Home > 106th Congressional Bills > H.R. 5613 (ih) To require an extension of the comment periods relating to certain proposed rules. [Introduced in House] ...H.R. 5613 (ih) To require an extension of the comment periods relating to certain proposed rules. [Introduced in House] ...
106th CONGRESS
2d Session
H. R. 5612
To amend titles XVIII, XIX, and XXI of the Social Security Act to
provide benefits improvements and beneficiary protections in the
Medicare and Medicaid Programs and the State child health insurance
program (SCHIP), as revised by the Balanced Budget Act of 1997 and the
Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999,
and for other purposes.
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IN THE HOUSE OF REPRESENTATIVES
November 1, 2000
Mr. Rangel (for himself, Mr. Dingell, Mr. Spratt, Mr. Stenholm, Mr.
Brown of Ohio, Mr. Berry, Mr. Allen, Mr. Andrews, Mr. Baca, Ms.
Baldwin, Mr. Boucher, Mr. Cardin, Mr. Costello, Mr. Coyne, Mr. DeFazio,
Mr. Dixon, Ms. Eshoo, Mr. Green of Texas, Mr. Hall of Ohio, Mr.
Hilliard, Mr. Jackson of Illinois, Mr. Kleczka, Mr. Levin, Mrs. Lowey,
Mr. Matsui, Mr. McGovern, Mr. McNulty, Ms. Millender-McDonald, Mr.
Oberstar, Mr. Rahall, Mr. Sawyer, Mr. Skelton, and Mr. Stupak)
introduced the following bill; which was referred to the Committee on
Ways and Means, and in addition to the Committee on Commerce, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
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A BILL
To amend titles XVIII, XIX, and XXI of the Social Security Act to
provide benefits improvements and beneficiary protections in the
Medicare and Medicaid Programs and the State child health insurance
program (SCHIP), as revised by the Balanced Budget Act of 1997 and the
Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999,
and for other purposes.
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 OTHER ACTS; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Medicare,
Medicaid, and SCHIP Benefits Improvement and Beneficiary Protection Act
of 2000''.
(b) Amendments to Social Security Act.--Except as otherwise
specifically provided, whenever in this Act 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 Other Acts.--In this Act:
(1) Balanced budget act of 1997.--The term ``BBA'' means
the Balanced Budget Act of 1997 (Public Law 105-33; 111 Stat.
251).
(2) Medicare, medicaid, and schip balanced budget
refinement act of 1999.--The term ``BBRA'' means the Medicare,
Medicaid, and SCHIP Balanced Budget Refinement Act of 1999
(Appendix F, 113 Stat. 1501A-321), as enacted into law by
section 1000(a)(6) of Public Law 106-113.
(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
other Acts; table of contents.
TITLE I--MEDICARE BENEFICIARY IMPROVEMENTS
Subtitle A--Improved Preventive Benefits
Sec. 101. Coverage of biennial screening pap smear and pelvic exams.
Sec. 102. Coverage of screening for glaucoma.
Sec. 103. Coverage of screening colonoscopy for average risk
individuals.
Sec. 104. Modernization of screening mammography benefit.
Sec. 105. Coverage of medical nutrition therapy services for
beneficiaries with diabetes or a renal
disease.
Sec. 106. Extension of part A coverage for workers with disabilities.
Subtitle B--Other Beneficiary Improvements
Sec. 111. Acceleration of reduction of beneficiary copayment for
hospital outpatient department services.
Sec. 112. Preservation of coverage of drugs and biologicals under part
B of the medicare program.
Sec. 113. Elimination of time limitation on medicare benefits for
immunosuppressive drugs.
Sec. 114. Imposition of billing limits on drugs.
Sec. 115. Improving availability of QMB/SLMB application forms.
Sec. 116. Waiver of 24-month waiting period for medicare coverage of
individuals disabled with amyotrophic
lateral sclerosis (ALS).
Subtitle C--Demonstration Projects and Studies
Sec. 121. Demonstration project for disease management for severely
chronically ill medicare beneficiaries.
