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. 4994 · Referred in Senate

   SECTION 1. SHORT TITLE[struck: , ETC][inserted: ; TABLE OF CONTENTS].

   (a) Short Title.--This Act may be cited as the "[struck: Taxpayer Assistance ][inserted: Medicare and Medicaid Extenders ]Act of 2010".

   Struck: (b) Amendment of Internal Revenue Code of 1986.--Except as otherwise expressly provided, whenever in this Act an amendment or repeal 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 a section or other provision of the Internal Revenue Code of 1986.

   ([struck: c][inserted: b]) Table of Contents.--The table of contents of this Act is as follows:

   Sec. 1. Short title[struck: , etc][inserted: ; table of contents].

   Struck: TITLE I--CELL PHONES AND ELECTRONIC FILING

   Struck: Sec. 101. Removal of cellular telephones and similar telecommunications equipment from listed property.

   Struck: Sec. 102. Electronic filing exemption for religious reasons.

   Struck: Sec. 103. Accelerate interest on refunds for returns filed electronically.

   Show 111 more struck paragraphsShow less

   Struck: TITLE II--COLLECTION

   Struck: Sec. 201. Study on the effectiveness of collection alternatives.

   Struck: Sec. 202. Repeal of partial payment requirement on submissions of offers-in-compromise.

   Struck: TITLE III--TAXPAYER ASSISTANCE AND PROTECTION IMPROVEMENTS

   Struck: Sec. 301. Referrals to Low-Income Taxpayer Clinics permitted.

   Struck: Sec. 302. Low-income taxpayer clinics.

   Struck: Sec. 303. EITC outreach.

   Struck: Sec. 304. Taxpayer notification of suspected identity theft.

   Struck: Sec. 305. Clarification of IRS unclaimed refund authority.

   Struck: Sec. 306. Study on delivery of tax refunds.

   Struck: Sec. 307. Study on timely processing and use of information returns.

   Struck: Sec. 308. Study on easing the burden of in-person tax payments.

   Struck: TITLE IV--REVENUE PROVISIONS

   Struck: Sec. 401. Expansion of bad check penalty to electronic payments.

   Struck: Sec. 402. Increase in information return penalties.

   Struck: Sec. 403. Budget compliance.

   Struck: TITLE I--CELL PHONES AND ELECTRONIC FILING

   Struck: SEC. 101. REMOVAL OF CELLULAR TELEPHONES AND SIMILAR TELECOMMUNICATIONS EQUIPMENT FROM LISTED PROPERTY.

   Struck: (a) In General.--Subparagraph (A) of section 280F(d)(4) (defining listed property) is amended by adding "and" at the end of clause (iv), by striking clause (v), and by redesignating clause (vi) as clause (v).

   Struck: (b) Effective Date.--The amendment made by subsection (a) shall apply to taxable years beginning after December 31, 2009.

   Struck: SEC. 102. ELECTRONIC FILING EXEMPTION FOR RELIGIOUS REASONS.

   Struck: Paragraph (3) of section 6011(e) (relating to special rule for tax return preparers) is amended by adding at the end the following new subparagraph:

   Struck: "(D) Exemption for religious reasons.--The Secretary may exempt from requirements under subparagraph (A) a tax return preparer who--

   Struck: "(i) is a member of a recognized religious sect or division thereof, and

   Struck: "(ii) is an adherent of established teachings or tenets that do not permit the use of magnetic media.".

   Struck: SEC. 103. ACCELERATE INTEREST ON REFUNDS FOR RETURNS FILED ELECTRONICALLY.

   Struck: (a) In General.--Subsection (e) of section 6611 (relating to disallowance of interest on certain overpayments) is amended by adding at the end the following new paragraph:

   Struck: "(4) Special rule.--In the case of any individual income tax return relating to income tax filed by electronic means, paragraph (1) shall be applied by substituting '30 days' for '45 days' each place it appears.".

   Struck: (b) Effective Date.--The amendments made by subsection (a) shall apply to taxable years beginning after December 31, 2011.

