HR 3962 IH

111th CONGRESS

1st Session

H. R. 3962

To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

October 29, 2009

Mr. DINGELL (for himself, Mr. RANGEL, Mr. WAXMAN, Mr. GEORGE MILLER of California, Mr. STARK, Mr. PALLONE, and Mr. ANDREWS) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Labor, Ways and Means, Oversight and Government Reform, the Budget, Rules, Natural Resources, and the Judiciary, 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 provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

SECTION 1. SHORT TITLE; TABLE OF DIVISIONS, TITLES, AND SUBTITLES.

DIVISION A--AFFORDABLE HEALTH CARE CHOICES

DIVISION B--MEDICARE AND MEDICAID IMPROVEMENTS

DIVISION C--PUBLIC HEALTH AND WORKFORCE DEVELOPMENT

DIVISION D--INDIAN HEALTH CARE IMPROVEMENT

DIVISION A--AFFORDABLE HEALTH CARE CHOICES

SEC. 100. PURPOSE; TABLE OF CONTENTS OF DIVISION; GENERAL DEFINITIONS.

TITLE I--IMMEDIATE REFORMS

TITLE II--PROTECTIONS AND STANDARDS FOR QUALIFIED HEALTH BENEFITS PLANS

Subtitle A--General Standards

Subtitle B--Standards Guaranteeing Access to Affordable Coverage

Subtitle C--Standards Guaranteeing Access to Essential Benefits

Subtitle D--Additional Consumer Protections

Subtitle E--Governance

Subtitle F--Relation to Other Requirements; Miscellaneous

TITLE III--HEALTH INSURANCE EXCHANGE AND RELATED PROVISIONS

Subtitle A--Health Insurance Exchange

Subtitle B--Public Health Insurance Option

Subtitle C--Individual Affordability Credits

TITLE IV--SHARED RESPONSIBILITY

Subtitle A--Individual Responsibility

Subtitle B--Employer Responsibility

Part 1--Health Coverage Participation Requirements

Part 2--Satisfaction of Health Coverage Participation Requirements

TITLE V--AMENDMENTS TO INTERNAL REVENUE CODE OF 1986

Subtitle A--Provisions Relating to Health Care Reform

Part 1--Shared Responsibility

subpart a--individual responsibility

subpart b--employer responsibility

Part 2--Credit for Small Business Employee Health Coverage Expenses

Part 3--Limitations on Health Care Related Expenditures

Part 4--Other Provisions to Carry Out Health Insurance Reform

Subtitle B--Other Revenue Provisions

Part 1--General Provisions

Part 2--Prevention of Tax Avoidance

Part 3--Parity in Health Benefits

TITLE I--IMMEDIATE REFORMS

SEC. 101. NATIONAL HIGH-RISK POOL PROGRAM.

SEC. 102. ENSURING VALUE AND LOWER PREMIUMS.

`SEC. 2714. ENSURING VALUE AND LOWER PREMIUMS.

`SEC. 2754. ENSURING VALUE AND LOWER PREMIUMS.

SEC. 103. ENDING HEALTH INSURANCE RESCISSION ABUSE.

`SEC. 2746. OPPORTUNITY FOR INDEPENDENT, EXTERNAL THIRD-PARTY REVIEW IN CASES OF RESCISSION.

`SEC. 2703. OPPORTUNITY FOR INDEPENDENT, EXTERNAL THIRD-PARTY REVIEW IN CASES OF RESCISSION.

SEC. 104. SUNSHINE ON PRICE GOUGING BY HEALTH INSURANCE ISSUERS.

SEC. 105. REQUIRING THE OPTION OF EXTENSION OF DEPENDENT COVERAGE FOR UNINSURED YOUNG ADULTS.

`SEC. 2703. REQUIRING THE OPTION OF EXTENSION OF DEPENDENT COVERAGE FOR UNINSURED YOUNG ADULTS.

`SEC. 704. REQUIRING THE OPTION OF EXTENSION OF DEPENDENT COVERAGE FOR UNINSURED YOUNG ADULTS.

`SEC. 9804. REQUIRING THE OPTION OF EXTENSION OF DEPENDENT COVERAGE FOR UNINSURED YOUNG ADULTS.

`SEC. 2746. REQUIRING THE OPTION OF EXTENSION OF DEPENDENT COVERAGE FOR UNINSURED YOUNG ADULTS.

SEC. 106. LIMITATIONS ON PREEXISTING CONDITION EXCLUSIONS IN GROUP HEALTH PLANS IN ADVANCE OF APPLICABILITY OF NEW PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS.

SEC. 107. PROHIBITING ACTS OF DOMESTIC VIOLENCE FROM BEING TREATED AS PREEXISTING CONDITIONS.

`SEC. 2754. PROHIBITION ON DOMESTIC VIOLENCE AS PREEXISTING CONDITION.

SEC. 108. ENDING HEALTH INSURANCE DENIALS AND DELAYS OF NECESSARY TREATMENT FOR CHILDREN WITH DEFORMITIES.

`SEC. 715. STANDARDS RELATING TO BENEFITS FOR MINOR CHILD'S CONGENITAL OR DEVELOPMENTAL DEFORMITY OR DISORDER.

`SEC. 9814. STANDARDS RELATING TO BENEFITS FOR MINOR CHILD'S CONGENITAL OR DEVELOPMENTAL DEFORMITY OR DISORDER.

`SEC. 2708. STANDARDS RELATING TO BENEFITS FOR MINOR CHILD'S CONGENITAL OR DEVELOPMENTAL DEFORMITY OR DISORDER.

`SEC. 2755. STANDARDS RELATING TO BENEFITS FOR MINOR CHILD'S CONGENITAL OR DEVELOPMENTAL DEFORMITY OR DISORDER.

SEC. 109. ELIMINATION OF LIFETIME LIMITS.

`SEC. 716. ELIMINATION OF LIFETIME AGGREGATE LIMITS.

`SEC. 9815. ELIMINATION OF LIFETIME AGGREGATE LIMITS.

`SEC. 2709. ELIMINATION OF LIFETIME AGGREGATE LIMITS.

`SEC. 2756. ELIMINATION OF ANNUAL OR LIFETIME AGGREGATE LIMITS.

SEC. 110. PROHIBITION AGAINST POSTRETIREMENT REDUCTIONS OF RETIREE HEALTH BENEFITS BY GROUP HEALTH PLANS.

`SEC. 717. PROTECTION AGAINST POSTRETIREMENT REDUCTION OF RETIREE HEALTH BENEFITS.

SEC. 111. REINSURANCE PROGRAM FOR RETIREES.

SEC. 112. WELLNESS PROGRAM GRANTS.

SEC. 113. EXTENSION OF COBRA CONTINUATION COVERAGE.

SEC. 114. STATE HEALTH ACCESS PROGRAM GRANTS.

SEC. 115. ADMINISTRATIVE SIMPLIFICATION.

`SEC. 1173A. STANDARDIZE ELECTRONIC ADMINISTRATIVE TRANSACTIONS.

`SEC. 1173B. INTERIM COMPANION GUIDES, INCLUDING OPERATING RULES.

TITLE II--PROTECTIONS AND STANDARDS FOR QUALIFIED HEALTH BENEFITS PLANS

Subtitle A--General Standards

SEC. 201. REQUIREMENTS REFORMING HEALTH INSURANCE MARKETPLACE.

SEC. 202. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

Subtitle B--Standards Guaranteeing Access to Affordable Coverage

SEC. 211. PROHIBITING PREEXISTING CONDITION EXCLUSIONS.

SEC. 212. GUARANTEED ISSUE AND RENEWAL FOR INSURED PLANS AND PROHIBITING RESCISSIONS.

SEC. 213. INSURANCE RATING RULES.

SEC. 214. NONDISCRIMINATION IN BENEFITS; PARITY IN MENTAL HEALTH AND SUBSTANCE ABUSE DISORDER BENEFITS.

SEC. 215. ENSURING ADEQUACY OF PROVIDER NETWORKS.

SEC. 216. REQUIRING THE OPTION OF EXTENSION OF DEPENDENT COVERAGE FOR UNINSURED YOUNG ADULTS.

SEC. 217. CONSISTENCY OF COSTS AND COVERAGE UNDER QUALIFIED HEALTH BENEFITS PLANS DURING PLAN YEAR.

Subtitle C--Standards Guaranteeing Access to Essential Benefits

SEC. 221. COVERAGE OF ESSENTIAL BENEFITS PACKAGE.

SEC. 222. ESSENTIAL BENEFITS PACKAGE DEFINED.

SEC. 223. HEALTH BENEFITS ADVISORY COMMITTEE.

SEC. 224. PROCESS FOR ADOPTION OF RECOMMENDATIONS; ADOPTION OF BENEFIT STANDARDS.

Subtitle D--Additional Consumer Protections

SEC. 231. REQUIRING FAIR MARKETING PRACTICES BY HEALTH INSURERS.

SEC. 232. REQUIRING FAIR GRIEVANCE AND APPEALS MECHANISMS.

SEC. 233. REQUIRING INFORMATION TRANSPARENCY AND PLAN DISCLOSURE.

SEC. 234. APPLICATION TO QUALIFIED HEALTH BENEFITS PLANS NOT OFFERED THROUGH THE HEALTH INSURANCE EXCHANGE.

SEC. 235. TIMELY PAYMENT OF CLAIMS.

SEC. 236. STANDARDIZED RULES FOR COORDINATION AND SUBROGATION OF BENEFITS.

SEC. 237. APPLICATION OF ADMINISTRATIVE SIMPLIFICATION.

SEC. 238. STATE PROHIBITIONS ON DISCRIMINATION AGAINST HEALTH CARE PROVIDERS.

SEC. 239. PROTECTION OF PHYSICIAN PRESCRIBER INFORMATION.

SEC. 240. DISSEMINATION OF ADVANCE CARE PLANNING INFORMATION.

Subtitle E--Governance

SEC. 241. HEALTH CHOICES ADMINISTRATION; HEALTH CHOICES COMMISSIONER.

SEC. 242. DUTIES AND AUTHORITY OF COMMISSIONER.

SEC. 243. CONSULTATION AND COORDINATION.

SEC. 244. HEALTH INSURANCE OMBUDSMAN.

Subtitle F--Relation to Other Requirements; Miscellaneous

SEC. 251. RELATION TO OTHER REQUIREMENTS.

SEC. 252. PROHIBITING DISCRIMINATION IN HEALTH CARE.

SEC. 253. WHISTLEBLOWER PROTECTION.

SEC. 254. CONSTRUCTION REGARDING COLLECTIVE BARGAINING.

SEC. 255. SEVERABILITY.

SEC. 256. TREATMENT OF HAWAII PREPAID HEALTH CARE ACT.

SEC. 257. ACTIONS BY STATE ATTORNEYS GENERAL.

SEC. 258. APPLICATION OF STATE AND FEDERAL LAWS REGARDING ABORTION.

SEC. 259. NONDISCRIMINATION ON ABORTION AND RESPECT FOR RIGHTS OF CONSCIENCE.

SEC. 260. AUTHORITY OF FEDERAL TRADE COMMISSION.

SEC. 261. CONSTRUCTION REGARDING STANDARD OF CARE.

SEC. 262. RESTORING APPLICATION OF ANTITRUST LAWS TO HEALTH SECTOR INSURERS.

SEC. 263. STUDY AND REPORT ON METHODS TO INCREASE EHR USE BY SMALL HEALTH CARE PROVIDERS.

