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H.R.3200
Beginning
July 14, 2009
- SECTION 1. SHORT TITLE; TABLE OF DIVISIONS, TITLES, AND SUBTITLES.
- Sec. 100. Purpose; table of contents of division; general definitions.
Subtitle A--General Standards
- SEC. 101. REQUIREMENTS REFORMING HEALTH INSURANCE MARKETPLACE.
- SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
- SEC. 111. PROHIBITING PRE-EXISTING CONDITION EXCLUSIONS.
- SEC. 112. GUARANTEED ISSUE AND RENEWAL FOR INSURED PLANS.
- SEC. 113. INSURANCE RATING RULES.
- SEC. 114. NONDISCRIMINATION IN BENEFITS; PARITY IN MENTAL HEALTH AND SUBSTANCE ABUSE DISORDER BENEFITS.
- SEC. 115. ENSURING ADEQUACY OF PROVIDER NETWORKS.
- SEC. 116. ENSURING VALUE AND LOWER PREMIUMS.
- SEC. 121. COVERAGE OF ESSENTIAL BENEFITS PACKAGE.
- SEC. 122. ESSENTIAL BENEFITS PACKAGE DEFINED.
- SEC. 123. HEALTH BENEFITS ADVISORY COMMITTEE.
- SEC. 124. PROCESS FOR ADOPTION OF RECOMMENDATIONS; ADOPTION OF BENEFIT STANDARDS.
- SEC. 131. REQUIRING FAIR MARKETING PRACTICES BY HEALTH INSURERS.
- SEC. 132. REQUIRING FAIR GRIEVANCE AND APPEALS MECHANISMS.
- SEC. 133. REQUIRING INFORMATION TRANSPARENCY AND PLAN DISCLOSURE.
- SEC. 134. APPLICATION TO QUALIFIED HEALTH BENEFITS PLANS NOT OFFERED THROUGH THE HEALTH INSURANCE EXCHANGE.
- SEC. 135. TIMELY PAYMENT OF CLAIMS.
- SEC. 136. STANDARDIZED RULES FOR COORDINATION AND SUBROGATION OF BENEFITS.
- SEC. 137. APPLICATION OF ADMINISTRATIVE SIMPLIFICATION.
- SEC. 141. HEALTH CHOICES ADMINISTRATION; HEALTH CHOICES COMMISSIONER.
- SEC. 142. DUTIES AND AUTHORITY OF COMMISSIONER.
- SEC. 143. CONSULTATION AND COORDINATION.
- SEC. 144. HEALTH INSURANCE OMBUDSMAN.
- SEC. 151. RELATION TO OTHER REQUIREMENTS.
- SEC. 152. PROHIBITING DISCRIMINATION IN HEALTH CARE.
- SEC. 153. WHISTLEBLOWER PROTECTION.
- SEC. 154. CONSTRUCTION REGARDING COLLECTIVE BARGAINING.
- SEC. 155. SEVERABILITY.
- SEC. 161. ENSURING VALUE AND LOWER PREMIUMS.
- `SEC. 2714. ENSURING VALUE AND LOWER PREMIUMS.
- `SEC. 2754. ENSURING VALUE AND LOWER PREMIUMS.
- SEC. 162. ENDING HEALTH INSURANCE RESCISSION ABUSE.
- `SEC. 2746. OPPORTUNITY FOR INDEPENDENT, EXTERNAL THIRD PARTY REVIEW IN CASES OF RESCISSION.
- SEC. 163. ADMINISTRATIVE SIMPLIFICATION.
- `SEC. 1173A. STANDARDIZE ELECTRONIC ADMINISTRATIVE TRANSACTIONS.
- SEC. 164. REINSURANCE PROGRAM FOR RETIREES.
Subtitle A--Health Insurance Exchange
- SEC. 201. ESTABLISHMENT OF HEALTH INSURANCE EXCHANGE; OUTLINE OF DUTIES; DEFINITIONS.
- SEC. 202. EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS.
- SEC. 203. BENEFITS PACKAGE LEVELS.
- SEC. 204. CONTRACTS FOR THE OFFERING OF EXCHANGE-PARTICIPATING HEALTH BENEFITS PLANS.
- SEC. 206. OTHER FUNCTIONS.
- SEC. 207. HEALTH INSURANCE EXCHANGE TRUST FUND.
- SEC. 208. OPTIONAL OPERATION OF STATE-BASED HEALTH INSURANCE EXCHANGES.
- SEC. 221. ESTABLISHMENT AND ADMINISTRATION OF A PUBLIC HEALTH INSURANCE OPTION AS AN EXCHANGE-QUALIFIED HEALTH BENEFITS PLAN.
- SEC. 222. PREMIUMS AND FINANCING.
- SEC. 223. PAYMENT RATES FOR ITEMS AND SERVICES.
