II 

Calendar No. 719 

110TH CONGRESS 

2D SESSION H. R. 5613 

IN THE SENATE OF THE UNITED STATES 

APRIL 24, 2008 

Received and read the first time 

APRIL 28, 2008 

Read the second time and placed on the calendar 

AN ACT 

To extend certain moratoria and impose additional moratoria 

on certain Medicaid regulations through April 1, 2009, 

and for other purposes. 

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 ‘‘Protecting the Med5 icaid Safety Net Act of 2008’’. 

6 SEC. 2. MORATORIA ON CERTAIN MEDICAID REGULATIONS. 

7 (a) EXTENSION OF CERTAIN MORATORIA IN PUBLIC

8 LAW 110–28.—Section 7002(a)(1) of the U.S. Troop 

9 Readiness, Veterans’ Care, Katrina Recovery, and Iraq 


pwalker on PROD1PC71 with BILLS
2 

HR 5613 PCS 

1 Accountability Appropriations Act, 2007 (Public Law 

2 110–28) is amended— 

3 (1) by striking ‘‘prior to the date that is 1 year 

4 after the date of enactment of this Act’’ and insert5 ing ‘‘prior to April 1, 2009’’; 

6 (2) in subparagraph (A), by inserting after 

7 ‘‘Federal Regulations)’’ the following: ‘‘or in the 

8 final regulation, relating to such parts, published on 

9 May 29, 2007 (72 Federal Register 29748)’’; and 

10 (3) in subparagraph (C), by inserting before the 

11 period at the end the following: ‘‘, including the pro12 posed regulation published on May 23, 2007 (72 

13 Federal Register 28930)’’. 

14 (b) EXTENSION OF CERTAIN MORATORIA IN PUBLIC

15 LAW 110–173.—Section 206 of the Medicare, Medicaid, 

16 and SCHIP Extension Act of 2007 (Public Law 110–173) 

17 is amended— 

18 (1) by striking ‘‘June 30, 2008’’ and inserting 

19 ‘‘April 1, 2009’’; 

20 (2) by inserting ‘‘, including the proposed regu21 lation published on August 13, 2007 (72 Federal 

22 Register 45201),’’ after ‘‘rehabilitation services’’; 

23 and 


pwalker on PROD1PC71 with BILLS
3 

HR 5613 PCS 

1 (3) by inserting ‘‘, including the final regulation 

2 published on December 28, 2007 (72 Federal Reg3 ister 73635),’’ after ‘‘school-based transportation’’. 

4 (c) ADDITIONAL MORATORIA.— 

5 (1) IN GENERAL.—Notwithstanding any other 

6 provision of law, the Secretary of Health and 

7 Human Services shall not, prior to April 1, 2009, 

8 take any action (through promulgation of regulation, 

9 issuance of regulatory guidance, use of Federal pay10 ment audit procedures, or other administrative ac11 tion, policy, or practice, including a Medical Assist12 ance Manual transmittal or letter to State Medicaid 

13 directors) to impose any restrictions relating to a 

14 provision described in subparagraph (A), (B), or (C) 

15 of paragraph (2) if such restrictions are more re16 strictive in any aspect than those applied to the re17 spective provision as of the date specified in para18 graph (3) for such provision. 

19 (2) PROVISIONS DESCRIBED.— 

20 (A) PORTION OF INTERIM FINAL REGULA21 TION RELATING TO MEDICAID TREATMENT OF

22 OPTIONAL CASE MANAGEMENT SERVICES.— 

23 (i) IN GENERAL.—Subject to clause 

24 (ii), the provision described in this sub25 paragraph is the interim final regulation 


pwalker on PROD1PC71 with BILLS
4 

HR 5613 PCS 

1 relating to optional State plan case man2 agement services under the Medicaid pro3 gram published on December 4, 2007 (72 

4 Federal Register 68077) in its entirety. 

5 (ii) EXCEPTION.—The provision de6 scribed in this subparagraph does not in7 clude the portion of such regulation as re8 lates directly to implementing section 

9 1915(g)(2)(A)(ii) of the Social Security 

10 Act, as amended by section 6052 of the 

11 Deficit Reduction Act of 2005 (Public Law 

12 109–171), through the definition of case 

13 management services and targeted case 

14 management services contained in pro15 posed section 440.169 of title 42, Code of 

