Social Security Act) who is providing primary health 
services full time and substantially all of whose pri-
mary health services are provided in a health profes-
sional shortage area. 
‘‘(5) 
HEALTH
PROFESSIONAL
SHORTAGE 
AREA.—The term ‘health professional shortage area’ 
means any area which, as of the beginning of the eli-
gible service period, is a health professional shortage 
area (as defined in section 332(a)(1) of the Public 
Health Service Act) taking into account only the cat-
egory of health services provided by the qualified pri-
mary care physician or qualified nurse practitioner, 
as applicable. 
‘‘(6) ONLY
MONTHS
TAKEN
INTO
AC-
COUNT.—In no event shall more than 60 months be 
taken into account under subsection (a) by any indi-
vidual for all taxable years.’’ 
(b) CLERICAL AMENDMENT.—The table of sections 
for subpart A of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 is amended by in-
serting after the item relating to section 25D the following 
new item: 
‘‘25E. Primary care physicians serving health professional shortage areas.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2007. 
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SEC. 3. INCREASE IN MEDICARE PHYSICIAN PAYMENTS 
THROUGH 2010. 
Section 1848(d)(9) of the Social Security Act (42 
U.S.C. 1395w–4(d)(9)), as added by section 131(a)(1)(B) 
of the Medicare Improvements for Patients and Providers 
Act of 2008 (Public Law 110–275), is amended— 
(1) in subparagraph (A), by striking ‘‘for 
2009’’ and inserting ‘‘for each of 2009 and 2010’’; 
and 
(2) in subparagraph (B), by striking ‘‘2010’’ 
and inserting ‘‘2011’’. 
SEC. 4. REFUNDABLE CREDIT FOR HEALTH INSURANCE 
COVERAGE. 
(a) IN GENERAL.—Subpart C of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
1986 (relating to refundable credits) is amended by redes-
ignating section 37 as section 38 and by inserting after 
section 36 the following new section: 
‘‘SEC. 37. QUALIFIED HEALTH INSURANCE CREDIT. 
‘‘(a) ALLOWANCE OF CREDIT.—In the case of an in-
dividual, there shall be allowed as a credit against the tax 
imposed by this chapter for the taxable year the sum of 
the monthly limitations determined under subsection (b) 
for the taxpayer and the taxpayers spouse and dependents. 
‘‘(b) MONTHLY LIMITATION.— 
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‘‘(1) IN GENERAL.—The monthly limitation for 
each month during the taxable year for an eligible 
individual is 1⁄12th of— 
‘‘(A) the applicable adult amount, in the 
case that the eligible individual is the taxpayer 
or the taxpayer’s spouse, 
‘‘(B) the applicable adult amount, in the 
case that the eligible individual is an adult de-
pendent, and 
‘‘(C) the applicable child amount, in the 
case that the eligible individual is a child de-
pendent. 
‘‘(2) LIMITATION ON AGGREGATE AMOUNT.— 
Notwithstanding paragraph (1), the aggregate 
monthly limitations for the taxpayer and the tax-
payer’s spouse and dependents for any month shall 
not exceed 1⁄12th of the applicable aggregate amount. 
‘‘(3) NO CREDIT FOR INELIGIBLE MONTHS.— 
With respect to any individual, the monthly limita-
tion shall be zero for any month for which such indi-
vidual is not an eligible individual. 
‘‘(c) APPLICABLE AMOUNTS.—For purposes of this 
section— 
‘‘(1) APPLICABLE ADULT AMOUNT.—The term 
‘applicable adult amount’ means $2,500. 
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‘‘(2) APPLICABLE CHILD AMOUNT.—The term 
‘applicable child amount’ means $1,000. 
‘‘(3) APPLICABLE AGGREGATE AMOUNT.—The 
term ‘applicable aggregate amount’ means $5,000. 
‘‘(d) ELIGIBLE INDIVIDUAL.—For purposes of this 
section— 
‘‘(1) IN
GENERAL.—The term ‘eligible indi-
vidual’ means, with respect to any month, an indi-
vidual who— 
‘‘(A) is the taxpayer, the taxpayer’s 
spouse, or the taxpayer’s dependent, and 
‘‘(B) is covered under qualified health in-
surance as of the 1st day of such month. 