Sec. 122. Cancer prevention and treatment demonstration for ethnic and
racial minorities.
Sec. 123. Study on medicare coverage of routine thyroid screening.
Sec. 124. MedPAC study on consumer coalitions.
Sec. 125. Study on limitation on State payment for medicare cost-
sharing affecting access to services for
qualified medicare beneficiaries.
Sec. 126. Studies on preventive interventions in primary care for older
Americans.
Sec. 127. MedPAC study and report on medicare coverage of cardiac and
pulmonary rehabilitation therapy services.
TITLE II--RURAL HEALTH CARE IMPROVEMENTS
Subtitle A--Critical Access Hospital Provisions
Sec. 201. Clarification of no beneficiary cost-sharing for clinical
diagnostic laboratory tests furnished by
critical access hospitals.
Sec. 202. Assistance with fee schedule payment for professional
services under all-inclusive rate.
Sec. 203. Exemption of critical access hospital swing beds from SNF
PPS.
Sec. 204. Payment in critical access hospitals for emergency room on-
call physicians.
Sec. 205. Treatment of ambulance services furnished by certain critical
access hospitals.
Sec. 206. GAO study on certain eligibility requirements for critical
access hospitals.
Subtitle B--Other Rural Hospitals Provisions
Sec. 211. Equitable treatment for rural disproportionate share
hospitals.
Sec. 212. Option to base eligibility for medicare dependent, small
rural hospital program on discharges during
2 of the 3 most recently audited cost
reporting periods.
Sec. 213. Extension of option to use rebased target amounts to all sole
community hospitals.
Sec. 214. MedPAC analysis of impact of volume on per unit cost of rural
hospitals with psychiatric units.
Subtitle C--Other Rural Provisions
Sec. 221. Assistance for providers of ambulance services in rural
areas.
Sec. 222. Payment for certain physician assistant services.
Sec. 223. Revision of medicare reimbursement for telehealth services.
Sec. 224. Expanding access to rural health clinics.
Sec. 225. MedPAC study on low-volume, isolated rural health care
providers.
TITLE III--PROVISIONS RELATING TO PART A
Subtitle A--Inpatient Hospital Services
Sec. 301. Eliminating reduction in PPS hospital payment update.
Sec. 302. Additional modification in transition for indirect medical
education (IME) percentage adjustment.
Sec. 303. Decrease in reductions for disproportionate share hospital
(DSH) payments.
Sec. 304. Wage index improvements.
Sec. 305. Payment for inpatient services of rehabilitation hospitals.
Sec. 306. Payment for inpatient services of psychiatric hospitals.
Sec. 307. Payment for inpatient services of long-term care hospitals.
Sec. 308. Increase in base payment to Puerto Rico acute care hospitals.
Subtitle B--Adjustments to PPS Payments for Skilled Nursing Facilities
Sec. 311. Elimination of reduction in skilled nursing facility (SNF)
market basket update in 2001.
Sec. 312. Increase in nursing component of PPS Federal rate.
Sec. 313. Application of SNF consolidated billing requirement limited
to part A covered stays.
Sec. 314. Adjustment of rehabilitation RUGs to correct anomaly in
payment rates.
Sec. 315. Establishment of process for geographic reclassification.
Subtitle C--Hospice Care
Sec. 321. Full market basket increase for 2001 and 2002.
Sec. 322. Clarification of physician certification.
Sec. 323. MedPAC report on access to, and use of, hospice benefit.
Subtitle D--Other Provisions
Sec. 331. Relief from medicare part A late enrollment penalty for group
buy-in for State and local retirees.
Sec. 332. Hospital geographic reclassification for labor costs for
other PPS systems.
Sec. 333. Nurse staffing and quality improvement; grants to States.
TITLE IV--PROVISIONS RELATING TO PART B
Subtitle A--Hospital Outpatient Services
Sec. 401. Revision of hospital outpatient PPS payment update.