16 Federal Regulations, but only to the extent 

17 that such portion is not more restrictive 

18 than the policies set forth in the Dear 

19 State Medicaid Director letter on case 

20 management issued on January 19, 2001 

21 (SMDL #01–013), and with respect to 

22 community transition case management, 

23 the Dear State Medicaid Director letter 

24 issued on July 25, 2000 (Olmstead Update 

25 3). 


pwalker on PROD1PC71 with BILLS
5 

HR 5613 PCS 

1 (B) PROPOSED REGULATION RELATING TO

2 REDEFINITION OF MEDICAID OUTPATIENT HOS3 PITAL SERVICES.—The provision described in 

4 this subparagraph is the proposed regulation re5 lating to clarification of outpatient clinic and 

6 hospital facility services definition and upper 

7 payment limit under the Medicaid program 

8 published on September 28, 2007 (72 Federal 

9 Register 55158) in its entirety. 

10 (C) PORTION OF PROPOSED REGULATION

11 RELATING TO MEDICAID ALLOWABLE PROVIDER

12 TAXES.— 

13 (i) IN GENERAL.—Subject to clause 

14 (ii), the provision described in this sub15 paragraph is the final regulation relating 

16 to health-care-related taxes under the Med17 icaid program published on February 22, 

18 2008 (73 Federal Register 9685) in its en19 tirety. 

20 (ii) EXCEPTION.—The provision de21 scribed in this subparagraph does not in22 clude the portions of such regulation as re23 late to the following: 

24 (I) REDUCTION IN THRESH25 OLD.—The reduction from 6 percent 


pwalker on PROD1PC71 with BILLS
6 

HR 5613 PCS 

1 to 5.5 percent in the threshold applied 

2 under section 433.68(f)(3)(i) of title 

3 42, Code of Federal Regulations, for 

4 determining whether or not there is 

5 an indirect guarantee to hold a tax6 payer harmless, as required to carry 

7 out section 1903(w)(4)(C)(ii) of the 

8 Social Security Act, as added by sec9 tion 403 of the Medicare Improvement 

10 and Extension Act of 2006 (division 

11 B of Public Law 109–432). 

12 (II) CHANGE IN DEFINITION OF

13 MANAGED CARE.—The change in the 

14 definition of managed care as pro15 posed in the revision of section 

16 433.56(a)(8) of title 42, Code of Fed17 eral Regulations, as required to carry 

18 out section 1903(w)(7)(A)(viii) of the 

19 Social Security Act, as amended by 

20 section 6051 of the Deficit Reduction 

21 Act of 2005 (Public Law 109–171). 

22 (3) DATE SPECIFIED.—The date specified in 

23 this paragraph for the provision described in— 

24 (A) subparagraph (A) of paragraph (2) is 

25 December 3, 2007; 


pwalker on PROD1PC71 with BILLS
7 

HR 5613 PCS 

1 (B) subparagraph (B) of such paragraph is 

2 September 27, 2007; or 

3 (C) subparagraph (C) of such paragraph is 

4 February 21, 2008. 

5 SEC. 3. FUNDS TO REDUCE MEDICAID FRAUD AND ABUSE. 

6 (a) IN GENERAL.—For purposes of reducing fraud 

7 and abuse in the Medicaid program under title XIX of 

8 the Social Security Act, there is appropriated to the Sec9 retary of Health and Human Services, out of any money 

10 in the Treasury not otherwise appropriated, $25,000,000, 

11 for each fiscal year (beginning with fiscal year 2009). 

12 Amounts appropriated under this section shall remain 

13 available for expenditure until expended and shall be in 

14 addition to any other amounts appropriated or made avail15 able to the Secretary for such purposes with respect to 

16 the Medicaid program. 

17 (b) ANNUAL REPORT.—Not later than September 30 

18 of 2009 and of each subsequent year, the Secretary of 

19 Health and Human Services shall submit to the Com20 mittee on Energy and Commerce of the House of Rep21 resentatives and the Committee on Finance of the Senate 

22 a report on the activities (and the results of such activi23 ties) funded under subsection (a) to reduce waste, fraud, 

24 and abuse in the Medicaid program under title XIX of 

25 the Social Security Act during the previous 12 month peVerDate Aug 31 2005 22:52 Apr 28, 2008 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5613.PCS H5613

pwalker on PROD1PC71 with BILLS
8 

HR 5613 PCS 

1 riod, including the amount of funds appropriated under 

2 such subsection (a) for each such activity and an estimate 

3 of the savings to the Medicaid program resulting from 

4 each such activity. 