- SEC. 224. MODERNIZED PAYMENT INITIATIVES AND DELIVERY SYSTEM REFORM.
- SEC. 225. PROVIDER PARTICIPATION.
- SEC. 226. APPLICATION OF FRAUD AND ABUSE PROVISIONS.
- SEC. 241. AVAILABILITY THROUGH HEALTH INSURANCE EXCHANGE.
- SEC. 242. AFFORDABLE CREDIT ELIGIBLE INDIVIDUAL.
- SEC. 243. AFFORDABLE PREMIUM CREDIT.
- SEC. 244. AFFORDABILITY COST-SHARING CREDIT.
- SEC. 245. INCOME DETERMINATIONS.
- SEC. 246. NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS.
Subtitle A--Individual Responsibility
- SEC. 301. INDIVIDUAL RESPONSIBILITY.
PART 1--HEALTH COVERAGE PARTICIPATION REQUIREMENTS
- SEC. 311. HEALTH COVERAGE PARTICIPATION REQUIREMENTS.
- SEC. 312. EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARDS EMPLOYEE AND DEPENDENT COVERAGE.
- SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.
- SEC. 314. AUTHORITY RELATED TO IMPROPER STEERING.
- `SEC. 801. ELECTION OF EMPLOYER TO BE SUBJECT TO NATIONAL HEALTH COVERAGE PARTICIPATION REQUIREMENTS.
- `SEC. 802. TREATMENT OF COVERAGE RESULTING FROM ELECTION.
- `SEC. 803. HEALTH COVERAGE PARTICIPATION REQUIREMENTS.
- `SEC. 804. RULES FOR APPLYING REQUIREMENTS.
- `SEC. 805. TERMINATION OF ELECTION IN CASES OF SUBSTANTIAL NONCOMPLIANCE.
- `SEC. 806. REGULATIONS.
- SEC. 322. SATISFACTION OF HEALTH COVERAGE PARTICIPATION REQUIREMENTS UNDER THE INTERNAL REVENUE CODE OF 1986.
- SEC. 323. SATISFACTION OF HEALTH COVERAGE PARTICIPATION REQUIREMENTS UNDER THE PUBLIC HEALTH SERVICE ACT.
- `SEC. 2793. NATIONAL HEALTH COVERAGE PARTICIPATION REQUIREMENTS.
- SEC. 324. ADDITIONAL RULES RELATING TO HEALTH COVERAGE PARTICIPATION REQUIREMENTS.
Subtitle A--Shared Responsibility
PART 1--INDIVIDUAL RESPONSIBILITY
- SEC. 401. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
`subpart a. tax on individuals without acceptable health care coverage.
`Subpart A--Tax on Individuals Without Acceptable Health Care Coverage
- `SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
- `SEC. 6050X. RETURNS RELATING TO HEALTH INSURANCE COVERAGE.
PART 2--EMPLOYER RESPONSIBILITY
- SEC. 411. ELECTION TO SATISFY HEALTH COVERAGE PARTICIPATION REQUIREMENTS.
- `SEC. 4980H. ELECTION WITH RESPECT TO HEALTH COVERAGE PARTICIPATION REQUIREMENTS.
- SEC. 412. RESPONSIBILITIES OF NONELECTING EMPLOYERS.
- SEC. 421. CREDIT FOR SMALL BUSINESS EMPLOYEE HEALTH COVERAGE EXPENSES.
- `SEC. 45R. SMALL BUSINESS EMPLOYEE HEALTH COVERAGE CREDIT.
- SEC. 431. DISCLOSURES TO CARRY OUT HEALTH INSURANCE EXCHANGE SUBSIDIES.
PART 1--GENERAL PROVISIONS
- SEC. 441. SURCHARGE ON HIGH INCOME INDIVIDUALS.
- `SEC. 59C. SURCHARGE ON HIGH INCOME INDIVIDUALS.
- SEC. 442. DELAY IN APPLICATION OF WORLDWIDE ALLOCATION OF INTEREST.
- SEC. 451. LIMITATION ON TREATY BENEFITS FOR CERTAIN DEDUCTIBLE PAYMENTS.
- SEC. 452. CODIFICATION OF ECONOMIC SUBSTANCE DOCTRINE.
- SEC. 453. PENALTIES FOR UNDERPAYMENTS.
- Sec. 1001. Table of contents of division.
- Sec. 1702. Requirements and special rules for certain Medicaid eligible individuals.
- Sec. 1757. Medicaid and CHIP exclusion from participation relating to certain ownership, control, and management affiliations.
- Sec. 1758. Requirement to report expanded set of data elements under MMIS to detect fraud and abuse.
Subtitle A--Provisions Related to Medicare Part A
PART 1--MARKET BASKET UPDATES
- SEC. 1101. SKILLED NURSING FACILITY PAYMENT UPDATE.