   Struck: TITLE II--COLLECTION

   Struck: SEC. 201. STUDY ON THE EFFECTIVENESS OF COLLECTION ALTERNATIVES.

   Struck: (a) In General.--The Secretary of the Treasury shall conduct a study to assess the effectiveness of collection alternatives, especially offers-in-compromise, on long-term tax compliance. Such a study shall analyze a group of taxpayers who applied for offers-in- compromise 5 or more years ago and compare the amount of revenue collected from the taxpayers whose offers were accepted with the amount of revenue collected from the taxpayers whose offers were rejected, and compare, among the taxpayers whose offers were rejected, the amount they offered with the amounts collected.

   Struck: (b) Report.--Not later than 1 year after the date of enactment of this Act, the Secretary of the Treasury shall submit a report to Congress containing the results of the study conducted under subsection (a).

   Struck: SEC. 202. REPEAL OF PARTIAL PAYMENT REQUIREMENT ON SUBMISSIONS OF OFFERS-IN-COMPROMISE.

   Struck: (a) In General.--Section 7122 is amended by striking subsection (c) and by redesignating subsections (d), (e), (f), and (g) as subsection (c), (d), (e), and (f), respectively.

   Struck: (b) Conforming Amendments.--

   Struck: (1) Paragraph (3) of section 7122(d) is amended--

   Struck: (A) by inserting "and" at the end of the subparagraph (A),

   Struck: (B) by striking ", and" at the end of subparagraph (B) and inserting a period, and

   Struck: (C) by striking subparagraph (C).

   Struck: (2) Subsection (f) of section 6159 is amended by striking "section 7122(e)" and inserting "section 7122(d)".

   Struck: (c) Effective Date.--The amendments made by this section shall apply to offers submitted after the date of the enactment of this Act.

   Struck: TITLE III--TAXPAYER ASSISTANCE AND PROTECTION IMPROVEMENTS

   Struck: SEC. 301. REFERRALS TO LOW-INCOME TAXPAYER CLINICS PERMITTED.

   Struck: (a) In General.--Subsection (c) of section 7526 is amended by adding at the end the following new paragraph:

   Struck: "(6) Treasury employees permitted to refer taxpayers to qualified low-income taxpayer clinics.--Notwithstanding any other provision of law, officers and employees of the Department of the Treasury may refer taxpayers for advice and assistance to qualified low-income taxpayer clinics receiving funding under this section.".

   Struck: (b) Effective Date.--The amendment made by this section shall apply to referrals made after the date of the enactment of this Act.

   Struck: SEC. 302. LOW-INCOME TAXPAYER CLINICS.

   Struck: (a) Increase in Authorized Grants.--Paragraph (1) of section 7526(c) (relating to aggregate limitation) is amended by striking "$6,000,000" and inserting "$20,000,000".

   Struck: (b) Clerical Amendment.--Section 7526(c)(5) is amended by inserting "qualified" before "low-income".

   Struck: (c) Effective Date.--The amendments made by this section shall apply with respect to grants made after the date of the enactment of this Act.

   Struck: SEC. 303. EITC OUTREACH.

   Struck: (a) In General.--Section 32 (relating to earned income) is amended by adding at the end the following new subsection:

   Struck: "(n) Notification of Potential Eligibility for Credit and Refund.--

   Struck: "(1) In general.--To the extent possible and on an annual basis, the Secretary shall provide to each taxpayer who--

   Struck: "(A) for any preceding taxable year for which credit or refund is not precluded by section 6511, and

   Struck: "(B) did not claim the credit under subsection (a) but may be allowed such credit for any such taxable year based on return or return information (as defined in section 6103(b)) available to the Secretary, notice that such taxpayer may be eligible to claim such credit and a refund for such taxable year.

   Struck: "(2) Notice.--Notice provided under paragraph (1) shall be in writing and sent to the last known address of the taxpayer.".

   Struck: (b) Effective Date.--The amendment made by this section shall take effect on the date of the enactment of this Act.

