H.R. 3200/Division B
DIVISION B—MEDICARE AND MEDICAID IMPROVEMENTS
[edit]SEC. 1001. TABLE OF CONTENTS OF DIVISION.
[edit]- The table of contents for this division is as follows:
Sec. 1001. Table of Contents of Division.
- Subtitle A—Provisions Related to Medicare PART A
- Part 3—Other Provisions
- Sec. 1141. Rental and Purchase of Power-Driven Wheelchairs.
- Sec. 1142. Extension of Payment Rule for Brachytherapy.
- Sec. 1143. Home Infusion Therapy Report to Ccongress.
- 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.
- Part 3—Other Provisions
- 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.
- 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.
- Subtitle D—Medicare Advantage Reforms
- 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.
- Part 1—Payment and Administration
- 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.
- Part 2—Beneficiary Protections and Anti-Fraud
- 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 Tthreshold Under PART D.
- Subtitle F—Medicare Rural Access Protections
- 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. 1233. 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. 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. 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.
- Sec. 1309. Extension of Physician Fee Schedule Mental Health Add-on.
- Sec. 1310. Expanding Access to Vaccines.
- 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.
- Part 1—Improving Transparency of Information on Skilled Nursing Facilities and Nursing Facilities
- Subtitle C—Quality Measurements
- Sec. 1441. Establishment of National Priorities for Quality Improvement.
- Sec. 1442. Development of New Quality Measures; 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.
- 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 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. 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.
- Subtitle C—Enhanced Program and Provider Protections
- Sec. 1631. Enhanced CMS Program Protection Authority.
- 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. 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.
- 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.
- 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. 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.
- Sec. 1905. Improved Ccoordination and Protection for Dual Eligibles.