- SEC. 1102. INPATIENT REHABILITATION FACILITY PAYMENT UPDATE.
- SEC. 1103. INCORPORATING PRODUCTIVITY IMPROVEMENTS INTO MARKET BASKET UPDATES THAT DO NOT ALREADY INCORPORATE SUCH IMPROVEMENTS.
- SEC. 1111. PAYMENTS TO SKILLED NURSING FACILITIES.
- SEC. 1112. MEDICARE DSH REPORT AND PAYMENT ADJUSTMENTS IN RESPONSE TO COVERAGE EXPANSION.
PART 1--PHYSICIANS' SERVICES
- SEC. 1121. SUSTAINABLE GROWTH RATE REFORM.
- SEC. 1122. MISVALUED CODES UNDER THE PHYSICIAN FEE SCHEDULE.
- SEC. 1123. PAYMENTS FOR EFFICIENT AREAS.
- SEC. 1124. MODIFICATIONS TO THE PHYSICIAN QUALITY REPORTING INITIATIVE (PQRI).
- SEC. 1125. ADJUSTMENT TO MEDICARE PAYMENT LOCALITIES.
- SEC. 1131. INCORPORATING PRODUCTIVITY IMPROVEMENTS INTO MARKET BASKET UPDATES THAT DO NOT ALREADY INCORPORATE SUCH IMPROVEMENTS.
- SEC. 1141. RENTAL AND PURCHASE OF POWER-DRIVEN WHEELCHAIRS.
- SEC. 1142. EXTENSION OF PAYMENT RULE FOR BRACHYTHERAPY.
- SEC. 1143. HOME INFUSION THERAPY REPORT TO CONGRESS.
- SEC. 1144. REQUIRE AMBULATORY SURGICAL CENTERS (ASCS) TO SUBMIT COST DATA AND OTHER DATA.
- SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS.
- SEC. 1146. MEDICARE IMPROVEMENT FUND.
- SEC. 1147. PAYMENT FOR IMAGING SERVICES.
- SEC. 1148. DURABLE MEDICAL EQUIPMENT PROGRAM IMPROVEMENTS.
- SEC. 1149. MEDPAC STUDY AND REPORT ON BONE MASS MEASUREMENT.
- SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS.
- SEC. 1152. POST ACUTE CARE SERVICES PAYMENT REFORM PLAN AND BUNDLING PILOT PROGRAM.
- `SEC. 1866D. CONVERSION OF ACUTE CARE EPISODE DEMONSTRATION TO PILOT PROGRAM AND EXPANSION TO INCLUDE POST ACUTE SERVICES.
- SEC. 1153. HOME HEALTH PAYMENT UPDATE FOR 2010.
- SEC. 1154. PAYMENT ADJUSTMENTS FOR HOME HEALTH CARE.
- SEC. 1155. INCORPORATING PRODUCTIVITY IMPROVEMENTS INTO MARKET BASKET UPDATE FOR HOME HEALTH SERVICES.
- SEC. 1156. LIMITATION ON MEDICARE EXCEPTIONS TO THE PROHIBITION ON CERTAIN PHYSICIAN REFERRALS MADE TO HOSPITALS.
- SEC. 1157. INSTITUTE OF MEDICINE STUDY OF GEOGRAPHIC ADJUSTMENT FACTORS UNDER MEDICARE.
- SEC. 1158. REVISION OF MEDICARE PAYMENT SYSTEMS TO ADDRESS GEOGRAPHIC INEQUITIES.
PART 1--PAYMENT AND ADMINISTRATION
- SEC. 1161. PHASE-IN OF PAYMENT BASED ON FEE-FOR-SERVICE COSTS.
- SEC. 1162. QUALITY BONUS PAYMENTS.
- SEC. 1163. EXTENSION OF SECRETARIAL CODING INTENSITY ADJUSTMENT AUTHORITY.
- SEC. 1164. SIMPLIFICATION OF ANNUAL BENEFICIARY ELECTION PERIODS.
- SEC. 1165. EXTENSION OF REASONABLE COST CONTRACTS.
- SEC. 1166. LIMITATION OF WAIVER AUTHORITY FOR EMPLOYER GROUP PLANS.
- SEC. 1167. IMPROVING RISK ADJUSTMENT FOR PAYMENTS.
- SEC. 1168. ELIMINATION OF MA REGIONAL PLAN STABILIZATION FUND.
- SEC. 1171. LIMITATION ON COST-SHARING FOR INDIVIDUAL HEALTH SERVICES.
- SEC. 1172. CONTINUOUS OPEN ENROLLMENT FOR ENROLLEES IN PLANS WITH ENROLLMENT SUSPENSION.
- SEC. 1173. INFORMATION FOR BENEFICIARIES ON MA PLAN ADMINISTRATIVE COSTS.