   Struck: SEC. 304. TAXPAYER NOTIFICATION OF SUSPECTED IDENTITY THEFT.

   Struck: (a) In General.--Chapter 77 (relating to miscellaneous provisions), as amended by this Act, is amended by adding at the end the following new section:

   Struck: "SEC. 7529. NOTIFICATION OF SUSPECTED IDENTITY THEFT.

   Struck: "If, in the course of an investigation under the internal revenue laws, the Secretary determines that there was or may have been an unauthorized use of the identity of the taxpayer or a dependent of the taxpayer, the Secretary shall, to the extent permitted by law--

   Struck: "(1) as soon as practicable and without jeopardizing such investigation, notify the taxpayer of such determination, and

   Struck: "(2) if any person is criminally charged by indictment or information with respect to such unauthorized use, notify such taxpayer as soon as practicable of such charge.".

   Struck: (b) Clerical Amendment.--The table of sections for chapter 77 is amended by adding at the end the following new item:

   Struck: "Sec. 7529. Notification of suspected identity theft.".

   Struck: (c) Effective Date.--The amendments made by this section shall apply to determinations made after the date of the enactment of this Act.

   Struck: SEC. 305. CLARIFICATION OF IRS UNCLAIMED REFUND AUTHORITY.

   Struck: Paragraph (1) of section 6103(m) (relating to tax refunds) is amended by inserting ", and through any other means of mass communication," after "media".

   Struck: SEC. 306. STUDY ON DELIVERY OF TAX REFUNDS.

   Struck: (a) In General.--The National Taxpayer Advocate shall conduct a study on the feasibility of delivering tax refunds on debit cards, prepaid cards, and other electronic means to assist individuals that do not have access to financial accounts or institutions.

   Struck: (b) Report.--Not later than 1 year after the date of enactment of this Act, the National Taxpayer Advocate shall submit a report to Congress containing the results of the study conducted under subsection (a).

   Struck: SEC. 307. STUDY ON TIMELY PROCESSING AND USE OF INFORMATION RETURNS.

   Struck: (a) In General.--The Secretary of the Treasury shall conduct a study on the administrative and legislative changes that would be needed to receive and process information returns before processing income tax returns.

   Struck: (b) Report.--Not later than 1 year after the date of the enactment of this Act, the Secretary shall submit a report to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate containing the results of the study conducted under subsection (a), together with such recommendations as the Secretary considers necessary or appropriate for implementation of these changes.

   Struck: SEC. 308. STUDY ON EASING THE BURDEN OF IN-PERSON TAX PAYMENTS.

   Struck: (a) In General.--The Secretary of the Treasury shall conduct a study on how to reduce the number of taxpayers making payments at IRS Taxpayer Assistance Centers. The report shall include an analysis of--

   Struck: (1) whether the Federal Tax Deposit Coupon (Form 8109) could be expanded so that it can be used with all Federal tax deposits and payments, and

   Struck: (2) what current or new return filing, payment, and proof of payment options could be implemented to reduce the burden of in-person payments.

   Struck: (b) Report.--Not later than 1 year after the date of the enactment of this Act, the Secretary shall submit a report to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate containing the results of the study conducted under subsection (a), together with such recommendations as the Secretary considers necessary or appropriate.

   Struck: TITLE IV--REVENUE PROVISIONS

   Struck: SEC. 401. EXPANSION OF BAD CHECK PENALTY TO ELECTRONIC PAYMENTS.

   Struck: (a) In General.--Section 6657 (relating to bad checks) is amended by adding at the end the following: "Except as otherwise provided by the Secretary, any authorization of a payment by commercially acceptable means (within the meaning of section 6311) shall be treated for purposes of this section in the same manner as a check.".

   Struck: (b) Effective Date.--The amendment made by subsection (a) shall apply to authorizations of payments made after December 31, 2010.

   Struck: SEC. 402. INCREASE IN INFORMATION RETURN PENALTIES.

