254 
tion to the payment rate described in sub-
section (c) for such physicians) that exceed 
the 
ratio 
permitted 
under 
section 
1848(g)(2)(C) of the Social Security Act. 
‘‘(B) OTHER PROVIDERS.—The Secretary 
shall provide for the participation (on an annual 
or other basis specified by the Secretary) of 
health care providers (other than physicians) 
under the public health insurance option under 
which payment shall only be available if the 
provider agrees to accept the payment rate es-
tablished under subsection (c) (without regard 
to cost-sharing) as the payment in full. 
‘‘(4) EXCLUSION
OF
CERTAIN
PROVIDERS.— 
The Secretary shall exclude from participation under 
the public health insurance option a health care pro-
vider that is excluded from participation in a Fed-
eral health care program (as defined in section 
1128B(f) of the Social Security Act). 
‘‘(f) APPLICATION OF FRAUD AND ABUSE PROVI-
SIONS.—Provisions of law (other than criminal law provi-
sions) identified by the Secretary by regulation, in con-
sultation with the Inspector General of the Department 
of Health and Human Services, that impose sanctions 
with respect to waste, fraud, and abuse under Medicare, 
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such as the False Claims Act (31 U.S.C. 3729 et seq.), 
shall also apply to the public health insurance option. 
‘‘(g) MEDICARE DEFINED.—For purposes of this sec-
tion, the term ‘Medicare’ means the health insurance pro-
grams under title XVIII of the Social Security Act.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) 
TREATMENT
AS
QUALIFIED
HEALTH 
PLAN.—Section 1301(a)(2) of the Patient Protection 
and Affordable Care Act, as amended by section 
10104(a) of such Act, is amended— 
(A) in the heading, by inserting ‘‘, THE 
PUBLIC HEALTH INSURANCE OPTION,’’ before 
‘‘AND’’; and 
(B) by inserting ‘‘the public health insur-
ance option under section 1325,’’ before ‘‘and a 
multi-State plan’’. 
(2) LEVEL PLAYING FIELD.—Section 1324(a) 
of such Act, as amended by section 10104(n) of such 
Act, is amended by inserting ‘‘the public health in-
surance option under section 1325,’’ before ‘‘or a 
multi-State qualified health plan’’. 
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Subtitle B—Medicare Prescription 
Drug Price Negotiation Act of 2011 
SEC. 3101. SHORT TITLE. 
This subtitle may be cited as the ‘‘Medicare Prescrip-
tion Drug Price Negotiation Act of 2011’’. 
SEC. 3102. NEGOTIATION OF LOWER COVERED PART D 
DRUG PRICES ON BEHALF OF MEDICARE 
BENEFICIARIES. 
(a) NEGOTIATION BY SECRETARY.—Section 1860D– 
11 of the Social Security Act (42 U.S.C. 1395w–111) is 
amended by striking subsection (i) (relating to noninter-
ference) and inserting the following: 
‘‘(i) NEGOTIATION OF LOWER DRUG PRICES.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of law, the Secretary shall negotiate with 
pharmaceutical manufacturers the prices (including 
discounts, rebates, and other price concessions) that 
may be charged to PDP sponsors and MA organiza-
tions for covered part D drugs for part D eligible in-
dividuals who are enrolled under a prescription drug 
plan or under an MA–PD plan. 
‘‘(2) 
NO
CHANGE
IN
RULES
FOR 
FORMULARIES.— 
‘‘(A) IN GENERAL.—Nothing in paragraph 
(1) shall be construed to authorize the Sec-
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retary to establish or require a particular for-
mulary. 
‘‘(B) CONSTRUCTION.—Subparagraph (A) 
shall not be construed as affecting the Sec-
retary’s authority to ensure appropriate and 
adequate access to covered part D drugs under 
prescription drug plans and under MA–PD 
plans, including compliance of such plans with 
formulary requirements under section 1860D– 
4(b)(3). 
‘‘(3) CONSTRUCTION.—Nothing in this sub-
section shall be construed as preventing the sponsor 
of a prescription drug plan, or an organization offer-
ing an MA–PD plan, from obtaining a discount or 
reduction of the price for a covered part D drug 
below the price negotiated under paragraph (1). 
‘‘(4) SEMI-ANNUAL REPORTS TO CONGRESS.— 
Not later than June 1, 2012, and every 6 months 
thereafter, the Secretary shall submit to the Com-
mittees on Ways and Means, Energy and Commerce, 
and Oversight and Government Reform of the House 
of Representatives and the Committee on Finance of 
the Senate a report on negotiations conducted by the 
Secretary to achieve lower prices for Medicare bene-
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ficiaries, and the prices and price discounts achieved 
by the Secretary as a result of such negotiations.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect on the date of the enact-
ment of this subtitle and shall first apply to negotiations 
and prices for plan years beginning on January 1, 2012. 
Subtitle C—Medicaid Enhancement 
and Emergency Job Creation 
Act of 2011 
SEC. 3201. SHORT TITLE. 
This subtitle may be cited as the ‘‘Medicaid Enhance-
ment and Emergency Job Creation Act of 2011’’. 