TITLE III--HEALTH INSURANCE EXCHANGE AND RELATED PROVISIONS

Subtitle A--Health Insurance Exchange

SEC. 301. ESTABLISHMENT OF HEALTH INSURANCE EXCHANGE; OUTLINE OF DUTIES; DEFINITIONS.

SEC. 302. EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS.

SEC. 303. BENEFITS PACKAGE LEVELS.

SEC. 304. CONTRACTS FOR THE OFFERING OF EXCHANGE-PARTICIPATING HEALTH BENEFITS PLANS.

SEC. 305. OUTREACH AND ENROLLMENT OF EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS IN EXCHANGE-PARTICIPATING HEALTH BENEFITS PLAN.

SEC. 306. OTHER FUNCTIONS.

SEC. 307. HEALTH INSURANCE EXCHANGE TRUST FUND.

SEC. 308. OPTIONAL OPERATION OF STATE-BASED HEALTH INSURANCE EXCHANGES.

SEC. 309. INTERSTATE HEALTH INSURANCE COMPACTS.

SEC. 310. HEALTH INSURANCE COOPERATIVES.

SEC. 311. RETENTION OF DOD AND VA AUTHORITY.

Subtitle B--Public Health Insurance Option

SEC. 321. ESTABLISHMENT AND ADMINISTRATION OF A PUBLIC HEALTH INSURANCE OPTION AS AN EXCHANGE-QUALIFIED HEALTH BENEFITS PLAN.

SEC. 322. PREMIUMS AND FINANCING.

SEC. 323. PAYMENT RATES FOR ITEMS AND SERVICES.

SEC. 324. MODERNIZED PAYMENT INITIATIVES AND DELIVERY SYSTEM REFORM.

SEC. 325. PROVIDER PARTICIPATION.

SEC. 326. APPLICATION OF FRAUD AND ABUSE PROVISIONS.

SEC. 327. APPLICATION OF HIPAA INSURANCE REQUIREMENTS.

SEC. 328. APPLICATION OF HEALTH INFORMATION PRIVACY, SECURITY, AND ELECTRONIC TRANSACTION REQUIREMENTS.

SEC. 329. ENROLLMENT IN PUBLIC HEALTH INSURANCE OPTION IS VOLUNTARY.

SEC. 330. ENROLLMENT IN PUBLIC HEALTH INSURANCE OPTION BY MEMBERS OF CONGRESS.

SEC. 331. REIMBURSEMENT OF SECRETARY OF VETERANS AFFAIRS.

Subtitle C--Individual Affordability Credits

SEC. 341. AVAILABILITY THROUGH HEALTH INSURANCE EXCHANGE.

`Coordination of Information With Health Choices Administration

SEC. 342. AFFORDABLE CREDIT ELIGIBLE INDIVIDUAL.

SEC. 343. AFFORDABILITY PREMIUM CREDIT.

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                  The initial premium percentage is-- The final premium percentage is-- The actuarial value percentage is-- The out-of-pocket limit for Y1 is-- 
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133% through 150%                                1.5%                              3.0%                                 97%                                $500 
150% through 200%                                3.0%                              5.5%                                 93%                              $1,000 
200% through 250%                                5.5%                              8.0%                                 85%                              $2,000 
250% through 300%                                8.0%                             10.0%                                 78%                              $4,000 
300% through 350%                               10.0%                             11.0%                                 72%                              $4,500 
350% through 400%                               11.0%                             12.0%                                 70%                              $5,000 
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SEC. 344. AFFORDABILITY COST-SHARING CREDIT.

SEC. 345. INCOME DETERMINATIONS.

SEC. 346. SPECIAL RULES FOR APPLICATION TO TERRITORIES.

SEC. 347. NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS.

TITLE IV--SHARED RESPONSIBILITY

Subtitle A--Individual Responsibility

SEC. 401. INDIVIDUAL RESPONSIBILITY.

Subtitle B--Employer Responsibility

PART 1--HEALTH COVERAGE PARTICIPATION REQUIREMENTS

SEC. 411. HEALTH COVERAGE PARTICIPATION REQUIREMENTS.

SEC. 412. EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARD EMPLOYEE AND DEPENDENT COVERAGE.

SEC. 413. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.

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If the annual payroll of such employer for the preceding calendar year: The applicable percentage is: 
                                                      Does not exceed $500,000                            0 percent 
                                Exceeds $500,000, but does not exceed $585,000                            2 percent 
                                Exceeds $585,000, but does not exceed $670,000                            4 percent 
                                Exceeds $670,000, but does not exceed $750,000                            6 percent 
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SEC. 414. AUTHORITY RELATED TO IMPROPER STEERING.

SEC. 415. IMPACT STUDY ON EMPLOYER RESPONSIBILITY REQUIREMENTS.

SEC. 416. STUDY ON EMPLOYER HARDSHIP EXEMPTION.

PART 2--SATISFACTION OF HEALTH COVERAGE PARTICIPATION REQUIREMENTS

SEC. 421. SATISFACTION OF HEALTH COVERAGE PARTICIPATION REQUIREMENTS UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974.

`PART 8--NATIONAL HEALTH COVERAGE PARTICIPATION REQUIREMENTS

`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.

`Part 8--National Health Coverage Participation Requirements

SEC. 422. SATISFACTION OF HEALTH COVERAGE PARTICIPATION REQUIREMENTS UNDER THE INTERNAL REVENUE CODE OF 1986.

SEC. 423. SATISFACTION OF HEALTH COVERAGE PARTICIPATION REQUIREMENTS UNDER THE PUBLIC HEALTH SERVICE ACT.

`SEC. 2793. NATIONAL HEALTH COVERAGE PARTICIPATION REQUIREMENTS.

SEC. 424. ADDITIONAL RULES RELATING TO HEALTH COVERAGE PARTICIPATION REQUIREMENTS.

TITLE V--AMENDMENTS TO INTERNAL REVENUE CODE OF 1986

Subtitle A--Provisions Relating to Health Care Reform

PART 1--SHARED RESPONSIBILITY

Subpart A--Individual Responsibility

SEC. 501. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.

`PART VIII--HEALTH CARE RELATED TAXES

`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 VIII. Health Care Related Taxes.'.

Subpart B--Employer Responsibility

SEC. 511. ELECTION TO SATISFY HEALTH COVERAGE PARTICIPATION REQUIREMENTS.

`SEC. 4980H. ELECTION WITH RESPECT TO HEALTH COVERAGE PARTICIPATION REQUIREMENTS.

SEC. 512. HEALTH CARE CONTRIBUTIONS OF NONELECTING EMPLOYERS.

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`If the annual payroll of such employer for the preceding calendar year: The applicable percentage is: 
                                                       Does not exceed $500,000                            0 percent 
                                 Exceeds $500,000, but does not exceed $585,000                            2 percent 
                                 Exceeds $585,000, but does not exceed $670,000                            4 percent 
                                 Exceeds $670,000, but does not exceed $750,000                            6 percent 
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PART 2--CREDIT FOR SMALL BUSINESS EMPLOYEE HEALTH COVERAGE EXPENSES

SEC. 521. CREDIT FOR SMALL BUSINESS EMPLOYEE HEALTH COVERAGE EXPENSES.

`SEC. 45R. SMALL BUSINESS EMPLOYEE HEALTH COVERAGE CREDIT.

PART 3--LIMITATIONS ON HEALTH CARE RELATED EXPENDITURES

SEC. 531. DISTRIBUTIONS FOR MEDICINE QUALIFIED ONLY IF FOR PRESCRIBED DRUG OR INSULIN.

SEC. 532. LIMITATION ON HEALTH FLEXIBLE SPENDING ARRANGEMENTS UNDER CAFETERIA PLANS.

SEC. 533. INCREASE IN PENALTY FOR NONQUALIFIED DISTRIBUTIONS FROM HEALTH SAVINGS ACCOUNTS.

SEC. 534. DENIAL OF DEDUCTION FOR FEDERAL SUBSIDIES FOR PRESCRIPTION DRUG PLANS WHICH HAVE BEEN EXCLUDED FROM GROSS INCOME.

PART 4--OTHER PROVISIONS TO CARRY OUT HEALTH INSURANCE REFORM

SEC. 541. DISCLOSURES TO CARRY OUT HEALTH INSURANCE EXCHANGE SUBSIDIES.

SEC. 542. OFFERING OF EXCHANGE-PARTICIPATING HEALTH BENEFITS PLANS THROUGH CAFETERIA PLANS.

SEC. 543. EXCLUSION FROM GROSS INCOME OF PAYMENTS MADE UNDER REINSURANCE PROGRAM FOR RETIREES.

SEC. 544. CLASS PROGRAM TREATED IN SAME MANNER AS LONG-TERM CARE INSURANCE.

SEC. 545. EXCLUSION FROM GROSS INCOME FOR MEDICAL CARE PROVIDED FOR INDIANS.

`SEC. 139D. MEDICAL CARE PROVIDED FOR INDIANS.

Subtitle B--Other Revenue Provisions

PART 1--GENERAL PROVISIONS

SEC. 551. SURCHARGE ON HIGH INCOME INDIVIDUALS.

`Subpart B--Surcharge on High Income Individuals

`SEC. 59C. SURCHARGE ON HIGH INCOME INDIVIDUALS.

`subpart b. surcharge on high income individuals.'.

SEC. 552. EXCISE TAX ON MEDICAL DEVICES.

`Subchapter D--Medical Devices

`SEC. 4061. MEDICAL DEVICES.

`subchapter d. medical devices.'.

SEC. 553. EXPANSION OF INFORMATION REPORTING REQUIREMENTS.

SEC. 554. DELAY IN APPLICATION OF WORLDWIDE ALLOCATION OF INTEREST.

PART 2--PREVENTION OF TAX AVOIDANCE

SEC. 561. LIMITATION ON TREATY BENEFITS FOR CERTAIN DEDUCTIBLE PAYMENTS.

SEC. 562. CODIFICATION OF ECONOMIC SUBSTANCE DOCTRINE; PENALTIES.

SEC. 563. CERTAIN LARGE OR PUBLICLY TRADED PERSONS MADE SUBJECT TO A MORE LIKELY THAN NOT STANDARD FOR AVOIDING PENALTIES ON UNDERPAYMENTS.

PART 3--PARITY IN HEALTH BENEFITS

SEC. 571. CERTAIN HEALTH RELATED BENEFITS APPLICABLE TO SPOUSES AND DEPENDENTS EXTENDED TO ELIGIBLE BENEFICIARIES.

DIVISION B--MEDICARE AND MEDICAID IMPROVEMENTS

SEC. 1001. TABLE OF CONTENTS OF DIVISION.