- SEC. 1174. STRENGTHENING AUDIT AUTHORITY.
- SEC. 1175. AUTHORITY TO DENY PLAN BIDS.
- SEC. 1177. EXTENSION OF AUTHORITY OF SPECIAL NEEDS PLANS TO RESTRICT ENROLLMENT.
- SEC. 1181. ELIMINATION OF COVERAGE GAP.
- SEC. 1182. DISCOUNTS FOR CERTAIN PART D DRUGS IN ORIGINAL COVERAGE GAP.
- SEC. 1185. PERMITTING MID-YEAR CHANGES IN ENROLLMENT FOR FORMULARY CHANGES THAT ADVERSELY IMPACT AN ENROLLEE.
- SEC. 1191. TELEHEALTH EXPANSION AND ENHANCEMENTS.
- SEC. 1192. EXTENSION OF OUTPATIENT HOLD HARMLESS PROVISION.
- SEC. 1193. EXTENSION OF SECTION 508 HOSPITAL RECLASSIFICATIONS.
- SEC. 1194. EXTENSION OF GEOGRAPHIC FLOOR FOR WORK.
- SEC. 1195. EXTENSION OF PAYMENT FOR TECHNICAL COMPONENT OF CERTAIN PHYSICIAN PATHOLOGY SERVICES.
- SEC. 1196. EXTENSION OF AMBULANCE ADD-ONS.
Subtitle A--Improving and Simplifying Financial Assistance for Low Income Medicare Beneficiaries
- SEC. 1201. IMPROVING ASSETS TESTS FOR MEDICARE SAVINGS PROGRAM AND LOW-INCOME SUBSIDY PROGRAM.
- SEC. 1202. ELIMINATION OF PART D COST-SHARING FOR CERTAIN NON-INSTITUTIONALIZED FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS.
- SEC. 1203. ELIMINATING BARRIERS TO ENROLLMENT.
- SEC. 1204. ENHANCED OVERSIGHT RELATING TO REIMBURSEMENTS FOR RETROACTIVE LOW INCOME SUBSIDY ENROLLMENT.
- SEC. 1205. INTELLIGENT ASSIGNMENT IN ENROLLMENT.
- SEC. 1206. SPECIAL ENROLLMENT PERIOD AND AUTOMATIC ENROLLMENT PROCESS FOR CERTAIN SUBSIDY ELIGIBLE INDIVIDUALS.
- SEC. 1207. APPLICATION OF MA PREMIUMS PRIOR TO REBATE IN CALCULATION OF LOW INCOME SUBSIDY BENCHMARK.
- SEC. 1221. ENSURING EFFECTIVE COMMUNICATION IN MEDICARE.
- SEC. 1223. IOM REPORT ON IMPACT OF LANGUAGE ACCESS SERVICES.
- SEC. 1224. DEFINITIONS.
- SEC. 1231. EXTENSION OF THERAPY CAPS EXCEPTIONS PROCESS.
- SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
- SEC. 1234. PART B SPECIAL ENROLLMENT PERIOD AND WAIVER OF LIMITED ENROLLMENT PENALTY FOR TRICARE BENEFICIARIES.
- SEC. 1236. DEMONSTRATION PROGRAM ON USE OF PATIENT DECISIONS AIDS.
- SEC. 1301. ACCOUNTABLE CARE ORGANIZATION PILOT PROGRAM.
- SEC. 1302. MEDICAL HOME PILOT PROGRAM.
- SEC. 1303. PAYMENT INCENTIVE FOR SELECTED PRIMARY CARE SERVICES.
- SEC. 1304. INCREASED REIMBURSEMENT RATE FOR CERTIFIED NURSE-MIDWIVES.
- SEC. 1305. COVERAGE AND WAIVER OF COST-SHARING FOR PREVENTIVE SERVICES.
- SEC. 1308. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL HEALTH COUNSELOR SERVICES.
`Mental Health Counselor Services
- SEC. 1309. EXTENSION OF PHYSICIAN FEE SCHEDULE MENTAL HEALTH ADD-ON.
- SEC. 1310. EXPANDING ACCESS TO VACCINES.
TITLE IV--QUALITY
Subtitle A--Comparative Effectiveness Research
- SEC. 1401. COMPARATIVE EFFECTIVENESS RESEARCH.
`COMPARATIVE EFFECTIVENESS RESEARCH
Subtitle B--Nursing Home Transparency
PART 1--IMPROVING TRANSPARENCY OF INFORMATION ON SKILLED NURSING FACILITIES AND NURSING FACILITIES
- SEC. 1411. REQUIRED DISCLOSURE OF OWNERSHIP AND ADDITIONAL DISCLOSABLE PARTIES INFORMATION.
- SEC. 1412. ACCOUNTABILITY REQUIREMENTS.
