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104TH CONGRESS

1ST SESSION H. R. 1134

To amend title XVIII of the Social Security Act to extend certain savings

provisions under the medicare program, as incorporated in the budget

submitted by the President for fiscal year 1996.

IN THE HOUSE OF REPRESENTATIVES

MARCH 6, 1995

Mr. THOMAS of California introduced the following bill; which was referred to

the Committee on Ways and Means and, in addition, to the Committee

on Commerce, 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 amend title XVIII of the Social Security Act to extend

certain savings provisions under the medicare program,

as incorporated in the budget submitted by the President

for fiscal year 1996.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Medicare Presidential

5 Budget Savings Extension Act of 1995’’.
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1 TITLE I—PROVISIONS RELATING TO PART A OF

2 THE MEDICARE PROGRAM

3 SEC. 101. MAINTAINING SAVINGS RESULTING FROM TEM4 PORARY FREEZE ON PAYMENT INCREASES

5 FOR SKILLED NURSING FACILITY SERVICES.

6 (a) BASING UPDATES TO PER DIEM COST LIMITS ON

7 LIMITS FOR FISCAL YEAR 1993.—

8 (1) IN GENERAL.—The last sentence of section

9 1888(a) of the Social Security Act (42 U.S.C.

10 1395yy(a)) is amended by adding at the end the fol11 lowing: ‘‘(except that such updates may not take

12 into account any changes in the routine service costs

13 of skilled nursing facilities occurring during cost re14 porting periods which began during fiscal year 1994

15 or fiscal year 1995).’’.

16 (2) NO EXCEPTIONS PERMITTED BASED ON

17 AMENDMENT.—The Secretary of Health and Human

18 Services shall not consider the amendment made by

19 paragraph (1) in making any adjustments pursuant

20 to section 1888(c) of the Social Security Act.

21 (b) PAYMENTS DETERMINED ON PROSPECTIVE

22 BASIS.—Any change made by the Secretary of Health and

23 Human Services in the amount of any prospective pay24 ment paid to a skilled nursing facility under section

25 1888(d) of the Social Security Act for cost reporting peri-
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1 ods beginning on or after October 1, 1995, may not take

2 into account any changes in the costs of services occurring

3 during cost reporting periods which began during fiscal

4 year 1994 or fiscal year 1995.

5 TITLE II—PROVISIONS RELATING TO PART B

6 OF THE MEDICARE PROGRAM

7 SEC. 201. SETTING THE PART B PREMIUM AT 25 PERCENT

8 OF PROGRAM EXPENDITURES PERMA9 NENTLY.

10 (a) IN GENERAL.—Section 1839(a)(3) of the Social

11 Security Act (42 U.S.C. 1395r(a)(3)) is amended by strik12 ing ‘‘The monthly premium’’ and all that follows through

13 ‘‘November 1.’’ and inserting the following: ‘‘The monthly

14 premium shall be equal to 50 percent of the monthly actu15 arial rate for enrollees age 65 and over, as determined ac16 cording to paragraph (1), for that succeeding calendar

17 year.’’.

18 (b) CONFORMING AMENDMENTS.—Section 1839 of

19 such Act (42 U.S.C. 1395r) is amended—

20 (1) in subsection (a)(2), by striking ‘‘(b) and

21 (e)’’ and inserting ‘‘(b), (c), (e), and (f)’’;

22 (2) in the last sentence of subsection (a)(3), by

23 striking ‘‘and the derivation of the dollar amounts

24 specified in this paragraph’’; and

25 (3) in subsection (e)—
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1 (A) by striking ‘‘(1)(A) Notwithstanding’’

2 and all that follows through ‘‘(B)’’,

3 (B) by striking paragraph (2), and

4 (C) by redesignating clauses (i) through

5 (v) as paragraphs (1) through (5).

6 TITLE III—PROVISIONS RELATING TO PARTS A

7 AND B OF THE MEDICARE PROGRAM

8 SEC. 301. PERMANENT EXTENSION OF CERTAIN SECOND9 ARY PAYER PROVISIONS.

10 (a) DATA MATCH.—

11 (1) Section 1862(b)(5)(C) of the Social Security

12 Act (42 U.S.C. 1395y(b)(5)(C)) is amended by strik13 ing clause (iii).

14 (2) Section 6103(l)(12) of the Internal Revenue

15 Code of 1986 is amended by striking subparagraph

16 (F).

17 (b) APPLICATION TO DISABLED INDIVIDUALS IN

18 LARGE GROUP HEALTH PLANS.—

19 (1) IN GENERAL.—Section 1862(b)(1)(B) of

20 the Social Security Act (42 U.S.C. 1395y(b)(1)(B))

21 is amended—

22 (A) in clause (i), by striking ‘‘clause (iv)’’

23 and inserting ‘‘clause (iii)’’,

24 (B) by striking clause (iii), and
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1 (C) by redesignating clause (iv) as clause

2 (iii).

3 (2) CONFORMING AMENDMENTS.—Paragraphs

4 (1) through (3) of section 1837(i) of such Act (42

5 U.S.C. 1395p(i)) and the second sentence of section

6 1839(b) of such Act (42 U.S.C. 1395r(b)) are each

7 amended by striking ‘‘1862(b)(1)(B)(iv)’’ each place

8 it appears and inserting ‘‘1862(b)(1)(B)(iii)’’.

9 (c) PERIOD OF APPLICATION TO INDIVIDUALS WITH

10 END STAGE RENAL DISEASE.—Section 1862(b)(1)(C) of

11 the Social Security Act (42 U.S.C. 1395y(b)(1)(C)) is

12 amended—

13 (1) in the first sentence, by striking ‘‘12-

14 month’’ each place it appears and inserting ‘‘18-

15 month’’, and

16 (2) by striking the second sentence.

17 SEC. 302. MAINTAINING SAVINGS RESULTING FROM TEM18 PORARY FREEZE ON PAYMENT INCREASES

19 FOR HOME HEALTH SERVICES.

20 (a) BASING UPDATES TO PER VISIT COST LIMITS ON

21 LIMITS FOR FISCAL YEAR 1993.—Section

22 1861(v)(1)(L)(iii) of the Social Security Act (42 U.S.C.

23 1395x(v)(1)(L)(iii)) is amended by adding at the end the

24 following sentence: ‘‘In establishing limits under this sub25 paragraph, the Secretary may not take into account any
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1 changes in the costs of the provision of services furnished

2 by home health agencies with respect to cost reporting pe3 riods which began on or after July 1, 1994, and before

4 July 1, 1996.’’.

5 (b) NO EXCEPTIONS PERMITTED BASED ON AMEND6 MENT.—The Secretary of Health and Human Services

7 shall not consider the amendment made by subsection (a)

8 in making any exemptions and exceptions pursuant to sec9 tion 1861(v)(1)(L)(ii) of the Social Security Act.

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