   Struck: (a) Failure To File Correct Information Returns.--

   Struck: (1) In general.--Subsections (a)(1), (b)(1)(A), and (b)(2)(A) of section 6721 are each amended by striking "$50" and inserting "$100".

   Struck: (2) Aggregate annual limitation.--Subsections (a)(1), (d)(1)(A), and (e)(3)(A) of section 6721 are each amended by striking "$250,000" and inserting "$1,500,000".

   Struck: (b) Reduction Where Correction Within 30 Days.--

   Struck: (1) In general.--Subparagraph (A) of section 6721(b)(1) is amended by striking "$15" and inserting "$30".

   Struck: (2) Aggregate annual limitation.--Subsections (b)(1)(B) and (d)(1)(B) of section 6721 are each amended by striking "$75,000" and inserting "$250,000".

   Struck: (c) Reduction Where Correction on or Before August 1.--

   Struck: (1) In general.--Subparagraph (A) of section 6721(b)(2) is amended by striking "$30" and inserting "$60".

   Struck: (2) Aggregate annual limitation.--Subsections (b)(2)(B) and (d)(1)(C) of section 6721 are each amended by striking "$150,000" and inserting "$500,000".

   Struck: (d) Aggregate Annual Limitations for Persons With Gross Receipts of Not More Than $5,000,000.--Paragraph (1) of section 6721(d) is amended--

   Struck: (1) by striking "$100,000" in subparagraph (A) and inserting "$500,000",

   Struck: (2) by striking "$25,000" in subparagraph (B) and inserting "$75,000", and

   Struck: (3) by striking "$50,000" in subparagraph (C) and inserting "$200,000".

   Struck: (e) Penalty in Case of Intentional Disregard.--Paragraph (2) of section 6721(e) is amended by striking "$100" and inserting "$250".

   Struck: (f) Adjustment for Inflation.--Section 6721 is amended by adding at the end the following new subsection:

   Struck: "(f) Adjustment for Inflation.--

   Struck: "(1) In general.--For each fifth calendar year beginning after 2012, each of the dollar amounts under subsections (a), (b), (d) (other than paragraph (2)(A) thereof), and (e) shall be increased by such dollar amount multiplied by the cost-of- living adjustment determined under section 1(f)(3) determined by substituting 'calendar year 2011' for 'calendar year 1992' in subparagraph (B) thereof.

   Struck: "(2) Rounding.--If any amount adjusted under paragraph (1)--

   Struck: "(A) is not less than $75,000 and is not a multiple of $500, such amount shall be rounded to the next lowest multiple of $500, and

   Struck: "(B) is not described in subparagraph (A) and is not a multiple of $10, such amount shall be rounded to the next lowest multiple of $10.".

   Struck: (g) Effective Date.--The amendments made by this section shall apply with respect to information returns required to be filed on or after January 1, 2011.

   Struck: SEC. 403. BUDGET 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 Committee on the Budget of the

   Struck: House of Representatives, provided that such statement has been submitted prior to the vote on passage.

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

   Inserted: TITLE I--EXTENSIONS

   Inserted: Sec. 101. Physician payment update.

   Inserted: Sec. 102. Extension of MMA section 508 reclassifications.

   Inserted: Sec. 103. Extension of Medicare work geographic adjustment floor.

   Inserted: Sec. 104. Extension of exceptions process for Medicare therapy caps.

   Inserted: Sec. 105. Extension of payment for technical component of certain physician pathology services.

   Inserted: Sec. 106. Extension of ambulance add-ons.

   Inserted: Sec. 107. Extension of physician fee schedule mental health add-on payment.

   Inserted: Sec. 108. Extension of outpatient hold harmless provision.

   Inserted: Sec. 109. Extension of Medicare reasonable costs payments for certain clinical diagnostic laboratory tests furnished to hospital patients in certain rural areas.

   Inserted: Sec. 110. Extension of the qualifying individual (QI) program.

   Inserted: Sec. 111. Extension of Transitional Medical Assistance (TMA).

   Show 118 more inserted paragraphsShow less

   Inserted: Sec. 112. Special diabetes programs.

