In the nature of a substitute.

1. Replaces the bill's text with a full substitute

   Replaces the full textEverything after the enacting clause

   In H.R. 5712 · Placed on Calendar Senate

   SECTION 1. SHORT TITLE.

   This Act may be cited as the "[struck: Veterans', Seniors', ][inserted: The Physician Payment ]and [struck: Children's Health Technical Corrections ][inserted: Therapy Relief ]Act of 2010".

   Struck: SEC. 2. CLARIFICATION OF EFFECTIVE DATE OF PART B SPECIAL ENROLLMENT PERIOD FOR DISABLED TRICARE BENEFICIARIES.

   Struck: Effective as if included in the enactment of Public Law 111-148, section 3110(a)(2) of such Act is amended to read as follows:

   Struck: "(2) Effective date.--The amendment made by paragraph (1) shall apply to elections made on and after the date of the enactment of this Act.".

   Struck: SEC. 3. REPEAL OF DELAY OF RUG-IV.

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   Struck: Effective as if included in the enactment of Public Law 111-148, section 10325 of such Act is repealed.

   Struck: SEC. 4. CLARIFICATION FOR AFFILIATED HOSPITALS FOR DISTRIBUTION OF ADDITIONAL RESIDENCY POSITIONS.

   Struck: Effective as if included in the enactment of section 5503(a) of Public Law 111-148, section 1886(h)(8) of the Social Security Act (42 U.S.C. 1395ww(h)(8)), as added by such section 5503(a), is amended by adding at the end the following new subparagraph:

   Struck: "(I) Affiliation.--The provisions of this paragraph shall be applied to hospitals which are members of the same affiliated group (as defined by the Secretary under paragraph (4)(H)(ii)) and the reference resident level for each such hospital shall be the reference resident level with respect to the cost reporting period that results in the smallest difference between the reference resident level and the otherwise applicable resident limit.".

   Struck: SEC. 5. CONTINUED INCLUSION OF ORPHAN DRUGS IN DEFINITION OF COVERED OUTPATIENT DRUGS WITH RESPECT TO CHILDREN'S HOSPITALS UNDER THE 340B DRUG DISCOUNT PROGRAM.

   Struck: (a) Definition of Covered Outpatient Drug.--

   Struck: (1) Amendment.--Subsection (e) of section 340B of the Public Health Service Act (42 U.S.C. 256b) is amended by striking "covered entities described in subparagraph (M)" and inserting "covered entities described in subparagraph (M) (other than a children's hospital described in subparagraph (M))".

   Struck: (2) Effective date.--The amendment made by paragraph (1) shall take effect as if included in the enactment of section 2302 of the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152).

   Struck: (b) Technical Amendment.--Subparagraph (B) of section 1927(a)(5) of the Social Security Act (42 U.S.C. 1396r-8(a)(5)) is amended by striking "and a children's hospital" and all that follows through the end of the subparagraph and inserting a period.

   Struck: SEC. 6. MEDICAID AND CHIP TECHNICAL CORRECTIONS.

   Struck: (a) Repeal of Exclusion of Certain Individuals and Entities From Medicaid.--Section 6502 of Public Law 111-148 is repealed and the provisions of law amended by such section are restored as if such section had never been enacted. Nothing in the previous sentence shall affect the execution or placement of the insertion made by section 6503 of such Act.

   Struck: (b) Income Level for Certain Children Under Medicaid.--Effective as if included in the enactment of Public Law 111-148, section 2001(a)(5)(B) of such Act is amended by striking all that follows "is amended" and inserting the following: "by inserting after '100 percent' the following: '(or, beginning January 1, 2014, 133 percent)'.".

   Struck: (c) Calculation and Publication of Payment Error Rate Measurement for Certain Years.--Section 601(b) of the Children's Health Insurance Program Reauthorization Act of 2009 (Public Law 111-3) is amended by adding at the end the following: "The Secretary is not required under this subsection to calculate or publish a national or a State-specific error rate for fiscal year 2009 or fiscal year 2010.".

   Inserted: SEC. 2. PHYSICIAN PAYMENT UPDATE.

   [struck: (d) Corrections to Exceptions to Exclusion of Children of Certain Employees.--]Section [struck: 2110][inserted: 1848]([struck: b][inserted: d])([struck: 6][inserted: 11]) of the Social Security Act (42 U.S.C. [struck: 1397jj][inserted: 1395w-4]([struck: b][inserted: d])([struck: 6][inserted: 11])) is amended--

   Struck: (1) in subparagraph (B)--

   ([struck: A][inserted: 1]) [inserted: in the heading, ]by striking "[struck: per person][inserted: november]" [struck: in the heading; and][inserted: and inserting "december";]

   Struck: (B) by striking "each employee" and inserting "employees"; and

   Struck: (2) in subparagraph (C), by striking ", on a case-by-case basis,".

