409 
HR 3162 PCS
‘‘(D) ADJUSTMENT
BASED
ON
SETTLED 
COST REPORT.—In the case of a hospital with 
a dual accredited osteopathic and allopathic 
family practice program for which— 
‘‘(i) the otherwise applicable resident 
limit was reduced under subparagraph 
(A)(i)(I); and 
‘‘(ii) such reduction was based on a 
reference resident level that was deter-
mined using a cost report and where a re-
vised or corrected notice of program reim-
bursement was issued between September 
1, 2006 and September 15, 2006, whether 
as a result of an appeal or otherwise, and 
the reference resident level under such set-
tled cost report is higher than the level 
used for the reduction under subparagraph 
(A)(i)(I); 
the 
Secretary 
shall 
apply 
subparagraph 
(A)(i)(I) using the higher resident reference 
level and make any necessary adjustments to 
such reduction. Any such necessary adjustments 
shall be effective for portions of cost reporting 
periods occurring on or after July 1, 2005.’’. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00409
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
410 
HR 3162 PCS
(b) EFFECTIVE DATES.—The amendment made by 
paragraph (1) shall be effective for cost reporting periods 
beginning on or after October 1, 2007, and the amend-
ments made by paragraph (2) shall take effect as if in-
cluded in the enactment of section 422 of the Medicare 
Prescription Drug, Improvement, and Modernization Act 
of 2003 (Public Law 108–173). 
SEC. 706. STUDIES RELATING TO HOME HEALTH. 
(a) IN GENERAL.—The Medicare Payment Advisory 
Commission shall conduct a study of Medicare bene-
ficiaries utilizing home health care services to determine— 
(1) the impact that remote monitoring equip-
ment and related services have on improving health 
care outcomes in the home health care setting for 
beneficiaries with chronic conditions; 
(2) the differences in the percentage of inpa-
tient hospital admissions and emergency room visits 
for beneficiaries with a similar health care risk pro-
file who utilize remote monitoring equipment and 
services compared to those who do not use such 
equipment and services; 
(3) the percentage of Medicare beneficiaries 
currently utilizing remote monitoring equipment and 
related services; 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00410
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
411 
HR 3162 PCS
(4) the estimated reduction in aggregate ex-
penditures under parts A and B of title XVIII of the 
Social Security Act expenditures if home health 
agencies increased their utilization of remote moni-
toring equipment and related services for patients 
with chronic disease conditions; and 
(5) the variation of utilization of remote moni-
toring equipment and related services within geo-
graphic regions and by size of home health agency. 
(b) DATA COLLECTION.—As a condition of a home 
health agency’s participation in the program under title 
XVIII of the Social Security Act, beginning no later than 
January 1, 2008, the Secretary of Health and Human 
Services shall require such agencies to collect, in a form 
and manner determined by the Secretary, the following 
data: 
(1) The extent of home health agency’s usage 
of remote monitoring equipment and related services 
for beneficiaries with chronic conditions. 
(2) Whether such equipment and services are 
used to monitor patients’ with chronic conditions 
vital signs on a daily basis. 
(3) Whether standing physician orders accom-
pany the use of remote monitoring equipment and 
services. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00411
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
412 
HR 3162 PCS
(4) The costs of remote monitoring equipment 
and related services. 
(c) REPORT TO CONGRESS.—Not later than June 1, 
2010, the Commission shall report to Congress on its find-
ings on the study conducted under subsection (a). Such 
report shall include recommendations regarding how Con-
gress may enact reimbursement policies that increase the 
appropriate utilization of remote monitoring equipment 
and services under the home health program for Medicare 
beneficiaries with chronic conditions in a manner that fa-
cilitates health care outcomes and leads to the long-term 
reduction of aggregate expenditures under the Medicare 
program. 
