II 

110TH CONGRESS 

1ST SESSION S. 1023 

To amend title XXI of the Social Security Act to eliminate the remainder 

of funding shortfalls for the State Children’s Health Insurance Program 

(SCHIP) for fiscal year 2007, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 29, 2007 

Mr. MENENDEZ introduced the following bill; which was read twice and 

referred to the Committee on Finance 

A BILL 

To amend title XXI of the Social Security Act to eliminate 

the remainder of funding shortfalls for the State Children’s Health Insurance Program (SCHIP) for fiscal 

year 2007, 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. ELIMINATION OF REMAINDER OF SCHIP FUND4 ING SHORTFALLS FOR FISCAL YEAR 2007. 

5 (a) IN GENERAL.—Section 2104(h) of the Social Se6 curity Act (42 U.S.C. 1397dd(h)), as added by section 

7 201(a) of the National Institutes of Health Reform Act 

8 of 2006 (Public Law 109–482), is amended— 


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1 (1) in the heading for paragraph (2), by strik2 ing ‘‘REMAINDER OF REDUCTION’’ and inserting 

3 ‘‘PART’’; and 

4 (2) by striking paragraph (4) and inserting the 

5 following: 

6 ‘‘(4) ADDITIONAL AMOUNTS TO ELIMINATE RE7 MAINDER OF FISCAL YEAR 2007 FUNDING SHORT8 FALLS.— 

9 ‘‘(A) IN GENERAL.—The Secretary shall 

10 allot to each remaining shortfall State described 

11 in subparagraph (B) such amount as the Sec12 retary determines will eliminate the estimated 

13 shortfall described in such subparagraph for the 

14 State for fiscal year 2007. 

15 ‘‘(B) REMAINING SHORTFALL STATE DE16 SCRIBED.—For purposes of subparagraph (A), 

17 a remaining shortfall State is a State with a 

18 State child health plan approved under this title 

19 for which the Secretary estimates, on the basis 

20 of the most recent data available to the Sec21 retary as of the date of the enactment of this 

22 paragraph, that the projected federal expendi23 tures under such plan for the State for fiscal 

24 year 2007 will exceed the sum of— 


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1 ‘‘(i) the amount of the State’s allot2 ments for each of fiscal years 2005 and 

3 2006 that will not be expended by the end 

4 of fiscal year 2006; 

5 ‘‘(ii) the amount of the State’s allot6 ment for fiscal year 2007; and 

7 ‘‘(iii) the amounts, if any, that are to 

8 be redistributed to the State during fiscal 

9 year 2007 in accordance with paragraphs 

10 (1) and (2). 

11 ‘‘(C) APPROPRIATION; ALLOTMENT AU12 THORITY.—For the purpose of providing addi13 tional allotments to remaining shortfall States 

14 under this paragraph there is appropriated, out 

15 of any funds in the Treasury not otherwise ap16 propriated, such sums as are necessary for fis17 cal year 2007. Amounts appropriated pursuant 

18 to the preceding sentence are designated as an 

19 emergency requirement pursuant to section 402 

20 of H. Con. Res. 95 (109th Congress).’’. 

21 (b) CONFORMING AMENDMENTS.—Section 2104(h) 

22 of such Act (42 U.S.C. 1397dd(h)) (as so added), is 

23 amended— 

24 (1) in paragraph (1)(B), by striking ‘‘subject to 

25 paragraph (4)(B) and’’; 


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1 (2) in paragraph (2)(B), by striking ‘‘subject to 

2 paragraph (4)(B) and’’; 

3 (3) in paragraph (5)(A), by striking ‘‘and (3)’’ 

4 and inserting ‘‘(3), and (4)’’; and 

5 (4) in paragraph (6)— 

6 (A) in the first sentence— 

7 (i) by inserting ‘‘or allotted’’ after 

8 ‘‘redistributed’’; and 

9 (ii) by inserting ‘‘or allotments’’ after 

10 ‘‘redistributions’’; and 

11 (B) by striking ‘‘and (3)’’ and inserting 

12 ‘‘(3), and (4)’’. 

13 SEC. 2. FUNDING PROVISIONS. 

14 (a) REQUIREMENT FOR USE OF TAMPER-RESISTANT

15 PRESCRIPTION PADS UNDER THE MEDICAID PRO16 GRAM.— 

17 (1) IN GENERAL.—Section 1903(i) of the Social 

18 Security Act (42 U.S.C. 1396b(i)) is amended— 

19 (A) by striking ‘‘or’’ at the end of para20 graph (21); 

21 (B) by striking the period at the end of 

22 paragraph (22) and inserting ‘‘; or’’; and 

23 (C) by inserting after paragraph (22) the 

24 following new paragraph: 


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1 ‘‘(23) with respect to amounts expended for 

2 medical assistance for covered outpatient drugs (as 

3 defined in section 1927(k)(2)) for which the pre4 scription was executed in written (and non-elec5 tronic) form unless the prescription was executed on 

6 a tamper-resistant pad.’’. 

7 (2) EFFECTIVE DATE.—The amendments made 

8 by paragraph (1) shall apply to prescriptions exe9 cuted after September 30, 2007. 

