datamatters24/research-document-archive huggingface dataset:
HR 4366 RFS
(ii) in subparagraph (E), by striking 
‘‘and opportunity for,’’ and inserting ‘‘op-
portunity for, and completion of’’; 
(iii) by amending subparagraph (F) to 
read as follows: 
‘‘(F) teaching, including information on 
pre-service preparation, professional develop-
ment, teacher distribution, and teacher and 
school leader evaluation;’’; 
(iv) in subparagraph (G), by inserting 
‘‘and school leaders’’ before the semicolon; 
(v) in subparagraph (H), by inserting 
‘‘, climate, and in- and out-of-school sus-
pensions and expulsions’’ before ‘‘, includ-
ing information regarding’’; 
(vi) by amending subparagraph (K) to 
read as follows: 
‘‘(K) the access to, and use of, technology 
to improve elementary schools and secondary 
schools;’’; 
(vii) in subparagraph (L), by striking 
‘‘and opportunity for,’’ and inserting ‘‘op-
portunity for, and quality of’’; 
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Subtitle E, Part 1
1995 or in fiscal year 1996 (referred to in this sub-
section individually as a ‘first payment year’), the
percentage determined under paragraph (2) for the
hospital is deemed to be the percentage applicable
under section 2231(b)(2) to the hospital, except that
the percentage under paragraph (2) shall be ad-
justed in accordance with section 2231(b)(2)(A) to
the extent determined by the Secretary to be nec-
essary with respect to a sum that equals 100 per-
cent.
‘‘(2) DETERMINATION
OF
PERCENTAGE.—For
purposes of paragraph (1), the percentage deter-
mined under this paragraph for a teaching hospital
is the percentage constituted by the ratio of the
amount determined under subparagraph (A) to the
amount determined under subparagraph (B), as fol-
lows:
‘‘(A)(i) If the first payment year for the
hospital is fiscal year 1995, the amount deter-
mined under this subparagraph is the total
amount of payments received by the hospital
under section 1886(h) for cost reporting periods
beginning in fiscal year 1995.
‘‘(ii) If the first payment year for the hos-
pital is fiscal year 1996, the amount determined
HR 4015 RDS
adjustment factor of 0 percent is as-
signed for a score at the performance 
threshold and an adjustment factor of 
the negative of the applicable percent 
specified in subparagraph (B) is as-
signed for a score of 0; and 
‘‘(II) MIPS eligible professionals 
with composite performance scores 
that are equal to or greater than 0, 
but not greater than 1⁄4 of the per-
formance threshold specified under 
subparagraph (D)(i) for such year, re-
ceive a negative payment adjustment 
factor that is equal to the negative of 
the applicable percent specified in 
subparagraph (B) for such year. 
‘‘(B) APPLICABLE
PERCENT
DEFINED.— 
For purposes of this paragraph, the term ‘ap-
plicable percent’ means— 
‘‘(i) for 2018, 4 percent; 
‘‘(ii) for 2019, 5 percent; 
‘‘(iii) for 2020, 7 percent; and 
‘‘(iv) for 2021 and subsequent years, 
9 percent. 
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345
Subtitle G, Part 1
penditures resulting from changes in the
update to the conversion factor under sub-
section (d),
minus 1 and multiplied by 100.
‘‘(B) SUBSEQUENT
FISCAL
YEARS.—The
sustainable growth rate for all physicians’ serv-
ices for fiscal year 1997 and each subsequent
fiscal year shall be equal to the product of—
‘‘(i) 1 plus the Secretary’s estimate of
the percentage change in the medicare eco-
nomic index for the fiscal year involved
(described in the fourth sentence of section
1842(b)(3)) (divided by 100),
‘‘(ii) 1 plus the Secretary’s estimate of
the percentage change (divided by 100) in
the average number of individuals enrolled
under this part (other than private plan
enrollees) from the previous fiscal year to
the fiscal year involved,
‘‘(iii) 1 plus the Secretary’s estimate
of the projected percentage growth in real
gross domestic product per capita (divided
by 100) from the previous fiscal year to
the fiscal year involved, plus 2 percentage
points, and
144 
‘‘(iii) 
EXEMPTION
FROM
BUDGET 
NEUTRALITY IF TARGET NOT MET.—If the 
estimated net reduction in expenditures de-
termined under clause (i) for the year is 
less than the target for the year, reduced 
expenditures in an amount equal to the 
target recapture amount shall not be taken 
into account in applying subparagraph 
(B)(ii)(II) with respect to fee schedules be-
ginning with 2015. 