TITLE I--IMPROVING HEALTH CARE VALUE

Subtitle A--Provisions Related to Medicare Part A

Part 1--Market Basket Updates

Part 2--Other Medicare Part A Provisions

Subtitle B--Provisions Related to Part B

Part 1--Physicians' Services

Part 2--Market Basket Updates

Part 3--Other Provisions

Subtitle C--Provisions Related to Medicare Parts A and B

Subtitle D--Medicare Advantage Reforms

Part 1--Payment and Administration

Part 2--Beneficiary Protections and Anti-Fraud

Part 3--Treatment of Special Needs Plans

Subtitle E--Improvements to Medicare Part D

Subtitle F--Medicare Rural Access Protections

TITLE II--MEDICARE BENEFICIARY IMPROVEMENTS

Subtitle A--Improving and Simplifying Financial Assistance for Low Income Medicare Beneficiaries

Subtitle B--Reducing Health Disparities

Subtitle C--Miscellaneous Improvements

TITLE III--PROMOTING PRIMARY CARE, MENTAL HEALTH SERVICES, AND COORDINATED CARE

TITLE IV--QUALITY

Subtitle A--Comparative Effectiveness Research

Subtitle B--Nursing Home Transparency

Part 1--Improving Transparency of Information on Skilled Nursing Facilities, Nursing Facilities, and Other Long-term Care Facilities

Part 2--Targeting Enforcement

Part 3--Improving Staff Training

Subtitle C--Quality Measurements

Subtitle D--Physician Payments Sunshine Provision

Subtitle E--Public Reporting on Health Care-Associated Infections

TITLE V--MEDICARE GRADUATE MEDICAL EDUCATION

TITLE VI--PROGRAM INTEGRITY

Subtitle A--Increased Funding to Fight Waste, Fraud, and Abuse

Subtitle B--Enhanced Penalties for Fraud and Abuse

Subtitle C--Enhanced Program and Provider Protections

Subtitle D--Access to Information Needed to Prevent Fraud, Waste, and Abuse

TITLE VII--MEDICAID AND CHIP

Subtitle A--Medicaid and Health Reform

Subtitle B--Prevention

Subtitle C--Access

Subtitle D--Coverage

Subtitle E--Financing

Subtitle F--Waste, Fraud, and Abuse

Subtitle G--Payments to the Territories

Subtitle H--Miscellaneous

TITLE VIII--REVENUE-RELATED PROVISIONS

TITLE IX--MISCELLANEOUS PROVISIONS

TITLE I--IMPROVING HEALTH CARE VALUE

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.

PART 2--OTHER MEDICARE PART A PROVISIONS

SEC. 1111. PAYMENTS TO SKILLED NURSING FACILITIES.

SEC. 1112. MEDICARE DSH REPORT AND PAYMENT ADJUSTMENTS IN RESPONSE TO COVERAGE EXPANSION.

SEC. 1113. EXTENSION OF HOSPICE REGULATION MORATORIUM.

SEC. 1114. PERMITTING PHYSICIAN ASSISTANTS TO ORDER POST-HOSPITAL EXTENDED CARE SERVICES AND TO PROVIDE FOR RECOGNITION OF ATTENDING PHYSICIAN ASSISTANTS AS ATTENDING PHYSICIANS TO SERVE HOSPICE PATIENTS.

Subtitle B--Provisions Related to Part B

PART 1--PHYSICIANS' SERVICES

SEC. 1121. RESOURCE-BASED FEEDBACK PROGRAM FOR PHYSICIANS IN MEDICARE.

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.

PART 2--MARKET BASKET UPDATES

SEC. 1131. INCORPORATING PRODUCTIVITY IMPROVEMENTS INTO MARKET BASKET UPDATES THAT DO NOT ALREADY INCORPORATE SUCH IMPROVEMENTS.

PART 3--OTHER PROVISIONS

SEC. 1141. RENTAL AND PURCHASE OF POWER-DRIVEN WHEELCHAIRS.

SEC. 1141A. ELECTION TO TAKE OWNERSHIP, OR TO DECLINE OWNERSHIP, OF A CERTAIN ITEM OF COMPLEX DURABLE MEDICAL EQUIPMENT AFTER THE 13-MONTH CAPPED RENTAL PERIOD ENDS.

`(aa) IN GENERAL- During the 10th continuous month during which payment is made for the rental of a Group 3 Support Surface under clause (i), the supplier of such item shall offer the individual the option to accept or reject transfer of title to a Group 3 Support Surface after the 13th continuous month during which payment is made for the rental of the Group 3 Support Surface under clause (i). Such title shall be transferred to the individual only if the individual notifies the supplier not later than 1 month after the supplier makes such offer that the individual agrees to accept transfer of the title to the Group 3 Support Surface. Unless the individual accepts transfer of title to the Group 3 Support Surface in the manner set forth in this subclause, the individual shall be deemed to have rejected transfer of title. If the individual agrees to accept the transfer of the title to the Group 3 Support Surface, the supplier shall transfer such title to the individual on the first day that begins after the 13th continuous month during which payment is made for the rental of the Group 3 Support Surface under clause (i).

`(bb) SPECIAL RULE- If, on the effective date of this subclause, an individual's rental period for a Group 3 Support Surface has exceeded 10 continuous months, but the first day that begins after the 13th continuous month during which payment is made for the rental under clause (i) has not been reached, the supplier shall, within 1 month following such effective date, offer the individual the option to accept or reject transfer of title to a Group 3 Support Surface. Such title shall be transferred to the individual only if the individual notifies the supplier not later than 1 month after the supplier makes such offer that the individual agrees to accept transfer of title to the Group 3 Support Surface. Unless the individual accepts transfer of title to the Group 3 Support Surface in the manner set forth in this subclause, the individual shall be deemed to have rejected transfer of title. If the individual agrees to accept the transfer of the title to the Group 3 Support Surface, the supplier shall transfer such title to the individual on the first day that begins after the 13th continuous month during which payment is made for the rental of the Group 3 Support Surface under clause (i) unless that day has passed, in which case the supplier shall transfer such title to the individual not later than 1 month after notification that the individual accepts transfer of title.

`(cc) TREATMENT OF SUBSEQUENT RESUPPLY WITHIN PERIOD OF REASONABLE USEFUL LIFETIME OF GROUP 3 SUPPORT SURFACE IN CASE OF NEED- If an individual rejects transfer of title to a Group 3 Support Surface under this subclause and the individual requires such Support Surface at any subsequent time during the period of the reasonable useful lifetime of such equipment (as defined by the Secretary) beginning with the first month for which payment is made for the rental of such equipment under clause (i), the supplier shall supply the equipment without charge to the individual or the program under this title during the remainder of such period, other than payment for maintenance and servicing during such period which would otherwise have been paid if the individual had accepted title to such equipment. The previous sentence shall not affect the payment of amounts under this part for such equipment after the end of such period of the reasonable useful lifetime of the equipment.

`(dd) PAYMENTS- Maintenance and servicing payments shall be made in accordance with clause (iv), in the case of a supplier that transfers title to the Group 3 Support Surface under this subclause, after such transfer and, in the case of an individual who rejects transfer of title under this subclause, after the end of the period of medical need during which payment is made under clause (i).'; and

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. PAYMENT FOR IMAGING SERVICES.

SEC. 1147. DURABLE MEDICAL EQUIPMENT PROGRAM IMPROVEMENTS.

SEC. 1148. MEDPAC STUDY AND REPORT ON BONE MASS MEASUREMENT.

SEC. 1149. TIMELY ACCESS TO POST-MASTECTOMY ITEMS.

SEC. 1149A. PAYMENT FOR BIOSIMILAR BIOLOGICAL PRODUCTS.

SEC. 1149B. STUDY AND REPORT ON DME COMPETITIVE BIDDING PROCESS.

Subtitle C--Provisions Related to Medicare Parts A and B

SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS.

SEC. 1152. POST ACUTE CARE SERVICES PAYMENT REFORM PLAN AND BUNDLING PILOT PROGRAM.

`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. 1155A. MEDPAC STUDY ON VARIATION IN HOME HEALTH MARGINS.

SEC. 1155B. PERMITTING HOME HEALTH AGENCIES TO ASSIGN THE MOST APPROPRIATE SKILLED SERVICE TO MAKE THE INITIAL ASSESSMENT VISIT UNDER A MEDICARE HOME HEALTH PLAN OF CARE FOR REHABILITATION CASES.

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.

SEC. 1159. INSTITUTE OF MEDICINE STUDY OF GEOGRAPHIC VARIATION IN HEALTH CARE SPENDING AND PROMOTING HIGH-VALUE HEALTH CARE.

SEC. 1160. IMPLEMENTATION, AND CONGRESSIONAL REVIEW, OF PROPOSAL TO REVISE MEDICARE PAYMENTS TO PROMOTE HIGH VALUE HEALTH CARE.

Subtitle D--Medicare Advantage Reforms

PART 1--PAYMENT AND ADMINISTRATION

SEC. 1161. PHASE-IN OF PAYMENT BASED ON FEE-FOR-SERVICE COSTS; QUALITY BONUS PAYMENTS.

SEC. 1162. AUTHORITY FOR SECRETARIAL CODING INTENSITY ADJUSTMENT AUTHORITY.

SEC. 1163. SIMPLIFICATION OF ANNUAL BENEFICIARY ELECTION PERIODS.

SEC. 1164. EXTENSION OF REASONABLE COST CONTRACTS.

SEC. 1165. LIMITATION OF WAIVER AUTHORITY FOR EMPLOYER GROUP PLANS.

SEC. 1166. IMPROVING RISK ADJUSTMENT FOR PAYMENTS.

SEC. 1167. ELIMINATION OF MA REGIONAL PLAN STABILIZATION FUND.

SEC. 1168. STUDY REGARDING THE EFFECTS OF CALCULATING MEDICARE ADVANTAGE PAYMENT RATES ON A REGIONAL AVERAGE OF MEDICARE FEE FOR SERVICE RATES.

PART 2--BENEFICIARY PROTECTIONS AND ANTI-FRAUD

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. 1175A. STATE AUTHORITY TO ENFORCE STANDARDIZED MARKETING REQUIREMENTS.

PART 3--TREATMENT OF SPECIAL NEEDS PLANS

SEC. 1176. LIMITATION ON ENROLLMENT OUTSIDE OPEN ENROLLMENT PERIOD OF INDIVIDUALS INTO CHRONIC CARE SPECIALIZED MA PLANS FOR SPECIAL NEEDS INDIVIDUALS.

SEC. 1177. EXTENSION OF AUTHORITY OF SPECIAL NEEDS PLANS TO RESTRICT ENROLLMENT; SERVICE AREA MORATORIUM FOR CERTAIN SNPS.

SEC. 1178. EXTENSION OF MEDICARE SENIOR HOUSING PLANS.

Subtitle E--Improvements to Medicare Part D

SEC. 1181. ELIMINATION OF COVERAGE GAP.

SEC. 1182. DISCOUNTS FOR CERTAIN PART D DRUGS IN ORIGINAL COVERAGE GAP.

SEC. 1183. REPEAL OF PROVISION RELATING TO SUBMISSION OF CLAIMS BY PHARMACIES LOCATED IN OR CONTRACTING WITH LONG-TERM CARE FACILITIES.

SEC. 1184. INCLUDING COSTS INCURRED BY AIDS DRUG ASSISTANCE PROGRAMS AND INDIAN HEALTH SERVICE IN PROVIDING PRESCRIPTION DRUGS TOWARD THE ANNUAL OUT-OF-POCKET THRESHOLD UNDER PART D.

SEC. 1185. NO MID-YEAR FORMULARY CHANGES PERMITTED.

SEC. 1186. NEGOTIATION OF LOWER COVERED PART D DRUG PRICES ON BEHALF OF MEDICARE BENEFICIARIES.

SEC. 1187. ACCURATE DISPENSING IN LONG-TERM CARE FACILITIES.

SEC. 1188. FREE GENERIC FILL.

SEC. 1189. STATE CERTIFICATION PRIOR TO WAIVER OF LICENSURE REQUIREMENTS UNDER MEDICARE PRESCRIPTION DRUG PROGRAM.

Subtitle F--Medicare Rural Access Protections

SEC. 1191. TELEHEALTH EXPANSION AND ENHANCEMENTS.