- SEC. 1413. NURSING HOME COMPARE MEDICARE WEBSITE.
- SEC. 1414. REPORTING OF EXPENDITURES.
- SEC. 1415. STANDARDIZED COMPLAINT FORM.
- SEC. 1416. ENSURING STAFFING ACCOUNTABILITY.
- SEC. 1421. CIVIL MONEY PENALTIES.
- SEC. 1422. NATIONAL INDEPENDENT MONITOR PILOT PROGRAM.
- SEC. 1423. NOTIFICATION OF FACILITY CLOSURE.
- SEC. 1431. DEMENTIA AND ABUSE PREVENTION TRAINING.
- SEC. 1432. STUDY AND REPORT ON TRAINING REQUIRED FOR CERTIFIED NURSE AIDES AND SUPERVISORY STAFF.
- SEC. 1441. ESTABLISHMENT OF NATIONAL PRIORITIES FOR QUALITY IMPROVEMENT.
`ESTABLISHMENT OF NATIONAL PRIORITIES FOR PERFORMANCE IMPROVEMENT
- SEC. 1442. DEVELOPMENT OF NEW QUALITY MEASURES; GAO EVALUATION OF DATA COLLECTION PROCESS FOR QUALITY MEASUREMENT.
- `SEC. 1192. DEVELOPMENT OF NEW QUALITY MEASURES.
- `SEC. 1193. GAO EVALUATION OF DATA COLLECTION PROCESS FOR QUALITY MEASUREMENT.
- SEC. 1443. MULTI-STAKEHOLDER PRE-RULEMAKING INPUT INTO SELECTION OF QUALITY MEASURES.
- SEC. 1444. APPLICATION OF QUALITY MEASURES.
- SEC. 1445. CONSENSUS-BASED ENTITY FUNDING.
Subtitle E--Public Reporting on Health Care-Associated Infections
- SEC. 1461. REQUIREMENT FOR PUBLIC REPORTING BY HOSPITALS AND AMBULATORY SURGICAL CENTERS ON HEALTH CARE-ASSOCIATED INFECTIONS.
- `SEC. 1138A. REQUIREMENT FOR PUBLIC REPORTING BY HOSPITALS AND AMBULATORY SURGICAL CENTERS ON HEALTH CARE-ASSOCIATED INFECTIONS.
- SEC. 1501. DISTRIBUTION OF UNUSED RESIDENCY POSITIONS.
- SEC. 1502. INCREASING TRAINING IN NONPROVIDER SETTINGS.
- SEC. 1503. RULES FOR COUNTING RESIDENT TIME FOR DIDACTIC AND SCHOLARLY ACTIVITIES AND OTHER ACTIVITIES.
- SEC. 1504. PRESERVATION OF RESIDENT CAP POSITIONS FROM CLOSED HOSPITALS.
- SEC. 1505. IMPROVING ACCOUNTABILITY FOR APPROVED MEDICAL RESIDENCY TRAINING.
Subtitle A--Increased Funding To Fight Waste, Fraud, and Abuse
- SEC. 1601. INCREASED FUNDING AND FLEXIBILITY TO FIGHT FRAUD AND ABUSE.
- SEC. 1611. ENHANCED PENALTIES FOR FALSE STATEMENTS ON PROVIDER OR SUPPLIER ENROLLMENT APPLICATIONS.
- SEC. 1612. ENHANCED PENALTIES FOR SUBMISSION OF FALSE STATEMENTS MATERIAL TO A FALSE CLAIM.
- SEC. 1613. ENHANCED PENALTIES FOR DELAYING INSPECTIONS.
- SEC. 1614. ENHANCED HOSPICE PROGRAM SAFEGUARDS.
- `SEC. 1819A. ASSURING QUALITY OF CARE IN HOSPICE CARE.
- `SEC. 2114. ASSURING QUALITY OF CARE IN HOSPICE CARE.
- SEC. 1615. ENHANCED PENALTIES FOR INDIVIDUALS EXCLUDED FROM PROGRAM PARTICIPATION.
- SEC. 1616. ENHANCED PENALTIES FOR PROVISION OF FALSE INFORMATION BY MEDICARE ADVANTAGE AND PART D PLANS.
- SEC. 1617. ENHANCED PENALTIES FOR MEDICARE ADVANTAGE AND PART D MARKETING VIOLATIONS.
- SEC. 1618. ENHANCED PENALTIES FOR OBSTRUCTION OF PROGRAM AUDITS.
- SEC. 1619. EXCLUSION OF CERTAIN INDIVIDUALS AND ENTITIES FROM PARTICIPATION IN MEDICARE AND STATE HEALTH CARE PROGRAMS.
- SEC. 1631. ENHANCED CMS PROGRAM PROTECTION AUTHORITY.