‘‘(2) COVERAGE UNDER MEDICARE, MEDICAID, 
SCHIP, MILITARY COVERAGE.—The term ‘eligible in-
dividual’ shall not include any individual for a month 
if, as of the first day of such month, such individual 
is— 
‘‘(A) entitled to benefits under part A of 
title XVIII of the Social Security Act or en-
rolled under part B of such title, and the indi-
vidual is not a participant or beneficiary in a 
group health plan or large group health plan 
that is a primary plan (as defined in section 
1862(b)(2)(A) of such Act), 
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‘‘(B) in the case of a State that has not 
made 
the 
election 
described 
in 
section 
1939(a)(1)(B) of the Social Security Act, en-
rolled in the program under title XIX of such 
Act (other than under section 1928 of such 
Act), or 
‘‘(C) entitled to benefits under chapter 55 
of title 10, United States Code. 
‘‘(3) IDENTIFICATION
REQUIREMENTS.—The 
term ‘eligible individual’ shall not include any indi-
vidual for any month unless the policy number asso-
ciated with the qualified refund eligible health insur-
ance and the TIN of each eligible individual covered 
under such health insurance for such month are in-
cluded on the return of tax for the taxable year in 
which such month occurs. 
‘‘(4) PRISONERS.—The term ‘eligible individual’ 
shall not include any individual for a month if, as 
of the first day of such month, such individual is im-
prisoned under Federal, State, or local authority. 
‘‘(5) ALIENS.—The term ‘eligible individual’ 
shall not include any alien individual for a month if, 
as of the first day of such month, such individual is 
not a lawful permanent resident of the United 
States. 
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‘‘(e) QUALIFIED HEALTH INSURANCE.—For pur-
poses of this section— 
‘‘(1) IN GENERAL.—The term ‘qualified health 
insurance’ means any insurance constituting medical 
care which (as determined under regulations pre-
scribed by the Secretary) provides coverage for inpa-
tient and outpatient care, emergency benefits, and 
physician care. 
‘‘(2) CERTAIN COVERAGE DISREGARDED.—Such 
term does not include any insurance— 
‘‘(A) substantially all of the coverage of 
which 
is 
coverage 
described 
in 
section 
223(c)(1)(B), or 
‘‘(B) which constitutes medical care under 
any health plan maintained by any employer (or 
former employer) of the taxpayer or the tax-
payer’s spouse. 
‘‘(f) OTHER DEFINITIONS.—For purposes of this sec-
tion— 
‘‘(1) DEPENDENT.—The term ‘dependent’ has 
the meaning given such term by section 152 (deter-
mined without regard to subsections (b)(1), (b)(2), 
and (d)(1)(B) thereof). An individual who is a child 
to whom section 152(e) applies shall be treated as 
a dependent of the custodial parent for a coverage 
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month unless the custodial and noncustodial parent 
agree otherwise. 
‘‘(2) ADULT.—The term ‘adult’ means an indi-
vidual who is not a child. 
‘‘(3) CHILD.—The term ‘child’ means a quali-
fying child (as defined in section 152(c)). 
‘‘(g) SPECIAL RULES.— 
‘‘(1) COORDINATION
WITH
MEDICAL
DEDUC-
TION, ETC.—Any amount paid by a taxpayer for in-
surance to which subsection (a) applies shall not be 
taken into account in computing the amount allow-
able to the taxpayer as a credit under section 35 or 
as a deduction under section 213(a). 
‘‘(2) MEDICAL
AND
HEALTH
SAVINGS
AC-
COUNTS.—The credit allowed under subsection (a) 
for any taxable year shall be reduced by the aggre-
gate amount distributed from Archer MSAs (as de-
fined in section 220(d)) and health savings accounts 
(as defined in section 223(d)) which are excludable 
from gross income for such taxable years by reason 
of being used to pay premiums for coverage of an 
eligible individual (as defined in subsection (e)) 
under qualified health insurance (as defined in sub-
section (f)) for any month. 
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‘‘(3) DENIAL OF CREDIT TO DEPENDENTS.—No 
credit shall be allowed under this section to any indi-
vidual with respect to whom a deduction under sec-
tion 151 is allowable to another taxpayer for a tax-
able year beginning in the calendar year in which 
such individuals taxable year begins. 