SEC. 707. RURAL HOME HEALTH QUALITY DEMONSTRA-
TION PROJECTS. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services (in this section referred to as the 
‘‘Secretary’’) shall make grants to eligible entities for dem-
onstration projects to assist home health agencies to better 
serve their Medicare populations while aiming to reduce 
costs to the Medicare program through utilization of tech-
nologies, including telemonitoring and other telehealth 
technologies, health information technologies, and tele-
communications technologies that— 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00412
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
413 
HR 3162 PCS
(1) implement procedures and standards that 
reduce the need for inpatient hospital services and 
health center visits; and 
(2) address the aims of safety, effectiveness, 
patient- or community-centeredness, timeliness, effi-
ciency, and equity identified by the Institute of Med-
icine of the National Academies in its report entitled 
‘‘Crossing the Quality Chasm: A New Health System 
for the 21st Century’’ released on March 1, 2001, 
when determining when and what care is needed. 
(b) ELIGIBLE ENTITIES.—In this section, the term 
‘‘eligible entity’’ means a State that includes— 
(1) a rural academic medical center; 
(2) no urban regional medical center; and 
(3) a Medicare population whose enrollees in 
the Medicare Part C program is less than 3 percent. 
(c) CONSULTATION.—In developing the program for 
awarding grants under this section, the Secretary shall 
consult with the Administrator of the Centers for Medi-
care &amp; Medicaid Services, home health agencies, rural 
health care researchers, and private and non-profit groups 
(including national associations) which are undertaking 
similar efforts. 
(d) DURATION.—Each demonstration project under 
this section shall be for a period of 2 years. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00413
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
414 
HR 3162 PCS
(e) REPORT.—Not later than one year after the con-
clusion of all of the demonstration projects funded under 
this section, the Secretary shall submit a report to the 
Congress on the results of such projects. The report shall 
include— 
(1) an evaluation of technologies utilized and 
effects on patient access to home health care, patient 
outcomes, and an analysis of the cost effectiveness 
of each such project; and 
(2) recommendations on Federal legislation, 
regulations, or administrative policies to enhance 
rural home health quality and outcomes. 
(f) FUNDING.—Out of any funds in the Treasury not 
otherwise appropriated, there are appropriated to the Sec-
retary for fiscal year 2008, $3,000,000 to carry out this 
section. Funds appropriated under this subsection shall 
remain available until expended. 
TITLE VIII—MEDICAID 
Subtitle A—Protecting Existing 
Coverage 
SEC. 801. MODERNIZING TRANSITIONAL MEDICAID. 
(a) FOUR-YEAR EXTENSION.— 
(1) IN GENERAL.—Sections 1902(e)(1)(B) and 
1925(f) of the Social Security Act (42 U.S.C. 
1396a(e)(1)(B), 1396r–6(f)) are each amended by 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00414
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
415 
HR 3162 PCS
striking ‘‘September 30, 2003’’ and inserting ‘‘Sep-
tember 30, 2011’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect on October 1, 
2007. 
(b) STATE OPTION OF INITIAL 12-MONTH ELIGI-
BILITY.—Section 1925 of the Social Security Act (42 
U.S.C. 1396r–6) is amended— 
(1) in subsection (a)(1), by inserting ‘‘but sub-
ject to paragraph (5)’’ after ‘‘Notwithstanding any 
other provision of this title’’; 
(2) by adding at the end of subsection (a) the 
following: 
‘‘(5) OPTION OF 12-MONTH INITIAL ELIGIBILITY 
PERIOD.—A State may elect to treat any reference 
in this subsection to a 6-month period (or 6 months) 
as a reference to a 12-month period (or 12 months). 
In the case of such an election, subsection (b) shall 
not apply.’’; and 
(3) in subsection (b)(1), by inserting ‘‘but sub-
ject to subsection (a)(5)’’ after ‘‘Notwithstanding 
any other provision of this title’’. 