SEC. 1192. EXTENSION OF OUTPATIENT HOLD HARMLESS PROVISION.

131`2010' and inserting `2012'; and

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.

TITLE II--MEDICARE BENEFICIARY IMPROVEMENTS

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 AND QUALITY BONUS PAYMENTS IN CALCULATION OF LOW INCOME SUBSIDY BENCHMARK.

Subtitle B--Reducing Health Disparities

SEC. 1221. ENSURING EFFECTIVE COMMUNICATION IN MEDICARE.

SEC. 1222. DEMONSTRATION TO PROMOTE ACCESS FOR MEDICARE BENEFICIARIES WITH LIMITED ENGLISH PROFICIENCY BY PROVIDING REIMBURSEMENT FOR CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES.

SEC. 1223. IOM REPORT ON IMPACT OF LANGUAGE ACCESS SERVICES.

SEC. 1224. DEFINITIONS.

Subtitle C--Miscellaneous Improvements

SEC. 1231. EXTENSION OF THERAPY CAPS EXCEPTIONS PROCESS.

SEC. 1232. EXTENDED MONTHS OF COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT PATIENTS AND OTHER RENAL DIALYSIS PROVISIONS.

SEC. 1233. VOLUNTARY ADVANCE CARE PLANNING CONSULTATION.

`Voluntary Advance Care Planning Consultation

SEC. 1234. PART B SPECIAL ENROLLMENT PERIOD AND WAIVER OF LIMITED ENROLLMENT PENALTY FOR TRICARE BENEFICIARIES.

SEC. 1235. EXCEPTION FOR USE OF MORE RECENT TAX YEAR IN CASE OF GAINS FROM SALE OF PRIMARY RESIDENCE IN COMPUTING PART B INCOME-RELATED PREMIUM.

SEC. 1236. DEMONSTRATION PROGRAM ON USE OF PATIENT DECISIONS AIDS.

TITLE III--PROMOTING PRIMARY CARE, MENTAL HEALTH SERVICES, AND COORDINATED CARE

SEC. 1301. ACCOUNTABLE CARE ORGANIZATION PILOT PROGRAM.

`ACCOUNTABLE CARE ORGANIZATION PILOT PROGRAM

SEC. 1302. MEDICAL HOME PILOT PROGRAM.

`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.

`Medicare Covered Preventive Services

SEC. 1306. WAIVER OF DEDUCTIBLE FOR COLORECTAL CANCER SCREENING TESTS REGARDLESS OF CODING, SUBSEQUENT DIAGNOSIS, OR ANCILLARY TISSUE REMOVAL.

SEC. 1307. EXCLUDING CLINICAL SOCIAL WORKER SERVICES FROM COVERAGE UNDER THE MEDICARE SKILLED NURSING FACILITY PROSPECTIVE PAYMENT SYSTEM AND CONSOLIDATED PAYMENT.

SEC. 1308. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL HEALTH COUNSELOR SERVICES.

`Marriage and Family Therapist Services

`Mental Health Counselor Services

SEC. 1309. EXTENSION OF PHYSICIAN FEE SCHEDULE MENTAL HEALTH ADD-ON.

SEC. 1310. EXPANDING ACCESS TO VACCINES.

`Federally Approved and Recommended Vaccines

SEC. 1311. EXPANSION OF MEDICARE-COVERED PREVENTIVE SERVICES AT FEDERALLY QUALIFIED HEALTH CENTERS.

SEC. 1312. INDEPENDENCE AT HOME DEMONSTRATION PROGRAM.

`INDEPENDENCE AT HOME MEDICAL PRACTICE DEMONSTRATION PROGRAM

SEC. 1313. RECOGNITION OF CERTIFIED DIABETES EDUCATORS AS CERTIFIED PROVIDERS FOR PURPOSES OF MEDICARE DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES.

TITLE IV--QUALITY

Subtitle A--Comparative Effectiveness Research

SEC. 1401. COMPARATIVE EFFECTIVENESS RESEARCH.

`Part D--Comparative Effectiveness Research

`COMPARATIVE EFFECTIVENESS RESEARCH

Subtitle B--Nursing Home Transparency

PART 1--IMPROVING TRANSPARENCY OF INFORMATION ON SKILLED NURSING FACILITIES, NURSING FACILITIES, AND OTHER LONG-TERM CARE 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. 1417. NATIONWIDE PROGRAM FOR NATIONAL AND STATE BACKGROUND CHECKS ON DIRECT PATIENT ACCESS EMPLOYEES OF LONG-TERM CARE FACILITIES AND PROVIDERS.

PART 2--TARGETING ENFORCEMENT

SEC. 1421. CIVIL MONEY PENALTIES.

`(aa) in the case where the deficiency is found to be a direct proximate cause of death of a resident of the facility, an amount not to exceed $100,000.

`(bb) in each case of a deficiency where the facility is cited for actual harm or immediate jeopardy, an amount not less than $3,050 and not more than $25,000; and

`(cc) in each case of any other deficiency, an amount not less than $250 and not to exceed $3050.

`(aa) in each case of a deficiency where the facility is cited for actual harm or immediate jeopardy, an amount not less than $3,050 and not more than $25,000 and

`(bb) in each case of any other deficiency, an amount not less than $250 and not to exceed $3,050.

`(aa) REPEAT DEFICIENCIES- The Secretary may not reduce under subclause (IV) the amount of a penalty if the deficiency is a repeat deficiency.

`(bb) CERTAIN OTHER DEFICIENCIES- The Secretary may not reduce under subclause (IV) the amount of a penalty if the penalty is imposed for a deficiency described in subclause (II)(aa) or (III)(aa) and the actual harm or widespread harm immediately jeopardizes the health or safety of a resident or residents of the facility, or if the penalty is imposed for a deficiency described in subclause (II)(bb).

`(aa) subject to item (cc), shall, not later than 30 days after the date of imposition of the penalty, provide the opportunity for the facility to participate in an independent informal dispute resolution process, established by the State survey agency, which generates a written record prior to the collection of such penalty, but such opportunity shall not affect the responsibility of the State survey agency for making final recommendations for such penalties;

`(bb) in the case where the penalty is imposed for each day of noncompliance, shall not impose a penalty for any day during the period beginning on the initial day of the imposition of the penalty and ending on the day on which the informal dispute resolution process under item (aa) is completed;

`(cc) may provide for the collection of such civil money penalty and the placement of such amounts collected in an escrow account under the direction of the Secretary on the earlier of the date on which the informal dispute resolution process under item (aa) is completed or the date that is 90 days after the date of the imposition of the penalty;

`(dd) may provide that such amounts collected are kept in such account pending the resolution of any subsequent appeals;

`(ee) in the case where the facility successfully appeals the penalty, may provide for the return of such amounts collected (plus interest) to the facility; and

`(ff) in the case where all such appeals are unsuccessful, may provide that some portion of such amounts collected may be used to support activities that benefit residents, including assistance to support and protect residents of a facility that closes (voluntarily or involuntarily) or is decertified (including offsetting costs of relocating residents to home and community-based settings or another facility), projects that support resident and family councils and other consumer involvement in assuring quality care in facilities, and facility improvement initiatives approved by the Secretary (including joint training of facility staff and surveyors, technical assistance for facilities under quality assurance programs, the appointment of temporary management, and other activities approved by the Secretary).

`(aa) subject to item (bb), shall, not later than 30 days after the date of imposition of the penalty, provide the opportunity for the facility to participate in an independent informal dispute resolution process which generates a written record prior to the collection of such penalty;

`(bb) in the case where the penalty is imposed for each day of noncompliance, shall not impose a penalty for any day during the period beginning on the initial day of the imposition of the penalty and ending on the day on which the informal dispute resolution process under item (aa) is completed;

`(cc) may provide for the collection of such civil money penalty and the placement of such amounts collected in an escrow account under the direction of the Secretary on the earlier of the date on which the informal dispute resolution process under item (aa) is completed or the date that is 90 days after the date of the imposition of the penalty;

`(dd) may provide that such amounts collected are kept in such account pending the resolution of any subsequent appeals;

`(ee) in the case where the facility successfully appeals the penalty, may provide for the return of such amounts collected (plus interest) to the facility; and

`(ff) in the case where all such appeals are unsuccessful, may provide that some portion of such amounts collected may be used to support activities that benefit residents, including assistance to support and protect residents of a facility that closes (voluntarily or involuntarily) or is decertified (including offsetting costs of relocating residents to home and community-based settings or another facility), projects that support resident and family councils and other consumer involvement in assuring quality care in facilities, and facility improvement initiatives approved by the Secretary (including joint training of facility staff and surveyors, technical assistance for facilities under quality assurance programs, the appointment of temporary management, and other activities approved by the Secretary).

SEC. 1422. NATIONAL INDEPENDENT MONITOR PILOT PROGRAM.

SEC. 1423. NOTIFICATION OF FACILITY CLOSURE.

PART 3--IMPROVING STAFF TRAINING

SEC. 1431. DEMENTIA AND ABUSE PREVENTION TRAINING.

SEC. 1432. STUDY AND REPORT ON TRAINING REQUIRED FOR CERTIFIED NURSE AIDES AND SUPERVISORY STAFF.

SEC. 1433. QUALIFICATION OF DIRECTOR OF FOOD SERVICES OF A SKILLED NURSING FACILITY OR NURSING FACILITY.

Subtitle C--Quality Measurements

SEC. 1441. ESTABLISHMENT OF NATIONAL PRIORITIES FOR QUALITY IMPROVEMENT.

`Part E--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 D--Physician Payments Sunshine Provision

SEC. 1451. REPORTS ON FINANCIAL RELATIONSHIPS BETWEEN MANUFACTURERS AND DISTRIBUTORS OF COVERED DRUGS, DEVICES, BIOLOGICALS, OR MEDICAL SUPPLIES UNDER MEDICARE, MEDICAID, OR CHIP AND PHYSICIANS AND OTHER HEALTH CARE ENTITIES AND BETWEEN PHYSICIANS AND OTHER HEALTH CARE ENTITIES.

`SEC. 1128H. FINANCIAL REPORTS ON PHYSICIANS' FINANCIAL RELATIONSHIPS WITH MANUFACTURERS AND DISTRIBUTORS OF COVERED DRUGS, DEVICES, BIOLOGICALS, OR MEDICAL SUPPLIES UNDER MEDICARE, MEDICAID, OR CHIP AND WITH ENTITIES THAT BILL FOR SERVICES UNDER MEDICARE.

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.

TITLE V--MEDICARE GRADUATE MEDICAL EDUCATION

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.

TITLE VI--PROGRAM INTEGRITY

Subtitle A--Increased Funding to Fight Waste, Fraud, and Abuse

SEC. 1601. INCREASED FUNDING AND FLEXIBILITY TO FIGHT FRAUD AND ABUSE.

Subtitle B--Enhanced Penalties for 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. 1620. OIG AUTHORITY TO EXCLUDE FROM FEDERAL HEALTH CARE PROGRAMS OFFICERS AND OWNERS OF ENTITIES CONVICTED OF FRAUD.

SEC. 1621. SELF-REFERRAL DISCLOSURE PROTOCOL.

Subtitle C--Enhanced Program and Provider Protections

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. 1637. PHYSICIANS WHO ORDER DURABLE MEDICAL EQUIPMENT OR HOME HEALTH SERVICES REQUIRED TO BE MEDICARE ENROLLED PHYSICIANS OR ELIGIBLE PROFESSIONALS.