‘‘(4) MARRIED COUPLES MUST FILE JOINT RE-
TURN.— 
‘‘(A) IN
GENERAL.—If the taxpayer is 
married at the close of the taxable year, the 
credit shall be allowed under subsection (a) only 
if the taxpayer and his spouse file a joint return 
for the taxable year. 
‘‘(B) MARITAL STATUS; CERTAIN MARRIED 
INDIVIDUALS LIVING APART.—Rules similar to 
the rules of paragraphs (3) and (4) of section 
21(e) shall apply for purposes of this para-
graph. 
‘‘(5) VERIFICATION
OF
COVERAGE, ETC.—No 
credit shall be allowed under this section with re-
spect to any individual unless such individual’s cov-
erage (and such related information as the Secretary 
may require) is verified in such manner as the Sec-
retary may prescribe. 
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‘‘(6) INSURANCE WHICH COVERS OTHER INDI-
VIDUALS; TREATMENT OF PAYMENTS.—Rules similar 
to the rules of paragraphs (7) and (8) of section 
35(g) shall apply for purposes of this section. 
‘‘(h) COORDINATION WITH ADVANCE PAYMENTS.— 
‘‘(1) REDUCTION IN CREDIT FOR ADVANCE PAY-
MENTS.—With respect to any taxable year, the 
amount which would (but for this subsection) be al-
lowed as a credit to the taxpayer under subsection 
(a) shall be reduced (but not below zero) by the ag-
gregate amount paid on behalf of such taxpayer 
under section 7527A for months beginning in such 
taxable year. 
‘‘(2) RECAPTURE
OF
EXCESS
ADVANCE
PAY-
MENTS.—If the aggregate amount paid on behalf of 
the taxpayer under section 7527A for months begin-
ning in the taxable year exceeds the sum of the 
monthly limitations determined under subsection (b) 
for the taxpayer and the taxpayer’s spouse and de-
pendents for such months, then the tax imposed by 
this chapter for such taxable year shall be increased 
by the sum of— 
‘‘(A) such excess, plus 
‘‘(B) interest on such excess determined at 
the underpayment rate established under sec-
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tion 6621 for the period from the date of the 
payment under section 7527A to the date such 
excess is paid. 
For purposes of subparagraph (B), an equal part of 
the aggregate amount of the excess shall be deemed 
to be attributable to payments made under section 
7527A on the first day of each month beginning in 
such taxable year, unless the taxpayer establishes 
the date on which each such payment giving rise to 
such excess occurred, in which case subparagraph 
(B) shall be applied with respect to each date so es-
tablished. 
‘‘(i) ANNUAL INFLATION ADJUSTMENT.—In the case 
of any taxable year beginning in a calendar year after 
2009, each of the dollar amounts contained in subsection 
(c) shall be annually increased by the annual inflation ad-
justment determined under subparagraph (B) section 
1809(c)(2) of the Social Security Act for such calendar 
year. Any adjustment under the preceding sentence shall 
be rounded in the manner described in subparagraph (A) 
of such section.’’. 
(b) ADVANCE PAYMENT OF CREDIT.—Chapter 77 
(relating to miscellaneous provisions) of such Code is 
amended by inserting after section 7527 the following new 
section: 
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‘‘SEC. 7527A. ADVANCE PAYMENT OF QUALIFIED HEALTH 
INSURANCE CREDIT. 
‘‘(a) IN GENERAL.—The Secretary shall establish a 
program for making payments on behalf of individuals to 
providers of qualified health insurance (as defined in sec-
tion 37(e)) for such individuals. 
‘‘(b) LIMITATION.—The Secretary may make pay-
ments under subsection (a) only to the extent that the Sec-
retary determines that the amount of such payments made 
on behalf of any taxpayer for any month does not exceed 
the sum of the monthly limitations determined under sec-
tion 37 for the taxpayer and taxpayer’s spouse and de-
pendents for such month.’’. 
(c) INFORMATION REPORTING.— 
(1) IN GENERAL.—Subpart B of part III of 
subchapter A of chapter 61 of such Code (relating 
to information concerning transactions with other 
persons) is amended by inserting after section 
6050V the following new section: 
‘‘SEC. 6050W. RETURNS RELATING TO QUALIFIED HEALTH 
INSURANCE CREDIT. 