   Inserted: TITLE II--OTHER PROVISIONS

   Inserted: Sec. 201. Clarification of effective date of part B special enrollment period for disabled TRICARE beneficiaries.

   Inserted: Sec. 202. Repeal of delay of RUG-IV.

   Inserted: Sec. 203. Clarification for affiliated hospitals for distribution of additional residency positions.

   Inserted: Sec. 204. Continued inclusion of orphan drugs in definition of covered outpatient drugs with respect to children's hospitals under the 340B drug discount program.

   Inserted: Sec. 205. Medicaid and CHIP technical corrections.

   Inserted: Sec. 206. Funding for claims reprocessing.

   Inserted: Sec. 207. Revision to the Medicare Improvement Fund.

   Inserted: Sec. 208. Limitations on aggregate amount recovered on reconciliation of the health insurance tax credit and the advance of that credit.

   Inserted: Sec. 209. Determination of budgetary effects.

   Inserted: TITLE I--EXTENSIONS

   Inserted: SEC. 101. PHYSICIAN PAYMENT UPDATE.

   Inserted: Section 1848(d) of the Social Security Act (42 U.S.C. 1395w-4(d)) is amended by adding at the end the following new paragraph:

   Inserted: "(12) Update for 2011.--

   Inserted: "(A) In general.--Subject to paragraphs (7)(B), (8)(B), (9)(B), (10)(B), and (11)(B), in lieu of the update to the single conversion factor established in paragraph (1)(C) that would otherwise apply for 2011, the update to the single conversion factor shall be 0 percent.

   Inserted: "(B) No effect on computation of conversion factor for 2012 and subsequent years.--The conversion factor under this subsection shall be computed under paragraph (1)(A) for 2012 and subsequent years as if subparagraph (A) had never applied.".

   Inserted: SEC. 102. EXTENSION OF MMA SECTION 508 RECLASSIFICATIONS.

   Inserted: (a) Extension.--

   Inserted: (1) 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 the Patient Protection and Affordable Care Act (Public Law 111-148), is amended by striking "September 30, 2010" and inserting "September 30, 2011".

   Inserted: (2) Special rule for fiscal year 2011.--

   Inserted: (A) In general.--Subject to subparagraph (B), for purposes of implementation of the amendment made by paragraph (1), including (notwithstanding paragraph (3) of section 117(a) of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173), as amended by section 124(b) of the Medicare Improvements for Patients and Providers Act of 2008 (Public Law 110-275)) for purposes of the implementation of paragraph (2) of such section 117(a), during fiscal year 2011, the Secretary of Health and Human Services shall use the hospital wage index that was promulgated by the Secretary of Health and Human Services in the Federal Register on August 16, 2010 (75 Fed. Reg. 50042), and any subsequent corrections.

   Inserted: (B) Exception.--Beginning on April 1, 2011, in determining the wage index applicable to hospitals that qualify for wage index reclassification, the Secretary shall include the average hourly wage data of hospitals whose reclassification was extended pursuant to the amendment made by paragraph (1) only if including such data results in a higher applicable reclassified wage index. Any revision to hospital wage indexes made as a result of this subparagraph shall not be effected in a budget neutral manner.

   Inserted: (3) Adjustment for certain hospitals in fiscal year 2011.--

   Inserted: (A) In general.--In the case of a subsection (d) hospital (as defined in subsection (d)(1)(B) of section 1886 of the Social Security Act (42 U.S.C. 1395ww)) with respect to which--

   Inserted: (i) a reclassification of its wage index for purposes of such section was extended pursuant to the amendment made by paragraph (1); and

   Inserted: (ii) the wage index applicable for such hospital for the period beginning on October 1, 2010, and ending on March 31, 2011, was lower than for the period beginning on April 1, 2011, and ending on September 30, 2011, by reason of the application of paragraph (2)(B);

   Inserted: the Secretary shall pay such hospital an additional payment that reflects the difference between the wage index for such periods.