10 (b) REPEAL OF THE LIMITED CONTINUOUS ENROLL11 MENT PROVISION FOR CERTAIN BENEFICIARIES UNDER

12 THE MEDICARE ADVANTAGE PROGRAM.— 

13 (1) IN GENERAL.—Subparagraph (E) of section 

14 1851(e)(2) of the Social Security Act (42 U.S.C. 

15 1395w–21(e)(2)), as added by section 206(a) of divi16 sion B of the Tax Relief and Health Care Act of 

17 2006 (Public Law 109–432), is repealed. 

18 (2) CONFORMING AMENDMENT.—Section 

19 1860D–1(b)(1)(B)(iii) of the Social Security Act (42 

20 U.S.C. 1395w–101(b)(1)(B)(iii)), as amended by 

21 206(b) of division B of the Tax Relief and Health 

22 Care Act of 2006 (Public Law 109–432), is amend23 ed by striking ‘‘subparagraphs (B), (C), and (E)’’ 

24 and inserting ‘‘subparagraphs (B) and (C)’’. 


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1 (3) EFFECTIVE DATE.—The amendments made 

2 by this subsection shall take effect on the day after 

3 the date of enactment of this Act. 

4 (c) DENIAL OF PAYMENTS FOR HOSPITAL SERVICES

5 OR AMBULATORY SURGICAL CENTER SERVICES THAT DI6 RECTLY HARM PATIENTS.— 

7 (1) IN GENERAL.—Section 1862(a) of the So8 cial Security Act (42 U.S.C. 1395y(a)) is amend9 ed— 

10 (A) by striking ‘‘or’’ at the end of para11 graph (21); 

12 (B) by striking the period at the end of 

13 paragraph (22) and inserting ‘‘; or’’; and 

14 (C) by inserting after paragraph (22) the 

15 following new paragraph: 

16 ‘‘(23) which are inpatient or outpatient hospital 

17 services or facility services furnished in an ambula18 tory surgical facility if in the provision of such serv19 ices there occurred a type of event (such as a sur20 gical event, product or device event, patient protec21 tion event, care management event, environmental 

22 event, or criminal event) which the Secretary has de23 termined, based on a consensus process involving cli24 nicians, quality experts, health care providers, and 

25 patients, which should never occur.’’. 


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1 (2) POTENTIAL APPLICATION OF NQF ‘‘NEVER

2 EVENTS’’ LISTS.—Nothing in section 1862(a)(23) of 

3 the Social Security Act, as inserted by paragraph 

4 (1), shall be construed as preventing the Secretary 

5 of Health and Human Services from applying all (or 

6 a subset of) the events that are listed and endorsed 

7 as ‘‘serious reportable events’’ (also known as ‘‘never 

8 events)’’ by the National Quality Forum as of No9 vember 16, 2006, (or such subsequent, revised list of 

10 such events issued by such Forum as the Secretary 

11 may specify) as events described in such section. 

12 (3) CONFORMING AMENDMENTS.— 

13 (A) Section 1834(j)(4)(C) of the Social Se14 curity Act (42 U.S.C. 1395m(j)(4)(C)) is 

15 amended by striking ‘‘or 1862(a)(23)’’ after 

16 ‘‘1862(a)(1)’’. 

17 (B) Section 1842(l) of such Act (42 U.S.C. 

18 1395u(l)) is amended— 

19 (i) in paragraph (1)(A)(iii)— 

20 (I) by striking ‘‘or (II)’’ and in21 serting ‘‘, (II)’’; and 

22 (II) by inserting ‘‘, or (III) pay23 ment under this title is denied under 

24 section 1862(a)(23)’’ after ‘‘section 

25 1154(a)(1)(B)’’; and 


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1 (ii) in paragraph (2), by inserting ‘‘or 

2 1862(a)(23)’’ after ‘‘1862(a)(1)’’. 

3 (C) Section 1866(a)(1)(K) of such Act (42 

4 U.S.C. 1395cc(a)(1)(K)) is amended by insert5 ing ‘‘or is denied under section 1862(a)(23)’’ 

6 after ‘‘1154(a)(1)(B)’’. 

7 (4) REPORT ON DISCLOSURE.—Not later than 

8 January 1, 2009, the Secretary of Health and 

9 Human Services shall submit to Congress a report 

10 on a process for public disclosure on never events de11 scribed in section 1862(a)(24) of the Social Security 

12 Act, as inserted by paragraph (1)(C), which will en13 sure protection of patient privacy and will permit the 

14 use of the disclosed information for a root cause 

15 analysis to inform the public and the medical com16 munity about safety issues involved. 

17 (5) EFFECTIVE DATE.—The amendments made 

18 by this subsection shall take effect on the date of the 

19 enactment of this Act and shall apply to payments 

20 for— 

21 (A) inpatient hospital services for dis22 charges occurring on or after October 1, 2007; 

23 and 


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1 (B) outpatient hospital services and facility 

2 services in an ambulatory surgical center fur3 nished on or after January 1, 2008. 

Æ 


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