‘‘(a) REQUIREMENT OF REPORTING.—Every person 
who is entitled to receive payments for any month of any 
calendar year under section 7527A (relating to advance 
payment of qualified health insurance credit) with respect 
to any individual shall, at such time as the Secretary may 
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prescribe, make the return described in subsection (b) with 
respect to each such individual. 
‘‘(b) FORM AND MANNER OF RETURNS.—A return 
is described in this subsection if such return— 
‘‘(1) is in such form as the Secretary may pre-
scribe, and 
‘‘(2) contains, with respect to each individual 
referred to in subsection (a)— 
‘‘(A) the name, address, and TIN of each 
such individual, 
‘‘(B) the months for which amounts pay-
ments under section 7527A were received, 
‘‘(C) the amount of each such payment, 
‘‘(D) the type of insurance coverage pro-
vide by such person with respect to such indi-
vidual and the policy number associated with 
such coverage, 
‘‘(E) the name, address, and TIN of the 
spouse and each dependent covered under such 
coverage, and 
‘‘(F) such other information as the Sec-
retary may prescribe. 
‘‘(c) STATEMENTS TO BE FURNISHED TO INDIVID-
UALS WITH RESPECT TO WHOM INFORMATION IS RE-
QUIRED.—Every person required to make a return under 
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subsection (a) shall furnish to each individual whose name 
is required to be set forth in such return a written state-
ment showing— 
‘‘(1) the name and address of the person re-
quired to make such return and the phone number 
of the information contact for such person, and 
‘‘(2) the information required to be shown on 
the return with respect to such individual. 
The written statement required under the preceding sen-
tence shall be furnished on or before January 31 of the 
year following the calendar year for which the return 
under subsection (a) is required to be made. 
‘‘(d) RETURNS WHICH WOULD BE REQUIRED TO BE 
MADE BY 2 OR MORE PERSONS.—Except to the extent 
provided in regulations prescribed by the Secretary, in the 
case of any amount received by any person on behalf of 
another person, only the person first receiving such 
amount shall be required to make the return under sub-
section (a).’’. 
(2) ASSESSABLE PENALTIES.— 
(A) 
Subparagraph 
(B) 
of 
section 
6724(d)(1) (relating to definitions) of such 
Code is amended by redesignating clauses (xv) 
through (xxi) as clauses (xvi) through (xxii), re-
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spectively, and by inserting after clause (xiv) 
the following new clause: 
‘‘(xv) section 6050W (relating to re-
turns relating to qualified health insurance 
credit),’’. 
(B) Paragraph (2) of section 6724(d) of 
such Code is amended by striking the period at 
the end of subparagraph (CC) and inserting ‘‘, 
or’’ and by inserting after subparagraph (CC) 
the following new subparagraph: 
‘‘(DD) section 6050W (relating to returns re-
lating to qualified health insurance credit).’’. 
(d) CONFORMING AMENDMENTS.— 
(1) Paragraph (2) of section 1324(b) of title 
31, United States Code, is amended by inserting 
‘‘37,’’ after ‘‘36,’’. 
(2) The table of sections for subpart C of part 
IV of subchapter A of chapter 1 of the Internal Rev-
enue Code of 1986 is amended by redesignating the 
item relating to section 37 as an item relating to 
section 38 and by inserting after the item relating 
to section 36 the following new item: 
‘‘Sec. 37. Qualified health insurance credit.’’. 
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(3) The table of sections for chapter 77 of such 
Code is amended by inserting after the item relating 
to section 7527 the following new item: 
‘‘Sec. 7527A. Advance payment of qualified health insurance credit.’’. 
(4) The table of sections for subpart B of part 
III of subchapter A of chapter 61 of such Code is 
amended by adding at the end the following new 
item: 
‘‘Sec. 6050W. Returns relating to qualified health insurance credit.’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2008. 
SEC. 5. HEALTH REIMBURSEMENT ARRANGEMENTS AND 
SPENDING ARRANGEMENTS IN COMBINATION 
WITH HEALTH SAVINGS ACCOUNTS. 