SEC. 3202. EXTENSION OF ARRA INCREASE IN FMAP 
THROUGH FISCAL YEAR 2012. 
(a) IN GENERAL.—Section 5001 of division B of the 
American Recovery and Reinvestment Act of 2009 (Public 
Law 111–5), as amended by section 201 of Public Law 
111–226, is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘and’’ at the end of para-
graph (2); 
(B) in paragraph (3), by striking ‘‘, but 
only for the first 3 calendar quarters in fiscal 
year 2011.’’ and inserting ‘‘; and’’; and 
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(C) by adding at the end the following new 
paragraph: 
‘‘(4) fiscal year 2011 is less than the FMAP as 
so determines for fiscal year 2008, fiscal year 2009 
(after the application of paragraph (1)), fiscal year 
2010 (after the application of paragraph (2), or fis-
cal year 2011 (after the application of paragraph 
(3)), the greatest of such FMAP for the State for 
fiscal year 2008, fiscal year 2009, fiscal year 2010, 
or fiscal year 2011, shall be substituted for the 
State’s FMAP for fiscal year 2012 before the appli-
cation of this section.’’; 
(2) in subsection (b)(3), by adding at the end 
the following: 
‘‘(C) FOURTH QUARTER OF FISCAL YEAR 
2011
AND
FIRST
AND
SECOND
QUARTERS
OF 
FISCAL
YEAR
2012.—For each State, for the 
fourth quarter of fiscal year 2011 and the first 
and second quarters of fiscal year 2012, the 
FMAP percentage increase for the State under 
paragraph (1) or (2) (as applicable) shall be 6.2 
percentage points. 
‘‘(D) THIRD
QUARTER
OF
FISCAL
YEAR 
2012.—For each State, for the third quarter of 
fiscal year 2012, the FMAP percentage increase 
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(6) in subsection (h)(3), by striking ‘‘June 30, 
2011’’ and inserting ‘‘September 30, 2012’’. 
(b) PAYMENT
ADJUSTMENT.—The Secretary of 
Health and Human Services shall provide, not later than 
30 days after the date of the enactment of this subtitle, 
for such adjustments of payments to States under title 
XIX of the Social Security Act as may be necessary for 
calendar quarters ending before such date to reflect the 
amendments made by subsection (a). 
Subtitle D—Keeping Our Social 
Security Promises Act 
SEC. 3301. SHORT TITLE. 
This subtitle may be cited as the ‘‘Keeping Our Social 
Security Promises Act’’. 
SEC. 3302. PAYROLL TAX ON REMUNERATION UP TO CON-
TRIBUTION AND BENEFIT BASE AND MORE 
THAN $250,000. 
(a) IN GENERAL.—Paragraph (1) of section 3121(a) 
of the Internal Revenue Code of 1986 is amended by in-
serting after ‘‘such calendar year.’’ the following: ‘‘The 
preceding sentence shall apply only to calendar years for 
which the contribution and benefit base (as so determined) 
is less than $250,000, and, for such calendar years, only 
to so much of the remuneration paid to such employee 
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by such employer with respect to employment as does not 
exceed $250,000.’’. 
(b) CONFORMING AMENDMENT.—Paragraph (1) of 
section 3121 of the Internal Revenue Code of 1986 is 
amended by striking ‘‘Act) to’’ and inserting ‘‘Act), or in 
excess of $250,000, to’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to remuneration paid after Decem-
ber 31, 2011. 
SEC. 3303. TAX ON NET EARNINGS FROM SELF-EMPLOY-
MENT UP TO CONTRIBUTION AND BENEFIT 
BASE AND MORE THAN $250,000. 
(a) IN GENERAL.—Paragraph (1) of section 1402(b) 
of the Internal Revenue Code of 1986 is amended to read 
as follows: 
‘‘(1) in the case of the tax imposed by section 
1401(a), the excess of— 
‘‘(A) that part of the net earnings from 
self-employment which is in excess of— 
‘‘(i) an amount equal to the contribu-
tion and benefit base (as determined under 
section 230 of the Social Security Act) 
which is effective for the calendar year in 
which such taxable year begins, minus 
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‘‘(ii) the amount of the wages paid to 
such individual during such taxable years; 
over 
‘‘(B) that part of the net earnings from 
self-employment which is in excess of the sum 
of— 
‘‘(i) the excess of— 
‘‘(I) the net earning from self- 
employment reduced by the excess (if 
any) of subparagraph (A)(i) over sub-
paragraph (A)(ii), over 
‘‘(II) $250,000, reduced by such 
contribution and benefit base, plus 
‘‘(ii) the amount of the wages paid to 
such individual during such taxable year in 
excess of such contribution and benefit 
base and not in excess of $250,000; or’’. 
(b) PHASEOUT.—Subsection (b) of section 1402 of 
the Internal Revenue Code of 1986 is amended by adding 
at the end the following: ‘‘Paragraph (1) shall apply only 
to taxable years beginning in calendar years for which the 
contribution and benefit base (as determined under section 
230 of the Social Security Act) is less than $250,000.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to net earnings from self-employ-
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ment derived, and remuneration paid, after December 31, 
2011. 
Æ 
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