. 508. Two-year extension of Medicare cost contracts. Sec. 509. Medicare+Choice nursing and allied health professional education payments. Sec. 510. Reduction in adjustment in national per capita Medicare+Choice growth percentage for 2002. Sec. 511. Deeming of Medicare+Choice organization to meet requirements. Sec. 512. Miscellaneous changes and studies. Sec. 513. MedPAC report on Medicare MSA (medical savings account) plans. Sec. 514. Clarification of nonapplicability of certain provisions of discharge planning process to Medicare+Choice plans. Subtitle B--Managed Care Demonstration Projects Sec. 521. Extension of social health maintenance organization demonstration (SHMO) project authority. Sec. 522. Extension of Medicare community nursing organization demonstration project. Sec. 523. Medicare+Choice competitive bidding demonstration project. Sec. 524. Extension of Medicare municipal health services demonstration projects. Sec. 525. Medicare coordinated care demonstration project. TITLE VI--MEDICAID Sec. 601. Making Medicaid DSH transition rule permanent. Sec. 602. Increase in DSH allotment for certain States and the District of Columbia. Sec. 603. New prospective payment system for Federally-qualified health centers and rural health clinics. Sec. 604. Parity in reimbursement for certain utilization and quality control services. TITLE VII--STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP) Sec. 701. Stabilizing the SCHIP allotment formula. Sec. 702. Increased allotments for territories under the State children's health insurance program. TITLE I--PROVISIONS RELATING TO PART A Subtitle A--PPS Hospitals SEC. 101. ONE-YEAR DELAY IN TRANSITION FOR INDIRECT MEDICAL EDUCATION (IME) PERCENTAGE ADJUSTMENT. (a) In General.--Section 1886(d)(5)(B)(ii) (42 U.S.C. 1395ww(d)(5)(B)(ii)), as amended by section 4621(a)(1) of BBA, is amended-- (1) in subclause (IV), by inserting ``and 2001'' after ``2000''; and (2) by striking ``2000'' in subclause (V) and inserting ``2001''. (b) Conforming Amendment Relating to Determination of Standardized Amount.--Section 1886(d)(2)(C)(i) (42 U.S.C. 1395ww(d)(2)(C)(i)), as amended by section 4621(a)(2) of BBA, is amended by inserting ``or any additional payments under such paragraph resulting from the amendment made by section 101(a) of Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999'' after ``Balanced Budget Act of 1997''. SEC. 102. DECREASE IN REDUCTIONS FOR DISPROPORTIONATE SHARE HOSPITALS; DATA COLLECTION REQUIREMENTS. (a) In General.--Section 1886(d)(5)(F)(ix) (42 U.S.C. 1395ww(d)(5)(F)(ix)), as added by section 4403(a) of BBA, is amended-- (1) in subclause (III), by striking ``during fiscal year 2000'' and inserting ``during each of fiscal years 2000 and 2001''; (2) by striking subclause (IV); (3) by redesignating subclauses (V) and (VI) and subclauses (IV) and (V), respectively; and (4) in subclause (IV), as so redesignated, by striking ``reduced by 5 percent'' and inserting ``reduced by 4 percent''. (b) Data Collection.-- (1) In general.--The Secretary of Health and Human Services shall require any subsection (d) hospital (as defined in section 1886(d)(1)(B) of the Social Security Act (42 U.S.C. 1395ww(d)(1)(B)) to submit to the Secretary, in the cost reports submitted to the Secretary by such hospital for discharges occurring during a fiscal year, data on the costs incurred by the hospital for providing inpatient and outpatient hospital services for which the hospital is not compensated, including non-Medicare bad debt, charity care, and charges for Medicaid an indigent care. (2) Effective date.--The Secretary shall require the submission of the data described in paragraph (1) in cost reports for cost reporting periods beginning on or after the date of the enactment of this Act. Subtitle B--PPS-Exempt Hospitals SEC. 111. WAGE ADJUSTMENT OF PERCENTILE CAP FOR PPS-EXEMPT HOSPITALS. (a) In General.--Section 1886(b)(3)(H) (42 U.S.C. 1395ww(b)(3)(H)), as amended by section 4414 of BBA, is amended-- (1) in clause (i), by inserting ``, as adjusted under clause (iii)'' before the period; (2) in clause (ii), by striking ``clause (i)'' and ``such clause'' and inserting ``subclause (I)'' and ``such subclause'' respectively; (3) by striking ``(H)(i)'' and inserting ``(ii)(I)''; (4) by redesignating clauses (ii) and (iii) as subclauses (II) and (III); (5) by inserting after clause (ii), as so redesignated, the following new clause: ``(iii) In applying clause (ii)(I) in the case of a hospital or unit, the Secretary shall provide for an appropriate adjustment to the labor-related portion of the amount determined under such subparagraph to take into account differences between average wage-related costs in the area of the hospital and the national average of such costs within the same class of hospital.''; and (6) by inserting before clause (ii), as so redesignated, the following new clause: ``(H)(i) In the case of a hospital or unit that is within a class of hospital described in clause (iv), for a cost reporting period
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