(a) IN GENERAL.—Subparagraph (B) of section 
223(c)(1) of the Internal Revenue Code of 1986 (relating 
to certain coverage disregarded) is amended by striking 
‘‘and’’ at the end of clause (ii), by striking the period at 
the end of clause (iii) and inserting ‘‘, and’’, and by insert-
ing after clause (iii) the following new clause: 
‘‘(iv) coverage under a flexible spend-
ing arrangement or a health reimburse-
ment arrangement, or both, which meets 
the requirements of paragraph (6).’’. 
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(b) COMBINATION HEALTH REIMBURSEMENT, SAV-
INGS, AND SPENDING ARRANGEMENTS.—Subsection (c) of 
section 223 of such Code (relating to definitions and spe-
cial rules) is amended by adding at the end the following 
new paragraph: 
‘‘(6) COMBINED LIMIT FOR CONTRIBUTIONS OR 
CREDITS TO HEALTH REIMBURSEMENT, ARRANGE-
MENTS AND SPENDING ARRANGEMENTS.— 
‘‘(A) IN GENERAL.—In the case of cov-
erage under a flexible spending arrangement or 
a health reimbursement arrangement, or both, 
such coverage meets the requirements of this 
paragraph if, with respect to an individual— 
‘‘(i) the sum of— 
‘‘(I) the amount allowable as a 
deduction under subsection (a), 
‘‘(II) 
the 
salary 
reduction 
amount elected by the individual and, 
if applicable, the employer contribu-
tion or credit allocated to the indi-
vidual for the taxable year under the 
flexible spending arrangement (as de-
fined in section 106(c)(2)), plus 
‘‘(III) the amounts that the indi-
vidual is permitted, under the terms 
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of the plan, to receive in reimburse-
ments for the taxable year under the 
health reimbursement arrangement, 
does not exceed 
‘‘(ii) the sum of the annual deductible 
and the other annual out-of-pocket ex-
penses (other than for premiums) required 
to be paid under the plan by the eligible 
individual for covered benefits. 
‘‘(B) EXCEPTIONS FOR DISREGARDED COV-
ERAGE.—For purposes of subparagraph (A)— 
‘‘(i) CERTAIN
FLEXIBLE
SPENDING 
ARRANGEMENTS.—Any flexible spending 
arrangement salary reduction amounts or 
employer contributions or credits that are 
restricted by the employer to use for cov-
erage described in paragraph (1)(B) shall 
not be taken into account under subpara-
graph (A)(i)(II). 
‘‘(ii) CERTAIN
HEALTH
REIMBURSE-
MENT
ARRANGEMENTS.—Any reimburse-
ments from a health reimbursement ar-
rangement for coverage described in para-
graph (1)(B) shall not be taken into ac-
count under subparagraph (A)(i)(III). 
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‘‘(iii) QUALIFIED HSA DISTRIBUTIONS 
FROM FSA AND HRA TERMINATIONS.—Any 
qualified HSA distribution (as defined in 
section 106(e)) shall not be taken into ac-
count under subparagraph (A)(i). 
‘‘(C) TERMINATION.—Coverage shall not 
be treated as meeting the requirements of this 
paragraph for any taxable year beginning after 
December 31, 2012.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2007. 
SEC. 6. INCREASE IN ANNUAL HSA CONTRIBUTION LIMITA-
TION. 
(a) IN GENERAL.—Paragraph (2) of section 223(b) 
of the Internal Revenue Code of 1986 (relating to monthly 
limitation) is amended— 
(1) in subparagraph (A) by striking ‘‘$2,250’’ 
and inserting ‘‘$4,500’’, and 
(2) in subparagraph (B) by striking ‘‘$4,500’’ 
and inserting ‘‘$9,000’’. 
(b) 
COST-OF-LIVING
ADJUSTMENT.—Section 
223(g)(1)(B)(i) of such Code is amended by striking ‘‘cal-
endar year 1997’’ and inserting ‘‘calendar year 2008’’. 
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(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2007. 
SEC. 7. PURCHASE OF HEALTH INSURANCE FROM HSA AC-
COUNT. 