SEC. 1638. REQUIREMENT FOR PHYSICIANS TO PROVIDE DOCUMENTATION ON REFERRALS TO PROGRAMS AT HIGH RISK OF WASTE AND ABUSE.

SEC. 1639. FACE-TO-FACE ENCOUNTER WITH PATIENT REQUIRED BEFORE ELIGIBILITY CERTIFICATIONS FOR HOME HEALTH SERVICES OR DURABLE MEDICAL EQUIPMENT.

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. 1646. REQUIRING PROVIDER AND SUPPLIER PAYMENTS UNDER MEDICARE TO BE MADE THROUGH DIRECT DEPOSIT OR ELECTRONIC FUNDS TRANSFER (EFT) AT INSURED DEPOSITORY INSTITUTIONS.

SEC. 1647. INSPECTOR GENERAL FOR THE HEALTH CHOICES ADMINISTRATION.

`SEC. 8M SPECIAL PROVISIONS RELATING TO THE HEALTH CHOICES ADMINISTRATION AND THE DEPARTMENT OF HEALTH AND HUMAN SERVICES.

Subtitle D--Access to Information Needed to Prevent Fraud, Waste, and Abuse

SEC. 1651. ACCESS TO INFORMATION NECESSARY TO IDENTIFY FRAUD, WASTE, AND ABUSE.

`Sec. 721. Access to certain information

SEC. 1652. ELIMINATION OF DUPLICATION BETWEEN THE HEALTHCARE INTEGRITY AND PROTECTION DATA BANK AND THE NATIONAL PRACTITIONER DATA BANK.

SEC. 1653. COMPLIANCE WITH HIPAA PRIVACY AND SECURITY STANDARDS.

TITLE VII--MEDICAID AND CHIP

SEC. 1. TABLE OF CONTENTS [Struck out->][ TEMPORARY ][<-Struck out] .

Subtitle A--Medicaid and Health Reform

Subtitle B--Prevention

Subtitle C--Access

Subtitle D--Coverage

Subtitle E--Financing

Subtitle F--Waste, Fraud, and Abuse

Subtitle G--Payments to the Territories

Subtitle H--Miscellaneous

Subtitle A--Medicaid and Health Reform

SEC. 1701. ELIGIBILITY FOR INDIVIDUALS WITH INCOME BELOW 150 PERCENT OF THE FEDERAL POVERTY LEVEL.

SEC. 1702. REQUIREMENTS AND SPECIAL RULES FOR CERTAIN MEDICAID ELIGIBLE INDIVIDUALS.

` REQUIREMENTS AND SPECIAL RULES FOR CERTAIN MEDICAID ELIGIBLE INDIVIDUALS

SEC. 1703. CHIP AND MEDICAID MAINTENANCE OF ELIGIBILITY.

SEC. 1704. REDUCTION IN MEDICAID DSH.

SEC. 1705. EXPANDED OUTSTATIONING.

Subtitle B--Prevention

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.

`PRESUMPTIVE ELIGIBILITY 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.

131`1905(l)(1)),'.

SEC. 1726. REQUIRING COVERAGE OF SERVICES OF PODIATRISTS.

SEC. 1726A. REQUIRING COVERAGE OF SERVICES OF OPTOMETRISTS.

SEC. 1727. THERAPEUTIC FOSTER CARE.

SEC. 1728. ASSURING ADEQUATE PAYMENT LEVELS FOR SERVICES.

`ASSURING ADEQUATE PAYMENT LEVELS FOR SERVICES

SEC. 1729. PRESERVING MEDICAID COVERAGE FOR YOUTHS UPON RELEASE FROM PUBLIC INSTITUTIONS.

SEC. 1730. QUALITY MEASURES FOR MATERNITY AND ADULT HEALTH SERVICES UNDER MEDICAID AND CHIP.

`SEC. 1139B. QUALITY MEASURES FOR MATERNITY AND ADULT HEALTH SERVICES UNDER MEDICAID AND CHIP.

SEC. 1730A. ACCOUNTABLE CARE ORGANIZATION PILOT PROGRAM.

SEC. 1730B. FQHC COVERAGE.

Subtitle D--Coverage

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. 1734. PREVENTING THE APPLICATION UNDER CHIP OF COVERAGE WAITING PERIODS FOR CERTAIN CHILDREN.

SEC. 1735. ADULT DAY HEALTH CARE SERVICES.

SEC. 1736. MEDICAID COVERAGE FOR CITIZENS OF FREELY ASSOCIATED STATES.

SEC. 1737. CONTINUING REQUIREMENT OF MEDICAID COVERAGE OF NONEMERGENCY TRANSPORTATION TO MEDICALLY NECESSARY SERVICES.

SEC. 1738. STATE OPTION TO DISREGARD CERTAIN INCOME IN PROVIDING CONTINUED MEDICAID COVERAGE FOR CERTAIN INDIVIDUALS WITH EXTREMELY HIGH PRESCRIPTION COSTS.

SEC. 1739. PROVISIONS RELATING TO COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS (CLASS).

Subtitle E--Financing

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. 1745. NURSING FACILITY SUPPLEMENTAL PAYMENT PROGRAM.

SEC. 1746. REPORT ON MEDICAID PAYMENTS.

SEC. 1747. REVIEWS OF MEDICAID.

SEC. 1748. EXTENSION OF DELAY IN MANAGED CARE ORGANIZATION PROVIDER TAX ELIMINATION.

SEC. 1749. EXTENSION OF ARRA INCREASE IN FMAP.

Subtitle F--Waste, Fraud, and Abuse

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. 1756. TERMINATION OF PROVIDER PARTICIPATION UNDER MEDICAID AND CHIP IF TERMINATED UNDER MEDICARE OR OTHER STATE PLAN OR CHILD HEALTH PLAN.

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. 1761. MANDATORY STATE USE OF NATIONAL CORRECT CODING INITIATIVE.

Subtitle G--Payments to the Territories

SEC. 1771. PAYMENT TO TERRITORIES.

Subtitle H--Miscellaneous

SEC. 1781. TECHNICAL CORRECTIONS.

SEC. 1782. EXTENSION OF QI PROGRAM.

SEC. 1783. ASSURING TRANSPARENCY OF INFORMATION.

`HOSPITAL PRICE TRANSPARENCY

SEC. 1784. MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION.

SEC. 1785. OUTREACH AND ENROLLMENT OF MEDICAID AND CHIP ELIGIBLE INDIVIDUALS.

SEC. 1786. PROHIBITIONS ON FEDERAL MEDICAID AND CHIP PAYMENT FOR UNDOCUMENTED ALIENS.

SEC. 1787. DEMONSTRATION PROJECT FOR STABILIZATION OF EMERGENCY MEDICAL CONDITIONS BY INSTITUTIONS FOR MENTAL DISEASES.

SEC. 1788. APPLICATION OF MEDICAID IMPROVEMENT FUND.

SEC. 1789. TREATMENT OF CERTAIN MEDICAID BROKERS.

SEC. 1790. RULE FOR CHANGES REQUIRING STATE LEGISLATION.

TITLE VIII--REVENUE-RELATED PROVISIONS

SEC. 1801. DISCLOSURES TO FACILITATE IDENTIFICATION OF INDIVIDUALS LIKELY TO BE INELIGIBLE FOR THE LOW-INCOME ASSISTANCE UNDER THE MEDICARE PRESCRIPTION DRUG PROGRAM TO ASSIST SOCIAL SECURITY ADMINISTRATION'S OUTREACH TO ELIGIBLE INDIVIDUALS.

SEC. 1802. COMPARATIVE EFFECTIVENESS RESEARCH TRUST FUND; FINANCING FOR TRUST FUND.

`SEC. 9511. HEALTH CARE COMPARATIVE EFFECTIVENESS RESEARCH TRUST FUND.

`Subchapter B--Insured and Self-Insured Health Plans

`SEC. 4375. HEALTH INSURANCE.

`SEC. 4376. SELF-INSURED HEALTH PLANS.

`SEC. 4377. DEFINITIONS AND SPECIAL RULES.

`CHAPTER 34--TAXES ON CERTAIN INSURANCE POLICIES

`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. 1904. GRANTS TO STATES FOR QUALITY HOME VISITATION PROGRAMS FOR FAMILIES WITH YOUNG CHILDREN AND FAMILIES EXPECTING CHILDREN.

`Subpart 3--Support for Quality Home Visitation Programs

`SEC. 440. HOME VISITATION PROGRAMS FOR FAMILIES WITH YOUNG CHILDREN AND FAMILIES EXPECTING CHILDREN.

SEC. 1905. IMPROVED COORDINATION AND PROTECTION FOR DUAL ELIGIBLES.

`IMPROVED COORDINATION AND PROTECTION FOR DUAL ELIGIBLES

SEC. 1906. ASSESSMENT OF MEDICARE COST-INTENSIVE DISEASES AND CONDITIONS.

SEC. 1907. ESTABLISHMENT OF CENTER FOR MEDICARE AND MEDICAID INNOVATION WITHIN CMS.

`CENTER FOR MEDICARE AND MEDICAID INNOVATION

SEC. 1908. APPLICATION OF EMERGENCY SERVICES LAWS.

SEC. 1909. DISREGARD UNDER THE SUPPLEMENTAL SECURITY INCOME PROGRAM OF COMPENSATION FOR PARTICIPATION IN CLINICAL TRIALS FOR RARE DISEASES OR CONDITIONS.

DIVISION C--PUBLIC HEALTH AND WORKFORCE DEVELOPMENT

SEC. 2001. TABLE OF CONTENTS; REFERENCES.

TITLE I--COMMUNITY HEALTH CENTERS

TITLE II--WORKFORCE

Subtitle A--Primary Care Workforce

Part 1--National Health Service Corps

Part 2--Promotion of Primary Care and Dentistry

`subpart xi--health professional needs areas

`Sec. 340H. In general.

`Sec. 340I. Loan repayments.

`Sec. 340J. Report.

`Sec. 340K. Allocation.

Subtitle B--Nursing Workforce

Subtitle C--Public Health Workforce

`subpart xii--public health workforce

`Sec. 340L. Public Health Workforce Corps.

`Sec. 340M. Public Health Workforce Scholarship Program.

`Sec. 340N. Public Health Workforce Loan Repayment Program.

Subtitle D--Adapting Workforce to Evolving Health System Needs

Part 1--Health Professions Training for Diversity

Part 2--Interdisciplinary Training Programs

Part 3--Advisory Committee on Health Workforce Evaluation and Assessment

Part 4--Health Workforce Assessment

Part 5--Authorization of Appropriations

TITLE III--PREVENTION AND WELLNESS

`TITLE XXXI--PREVENTION AND WELLNESS

`Subtitle A--Prevention and Wellness Trust

`Sec. 3111. Prevention and Wellness Trust.

`Subtitle B--National Prevention and Wellness Strategy

`Sec. 3121. National Prevention and Wellness Strategy.

`Subtitle C--Prevention Task Forces

`Sec. 3131. Task Force on Clinical Preventive Services.

`Sec. 3132. Task Force on Community Preventive Services.

`Subtitle D--Prevention and Wellness Research

`Sec. 3141. Prevention and wellness research activity coordination.

`Sec. 3142. Community prevention and wellness research grants.

`Sec. 3143. Research on subsidies and rewards to encourage wellness and healthy behaviors.

`Subtitle E--Delivery of Community Prevention and Wellness Services

`Sec. 3151. Community prevention and wellness services grants.