5 SEC. 4. STUDY AND REPORTS TO CONGRESS. 

6 (a) SECRETARIAL REPORT IDENTIFYING PROB7 LEMS.—Not later than July 1, 2008, the Secretary of 

8 Health and Human Services shall submit to the Com9 mittee on Energy and Commerce of the House of Rep10 resentatives and the Committee on Finance of the Senate 

11 a report that— 

12 (1) outlines the specific problems the Medicaid 

13 regulations referred to in the amendments made by 

14 subsections (a) and (b) of section 2 and in the provi15 sions described in subsection (c)(2) of such section 

16 were intended to address; 

17 (2) detailing how these regulations were de18 signed to address these specific problems; and 

19 (3) cites the legal authority for such regula20 tions. 

21 (b) INDEPENDENT COMPREHENSIVE STUDY AND RE22 PORT.— 

23 (1) IN GENERAL.—Not later than July 1, 2008, 

24 the Secretary of Health and Human Services shall 


pwalker on PROD1PC71 with BILLS
9 

HR 5613 PCS 

1 enter into a contract with an independent organiza2 tion for the purpose of— 

3 (A) producing a comprehensive report on 

4 the prevalence of the problems outlined in the 

5 report submitted under subsection (a); 

6 (B) identifying strategies in existence to 

7 address these problems; and 

8 (C) assessing the impact of each regulation 

9 referred to in such subsection on each State 

10 and the District of Columbia. 

11 (2) ADDITIONAL MATTER.—The report under 

12 paragraph (1) shall also include— 

13 (A) an identification of which claims for 

14 items and services (including administrative ac15 tivities) under title XIX of the Social Security 

16 Act are not processed through systems de17 scribed in section 1903(r) of such Act; 

18 (B) an examination of the reasons why 

19 these claims for such items and services are not 

20 processed through such systems; and 

21 (C) recommendations on actions by the 

22 Federal government and the States that can 

23 make claims for such items and services more 

24 accurate and complete consistent with such 

25 title. 


pwalker on PROD1PC71 with BILLS
10 

HR 5613 PCS 

1 (3) DEADLINE.—The report under paragraph 

2 (1) shall be submitted to the Committee on Energy 

3 and Commerce of the House of Representatives and 

4 the Committee on Finance of the Senate not later 

5 than March 1, 2009. 

6 (4) COOPERATION OF STATES.—If the Sec7 retary of Health and Human Services determines 

8 that a State or the District of Columbia has not co9 operated with the independent organization for pur10 poses of the report under this subsection, the Sec11 retary shall reduce the amount paid to the State or 

12 District under section 1903(a) of the Social Security 

13 Act (42 U.S.C. 1396b(a)) by $25,000 for each day 

14 on which the Secretary determines such State or 

15 District has not so cooperated. Such reduction shall 

16 be made through a process that permits the State or 

17 District to challenge the Secretary’s determination. 

18 (c) FUNDING.— 

19 (1) IN GENERAL.—Out of any money in the 

20 Treasury of the United States not otherwise appro21 priated, there are appropriated to the Secretary 

22 without further appropriation, $5,000,000 to carry 

23 out this section. 

24 (2) AVAILABILITY; AMOUNTS IN ADDITION TO

25 OTHER AMOUNTS APPROPRIATED FOR SUCH ACTIVIVerDate Aug 31 2005 22:52 Apr 28, 2008 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H5613.PCS H5613

pwalker on PROD1PC71 with BILLS
11 

HR 5613 PCS 

1 TIES.—Amounts appropriated pursuant to para2 graph (1) shall— 

3 (A) remain available until expended; and 

4 (B) be in addition to any other amounts 

5 appropriated or made available to the Secretary 

6 of Health and Human Services with respect to 

7 the Medicaid program. 

8 SEC. 5. ASSET VERIFICATION THROUGH ACCESS TO INFOR9 MATION HELD BY FINANCIAL INSTITUTIONS. 

10 (a) ADDITION OF AUTHORITY.—Title XIX of the So11 cial Security Act is amended by inserting after section 

12 1939 the following new section: 

13 ‘‘ASSET VERIFICATION THROUGH ACCESS TO

14 INFORMATION HELD BY FINANCIAL INSTITUTIONS

15 ‘‘SEC. 1940. (a) IMPLEMENTATION.— 

16 ‘‘(1) IN GENERAL.—Subject to the provisions of 

17 this section, each State shall implement an asset 

18 verification program described in subsection (b), for 

19 purposes of determining or redetermining the eligi20 bility of an individual for medical assistance under 

21 the State plan under this title. 