- `SEC. 1128G. ENHANCED PROGRAM AND PROVIDER PROTECTIONS IN THE MEDICARE, MEDICAID, AND CHIP PROGRAMS.
- SEC. 1632. ENHANCED MEDICARE, MEDICAID, AND CHIP PROGRAM DISCLOSURE REQUIREMENTS RELATING TO PREVIOUS AFFILIATIONS.
- SEC. 1633. REQUIRED INCLUSION OF PAYMENT MODIFIER FOR CERTAIN EVALUATION AND MANAGEMENT SERVICES.
- SEC. 1634. EVALUATIONS AND REPORTS REQUIRED UNDER MEDICARE INTEGRITY PROGRAM.
- SEC. 1635. REQUIRE PROVIDERS AND SUPPLIERS TO ADOPT PROGRAMS TO REDUCE WASTE, FRAUD, AND ABUSE.
- SEC. 1636. MAXIMUM PERIOD FOR SUBMISSION OF MEDICARE CLAIMS REDUCED TO NOT MORE THAN 12 MONTHS.
- SEC. 1638. REQUIREMENT FOR PHYSICIANS TO PROVIDE DOCUMENTATION ON REFERRALS TO PROGRAMS AT HIGH RISK OF WASTE AND ABUSE.
- SEC. 1640. EXTENSION OF TESTIMONIAL SUBPOENA AUTHORITY TO PROGRAM EXCLUSION INVESTIGATIONS.
- SEC. 1641. REQUIRED REPAYMENTS OF MEDICARE AND MEDICAID OVERPAYMENTS.
- SEC. 1642. EXPANDED APPLICATION OF HARDSHIP WAIVERS FOR OIG EXCLUSIONS TO BENEFICIARIES OF ANY FEDERAL HEALTH CARE PROGRAM.
- SEC. 1643. ACCESS TO CERTAIN INFORMATION ON RENAL DIALYSIS FACILITIES.
- SEC. 1644. BILLING AGENTS, CLEARINGHOUSES, OR OTHER ALTERNATE PAYEES REQUIRED TO REGISTER UNDER MEDICARE.
- SEC. 1645. CONFORMING CIVIL MONETARY PENALTIES TO FALSE CLAIMS ACT AMENDMENTS.
- SEC. 1651. ACCESS TO INFORMATION NECESSARY TO IDENTIFY FRAUD, WASTE, AND ABUSE.
- SEC. 1653. COMPLIANCE WITH HIPAA PRIVACY AND SECURITY STANDARDS.
Subtitle A--Medicaid and Health Reform
- SEC. 1701. ELIGIBILITY FOR INDIVIDUALS WITH INCOME BELOW 133 1/3 PERCENT OF THE FEDERAL POVERTY LEVEL.
- SEC. 1702. REQUIREMENTS AND SPECIAL RULES FOR CERTAIN MEDICAID ELIGIBLE INDIVIDUALS.
- SEC. 1703. CHIP AND MEDICAID MAINTENANCE OF EFFORT.
- SEC. 1704. REDUCTION IN MEDICAID DSH.
- SEC. 1705. EXPANDED OUTSTATIONING.
- SEC. 1711. REQUIRED COVERAGE OF PREVENTIVE SERVICES.
- SEC. 1712. TOBACCO CESSATION.
- SEC. 1713. OPTIONAL COVERAGE OF NURSE HOME VISITATION SERVICES.
- SEC. 1714. STATE ELIGIBILITY OPTION FOR FAMILY PLANNING SERVICES.
Subtitle C--Access
- SEC. 1721. PAYMENTS TO PRIMARY CARE PRACTITIONERS.
- SEC. 1722. MEDICAL HOME PILOT PROGRAM.
- SEC. 1723. TRANSLATION OR INTERPRETATION SERVICES.
- SEC. 1724. OPTIONAL COVERAGE FOR FREESTANDING BIRTH CENTER SERVICES.
- SEC. 1725. INCLUSION OF PUBLIC HEALTH CLINICS UNDER THE VACCINES FOR CHILDREN PROGRAM.
- SEC. 1731. OPTIONAL MEDICAID COVERAGE OF LOW-INCOME HIV-INFECTED INDIVIDUALS.
- SEC. 1732. EXTENDING TRANSITIONAL MEDICAID ASSISTANCE (TMA).
- SEC. 1733. REQUIREMENT OF 12-MONTH CONTINUOUS COVERAGE UNDER CERTAIN CHIP PROGRAMS.
- SEC. 1741. PAYMENTS TO PHARMACISTS.
- SEC. 1742. PRESCRIPTION DRUG REBATES.
- SEC. 1743. EXTENSION OF PRESCRIPTION DRUG DISCOUNTS TO ENROLLEES OF MEDICAID MANAGED CARE ORGANIZATIONS.