`Subtitle F--Core Public Health Infrastructure

`Sec. 3161. Core public health infrastructure for State, local, and tribal health departments.

`Sec. 3162. Core public health infrastructure and activities for CDC.

`Subtitle G--General Provisions

`Sec. 3171. Definitions.

TITLE IV--QUALITY AND SURVEILLANCE

TITLE V--OTHER PROVISIONS

Subtitle A--Drug Discount for Rural and Other Hospitals; 340B Program Integrity

Subtitle B--Programs

Part 1--Grants for Clinics and Centers

Part 2--Other Grant Programs

Part 3--Emergency Care-Related Programs

Part 4--Pain Care and Management Programs

Subtitle C--Food and Drug Administration

Part 1--In General

Part 2--Biosimilars

Subtitle D--Community Living Assistance Services and Supports

`TITLE XXXII--COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS

`Sec. 3201. Purpose.

`Sec. 3202. Definitions.

`Sec. 3203. CLASS Independence Benefit Plan.

`Sec. 3204. Enrollment and disenrollment requirements.

`Sec. 3205. Benefits.

`Sec. 3206. CLASS Independence Fund.

`Sec. 3207. CLASS Independence Advisory Council.

`Sec. 3208. Regulations; annual report.

`Sec. 3209. Inspector General's report.

Subtitle E--Miscellaneous

SEC. 2002. PUBLIC HEALTH INVESTMENT FUND.

SEC. 2003. DEFICIT NEUTRALITY.

TITLE I--COMMUNITY HEALTH CENTERS

SEC. 2101. INCREASED FUNDING.

TITLE II--WORKFORCE

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.

PART 2--PROMOTION OF PRIMARY CARE AND DENTISTRY

SEC. 2211. FRONTLINE HEALTH PROVIDERS.

`Subpart XI--Health Professional Needs Areas

`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 ASSISTANTS.

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. 2217. STUDY ON EFFECTIVENESS OF SCHOLARSHIPS AND LOAN REPAYMENTS.

Subtitle B--Nursing Workforce

SEC. 2221. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

`SEC. 809. REPORTS.

`SEC. 872. FUNDING THROUGH PUBLIC HEALTH INVESTMENT FUND.

`SEC. 871. FUNDING.

Subtitle C--Public Health Workforce

SEC. 2231. PUBLIC HEALTH WORKFORCE CORPS.

`Subpart XII--Public Health Workforce

`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.

Subtitle D--Adapting Workforce to Evolving Health System Needs

PART 1--HEALTH PROFESSIONS TRAINING FOR DIVERSITY

SEC. 2241. SCHOLARSHIPS FOR DISADVANTAGED STUDENTS, LOAN REPAYMENTS AND FELLOWSHIPS REGARDING FACULTY POSITIONS, AND EDUCATIONAL ASSISTANCE IN THE HEALTH PROFESSIONS REGARDING INDIVIDUALS FROM DISADVANTAGED BACKGROUNDS.

SEC. 2242. NURSING WORKFORCE DIVERSITY GRANTS.

SEC. 2243. COORDINATION OF DIVERSITY AND CULTURAL COMPETENCY PROGRAMS.

`SEC. 739A. COORDINATION OF DIVERSITY AND CULTURAL COMPETENCY PROGRAMS.

PART 2--INTERDISCIPLINARY TRAINING PROGRAMS

SEC. 2251. CULTURAL AND LINGUISTIC COMPETENCY TRAINING FOR HEALTH PROFESSIONALS.

SEC. 2252. INNOVATIONS IN INTERDISCIPLINARY CARE TRAINING.

`SEC. 759. INNOVATIONS IN INTERDISCIPLINARY CARE TRAINING.

PART 3--ADVISORY COMMITTEE ON HEALTH WORKFORCE EVALUATION AND ASSESSMENT

SEC. 2261. HEALTH WORKFORCE EVALUATION AND ASSESSMENT.

`SEC. 764. HEALTH WORKFORCE EVALUATION AND ASSESSMENT.

PART 4--HEALTH WORKFORCE ASSESSMENT

SEC. 2271. HEALTH WORKFORCE ASSESSMENT.

PART 5--AUTHORIZATION OF APPROPRIATIONS

SEC. 2281. AUTHORIZATION OF APPROPRIATIONS.

TITLE III--PREVENTION AND WELLNESS

SEC. 2301. PREVENTION AND WELLNESS.

`TITLE XXXI--PREVENTION AND WELLNESS

`Subtitle A--Prevention and Wellness Trust

`SEC. 3111. PREVENTION AND WELLNESS TRUST.

`Subtitle B--National Prevention and Wellness Strategy

`SEC. 3121. NATIONAL PREVENTION AND WELLNESS STRATEGY.

`Subtitle C--Prevention Task Forces

`SEC. 3131. TASK FORCE ON CLINICAL PREVENTIVE SERVICES.

`SEC. 3132. TASK FORCE ON COMMUNITY PREVENTIVE SERVICES.

`Subtitle D--Prevention and Wellness Research

`SEC. 3141. PREVENTION AND WELLNESS RESEARCH ACTIVITY COORDINATION.

`SEC. 3142. COMMUNITY PREVENTION AND WELLNESS RESEARCH GRANTS.

`SEC. 3143. RESEARCH ON SUBSIDIES AND REWARDS TO ENCOURAGE WELLNESS AND HEALTHY BEHAVIORS.

`Subtitle E--Delivery of Community Prevention and Wellness Services

`SEC. 3151. COMMUNITY PREVENTION AND WELLNESS SERVICES GRANTS.

`Subtitle F--Core Public Health Infrastructure

`SEC. 3161. CORE PUBLIC HEALTH INFRASTRUCTURE FOR STATE, LOCAL, AND TRIBAL HEALTH DEPARTMENTS.

`SEC. 3162. CORE PUBLIC HEALTH INFRASTRUCTURE AND ACTIVITIES FOR CDC.

`Subtitle G--General Provisions

`SEC. 3171. DEFINITIONS.

TITLE IV--QUALITY AND SURVEILLANCE

SEC. 2401. IMPLEMENTATION OF BEST PRACTICES IN THE DELIVERY OF HEALTH CARE.

`PART D--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.

TITLE V--OTHER PROVISIONS

Subtitle A--Drug Discount for Rural and Other Hospitals; 340B Program Integrity

SEC. 2501. EXPANDED PARTICIPATION IN 340B PROGRAM.

SEC. 2502. IMPROVEMENTS TO 340B PROGRAM INTEGRITY.

SEC. 2503. EFFECTIVE DATE.

Subtitle B--Programs

PART 1--GRANTS FOR CLINICS AND CENTERS

SEC. 2511. SCHOOL-BASED HEALTH CLINICS.

`SEC. 399Z-1. SCHOOL-BASED HEALTH CLINICS.

SEC. 2512. NURSE-MANAGED HEALTH CENTERS.

`PART S--NURSE-MANAGED HEALTH CENTERS

`SEC. 399FF. NURSE-MANAGED HEALTH CENTERS.

SEC. 2513. FEDERALLY QUALIFIED BEHAVIORAL HEALTH CENTERS.

PART 2--OTHER GRANT PROGRAMS

SEC. 2521. COMPREHENSIVE PROGRAMS TO PROVIDE EDUCATION TO NURSES AND CREATE A PIPELINE TO NURSING.

SEC. 2522. MENTAL AND BEHAVIORAL HEALTH TRAINING.

`Subpart 3--Mental and Behavioral Health Training

`SEC. 775. MENTAL AND BEHAVIORAL HEALTH TRAINING PROGRAM.

SEC. 2523. REAUTHORIZATION OF TELEHEALTH AND TELEMEDICINE GRANT PROGRAMS.

SEC. 2524. NO CHILD LEFT UNIMMUNIZED AGAINST INFLUENZA: DEMONSTRATION PROGRAM USING ELEMENTARY AND SECONDARY SCHOOLS AS INFLUENZA VACCINATION CENTERS.

SEC. 2525. EXTENSION OF WISEWOMAN PROGRAM.

SEC. 2526. HEALTHY TEEN INITIATIVE TO PREVENT TEEN PREGNANCY.

`SEC. 317U. HEALTHY TEEN INITIATIVE TO PREVENT TEEN PREGNANCY.

SEC. 2527. NATIONAL TRAINING INITIATIVES ON AUTISM SPECTRUM DISORDERS.

`Subtitle F--National Training Initiative on Autism Spectrum Disorders

`SEC. 171. NATIONAL TRAINING INITIATIVE.

SEC. 2528. IMPLEMENTATION OF MEDICATION MANAGEMENT SERVICES IN TREATMENT OF CHRONIC DISEASES.

SEC. 2529. POSTPARTUM DEPRESSION.

SEC. 2530. GRANTS TO PROMOTE POSITIVE HEALTH BEHAVIORS AND OUTCOMES.

`SEC. 399V. GRANTS TO PROMOTE POSITIVE HEALTH BEHAVIORS AND OUTCOMES.

SEC. 2531. MEDICAL LIABILITY ALTERNATIVES.

SEC. 2532. INFANT MORTALITY PILOT PROGRAMS.

SEC. 2533. SECONDARY SCHOOL HEALTH SCIENCES TRAINING PROGRAM.

SEC. 2534. COMMUNITY-BASED COLLABORATIVE CARE NETWORKS.

`Subpart XIII--Community-Based Collaborative Care Network Program

`SEC. 340O. COMMUNITY-BASED COLLABORATIVE CARE NETWORK PROGRAM.

SEC. 2535. COMMUNITY-BASED OVERWEIGHT AND OBESITY PREVENTION PROGRAM.

`SEC. 399W-1. COMMUNITY-BASED OVERWEIGHT AND OBESITY PREVENTION PROGRAM.

SEC. 2536. REDUCING STUDENT-TO-SCHOOL NURSE RATIOS.

SEC. 2537. MEDICAL-LEGAL PARTNERSHIPS.

PART 3--EMERGENCY CARE-RELATED PROGRAMS

SEC. 2551. TRAUMA CARE CENTERS.

`SEC. 1241. GRANTS FOR CERTAIN TRAUMA CENTERS.

`SEC. 1242. CONSIDERATIONS IN MAKING GRANTS.

`SEC. 1243. CERTAIN AGREEMENTS.

`SEC. 1244. GENERAL PROVISIONS.

`SEC. 1245. AUTHORIZATION OF APPROPRIATIONS.

SEC. 2552. EMERGENCY CARE COORDINATION.

`SEC. 2816. EMERGENCY CARE COORDINATION.

SEC. 2553. PILOT PROGRAMS TO IMPROVE EMERGENCY MEDICAL CARE.

`SEC. 315. REGIONALIZED COMMUNICATION SYSTEMS FOR EMERGENCY CARE RESPONSE.

SEC. 2554. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL TRAINING TO BECOME STATE-LICENSED OR CERTIFIED EMERGENCY MEDICAL TECHNICIANS (EMTS).

`SEC. 315A. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL TRAINING TO BECOME STATE-LICENSED OR CERTIFIED EMERGENCY MEDICAL TECHNICIANS (EMTS).

SEC. 2555. DENTAL EMERGENCY RESPONDERS: PUBLIC HEALTH AND MEDICAL RESPONSE.

SEC. 2556. DENTAL EMERGENCY RESPONDERS: HOMELAND SECURITY.

PART 4--PAIN CARE AND MANAGEMENT PROGRAMS

SEC. 2561. INSTITUTE OF MEDICINE CONFERENCE ON PAIN.