(a) IN GENERAL.—Paragraph (2) of section 223(d) 
of the Internal Revenue Code of 1986 (defining qualified 
medical expenses) is amended— 
(1) by striking subparagraphs (B) and (C), 
(2) in subparagraph (A) by striking ‘‘(A) IN 
GENERAL.—’’ and moving the text 2 ems to the left, 
and 
(3) by inserting ‘‘ and including payment for in-
surance)’’ after ‘‘section 213(d)’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to insurance pur-
chased after the date of the enactment of this Act in tax-
able years beginning after such date. 
SEC. 8. SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES 
INCURRED BEFORE ESTABLISHMENT OF AC-
COUNT. 
(a) IN GENERAL.—Subsection (d) of section 223 of 
the Internal Revenue Code of 1986 is amended by redesig-
nating paragraph (4) as paragraph (5) and by inserting 
after paragraph (3) the following new paragraph: 
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‘‘(4) CERTAIN MEDICAL EXPENSES INCURRED 
BEFORE ESTABLISHMENT OF ACCOUNT TREATED AS 
QUALIFIED.— 
‘‘(A) IN GENERAL.—For purposes of para-
graph (2), an expense shall not fail to be treat-
ed as a qualified medical expense solely because 
such expense was incurred before the establish-
ment of the health savings account if such ex-
pense was incurred during the 60-day period 
beginning on the date on which the high de-
ductible health plan is first effective. 
‘‘(B) SPECIAL
RULES.—For purposes of 
subparagraph (A)— 
‘‘(i) an individual shall be treated as 
an eligible individual for any portion of a 
month for which the individual is described 
in subsection (c)(1), determined without 
regard to whether the individual is covered 
under a high deductible health plan on the 
1st day of such month, and 
‘‘(ii) the effective date of the health 
savings account is deemed to be the date 
on which the high deductible health plan is 
first effective after the date of the enact-
ment of this paragraph.’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply with respect to insurance pur-
chased after the date of the enactment of this Act in tax-
able years beginning after such date. 
SEC. 9. PROVISIONS RELATING TO MEDICARE. 
(a) INDIVIDUALS OVER AGE 65 ONLY ENROLLED IN 
MEDICARE PART A.—Section 223(b)(7) of the Internal 
Revenue Code of 1986 (relating to contribution limitation 
on Medicare eligible individuals) is amended by adding at 
the end the following new sentence: ‘‘This paragraph shall 
not apply to any individual during any period the individ-
ual’s only entitlement to such benefits is an entitlement 
to hospital insurance benefits under part A of title XVIII 
of such Act pursuant to an enrollment for such hospital 
insurance benefits under section 226(a)(1) of such Act.’’. 
(b) MEDICARE BENEFICIARIES PARTICIPATING
IN 
MEDICARE ADVANTAGE MSA MAY CONTRIBUTE THEIR 
OWN MONEY TO THEIR MSA.—Subsection (b) of section 
138 of such Code is amended by striking paragraph (2) 
and redesignating paragraphs (3) and (4) as paragraphs 
(2) and (3), respectively. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
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SEC. 10. INDIVIDUALS ELIGIBLE FOR VETERANS BENEFITS 
FOR A SERVICE-CONNECTED DISABILITY. 
(a) IN GENERAL.—Section 223(c)(1) of the Internal 
Revenue Code of 1986 (defining eligible individual) is 
amended by adding at the end the following new subpara-
graph: 
‘‘(D) SPECIAL RULE FOR INDIVIDUALS EL-
IGIBLE FOR CERTAIN VETERANS BENEFITS.— 
For purposes of subparagraph (A)(ii), an indi-
vidual shall not be treated as covered under a 
health plan described in such subparagraph 
merely because the individual receives periodic 
hospital care or medical services for a service- 
connected disability under any law administered 
by the Secretary of Veterans Affairs but only if 
the individual is not eligible to receive such care 
or services for any condition other than a serv-
ice-connected disability.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 11. ALLOW BOTH SPOUSES TO MAKE CATCH-UP CON-
TRIBUTIONS TO THE SAME HSA ACCOUNT. 