   Struck: (e) Electronic Health Records.--Effective as if included in the enactment of section 4201(a)(2) of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5), section 1903(t) of the Social Security Act (42 U.S.C. 1396b(t)) is amended--

   Struck: (1) in paragraph (3)(E), by striking "reduced by any payment that is made to such Medicaid provider from any other source (other than under this subsection or by a State or local government)" and inserting "reduced by the average payment the Secretary estimates will be made to such Medicaid providers (determined on a percentage or other basis for such classes or types of providers as the Secretary may specify) from other sources (other than under this subsection, or by the Federal government or a State or local government)"; and

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   Struck: (2) in paragraph (6)(B), by inserting before the period the following: "and shall be determined to have met such responsibility to the extent that the payment to the Medicaid provider is not in excess of 85 percent of the net average allowable cost".

   Struck: (f) Corrections of Designations.--

   Struck: (1) Section 1902 of the Social Security Act (42 U.S.C. 1396a) is amended--

   Struck: (A) in subsection (a)(10), in the matter following subparagraph (G), by striking "and" before "(XVI) the medical" and by striking "(XVI) if" and inserting "(XVII) if"; and

   ([struck: B][inserted: 2]) in [struck: subsection][inserted: subparagraph] ([struck: ii][inserted: A])[struck: (2)], by striking "[struck: (XV)][inserted: November 30]" and inserting "[struck: (XVI)][inserted: December 31]"[struck: .][inserted: ; and]

   Struck: (2) Section 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended by redesignating the subparagraph (N) of that section added by 2101(e) of Public Law 111-148 as subparagraph (O).

   Struck: SEC. 7. FUNDING FOR CLAIMS REPROCESSING.

   Struck: For purposes of carrying out the provisions of, and amendments made by, this Act that relate to title XVIII of the Social Security Act, and other provisions relating to such title that involve reprocessing of claims, there are appropriated to the Secretary of Health and Human Services for the Centers for Medicare & Medicaid Services Program Management Account, from amounts in the general fund of the Treasury not otherwise appropriated, $95,000,000. Amounts appropriated under the preceding sentence shall remain available until expended.

   Struck: SEC. 8. EXTENSION OF SECTION 508 RECLASSIFICATIONS.

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   Struck: (a) In General.--Section 106(a) of division B of the Tax Relief and Health Care Act of 2006 (42 U.S.C. 1395 note), as amended by section 117 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173), section 124 of the Medicare Improvements for Patients and Providers Act of 2008 (Public Law 110-275), and sections 3137(a) and 10317 of Public Law 111-148, is amended by striking "September 30, 2010" and inserting "September 30, 2011".

   Struck: (b) Conforming Amendment.--Section 117(a)(3) of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173), is amended by inserting "in fiscal years 2008 and 2009" after "For purposes of implementation of this subsection".

   Struck: SEC. 9. REVISION TO THE MEDICARE IMPROVEMENT FUND.

   Struck: Section 1898(b)(1) of the Social Security Act (42 U.S.C. 1395iii(b)(1)) is amended by striking subparagraphs (A) and (B) and inserting the following subparagraphs:

   Struck: "(A) fiscal year 2015, $0;

   Struck: "(B) fiscal year 2016, $125,000,000; and".

   Struck: SEC. 10. PAYGO COMPLIANCE.

   Struck: The budgetary effects of this Act, for the purpose of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled "Budgetary Effects of PAYGO Legislation" for this Act, submitted for printing in the Congressional Record by the Chairman of the House Budget Committee, provided that such statement has been submitted prior to the vote on passage.

   Struck: Passed the House of Representatives July 14, 2010.

   Inserted: (3) in subparagraph (B)--

   Inserted: (A) in the heading, by striking "remaining portion of 2010" and inserting "2011"; and

   Inserted: (B) by striking "the period beginning on December 1, 2010, and ending on December 31, 2010, and for".

   Inserted: SEC. 3. TREATMENT OF MULTIPLE SERVICE PAYMENT POLICIES FOR THERAPY SERVICES.

   Inserted: (a) Smaller Payment Discount for Certain Multiple Therapy Services.--Section 1848(b) of the Social Security Act (42 U.S.C. 1395w-4(b)) is amended by adding at the end the following new paragraph:

   Inserted: "(7) Adjustment in discount for certain multiple therapy services.--In the case of therapy services furnished on or after January 1, 2011, and for which payment is made under fee schedules established under this section, instead of the 25 percent multiple procedure payment reduction specified in the final rule published by the Secretary in the Federal Register on November 29, 2010, the reduction percentage shall be 20 percent.".

   Inserted: (b) Exemption of Payment Reduction From Budget-neutrality.--Section 1848(c)(2)(B)(v) of the Social Security Act (42 U.S.C. 1395w-4(c)(2)(B)(v)) is amended by adding at the end the following new subclause:

   Inserted: "(VII) Reduced expenditures for multiple therapy services.--Effective for fee schedules established beginning with 2011, reduced expenditures attributable to the multiple procedure payment reduction for therapy services (as described in subsection (b)(7)).".

   Inserted: SEC. 4. DETERMINATION OF BUDGETARY EFFECTS.

   Inserted: The budgetary effects of this Act, for the purpose of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled "Budgetary Effects of PAYGO Legislation" for this Act, submitted for printing in the Congressional Record by the Chairman of the Senate Budget Committee, provided that such statement has been submitted prior to the vote on passage.

   Original wording

   Strike all after the enacting clause and insert the following:

Read automatically from the Congressional Record. Check the original before relying on it.

As printed