SEC. 2562. PAIN RESEARCH AT NATIONAL INSTITUTES OF HEALTH.

`SEC. 409J. PAIN RESEARCH.

SEC. 2563. PUBLIC AWARENESS CAMPAIGN ON PAIN MANAGEMENT.

`SEC. 249. NATIONAL EDUCATION OUTREACH AND AWARENESS CAMPAIGN ON PAIN MANAGEMENT.

Subtitle C--Food and Drug Administration

PART 1--IN GENERAL

SEC. 2571. NATIONAL MEDICAL DEVICE REGISTRY.

`National Medical Device Registry

SEC. 2572. NUTRITION LABELING OF STANDARD MENU ITEMS AT CHAIN RESTAURANTS AND OF ARTICLES OF FOOD SOLD FROM VENDING MACHINES.

SEC. 2573. PROTECTING CONSUMER ACCESS TO GENERIC DRUGS.

PART 2--BIOSIMILARS

SEC. 2575. LICENSURE PATHWAY FOR BIOSIMILAR BIOLOGICAL PRODUCTS.

`(aa) analytical studies that demonstrate that the biological product is highly similar to the reference product notwithstanding minor differences in clinically inactive components;

`(bb) animal studies (including the assessment of toxicity); and

`(cc) a clinical study or studies (including the assessment of immunogenicity and pharmacokinetics or pharmacodynamics) that are sufficient to demonstrate safety, purity, and potency in 1 or more appropriate conditions of use for which the reference product is licensed and intended to be used and for which licensure is sought for the biological product;

SEC. 2576. FEES RELATING TO BIOSIMILAR BIOLOGICAL PRODUCTS.

SEC. 2577. AMENDMENTS TO CERTAIN PATENT PROVISIONS.

Subtitle D--Community Living Assistance Services and Supports

SEC. 2581. ESTABLISHMENT OF NATIONAL VOLUNTARY INSURANCE PROGRAM FOR PURCHASING COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORT (CLASS PROGRAM).

`TITLE XXXII--COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS

`SEC. 3201. PURPOSE.

`SEC. 3202. DEFINITIONS.

`SEC. 3203. CLASS INDEPENDENCE BENEFIT PLAN.

`SEC. 3204. ENROLLMENT AND DISENROLLMENT REQUIREMENTS.

`SEC. 3205. BENEFITS.

`SEC. 3206. CLASS INDEPENDENCE FUND.

`SEC. 3207. CLASS INDEPENDENCE ADVISORY COUNCIL.

`SEC. 3208. REGULATIONS; ANNUAL REPORT.

`SEC. 3209. INSPECTOR GENERAL'S REPORT.

Subtitle E--Miscellaneous

SEC. 2585. STATES FAILING TO ADHERE TO CERTAIN EMPLOYMENT OBLIGATIONS.

SEC. 2586. HEALTH CENTERS UNDER PUBLIC HEALTH SERVICE ACT; LIABILITY PROTECTIONS FOR VOLUNTEER PRACTITIONERS.

SEC. 2587. REPORT TO CONGRESS ON THE CURRENT STATE OF PARASITIC DISEASES THAT HAVE BEEN OVERLOOKED AMONG THE POOREST AMERICANS.

SEC. 2588. OFFICE OF WOMEN'S HEALTH.

`SEC. 229. HEALTH AND HUMAN SERVICES OFFICE ON WOMEN'S HEALTH.

`SEC. 310A. CENTERS FOR DISEASE CONTROL AND PREVENTION OFFICE OF WOMEN'S HEALTH.

`SEC. 927. ACTIVITIES REGARDING WOMEN'S HEALTH.

`SEC. 713. OFFICE OF WOMEN'S HEALTH.

`SEC. 911. OFFICE OF WOMEN'S HEALTH.

SEC. 2589. LONG-TERM CARE AND FAMILY CAREGIVER SUPPORT.

SEC. 2590. WEB SITE ON HEALTH CARE LABOR MARKET AND RELATED EDUCATIONAL AND TRAINING OPPORTUNITIES.

SEC. 2591. ONLINE HEALTH WORKFORCE TRAINING PROGRAMS.

SEC. 2592. ACCESS FOR INDIVIDUALS WITH DISABILITIES.

`SEC. 510. STANDARDS FOR ACCESSIBILITY OF MEDICAL DIAGNOSTIC EQUIPMENT.

DIVISION D--INDIAN HEALTH CARE IMPROVEMENT

SEC. 3001. SHORT TITLE; TABLE OF CONTENTS.

DIVISION D--INDIAN HEALTH CARE IMPROVEMENT

TITLE I--AMENDMENTS TO INDIAN LAWS

TITLE II--IMPROVEMENT OF INDIAN HEALTH CARE PROVIDED UNDER THE SOCIAL SECURITY ACT

TITLE I--AMENDMENTS TO INDIAN LAWS

SEC. 3101. INDIAN HEALTH CARE IMPROVEMENT AMENDED.

`SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

`TITLE I--INDIAN HEALTH, HUMAN RESOURCES, AND DEVELOPMENT

`TITLE II--HEALTH SERVICES

`TITLE III--FACILITIES

`TITLE IV--ACCESS TO HEALTH SERVICES

`TITLE V--HEALTH SERVICES FOR URBAN INDIANS

`TITLE VI--ORGANIZATIONAL IMPROVEMENTS

`TITLE VII--BEHAVIORAL HEALTH PROGRAMS

`TITLE VIII--MISCELLANEOUS

`SEC. 2. FINDINGS.

`SEC. 3. DECLARATION OF NATIONAL INDIAN HEALTH POLICY.

`SEC. 4. DEFINITIONS.

`TITLE I--INDIAN HEALTH, HUMAN RESOURCES, AND DEVELOPMENT

`SEC. 101. PURPOSE.

`SEC. 102. HEALTH PROFESSIONS RECRUITMENT PROGRAM FOR INDIANS.

`SEC. 103. HEALTH PROFESSIONS PREPARATORY SCHOLARSHIP PROGRAM FOR INDIANS.

`SEC. 104. INDIAN HEALTH PROFESSIONS SCHOLARSHIPS.

`SEC. 105. AMERICAN INDIANS INTO PSYCHOLOGY PROGRAM.

`SEC. 106. SCHOLARSHIP PROGRAMS FOR INDIAN TRIBES.

`SEC. 107. INDIAN HEALTH SERVICE EXTERN PROGRAMS.

`SEC. 108. CONTINUING EDUCATION ALLOWANCES.

`SEC. 109. COMMUNITY HEALTH REPRESENTATIVE PROGRAM.

`SEC. 110. INDIAN HEALTH SERVICE LOAN REPAYMENT PROGRAM.

`(aa) to maintain enrollment in a course of study or training described in subsection (b)(1)(A) until the individual completes the course of study or training; and

`(bb) while enrolled in such course of study or training, to maintain an acceptable level of academic standing (as determined under regulations of the Secretary by the educational institution offering such course of study or training); and

`SEC. 111. SCHOLARSHIP AND LOAN REPAYMENT RECOVERY FUND.

`SEC. 112. RECRUITMENT ACTIVITIES.

`SEC. 113. INDIAN RECRUITMENT AND RETENTION PROGRAM.

`SEC. 114. ADVANCED TRAINING AND RESEARCH.

`SEC. 115. QUENTIN N. BURDICK AMERICAN INDIANS INTO NURSING PROGRAM.

`SEC. 116. TRIBAL CULTURAL ORIENTATION.

`SEC. 117. INMED PROGRAM.

`SEC. 118. HEALTH TRAINING PROGRAMS OF COMMUNITY COLLEGES.

`SEC. 119. RETENTION BONUS.

`SEC. 120. NURSING RESIDENCY PROGRAM.

`SEC. 121. COMMUNITY HEALTH AIDE PROGRAM.

`SEC. 122. TRIBAL HEALTH PROGRAM ADMINISTRATION.

`SEC. 123. HEALTH PROFESSIONAL CHRONIC SHORTAGE DEMONSTRATION PROGRAMS.

`SEC. 124. NATIONAL HEALTH SERVICE CORPS.

`SEC. 125. SUBSTANCE ABUSE COUNSELOR EDUCATIONAL CURRICULA DEMONSTRATION PROGRAMS.

`SEC. 126. BEHAVIORAL HEALTH TRAINING AND COMMUNITY EDUCATION PROGRAMS.

`SEC. 127. EXEMPTION FROM PAYMENT OF CERTAIN FEES.

`SEC. 128. AUTHORIZATION OF APPROPRIATIONS.

`TITLE II--HEALTH SERVICES

`SEC. 201. INDIAN HEALTH CARE IMPROVEMENT FUND.

`SEC. 202. HEALTH PROMOTION AND DISEASE PREVENTION SERVICES.

`SEC. 203. DIABETES PREVENTION, TREATMENT, AND CONTROL.

`SEC. 204. SHARED SERVICES FOR LONG-TERM CARE.

`SEC. 205. HEALTH SERVICES RESEARCH.

`SEC. 206. MAMMOGRAPHY AND OTHER CANCER SCREENING.

`SEC. 207. PATIENT TRAVEL COSTS.

`SEC. 208. EPIDEMIOLOGY CENTERS.

`SEC. 209. COMPREHENSIVE SCHOOL HEALTH EDUCATION PROGRAMS.

`SEC. 210. INDIAN YOUTH PROGRAM.

`SEC. 211. PREVENTION, CONTROL, AND ELIMINATION OF COMMUNICABLE AND INFECTIOUS DISEASES.

`SEC. 212. OTHER AUTHORITY FOR PROVISION OF SERVICES.

`SEC. 213. INDIAN WOMEN'S HEALTH CARE.

`SEC. 214. ENVIRONMENTAL AND NUCLEAR HEALTH HAZARDS.

`SEC. 215. ARIZONA AS A CONTRACT HEALTH SERVICE DELIVERY AREA.

`SEC. 216. NORTH DAKOTA AND SOUTH DAKOTA AS CONTRACT HEALTH SERVICE DELIVERY AREA.

`SEC. 217. CALIFORNIA CONTRACT HEALTH SERVICES PROGRAM.

`SEC. 218. CALIFORNIA AS A CONTRACT HEALTH SERVICE DELIVERY AREA.

`SEC. 219. CONTRACT HEALTH SERVICES FOR THE TRENTON SERVICE AREA.

`SEC. 220. PROGRAMS OPERATED BY INDIAN TRIBES AND TRIBAL ORGANIZATIONS.

`SEC. 221. LICENSING.

`SEC. 222. NOTIFICATION OF PROVISION OF EMERGENCY CONTRACT HEALTH SERVICES.

`SEC. 223. PROMPT ACTION ON PAYMENT OF CLAIMS.

`SEC. 224. LIABILITY FOR PAYMENT.

`SEC. 225. OFFICE OF INDIAN MEN'S HEALTH.

`SEC. 226. CATASTROPHIC HEALTH EMERGENCY FUND.

`SEC. 227. AUTHORIZATION OF APPROPRIATIONS.

`TITLE III--FACILITIES

`SEC. 301. CONSULTATION; CONSTRUCTION AND RENOVATION OF FACILITIES; REPORTS.

`(aa) to provide advice and recommendations for policies and procedures of the programs funded pursuant to facilities appropriations; and

`(bb) to address other facilities issues.

`(aa) to review the health care facilities construction priority system; and

`(bb) to make recommendations to the Facilities Appropriation Advisory Board for revising the priority system.