(c) REMOVAL OF REQUIREMENT FOR PREVIOUS RE-
CEIPT OF MEDICAL ASSISTANCE.—Section 1925(a)(1) of 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00415
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
416 
HR 3162 PCS
such Act (42 U.S.C. 1396r–6(a)(1)), as amended by sub-
section (b)(1), is further amended— 
(1) by inserting ‘‘subparagraph (B) and’’ before 
‘‘paragraph (5)’’; 
(2) by redesignating the matter after ‘‘RE-
QUIREMENT.—’’ as a subparagraph (A) with the 
heading ‘‘IN GENERAL.—’’ and with the same inden-
tation as subparagraph (B) (as added by paragraph 
(3)); and 
(3) by adding at the end the following: 
‘‘(B) STATE OPTION TO WAIVE REQUIRE-
MENT
FOR
MONTHS
BEFORE
RECEIPT
OF 
MEDICAL ASSISTANCE.—A State may, at its op-
tion, elect also to apply subparagraph (A) in 
the case of a family that was receiving such aid 
for fewer than three months or that had applied 
for and was eligible for such aid for fewer than 
3 months during the 6 immediately preceding 
months described in such subparagraph.’’. 
(d) CMS REPORT ON ENROLLMENT AND PARTICIPA-
TION RATES UNDER TMA.—Section 1925 of such Act (42 
U.S.C. 1396r–6), as amended by this section, is further 
amended by adding at the end the following new sub-
section: 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00416
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
417 
HR 3162 PCS
‘‘(g) COLLECTION AND REPORTING OF PARTICIPA-
TION INFORMATION.— 
‘‘(1) COLLECTION
OF
INFORMATION
FROM 
STATES.—Each State shall collect and submit to the 
Secretary (and make publicly available), in a format 
specified by the Secretary, information on average 
monthly enrollment and average monthly participa-
tion rates for adults and children under this section 
and of the number and percentage of children who 
become ineligible for medical assistance under this 
section whose medical assistance is continued under 
another eligibility category or who are enrolled under 
the State’s child health plan under title XXI. Such 
information shall be submitted at the same time and 
frequency in which other enrollment information 
under this title is submitted to the Secretary. 
‘‘(2) ANNUAL REPORTS TO CONGRESS.—Using 
the information submitted under paragraph (1), the 
Secretary shall submit to Congress annual reports 
concerning enrollment and participation rates de-
scribed in such paragraph.’’. 
(e) EFFECTIVE DATE.—The amendments made by 
subsections (b) through (d) shall take effect on the date 
of the enactment of this Act. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00417
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
418 
HR 3162 PCS
SEC. 802. FAMILY PLANNING SERVICES. 
(a) 
COVERAGE
AS
OPTIONAL
CATEGORICALLY 
NEEDY GROUP.— 
(1) IN
GENERAL.—Section 1902(a)(10)(A)(ii) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396a(a)(10)(A)(ii)) is amended— 
(A) in subclause (XVIII), by striking ‘‘or’’ 
at the end; 
(B) in subclause (XIX), by adding ‘‘or’’ at 
the end; and 
(C) by adding at the end the following new 
subclause: 
‘‘(XX) who are described in subsection (ee) (re-
lating to individuals who meet certain income stand-
ards);’’. 
(2) GROUP DESCRIBED.—Section 1902 of the 
Social Security Act (42 U.S.C. 1396a), as amended 
by section 112(c), is amended by adding at the end 
the following new subsection: 
‘‘(ee)(1) Individuals described in this subsection are 
individuals— 
‘‘(A) whose income does not exceed an in-
come eligibility level established by the State 
that does not exceed the highest income eligi-
bility level established under the State plan 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00418
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
419 
HR 3162 PCS
under this title (or under its State child health 
plan under title XXI) for pregnant women; and 
‘‘(B) who are not pregnant. 
‘‘(2) At the option of a State, individuals de-
scribed in this subsection may include individuals 
who are determined to meet the eligibility require-
ments referred to in paragraph (1) under the terms, 
conditions, and procedures applicable to making eli-
gibility determinations for medical assistance under 
this title under a waiver to provide the benefits de-
scribed in clause (XV) of the matter following sub-
paragraph (G) of section 1902(a)(10) granted to the 
State under section 1115 as of January 1, 2007.’’. 
(3) 
LIMITATION
ON
BENEFITS.—Section 
1902(a)(10) of the Social Security Act (42 U.S.C. 