   Inserted: (B) Timeframe for payments.--The Secretary shall make payments required under subparagraph (A) by not later than December 31, 2011.

   Inserted: (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".

   Inserted: SEC. 103. EXTENSION OF MEDICARE WORK GEOGRAPHIC ADJUSTMENT FLOOR.

   Inserted: Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 1395w-4(e)(1)(E)) is amended by striking "before January 1, 2011" and inserting "before January 1, 2012".

   Inserted: SEC. 104. EXTENSION OF EXCEPTIONS PROCESS FOR MEDICARE THERAPY CAPS.

   Inserted: Section 1833(g)(5) of the Social Security Act (42 U.S.C. 1395l(g)(5)) is amended by striking "and ending on" and all that follows through "2010" and inserting "and ending on December 31, 2011".

   Inserted: SEC. 105. EXTENSION OF PAYMENT FOR TECHNICAL COMPONENT OF CERTAIN PHYSICIAN PATHOLOGY SERVICES.

   Inserted: Section 542(c) of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (as enacted into law by section 1(a)(6) of Public Law 106-554), as amended by section 732 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (42 U.S.C. 1395w-4 note), section 104 of division B of the Tax Relief and Health Care Act of 2006 (42 U.S.C. 1395w-4 note), section 104 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173), section 136 of the Medicare Improvements for Patients and Providers Act of 2008 (Public Law 110-275), and section 3104 of the Patient Protection and Affordable Care Act (Public Law 111-148) is amended by striking "and 2010" and inserting "2010, and 2011".

   Inserted: SEC. 106. EXTENSION OF AMBULANCE ADD-ONS.

   Inserted: (a) Ground Ambulance.--Section 1834(l)(13)(A) of the Social Security Act (42 U.S.C. 1395m(l)(13)(A)) is amended--

   Inserted: (1) in the matter preceding clause (i), by striking "2011" and inserting "2012,"; and

   Inserted: (2) in each of clauses (i) and (ii), by striking "January 1, 2011" and inserting "January 1, 2012" each place it appears.

   Inserted: (b) Air Ambulance.--Section 146(b)(1) of the Medicare Improvements for Patients and Providers Act of 2008 (Public Law 110-275), as amended by sections 3105(b) and 10311(b) of Public Law 111-148, is amended by striking "December 31, 2010" and inserting "December 31, 2011".

   Inserted: (c) Super Rural Ambulance.--Section 1834(l)(12)(A) of the Social Security Act (42 U.S.C. 1395m(l)(12)(A)) is amended by striking "2011" and inserting "2012".

   Inserted: SEC. 107. EXTENSION OF PHYSICIAN FEE SCHEDULE MENTAL HEALTH ADD-ON PAYMENT.

   Inserted: Section 138(a)(1) of the Medicare Improvements for Patients and Providers Act of 2008 (Public Law 110-275), as amended by section 3107 of the Patient Protection and Affordable Care Act (Public Law 111-148), is amended by striking "December 31, 2010" and inserting "December 31, 2011".

   Inserted: SEC. 108. EXTENSION OF OUTPATIENT HOLD HARMLESS PROVISION.

   Inserted: Section 1833(t)(7)(D)(i) of the Social Security Act (42 U.S.C. 1395l(t)(7)(D)(i)), as amended by section 3121(a) of the Patient Protection and Affordable Care Act (Public Law 111-148), is amended--

   Inserted: (1) in subclause (II)--

   Inserted: (A) in the first sentence, by striking "2011"and inserting "2012"; and

   Inserted: (B) in the second sentence, by striking "or 2010" and inserting "2010, or 2011"; and

   Inserted: (2) in subclause (III), by striking "January 1, 2011" and inserting "January 1, 2012".

   Inserted: SEC. 109. EXTENSION OF MEDICARE REASONABLE COSTS PAYMENTS FOR CERTAIN CLINICAL DIAGNOSTIC LABORATORY TESTS FURNISHED TO HOSPITAL PATIENTS IN CERTAIN RURAL AREAS.