(a) IN GENERAL.—Paragraph (3) of section 223(b) 
of the Internal Revenue Code of 1986 is amended by add-
ing at the end the following new subparagraph: 
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‘‘(C) 
SPECIAL
RULE
WHERE
BOTH 
SPOUSES ARE ELIGIBLE INDIVIDUALS WITH 1 
ACCOUNT.—If— 
‘‘(i) an individual and the individual’s 
spouse have both attained age 55 before 
the close of the taxable year, and 
‘‘(ii) the spouse is not an account ben-
eficiary of a health savings account as of 
the close of such year, 
the additional contribution amount shall be 200 
percent of the amount otherwise determined 
under subparagraph (B).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 12. FSA AND HRA TERMINATION TO FUND HSAS. 
(a) 
GRACE
PERIOD
NOT
REQUIRED.—Section 
106(e)(2) of the Internal Revenue Code of 1986 is amend-
ed by adding at the end the following new sentence: ‘‘A 
distribution shall not fail to be treated as a qualified HSA 
distribution merely because the balance in such arrange-
ment is determined without regard to the requirement that 
unused amounts remaining at the end of a plan year must 
be forfeited in the absence of a grace period.’’. 
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(b) DEPOSIT IN LIMITED FSA OR HRA OF FUNDS 
IN EXCESS FSA OR HRA TERMINATION DISTRIBU-
TION.—Paragraph (1) of section 106(e) of such Code is 
amended by inserting before the period at the end thereof 
the following: ‘‘and the deposit of funds in excess of a 
qualified HSA distribution amount into a health flexible 
spending account or health reimbursement arrangement 
which is compatible with a health savings account and 
which, on the date of such distribution, is a part of the 
employer’s plan’’. 
(c) DISCLAIMER OF DISQUALIFYING COVERAGE.— 
Subparagraph (B) of section 223(c)(1) of such Code is 
amended by striking ‘‘and’’ at the end of clause (ii), by 
striking the period at the end of clause (iii) and inserting 
‘‘, and’’, and by inserting after clause (iii) the following 
new clause: 
‘‘(iv) any coverage (whether actual or 
prospective) otherwise described in sub-
paragraph (A)(ii) which is disclaimed at 
the time of the creation or organization of 
the health savings account.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
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SEC. 13. INCLUDING INFORMATION ON ADVANCE DIREC-
TIVES IN MEDICARE & YOU HANDBOOK. 
(a) IN GENERAL.—Section 1804(a) of the Social Se-
curity Act (42 U.S.C. 1395b–2(a)) is amended— 
(1) in paragraph (2), at the end by striking 
‘‘and’’; 
(2) in paragraph (3), at the end by striking the 
period and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (3), the fol-
lowing new paragraph: 
‘‘(4) educational information about advance di-
rectives (as defined in section 1866(f)(3)).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to information distributed for 
years beginning on or after the date of the enactment of 
this Act. 
SEC. 14. RESTORING ACCESS REQUIREMENTS FOR CER-
TAIN MA PRIVATE FEE-FOR-SERVICE PLAN 
PROVISIONS AS IN EXISTENCE BEFORE PUB-
LIC LAW 110–275. 
(a) IN GENERAL.—Section 1852(d) of the Social Se-
curity Act (42 U.S.C. 1395w–22(d)), as amended by sec-
tion 162(a) of the Medicare Improvements for Patients 
and Providers Act of 2008 (Public Law 110–275), is 
amended— 
(1) in paragraph (4), in the second sentence— 
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(A) by striking ‘‘Subject to paragraphs (5) 
and (6), the Secretary’’ and inserting ‘‘The Sec-
retary’’; and 
(B) in subparagraph (B), by striking ‘‘suf-
ficient number and range of providers within 
such category to meet the access standards in 
subparagraphs (A) through (E) of paragraph 
(1)’’ and inserting ‘‘sufficient number and 
range of providers within such category to pro-
vide covered services under the terms of the 
plan’’; and 
(2) by striking paragraphs (5) and (6). 
(b) CLARIFICATION REGARDING UTILIZATION.—Sec-
tion 1859(b)(2) of the Social Security Act (42 U.S.C. 
1395w–28(b)(2)), as amended by section 162(b) of the 
Medicare Improvements for Patients and Providers Act of 
2008 (Public Law 110–275), is amended by striking 
‘‘Nothing in subparagraph (B)’’ through ‘‘specified pre-
ventive or screening services.’’. 
Æ 
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