- SEC. 1744. PAYMENTS FOR GRADUATE MEDICAL EDUCATION.
- SEC. 1751. HEALTH-CARE ACQUIRED CONDITIONS.
- SEC. 1752. EVALUATIONS AND REPORTS REQUIRED UNDER MEDICAID INTEGRITY PROGRAM.
- SEC. 1753. REQUIRE PROVIDERS AND SUPPLIERS TO ADOPT PROGRAMS TO REDUCE WASTE, FRAUD, AND ABUSE.
- SEC. 1754. OVERPAYMENTS.
- SEC. 1755. MANAGED CARE ORGANIZATIONS.
- SEC. 1757. MEDICAID AND CHIP EXCLUSION FROM PARTICIPATION RELATING TO CERTAIN OWNERSHIP, CONTROL, AND MANAGEMENT AFFILIATIONS.
- SEC. 1758. REQUIREMENT TO REPORT EXPANDED SET OF DATA ELEMENTS UNDER MMIS TO DETECT FRAUD AND ABUSE.
- SEC. 1759. BILLING AGENTS, CLEARINGHOUSES, OR OTHER ALTERNATE PAYEES REQUIRED TO REGISTER UNDER MEDICAID.
- SEC. 1760. DENIAL OF PAYMENTS FOR LITIGATION-RELATED MISCONDUCT.
- SEC. 1771. PUERTO RICO AND TERRITORIES.
- SEC. 1781. TECHNICAL CORRECTIONS.
- SEC. 1782. EXTENSION OF QI PROGRAM.
- SEC. 1802. COMPARATIVE EFFECTIVENESS RESEARCH TRUST FUND; FINANCING FOR TRUST FUND.
- `SEC. 9511. HEALTH CARE COMPARATIVE EFFECTIVENESS RESEARCH TRUST FUND.
- `SEC. 4375. HEALTH INSURANCE.
- `SEC. 4376. SELF-INSURED HEALTH PLANS.
- `SEC. 4377. DEFINITIONS AND SPECIAL RULES.
`subchapter a. policies issued by foreign insurers
`subchapter b. insured and self-insured health plans
`Subchapter A--Policies Issued By Foreign Insurers'.
`Chapter 34--Taxes on Certain Insurance Policies'.
TITLE IX--MISCELLANEOUS PROVISIONS
- SEC. 1901. REPEAL OF TRIGGER PROVISION.
- SEC. 1902. REPEAL OF COMPARATIVE COST ADJUSTMENT (CCA) PROGRAM.
- SEC. 1903. EXTENSION OF GAINSHARING DEMONSTRATION.
- `SEC. 440. HOME VISITATION PROGRAMS FOR FAMILIES WITH YOUNG CHILDREN AND FAMILIES EXPECTING CHILDREN.
- SEC. 1905. IMPROVED COORDINATION AND PROTECTION FOR DUAL ELIGIBLES.
DIVISION C--PUBLIC HEALTH AND WORKFORCE DEVELOPMENT
- Sec. 2001. Table of contents; references.
- SEC. 2002. PUBLIC HEALTH INVESTMENT FUND.
- SEC. 2101. INCREASED FUNDING.
Subtitle A--Primary Care Workforce
PART 1--NATIONAL HEALTH SERVICE CORPS
- SEC. 2201. NATIONAL HEALTH SERVICE CORPS.
- SEC. 2202. AUTHORIZATIONS OF APPROPRIATIONS.
- `SEC. 338H-1. ADDITIONAL FUNDING.
- SEC. 2211. FRONTLINE HEALTH PROVIDERS.
- `SEC. 340H. IN GENERAL.
- `SEC. 340I. LOAN REPAYMENTS.
- `SEC. 340J. REPORT.
- `SEC. 340K. ALLOCATION.
- SEC. 2212. PRIMARY CARE STUDENT LOAN FUNDS.
- SEC. 2213. TRAINING IN FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, GENERAL PEDIATRICS, GERIATRICS, AND PHYSICIAN ASSISTANTSHIP.
- SEC. 2214. TRAINING OF MEDICAL RESIDENTS IN COMMUNITY-BASED SETTINGS.
- `SEC. 748. TRAINING OF MEDICAL RESIDENTS IN COMMUNITY-BASED SETTINGS.
- SEC. 2215. TRAINING FOR GENERAL, PEDIATRIC, AND PUBLIC HEALTH DENTISTS AND DENTAL HYGIENISTS.
- `SEC. 749. TRAINING FOR GENERAL, PEDIATRIC, AND PUBLIC HEALTH DENTISTS AND DENTAL HYGIENISTS.
- SEC. 2216. AUTHORIZATION OF APPROPRIATIONS.
- `SEC. 799C. FUNDING THROUGH PUBLIC HEALTH INVESTMENT FUND.
- SEC. 2221. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.