22 ‘‘(2) PLAN SUBMITTAL.—In order to meet the 

23 requirement of paragraph (1), each State shall— 

24 ‘‘(A) submit not later than a deadline spec25 ified by the Secretary consistent with paragraph 

26 (3), a State plan amendment under this title 


pwalker on PROD1PC71 with BILLS
12 

HR 5613 PCS 

1 that describes how the State intends to imple2 ment the asset verification program; and 

3 ‘‘(B) provide for implementation of such 

4 program for eligibility determinations and rede5 terminations made on or after 6 months after 

6 the deadline established for submittal of such 

7 plan amendment. 

8 ‘‘(3) PHASE-IN.— 

9 ‘‘(A) IN GENERAL.— 

10 ‘‘(i) IMPLEMENTATION IN CURRENT

11 ASSET VERIFICATION DEMO STATES.—The 

12 Secretary shall require those States speci13 fied in subparagraph (C) (to which an 

14 asset verification program has been applied 

15 before the date of the enactment of this 

16 section) to implement an asset verification 

17 program under this subsection by the end 

18 of fiscal year 2009. 

19 ‘‘(ii) IMPLEMENTATION IN OTHER

20 STATES.—The Secretary shall require 

21 other States to submit and implement an 

22 asset verification program under this sub23 section in such manner as is designed to 

24 result in the application of such programs, 

25 in the aggregate for all such other States, 


pwalker on PROD1PC71 with BILLS
13 

HR 5613 PCS 

1 to enrollment of approximately, but not 

2 less than, the following percentage of en3 rollees, in the aggregate for all such other 

4 States, by the end of the fiscal year in5 volved: 

6 ‘‘(I) 12.5 percent by the end of 

7 fiscal year 2009. 

8 ‘‘(II) 25 percent by the end of 

9 fiscal year 2010. 

10 ‘‘(III) 50 percent by the end of 

11 fiscal year 2011. 

12 ‘‘(IV) 75 percent by the end of 

13 fiscal year 2012. 

14 ‘‘(V) 100 percent by the end of 

15 fiscal year 2013. 

16 ‘‘(B) CONSIDERATION.—In selecting States 

17 under subparagraph (A)(ii), the Secretary shall 

18 consult with the States involved and take into 

19 account the feasibility of implementing asset 

20 verification programs in each such State. 

21 ‘‘(C) STATES SPECIFIED.—The States 

22 specified in this subparagraph are California, 

23 New York, and New Jersey. 

24 ‘‘(D) CONSTRUCTION.—Nothing in sub25 paragraph (A)(ii) shall be construed as preVerDate Aug 31 2005 22:52 Apr 28, 2008 Jkt 059200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H5613.PCS H5613

pwalker on PROD1PC71 with BILLS
14 

HR 5613 PCS 

1 venting a State from requesting, and the Sec2 retary approving, the implementation of an 

3 asset verification program in advance of the 

4 deadline otherwise established under such sub5 paragraph. 

6 ‘‘(4) EXEMPTION OF TERRITORIES.—This sec7 tion shall only apply to the 50 States and the Dis8 trict of Columbia. 

9 ‘‘(b) ASSET VERIFICATION PROGRAM.— 

10 ‘‘(1) IN GENERAL.—For purposes of this sec11 tion, an asset verification program means a program 

12 described in paragraph (2) under which a State— 

13 ‘‘(A) requires each applicant for, or recipi14 ent of, medical assistance under the State plan 

15 under this title on the basis of being aged, 

16 blind, or disabled to provide authorization by 

17 such applicant or recipient (and any other per18 son whose resources are material to the deter19 mination of the eligibility of the applicant or re20 cipient for such assistance) for the State to ob21 tain (subject to the cost reimbursement require22 ments of section 1115(a) of the Right to Finan23 cial Privacy Act but at no cost to the applicant 

24 or recipient) from any financial institution 

25 (within the meaning of section 1101(1) of such 


pwalker on PROD1PC71 with BILLS
15 

HR 5613 PCS 

1 Act) any financial record (within the meaning 

2 of section 1101(2) of such Act) held by the in3 stitution with respect to the applicant or recipi4 ent (and such other person, as applicable), 

5 whenever the State determines the record is 

6 needed in connection with a determination with 

7 respect to such eligibility for (or the amount or 

8 extent of) such medical assistance; and 

9 ‘‘(B) uses the authorization provided under 

10 subparagraph (A) to verify the financial re11 sources of such applicant or recipient (and such 

12 other person, as applicable), in order to deter13 mine or redetermine the eligibility of such appli14 cant or recipient for medical assistance under 

15 the State plan. 