1396a(a)(10)) is amended in the matter following 
subparagraph (G)— 
(A) by striking ‘‘and (XIV)’’ and inserting 
‘‘(XIV)’’; and 
(B) by inserting ‘‘, and (XV) the medical 
assistance made available to an individual de-
scribed in subsection (ee) shall be limited to 
family planning services and supplies described 
in section 1905(a)(4)(C) including medical di-
agnosis or treatment services that are provided 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00419
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
420 
HR 3162 PCS
pursuant to a family planning service in a fam-
ily planning setting provided during the period 
in which such an individual is eligible’’ after 
‘‘cervical cancer’’. 
(4) 
CONFORMING
AMENDMENTS.—Section 
1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)) is amended in the matter preceding para-
graph (1)— 
(A) in clause (xii), by striking ‘‘or’’ at the 
end; 
(B) in clause (xiii), by adding ‘‘or’’ at the 
end; and 
(C) by inserting after clause (xiii) the fol-
lowing: 
‘‘(xiv) individuals described in section 
1902(ee),’’. 
(b) PRESUMPTIVE ELIGIBILITY.— 
(1) IN GENERAL.—Title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.) is amended by 
inserting after section 1920B the following: 
‘‘PRESUMPTIVE ELIGIBILITY FOR FAMILY PLANNING 
SERVICES 
‘‘SEC. 1920C. (a) STATE OPTION.—State plan ap-
proved under section 1902 may provide for making med-
ical assistance available to an individual described in sec-
tion 1902(ee) (relating to individuals who meet certain in-
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00420
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
421 
HR 3162 PCS
come eligibility standard) during a presumptive eligibility 
period. In the case of an individual described in section 
1902(ee), such medical assistance shall be limited to fam-
ily 
planning 
services 
and 
supplies 
described 
in 
1905(a)(4)(C) and, at the State’s option, medical diag-
nosis or treatment services that are provided in conjunc-
tion with a family planning service in a family planning 
setting provided during the period in which such an indi-
vidual is eligible. 
‘‘(b) DEFINITIONS.—For purposes of this section: 
‘‘(1) PRESUMPTIVE ELIGIBILITY PERIOD.—The 
term ‘presumptive eligibility period’ means, with re-
spect to an individual described in subsection (a), 
the period that— 
‘‘(A) begins with the date on which a 
qualified entity determines, on the basis of pre-
liminary information, that the individual is de-
scribed in section 1902(ee); and 
‘‘(B) ends with (and includes) the earlier 
of— 
‘‘(i) the day on which a determination 
is made with respect to the eligibility of 
such individual for services under the State 
plan; or 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00421
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
422 
HR 3162 PCS
‘‘(ii) in the case of such an individual 
who does not file an application by the last 
day of the month following the month dur-
ing which the entity makes the determina-
tion referred to in subparagraph (A), such 
last day. 
‘‘(2) QUALIFIED ENTITY.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the term ‘qualified entity’ means 
any entity that— 
‘‘(i) is eligible for payments under a 
State plan approved under this title; and 
‘‘(ii) is determined by the State agen-
cy to be capable of making determinations 
of the type described in paragraph (1)(A). 
‘‘(B) RULE OF CONSTRUCTION.—Nothing 
in this paragraph shall be construed as pre-
venting a State from limiting the classes of en-
tities that may become qualified entities in 
order to prevent fraud and abuse. 
‘‘(c) ADMINISTRATION.— 
‘‘(1) IN GENERAL.—The State agency shall pro-
vide qualified entities with— 
‘‘(A) such forms as are necessary for an 
application to be made by an individual de-
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00422
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
423 
HR 3162 PCS
scribed in subsection (a) for medical assistance 
under the State plan; and 
‘‘(B) information on how to assist such in-
dividuals in completing and filing such forms. 
‘‘(2) NOTIFICATION REQUIREMENTS.—A quali-
fied 
entity 
that 
determines 
under 
subsection 
(b)(1)(A) that an individual described in subsection 
(a) is presumptively eligible for medical assistance 
under a State plan shall— 
‘‘(A) notify the State agency of the deter-
mination within 5 working days after the date 
on which determination is made; and 
‘‘(B) inform such individual at the time 
the determination is made that an application 
for medical assistance is required to be made by 
not later than the last day of the month fol-
lowing the month during which the determina-
tion is made. 