   Inserted: Section 416(b) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (42 U.S.C. 1395l-4), as amended by section 105 of division B of the Tax Relief and Health Care Act of 2006 (42 U.S.C. 1395l note), section 107 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (42 U.S.C. 1395l note), and section 3122 of the Patient Protection and Affordable Care Act (Public Law 111-148), is amended by striking "the 1-year period beginning on July 1, 2010" and inserting "the 2-year period beginning on July 1, 2010".

   Inserted: SEC. 110. EXTENSION OF THE QUALIFYING INDIVIDUAL (QI) PROGRAM.

   Inserted: (a) Extension.--Section 1902(a)(10)(E)(iv) of the Social Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended by striking "December 2010" and inserting "December 2011".

   Inserted: (b) Extending Total Amount Available for Allocation.--Section 1933(g) of such Act (42 U.S.C. 1396u-3(g)) is amended--

   Inserted: (1) in paragraph (2)--

   Inserted: (A) by striking "and" at the end of subparagraph (M);

   Inserted: (B) in subparagraph (N), by striking the period at the end and inserting a semicolon; and

   Inserted: (C) by adding at the end the following new subparagraphs:

   Inserted: "(O) for the period that begins on January 1, 2011, and ends on September 30, 2011, the total allocation amount is $720,000,000; and

   Inserted: "(P) for the period that begins on October 1, 2011, and ends on December 31, 2011, the total allocation amount is $280,000,000."; and

   Inserted: (2) in paragraph (3), in the matter preceding subparagraph (A), by striking "or (N)" and inserting "(N), or (P)".

   Inserted: SEC. 111. EXTENSION OF TRANSITIONAL MEDICAL ASSISTANCE (TMA).

   Inserted: Sections 1902(e)(1)(B) and 1925(f) of the Social Security Act (42 U.S.C. 1396a(e)(1)(B), 1396r-6(f)) are each amended by striking "December 31, 2010" and inserting "December 31, 2011".

   Inserted: SEC. 112. SPECIAL DIABETES PROGRAMS.

   Inserted: (1) Special diabetes programs for type i diabetes.--Section 330B(b)(2)(C) of the Public Health Service Act (42 U.S.C. 254c-2(b)(2)(C)) is amended by striking "2011" and inserting "2013".

   Inserted: (2) Special diabetes programs for indians.--Section 330C(c)(2)(C) of the Public Health Service Act (42 U.S.C. 254c-3(c)(2)(C)) is amended by striking "2011" and inserting "2013".

   Inserted: TITLE II--OTHER PROVISIONS

   Inserted: SEC. 201. CLARIFICATION OF EFFECTIVE DATE OF PART B SPECIAL ENROLLMENT PERIOD FOR DISABLED TRICARE BENEFICIARIES.

   Inserted: 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:

   Inserted: "(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.".

   Inserted: SEC. 202. REPEAL OF DELAY OF RUG-IV.

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

   Inserted: SEC. 203. CLARIFICATION FOR AFFILIATED HOSPITALS FOR DISTRIBUTION OF ADDITIONAL RESIDENCY POSITIONS.

   Inserted: 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:

   Inserted: "(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.".

   Inserted: SEC. 204. CONTINUED INCLUSION OF ORPHAN DRUGS IN DEFINITION OF COVERED OUTPATIENT DRUGS WITH RESPECT TO CHILDREN'S HOSPITALS UNDER THE 340B DRUG DISCOUNT PROGRAM.

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

   Inserted: (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))".

   Inserted: (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).

   Inserted: (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.

   Inserted: SEC. 205. MEDICAID AND CHIP TECHNICAL CORRECTIONS.

   Inserted: (a) Repeal of Exclusion of Certain Individuals and Entities From Medicaid.--Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is amended by striking paragraph (78).

   Inserted: (b) Income Level for Certain Children Under Medicaid.--Section 1902(l)(2)(C) of the Social Security Act (42 U.S.C. 1396a(l)(2)(C)) is amended by striking "133 percent" and inserting "100 percent (or, beginning January 1, 2014, 133 percent)".