Sec. 402. Clarifying process and standards for determining eligibility
of devices for pass-through payments under
hospital outpatient PPS.
Sec. 403. Application of OPD PPS transitional corridor payments to
certain hospitals that did not submit a
1996 cost report.
Sec. 404. Application of rules for determining provider-based status
for certain entities.
Sec. 405. Treatment of children's hospitals under prospective payment
system.
Sec. 406. Inclusion of temperature monitored cryoablation in
transitional pass-through for certain
medical devices, drugs, and biologicals
under OPD PPS.
Sec. 407. Contrast enhanced diagnostic procedures under hospital
prospective payment system.
Subtitle B--Provisions Relating to Physicians' Services
Sec. 411. GAO studies relating to physicians' services.
Sec. 412. Physician group practice demonstration.
Sec. 413. Study on enrollment procedures for groups that retain
independent contractor physicians.
Subtitle C--Other Services
Sec. 421. 1-year extension of moratorium on therapy caps; report on
standards for supervision of physical
therapy assistants.
Sec. 422. Update in renal dialysis composite rate.
Sec. 423. Payment for ambulance services.
Sec. 424. Ambulatory surgical centers.
Sec. 425. Full update for durable medical equipment.
Sec. 426. Full update for orthotics and prosthetics.
Sec. 427. Establishment of special payment provisions and requirements
for prosthetics and certain custom
fabricated orthotic items.
Sec. 428. Replacement of prosthetic devices and parts.
Sec. 429. Revised part B payment for drugs and biologicals and related
services.
Sec. 430. Qualifications for community mental health centers.
Sec. 431. Modification of medicare billing requirements for certain
Indian providers.
Sec. 432. GAO study on coverage of surgical first assisting services of
certified registered nurse first
assistants.
Sec. 433. MedPAC study and report on medicare reimbursement for
services provided by certain providers.
Sec. 434. MedPAC study and report on medicare coverage of services
provided by certain nonphysician providers.
Sec. 435. GAO study and report on the costs of emergency and medical
transportation services.
Sec. 436. GAO studies and reports on medicare payments.
Sec. 437. MedPAC study on access to outpatient pain management
services.
TITLE V--PROVISIONS RELATING TO PARTS A AND B
Subtitle A--Home Health Services
Sec. 501. 2-year additional delay in application of 15 percent
reduction on payment limits for home health
services.
Sec. 502. Restoration of full home health market basket update for home
health services for fiscal year 2001.
Sec. 503. Temporary two-month extension of periodic interim payments.
Sec. 504. Use of telehealth in delivery of home health services.
Sec. 505. Study on costs to home health agencies of purchasing
nonroutine medical supplies.
Sec. 506. Treatment of branch offices; GAO study on supervision of home
health care provided in isolated rural
areas.
Sec. 507. Clarification of the homebound definition under the medicare
home health benefit.
Sec. 508. Temporary increase for home health services furnished in a
rural area.
Subtitle B--Direct Graduate Medical Education
Sec. 511. Increase in floor for direct graduate medical education
payments.
Sec. 512. Change in distribution formula for Medicare+Choice-related
nursing and allied health education costs.
Subtitle C--Changes in Medicare Coverage and Appeals Process
Sec. 521. Revisions to medicare appeals process.
Sec. 522. Revisions to medicare coverage process.
Subtitle D--Improving Access to New Technologies
Sec. 531. Reimbursement improvements for new clinical laboratory tests
and durable medical equipment.
Sec. 532. Retention of HCPCS level III codes.
Sec. 533. Recognition of new medical technologies under inpatient
hospital PPS.
Subtitle E--Other Provisions
Sec. 541. Increase in reimbursement for bad debt.
Sec. 542. Treatment of certain physician pathology services under
medicare.
Sec. 543. Extension of advisory opinion authority.
Sec. 544. Change in annual MedPAC reporting.
Sec. 545. Development of patient assessment instruments.
Sec. 546. GAO report on impact of the Emergency Medical Treatment and
Active Labor Act (EMTALA) on hospital
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