16 ‘‘(2) PROGRAM DESCRIBED.—A program de17 scribed in this paragraph is a program for verifying 

18 individual assets in a manner consistent with the ap19 proach used by the Commissioner of Social Security 

20 under section 1631(e)(1)(B)(ii). 

21 ‘‘(c) DURATION OF AUTHORIZATION.—Notwith22 standing section 1104(a)(1) of the Right to Financial Pri23 vacy Act, an authorization provided to a State under sub24 section (b)(1) shall remain effective until the earliest of— 


pwalker on PROD1PC71 with BILLS
16 

HR 5613 PCS 

1 ‘‘(1) the rendering of a final adverse decision on 

2 the applicant’s application for medical assistance 

3 under the State’s plan under this title; 

4 ‘‘(2) the cessation of the recipient’s eligibility 

5 for such medical assistance; or 

6 ‘‘(3) the express revocation by the applicant or 

7 recipient (or such other person described in sub8 section (b)(1), as applicable) of the authorization, in 

9 a written notification to the State. 

10 ‘‘(d) TREATMENT OF RIGHT TO FINANCIAL PRIVACY

11 ACT REQUIREMENTS.— 

12 ‘‘(1) An authorization obtained by the State 

13 under subsection (b)(1) shall be considered to meet 

14 the requirements of the Right to Financial Privacy 

15 Act for purposes of section 1103(a) of such Act, and 

16 need not be furnished to the financial institution, 

17 notwithstanding section 1104(a) of such Act. 

18 ‘‘(2) The certification requirements of section 

19 1103(b) of the Right to Financial Privacy Act shall 

20 not apply to requests by the State pursuant to an 

21 authorization provided under subsection (b)(1). 

22 ‘‘(3) A request by the State pursuant to an au23 thorization provided under subsection (b)(1) is 

24 deemed to meet the requirements of section 

25 1104(a)(3) of the Right to Financial Privacy Act 


pwalker on PROD1PC71 with BILLS
17 

HR 5613 PCS 

1 and of section 1102 of such Act, relating to a rea2 sonable description of financial records. 

3 ‘‘(e) REQUIRED DISCLOSURE.—The State shall in4 form any person who provides authorization pursuant to 

5 subsection (b)(1)(A) of the duration and scope of the au6 thorization. 

7 ‘‘(f) REFUSAL OR REVOCATION OF AUTHORIZA8 TION.—If an applicant for, or recipient of, medical assist9 ance under the State plan under this title (or such other 

10 person described in subsection (b)(1), as applicable) re11 fuses to provide, or revokes, any authorization made by 

12 the applicant or recipient (or such other person, as appli13 cable) under subsection (b)(1)(A) for the State to obtain 

14 from any financial institution any financial record, the 

15 State may, on that basis, determine that the applicant or 

16 recipient is ineligible for medical assistance. 

17 ‘‘(g) USE OF CONTRACTOR.—For purposes of imple18 menting an asset verification program under this section, 

19 a State may select and enter into a contract with a public 

20 or private entity meeting such criteria and qualifications 

21 as the State determines appropriate, consistent with re22 quirements in regulations relating to general contracting 

23 provisions and with section 1903(i)(2). In carrying out ac24 tivities under such contract, such an entity shall be subject 

25 to the same requirements and limitations on use and disVerDate Aug 31 2005 22:52 Apr 28, 2008 Jkt 059200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H5613.PCS H5613

pwalker on PROD1PC71 with BILLS
18 

HR 5613 PCS 

1 closure of information as would apply if the State were 

2 to carry out such activities directly. 

3 ‘‘(h) TECHNICAL ASSISTANCE.—The Secretary shall 

4 provide States with technical assistance to aid in imple5 mentation of an asset verification program under this sec6 tion. 

7 ‘‘(i) REPORTS.—A State implementing an asset 

8 verification program under this section shall furnish to the 

9 Secretary such reports concerning the program, at such 

10 times, in such format, and containing such information 

11 as the Secretary determines appropriate. 