‘‘(3) 
APPLICATION
FOR
MEDICAL
ASSIST-
ANCE.—In the case of an individual described in 
subsection (a) who is determined by a qualified enti-
ty to be presumptively eligible for medical assistance 
under a State plan, the individual shall apply for 
medical assistance by not later than the last day of 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00423
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
424 
HR 3162 PCS
the month following the month during which the de-
termination is made. 
‘‘(d) PAYMENT.—Notwithstanding any other provi-
sion of this title, medical assistance that— 
‘‘(1) is furnished to an individual described in 
subsection (a)— 
‘‘(A) during a presumptive eligibility pe-
riod; 
‘‘(B) by a entity that is eligible for pay-
ments under the State plan; and 
‘‘(2) is included in the care and services covered 
by the State plan, shall be treated as medical assist-
ance provided by such plan for purposes of clause 
(4) of the first sentence of section 1905(b).’’. 
(2) CONFORMING AMENDMENTS.— 
(A) Section 1902(a)(47) of the Social Se-
curity Act (42 U.S.C. 1396a(a)(47)) is amend-
ed by inserting before the semicolon at the end 
the following: ‘‘and provide for making medical 
assistance available to individuals described in 
subsection (a) of section 1920C during a pre-
sumptive eligibility period in accordance with 
such section’’. 
(B) Section 1903(u)(1)(D)(v) of such Act 
(42 U.S.C. 1396b(u)(1)(D)(v)) is amended— 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00424
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
425 
HR 3162 PCS
(i) by striking ‘‘or for’’ and inserting 
‘‘for’’; and 
(ii) by inserting before the period the 
following: ‘‘, or for medical assistance pro-
vided to an individual described in sub-
section (a) of section 1920C during a pre-
sumptive eligibility period under such sec-
tion’’. 
(e) CLARIFICATION OF COVERAGE OF FAMILY PLAN-
NING SERVICES AND SUPPLIES.—Section 1937(b) of the 
Social Security Act (42 U.S.C. 1396u–7(b)) is amended 
by adding at the end the following: 
‘‘(5) COVERAGE OF FAMILY PLANNING SERV-
ICES AND SUPPLIES.—Notwithstanding the previous 
provisions of this section, a State may not provide 
for medical assistance through enrollment of an indi-
vidual with benchmark coverage or benchmark-equiv-
alent coverage under this section unless such cov-
erage includes for any individual described in section 
1905(a)(4)(C), medical assistance for family plan-
ning services and supplies in accordance with such 
section.’’. 
(f) EFFECTIVE DATE.—The amendments made by 
this section take effect on October 1, 2007. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00425
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS
426 
HR 3162 PCS
SEC. 803. AUTHORITY TO CONTINUE PROVIDING ADULT 
DAY HEALTH SERVICES APPROVED UNDER A 
STATE MEDICAID PLAN. 
(a) IN GENERAL.—During the period described in 
subsection (b), the Secretary of Health and Human Serv-
ices shall not— 
(1) withhold, suspend, disallow, or otherwise 
deny Federal financial participation under section 
1903(a) of the Social Security Act (42 U.S.C. 
1396b(a)) for the provision of adult day health care 
services, day activity and health services, or adult 
medical day care services, as defined under a State 
Medicaid plan approved during or before 1994, dur-
ing such period if such services are provided con-
sistent with such definition and the requirements of 
such plan; or 
(2) withdraw Federal approval of any such 
State plan or part thereof regarding the provision of 
such services (by regulation or otherwise). 
(b) PERIOD DESCRIBED.—The period described in 
this subsection is the period that begins on November 3, 
2005, and ends on March 1, 2009. 
VerDate Aug 31 2005 
02:04 Sep 05, 2007
Jkt 059200
PO 00000
Frm 00426
Fmt 6652
Sfmt 6201
E:\BILLS\H3162.PCS
H3162
bajohnson on PROD1PC71 with BILLS