Home > 106th Congressional Bills > H.R. 5662 (ih) To amend the Internal Revenue Code of 1986 to provide for community revitalization and a 2-year extension of medical saving accounts, and for other purposes. [Introduced in House] ...

H.R. 5662 (ih) To amend the Internal Revenue Code of 1986 to provide for community revitalization and a 2-year extension of medical saving accounts, and for other purposes. [Introduced in House] ...


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106th CONGRESS
  2d Session
                                H. R. 5661

   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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 14, 2000

Mr. Thomas (for himself, Mr. Bliley, and Mr. Bilirakis) 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

_______________________________________________________________________

                                 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 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.
               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. 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.
Sec. 128. Lifestyle modification program demonstration.
                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. Treatment of rural disproportionate share hospitals.
Sec. 212. Option to base eligibility for medicare dependent, small 
                            rural hospital program on discharges during 
                            two of the three 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. Revision of acute care hospital payment update for 2001.
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.
 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. Five percent increase in payment base.
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.
                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.
        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. One-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. Contrast enhanced diagnostic procedures under hospital 
                            prospective payment system.
Sec. 431. Qualifications for community mental health centers.
Sec. 432. Payment of physician and nonphysician services in certain 
                            Indian providers.
Sec. 433. GAO study on coverage of surgical first assisting services of 
                            certified registered nurse first 
                            assistants.
Sec. 434. MedPAC study and report on medicare reimbursement for 
                            services provided by certain providers.
Sec. 435. MedPAC study and report on medicare coverage of services 
                            provided by certain nonphysician providers.
Sec. 436. GAO study and report on the costs of emergency and medical 
                            transportation services.
Sec. 437. GAO studies and reports on medicare payments.
Sec. 438. 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. One-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 periodic interim payment.
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 
                            emergency departments.
Sec. 547. Clarification of application of temporary payment increases 
                            for 2001.
 TITLE VI--PROVISIONS RELATING TO PART C (MEDICARE+CHOICE PROGRAM) AND 
                 OTHER MEDICARE MANAGED CARE PROVISIONS

              Subtitle A--Medicare+Choice Payment Reforms

Sec. 601. Increase in minimum payment amount.
Sec. 602. Increase in minimum percentage increase.
Sec. 603. Phase-in of risk adjustment.
Sec. 604. Transition to revised Medicare+Choice payment rates.
Sec. 605. Revision of payment rates for ESRD patients enrolled in 

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