   Inserted: (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: (d) Corrections to Exceptions to Exclusion of Children of Certain Employees.--Section 2110(b)(6) of the Social Security Act (42 U.S.C. 1397jj(b)(6)) is amended--

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

   Inserted: (A) by striking "per person" in the heading; and

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

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

   Inserted: (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--

   Inserted: (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

   Inserted: (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".

   Inserted: (f) Corrections of Designations.--

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

   Inserted: (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";

   Inserted: (B) in subsection (a)(23), by striking "(ii)" and inserting "(kk)";

   Inserted: (C) in subsection (a)(77), by striking "(ii)" and inserting "(kk)";

   Inserted: (D) in subsection (ii)(2), as added by section 2303(a)(2) of Public Law 111-148, by striking "(XV)" and inserting "(XVI)"; and

   Inserted: (E) by redesignating subsection (ii), as added by section 6401(b)(1)(B) of Public Law 111-148, as subsection (kk) and transferring such subsection so as to appear after subsection (jj) of that section.

   Inserted: (2) Section 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended--

   Inserted: (A) in subparagraph (D), as added by section 6401(c) of Public Law 111-148, by striking "(ii)" and inserting "(kk)"; and

   Inserted: (B) by redesignating the subparagraph (N) of that section added by 2101(e) of Public Law 111-148 as subparagraph (O).

   Inserted: SEC. 206. FUNDING FOR CLAIMS REPROCESSING.

   Inserted: 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 of, or relating to, such title that ensure appropriate payment 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, $200,000,000. Amounts appropriated under the preceding sentence shall be in addition to any other funds available for such purposes, shall remain available until expended, and shall not be used to implement changes to title XVIII of the Social Security Act made by Public Laws 111-148 and 111-152.

   Inserted: SEC. 207. REVISION TO THE MEDICARE IMPROVEMENT FUND.

   Inserted: Section 1898(b)(1)(B) of the Social Security Act (42 U.S.C. 1395iii(b)(1)(B)) is amended by striking "$550,000,000" and inserting "$275,000,000".

   Inserted: SEC. 208. LIMITATIONS ON AGGREGATE AMOUNT RECOVERED ON RECONCILIATION OF THE HEALTH INSURANCE TAX CREDIT AND THE ADVANCE OF THAT CREDIT.

   Inserted: (a) In General.--So much of section 36B(f)(2)(B) of the Internal Revenue Code of 1986 as precedes clause (ii) thereof is amended to read as follows:

   Inserted: "(B) Limitation on increase.--

   Inserted: "(i) In general.--In the case of a taxpayer whose household income is less than 500 percent of the poverty line for the size of the family involved for the taxable year, the amount of the increase under subparagraph (A) shall in no event exceed the applicable dollar amount determined in accordance with the following table (one-half of such amount in the case of a taxpayer whose tax is determined under section 1(c) for the taxable year):

   Inserted: "If the household income (expressed as a The applicable dollar amount percent of poverty line) is: is:

   Inserted: Less than 200%............................ $600 At least 200% but less than 250%.......... $1,000 At least 250% but less than 300%.......... $1,500 At least 300% but less than 350%.......... $2,000 At least 350% but less than 400%.......... $2,500 At least 400% but less than 450%.......... $3,000 At least 450% but less than 500%.......... $3,500

   Inserted: (b) Conforming Amendment.--Section 36B(f)(2)(B)(ii) of such Code is amended by inserting "in the table contained" after "each of the dollar amounts".

   Inserted: (c) Effective Date.--The amendments made by this section shall apply to taxable years beginning after December 31, 2013.

   Inserted: SEC. 209. DETERMINATION OF BUDGETARY EFFECTS.

   Inserted: (a) In General.--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.

   Inserted: (b) Emergency Designation for Congressional Enforcement.--In the House of Representatives, this Act, with the exception of section 101, is designated as an emergency for purposes of pay-as-you-go principles.

   Original wording

   Strike all after the enacting clause and insert the following:

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As printed