- `SEC. 872. FUNDING THROUGH PUBLIC HEALTH INVESTMENT FUND.
- `SEC. 871. FUNDING.
- SEC. 2231. PUBLIC HEALTH WORKFORCE CORPS.
- `SEC. 340L. PUBLIC HEALTH WORKFORCE CORPS.
- `SEC. 340M. PUBLIC HEALTH WORKFORCE SCHOLARSHIP PROGRAM.
- `SEC. 340N. PUBLIC HEALTH WORKFORCE LOAN REPAYMENT PROGRAM.
- SEC. 2232. ENHANCING THE PUBLIC HEALTH WORKFORCE.
- `SEC. 765. ENHANCING THE PUBLIC HEALTH WORKFORCE.
- SEC. 2233. PUBLIC HEALTH TRAINING CENTERS.
- SEC. 2234. PREVENTIVE MEDICINE AND PUBLIC HEALTH TRAINING GRANT PROGRAM.
- `SEC. 768. PREVENTIVE MEDICINE AND PUBLIC HEALTH TRAINING GRANT PROGRAM.
- SEC. 2235. AUTHORIZATION OF APPROPRIATIONS.
PART 1--HEALTH PROFESSIONS TRAINING FOR DIVERSITY
- SEC. 2242. NURSING WORKFORCE DIVERSITY GRANTS.
- SEC. 2243. COORDINATION OF DIVERSITY AND CULTURAL COMPETENCY PROGRAMS.
- `SEC. 739A. COORDINATION OF DIVERSITY AND CULTURAL COMPETENCY PROGRAMS.
- SEC. 2251. CULTURAL AND LINGUISTIC COMPETENCY TRAINING FOR HEALTH CARE PROFESSIONALS.
- SEC. 2252. INNOVATIONS IN INTERDISCIPLINARY CARE TRAINING.
- `SEC. 759. INNOVATIONS IN INTERDISCIPLINARY CARE TRAINING.
- SEC. 2261. HEALTH WORKFORCE EVALUATION AND ASSESSMENT.
- `SEC. 764. HEALTH WORKFORCE EVALUATION AND ASSESSMENT.
- SEC. 2271. HEALTH WORKFORCE ASSESSMENT.
- SEC. 2281. AUTHORIZATION OF APPROPRIATIONS.
- SEC. 2301. PREVENTION AND WELLNESS.
`Subtitle A--Prevention and Wellness Trust
- `SEC. 3111. PREVENTION AND WELLNESS TRUST.
- `SEC. 3121. NATIONAL PREVENTION AND WELLNESS STRATEGY.
- `SEC. 3131. TASK FORCE ON CLINICAL PREVENTIVE SERVICES.
- `SEC. 3132. TASK FORCE ON COMMUNITY PREVENTIVE SERVICES.
- `SEC. 3141. PREVENTION AND WELLNESS RESEARCH ACTIVITY COORDINATION.
- `SEC. 3142. COMMUNITY PREVENTION AND WELLNESS RESEARCH GRANTS.
- `SEC. 3151. COMMUNITY PREVENTION AND WELLNESS SERVICES GRANTS.
- `SEC. 3161. CORE PUBLIC HEALTH INFRASTRUCTURE FOR STATE, LOCAL, AND TRIBAL HEALTH DEPARTMENTS.
- `SEC. 3162. CORE PUBLIC HEALTH INFRASTRUCTURE AND ACTIVITIES FOR CDC.
- `SEC. 3171. DEFINITIONS.
- SEC. 2401. IMPLEMENTATION OF BEST PRACTICES IN THE DELIVERY OF HEALTH CARE.
- `SEC. 931. CENTER FOR QUALITY IMPROVEMENT.
- SEC. 2402. ASSISTANT SECRETARY FOR HEALTH INFORMATION.
- `SEC. 1709. ASSISTANT SECRETARY FOR HEALTH INFORMATION.
- SEC. 2403. AUTHORIZATION OF APPROPRIATIONS.
Subtitle A--Drug Discount for Rural and Other Hospitals
- SEC. 2501. EXPANDED PARTICIPATION IN 340B PROGRAM.
- SEC. 2502. EXTENSION OF DISCOUNTS TO INPATIENT DRUGS.
- SEC. 2503. EFFECTIVE DATE.
- SEC. 2511. SCHOOL-BASED HEALTH CLINICS.
- `SEC. 399Z-1. SCHOOL-BASED HEALTH CLINICS.
- SEC. 2521. NATIONAL MEDICAL DEVICE REGISTRY.
Subtitle D--Grants for Comprehensive Programs To Provide Education to Nurses and Create a Pipeline to Nursing
- SEC. 2531. ESTABLISHMENT OF GRANT PROGRAM.
- SEC. 2541. LIMITATION ON FEDERAL FUNDS.
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