`(aa) the methodology and criteria used by the Service in determining the needs and establishing the ranking of the facilities needs; and

`(bb) such other information as the Secretary determines to be appropriate.

`SEC. 302. SANITATION FACILITIES.

`(aa) a safe water supply system; or

`(bb) a waste disposal system;

`SEC. 303. PREFERENCE TO INDIANS AND INDIAN FIRMS.

`SEC. 304. EXPENDITURE OF NON-SERVICE FUNDS FOR RENOVATION.

`SEC. 305. FUNDING FOR THE CONSTRUCTION, EXPANSION, AND MODERNIZATION OF SMALL AMBULATORY CARE FACILITIES.

`SEC. 306. INDIAN HEALTH CARE DELIVERY DEMONSTRATION PROJECT.

`SEC. 307. LAND TRANSFER.

`SEC. 308. LEASES, CONTRACTS, AND OTHER AGREEMENTS.

`SEC. 309. STUDY ON LOANS, LOAN GUARANTEES, AND LOAN REPAYMENT.

`SEC. 310. TRIBAL LEASING.

`SEC. 311. INDIAN HEALTH SERVICE/TRIBAL FACILITIES JOINT VENTURE PROGRAM.

`SEC. 312. LOCATION OF FACILITIES.

`SEC. 313. MAINTENANCE AND IMPROVEMENT OF HEALTH CARE FACILITIES.

`SEC. 314. TRIBAL MANAGEMENT OF FEDERALLY OWNED QUARTERS.

`SEC. 315. APPLICABILITY OF BUY AMERICAN ACT REQUIREMENT.

`SEC. 316. OTHER FUNDING FOR FACILITIES.

`SEC. 317. AUTHORIZATION OF APPROPRIATIONS.

`TITLE IV--ACCESS TO HEALTH SERVICES

`SEC. 401. TREATMENT OF PAYMENTS UNDER SOCIAL SECURITY ACT HEALTH BENEFITS PROGRAMS.

`SEC. 402. GRANTS TO AND CONTRACTS WITH THE SERVICE, INDIAN TRIBES, TRIBAL ORGANIZATIONS, AND URBAN INDIAN ORGANIZATIONS TO FACILITATE OUTREACH, ENROLLMENT, AND COVERAGE OF INDIANS UNDER SOCIAL SECURITY ACT HEALTH BENEFIT PROGRAMS.

`SEC. 403. REIMBURSEMENT FROM CERTAIN THIRD PARTIES OF COSTS OF HEALTH SERVICES.

`SEC. 404. CREDITING OF REIMBURSEMENTS.

`SEC. 405. PURCHASING HEALTH CARE COVERAGE.

`SEC. 406. SHARING ARRANGEMENTS WITH FEDERAL AGENCIES.

`SEC. 407. ELIGIBLE INDIAN VETERAN SERVICES.

`SEC. 408. PAYOR OF LAST RESORT.

`SEC. 409. CONSULTATION.

`SEC. 410. STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP).

`SEC. 411. PREMIUM AND COST SHARING PROTECTIONS AND ELIGIBILITY DETERMINATIONS UNDER MEDICAID AND SCHIP AND PROTECTION OF CERTAIN INDIAN PROPERTY FROM MEDICAID ESTATE RECOVERY.

`SEC. 412. TREATMENT UNDER MEDICAID AND SCHIP MANAGED CARE.

`SEC. 413. NAVAJO NATION MEDICAID AGENCY FEASIBILITY STUDY.

`SEC. 414. EXCEPTION FOR EXCEPTED BENEFITS.

`SEC. 415. AUTHORIZATION OF APPROPRIATIONS.

`TITLE V--HEALTH SERVICES FOR URBAN INDIANS

`SEC. 501. PURPOSE.

`SEC. 502. CONTRACTS WITH, AND GRANTS TO, URBAN INDIAN ORGANIZATIONS.

`SEC. 503. CONTRACTS AND GRANTS FOR THE PROVISION OF HEALTH CARE AND REFERRAL SERVICES.

`SEC. 504. USE OF FEDERAL GOVERNMENT FACILITIES AND SOURCES OF SUPPLY.

`SEC. 505. CONTRACTS AND GRANTS FOR THE DETERMINATION OF UNMET HEALTH CARE NEEDS.

`SEC. 506. EVALUATIONS; RENEWALS.

`SEC. 507. OTHER CONTRACT AND GRANT REQUIREMENTS.

`SEC. 508. REPORTS AND RECORDS.

`SEC. 509. LIMITATION ON CONTRACT AUTHORITY.

`SEC. 510. FACILITIES.

`SEC. 511. DIVISION OF URBAN INDIAN HEALTH.

`SEC. 512. GRANTS FOR ALCOHOL AND SUBSTANCE ABUSE-RELATED SERVICES.

`SEC. 513. TREATMENT OF CERTAIN DEMONSTRATION PROJECTS.

`SEC. 514. URBAN NIAAA TRANSFERRED PROGRAMS.

`SEC. 515. CONFERRING WITH URBAN INDIAN ORGANIZATIONS.

`SEC. 516. URBAN YOUTH TREATMENT CENTER DEMONSTRATION.

`SEC. 517. GRANTS FOR DIABETES PREVENTION, TREATMENT, AND CONTROL.

`SEC. 518. COMMUNITY HEALTH REPRESENTATIVES.

`SEC. 519. EFFECTIVE DATE.

`SEC. 520. ELIGIBILITY FOR SERVICES.

`SEC. 521. AUTHORIZATION OF APPROPRIATIONS.

`SEC. 522. HEALTH INFORMATION TECHNOLOGY.

`TITLE VI--ORGANIZATIONAL IMPROVEMENTS

`SEC. 601. ESTABLISHMENT OF THE INDIAN HEALTH SERVICE AS AN AGENCY OF THE PUBLIC HEALTH SERVICE.

`SEC. 602. AUTOMATED MANAGEMENT INFORMATION SYSTEM.

`SEC. 603. AUTHORIZATION OF APPROPRIATIONS.

`TITLE VII--BEHAVIORAL HEALTH PROGRAMS

`SEC. 701. BEHAVIORAL HEALTH PREVENTION AND TREATMENT SERVICES.

`SEC. 702. MEMORANDA OF AGREEMENT WITH THE DEPARTMENT OF THE INTERIOR.

`SEC. 703. COMPREHENSIVE BEHAVIORAL HEALTH PREVENTION AND TREATMENT PROGRAM.

`SEC. 704. MENTAL HEALTH TECHNICIAN PROGRAM.

`SEC. 705. LICENSING REQUIREMENT FOR MENTAL HEALTH CARE WORKERS.

`SEC. 706. INDIAN WOMEN TREATMENT PROGRAMS.

`SEC. 707. INDIAN YOUTH PROGRAM.

`SEC. 708. INDIAN YOUTH TELEMENTAL HEALTH DEMONSTRATION PROJECT.

`SEC. 709. INPATIENT AND COMMUNITY-BASED MENTAL HEALTH FACILITIES DESIGN, CONSTRUCTION, AND STAFFING.

`SEC. 710. TRAINING AND COMMUNITY EDUCATION.

`SEC. 711. BEHAVIORAL HEALTH PROGRAM.

`SEC. 712. FETAL ALCOHOL DISORDER PROGRAMS.

`SEC. 713. CHILD SEXUAL ABUSE AND PREVENTION TREATMENT PROGRAMS.

`SEC. 714. DOMESTIC AND SEXUAL VIOLENCE PREVENTION AND TREATMENT.

`SEC. 715. BEHAVIORAL HEALTH RESEARCH.

`SEC. 716. DEFINITIONS.

`SEC. 717. AUTHORIZATION OF APPROPRIATIONS.

`TITLE VIII--MISCELLANEOUS

`SEC. 801. REPORTS.

`SEC. 802. REGULATIONS.

`SEC. 803. PLAN OF IMPLEMENTATION.

`SEC. 804. LIMITATION ON USE OF FUNDS APPROPRIATED TO INDIAN HEALTH SERVICE.

`SEC. 805. ELIGIBILITY OF CALIFORNIA INDIANS.

`SEC. 806. HEALTH SERVICES FOR INELIGIBLE PERSONS.

`SEC. 807. REALLOCATION OF BASE RESOURCES.

`SEC. 808. RESULTS OF DEMONSTRATION PROJECTS.

`SEC. 809. PROVISION OF SERVICES IN MONTANA.

`SEC. 810. MORATORIUM.

`SEC. 811. SEVERABILITY PROVISIONS.

`SEC. 812. USE OF PATIENT SAFETY ORGANIZATIONS.

`SEC. 813. CONFIDENTIALITY OF MEDICAL QUALITY ASSURANCE RECORDS; QUALIFIED IMMUNITY FOR PARTICIPANTS.

`SEC. 814. CLAREMORE INDIAN HOSPITAL.

`SEC. 815. SENSE OF CONGRESS REGARDING LAW ENFORCEMENT AND METHAMPHETAMINE ISSUES IN INDIAN COUNTRY.

`SEC. 816. PERMITTING IMPLEMENTATION THROUGH CONTRACTS WITH TRIBAL HEALTH PROGRAMS.

`SEC. 817. AUTHORIZATION OF APPROPRIATIONS; AVAILABILITY.

`SEC. 5. AUTHORITY OF ASSISTANT SECRETARY FOR INDIAN HEALTH.';

SEC. 3102. SOBOBA SANITATION FACILITIES.

SEC. 3103. NATIVE AMERICAN HEALTH AND WELLNESS FOUNDATION.

`TITLE VIII--NATIVE AMERICAN HEALTH AND WELLNESS FOUNDATION

`SEC. 801. DEFINITIONS.

`SEC. 802. NATIVE AMERICAN HEALTH AND WELLNESS FOUNDATION.

`SEC. 803. ADMINISTRATIVE SERVICES AND SUPPORT.

SEC. 3104. GAO STUDY AND REPORT ON PAYMENTS FOR CONTRACT HEALTH SERVICES.

TITLE II--IMPROVEMENT OF INDIAN HEALTH CARE PROVIDED UNDER THE SOCIAL SECURITY ACT

SEC. 3201. EXPANSION OF PAYMENTS UNDER MEDICARE, MEDICAID, AND SCHIP FOR ALL COVERED SERVICES FURNISHED BY INDIAN HEALTH PROGRAMS.

`SEC. 1911. INDIAN HEALTH PROGRAMS.';

`SEC. 1880. INDIAN HEALTH PROGRAMS.';

SEC. 3202. ADDITIONAL PROVISIONS TO INCREASE OUTREACH TO, AND ENROLLMENT OF, INDIANS IN SCHIP AND MEDICAID.

SEC. 3203. SOLICITATION OF PROPOSALS FOR SAFE HARBORS UNDER THE SOCIAL SECURITY ACT FOR FACILITIES OF INDIAN HEALTH PROGRAMS AND URBAN INDIAN ORGANIZATIONS.

SEC. 3204. ANNUAL REPORT ON INDIANS SERVED BY SOCIAL SECURITY ACT HEALTH BENEFIT PROGRAMS.

SEC. 3205. DEVELOPMENT OF RECOMMENDATIONS TO IMPROVE INTERSTATE COORDINATION OF MEDICAID AND SCHIP COVERAGE OF INDIAN CHILDREN AND OTHER CHILDREN WHO ARE OUTSIDE OF THEIR STATE OF RESIDENCY BECAUSE OF EDUCATIONAL OR OTHER NEEDS.

END