12 ‘‘(j) TREATMENT OF PROGRAM EXPENSES.—Not13 withstanding any other provision of law, reasonable ex14 penses of States in carrying out the program under this 

15 section shall be treated, for purposes of section 1903(a), 

16 in the same manner as State expenditures specified in 

17 paragraph (7) of such section.’’. 

18 (b) STATE PLAN REQUIREMENTS.—Section 1902(a) 

19 of such Act (42 U.S.C. 1396a(a)) is amended— 

20 (1) in paragraph (69) by striking ‘‘and’’ at the 

21 end; 

22 (2) in paragraph (70) by striking the period at 

23 the end and inserting ‘‘; and’’; and 

24 (3) by inserting after paragraph (70), as so 

25 amended, the following new paragraph: 


pwalker on PROD1PC71 with BILLS
19 

HR 5613 PCS 

1 ‘‘(71) provide that the State will implement an 

2 asset verification program as required under section 

3 1940.’’. 

4 (c) WITHHOLDING OF FEDERAL MATCHING PAY5 MENTS FOR NONCOMPLIANT STATES.—Section 1903(i) of 

6 such Act (42 U.S.C. 1396b(i)) is amended— 

7 (1) in paragraph (22) by striking ‘‘or’’ at the 

8 end; 

9 (2) in paragraph (23) by striking the period at 

10 the end and inserting ‘‘; or’’; and 

11 (3) by adding after paragraph (23) the fol12 lowing new paragraph: 

13 ‘‘(24) if a State is required to implement an 

14 asset verification program under section 1940 and 

15 fails to implement such program in accordance with 

16 such section, with respect to amounts expended by 

17 such State for medical assistance for individuals 

18 subject to asset verification under such section, un19 less— 

20 ‘‘(A) the State demonstrates to the Sec21 retary’s satisfaction that the State made a good 

22 faith effort to comply; 

23 ‘‘(B) not later than 60 days after the date 

24 of a finding that the State is in noncompliance, 

25 the State submits to the Secretary (and the 


pwalker on PROD1PC71 with BILLS
20 

HR 5613 PCS 

1 Secretary approves) a corrective action plan to 

2 remedy such noncompliance; and 

3 ‘‘(C) not later than 12 months after the 

4 date of such submission (and approval), the 

5 State fulfills the terms of such corrective action 

6 plan.’’. 

7 (d) REPEAL.—Section 4 of Public Law 110–90 is re8 pealed. 

9 SEC. 6. ADJUSTMENT TO PAQI FUND. 

10 Section 1848(l)(2) of the Social Security Act (42 

11 U.S.C. 1395w-4(l)(2)), as amended by section 101(a)(2) 

12 of the Medicare, Medicaid, and SCHIP Extension Act of 

13 2007 (Public Law 110-173), is amended— 

14 (1) in subparagraph (A)(i)— 

15 (A) in subclause (III), by striking 

16 ‘‘$4,960,000,000’’ and inserting 

17 ‘‘$3,790,000,000’’; and 

18 (B) by adding at the end the following new 

19 subclause: 

20 ‘‘(IV) For expenditures during 

21 2014, an amount equal to 

22 $3,690,000,000.’’; 

23 (2) in subparagraph (A)(ii), by adding at the 

24 end the following new subclause: 


pwalker on PROD1PC71 with BILLS
21 

HR 5613 PCS 

1 ‘‘(IV) 2014.—The amount avail2 able for expenditures during 2014 

3 shall only be available for an adjust4 ment to the update of the conversion 

5 factor under subsection (d) for that 

6 year.’’; and 

7 (3) in subparagraph (B)— 

8 (A) in clause (ii), by striking ‘‘and’’ at the 

9 end; 

10 (B) in clause (iii), by striking the period at 

11 the end and inserting ‘‘; and’’; and 

12 (C) by adding at the end the following new 

13 clause: 

14 ‘‘(iv) 2014 for payment with respect 

15 to physicians’ services furnished during 

16 2014.’’. 

Passed the House of Representatives April 23, 2008. 

Attest: LORRAINE C. MILLER, 

Clerk. 


pwalker on PROD1PC71 with BILLS
Calendar No. 719 

110TH CONGRESS 

2D SESSION H. R. 5613 

AN ACT 

To extend certain moratoria and impose additional 

through April 1, 2009, and for other purposes. moratoria on certain Medicaid regulations 

APRIL 28, 2008 

Read the second time and placed on the calendar 


pwalker on PROD1PC71 with BILLS