‘‘(iv) TARGET RECAPTURE AMOUNT.— 
For purposes of clause (iii), the target re-
capture amount is, with respect to a year, 
an amount equal to the difference be-
tween— 
‘‘(I) the target for the year; and 
‘‘(II) the estimated net reduction 
in expenditures determined under 
clause (i) for the year. 
‘‘(v) TARGET.—For purposes of this 
subparagraph, with respect to a year, the 
target is calculated as 0.5 percent of the 
estimated amount of expenditures under 
the fee schedule under this section for the 
year.’’. 
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‘‘(i) IN
GENERAL.—Subject to sub-
paragraph (D), a MedicarePlus organiza-
tion that is a Taft-Hartley sponsor (as de-
fined in clause (ii)) shall limit eligibility of
enrollees under this part for MedicarePlus
products it offers to individuals who are
entitled to obtain benefits through such
products under the terms of an applicable
collective bargaining agreement.
‘‘(ii) TAFT-HARTLEY
SPONSOR.—In
this part and section 1805, the term ‘Taft-
Hartley sponsor’ means, in relation to a
group health plan that is established or
maintained by two or more employers or
jointly by one or more employers and one
or more employee organizations, the asso-
ciation, committee, joint board of trustees,
or other similar group of representatives of
parties who establish or maintain the plan.
‘‘(C) QUALIFIED ASSOCIATIONS.—
‘‘(i) IN
GENERAL.—Subject to sub-
paragraph (D), a MedicarePlus organiza-
tion that is a qualified association (as de-
fined in clause (iii)) shall limit eligibility of
individuals under this part for products it
I 
113TH CONGRESS 
2D SESSION 
H. R. 4068 
To amend the Servicemembers Civil Relief Act to require the consent of 
parties to contracts for the use of arbitration to resolve controversies 
arising under the contracts and subject to provisions of such Act and 
to preserve the rights of servicemembers to bring class actions under 
such Act, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 18, 2014 
Mr. JONES introduced the following bill; which was referred to the Committee 
on Veterans’ Affairs 
A BILL 
To amend the Servicemembers Civil Relief Act to require 
the consent of parties to contracts for the use of arbitra-
tion to resolve controversies arising under the contracts 
and subject to provisions of such Act and to preserve 
the rights of servicemembers to bring class actions under 
such Act, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘SCRA Rights Protec-
tion Act of 2014’’. 
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‘‘(A) ESTABLISHMENT.—Under the MIPS, 
the Secretary shall establish performance stand-
ards with respect to measures and activities 
specified under paragraph (2)(B) for a perform-
ance period (as established under paragraph 
(4)) for a year. 
‘‘(B) CONSIDERATIONS IN ESTABLISHING 
STANDARDS.—In establishing such performance 
standards with respect to measures and activi-
ties specified under paragraph (2)(B), the Sec-
retary shall consider the following: 
‘‘(i) Historical performance standards. 
‘‘(ii) Improvement. 
‘‘(iii) The opportunity for continued 
improvement. 
‘‘(4) PERFORMANCE
PERIOD.—The Secretary 
shall establish a performance period (or periods) for 
a year (beginning with the year described in para-
graph (1)(B)). Such performance period (or periods) 
shall begin and end prior to the beginning of such 
year and be as close as possible to such year. In this 
subsection, such performance period (or periods) for 
a year shall be referred to as the performance period 
for the year. 
‘‘(5) COMPOSITE PERFORMANCE SCORE.— 
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352
Subtitle G, Part 1
(A) by striking ‘‘(or factors)’’ each place it
appears 
in 
subsection 
(d)(1)(A) 
and
(d)(1)(D)(ii);
(B) in subsection (d)(1)(A), by striking ‘‘or
updates’’;
(C) in subsection (d)(1)(D)(ii), by striking
‘‘(or updates)’’; and
(D) in subsection (i)(1)(C), by striking
‘‘conversion factors’’ and inserting ‘‘the conver-
sion factor’’.
SEC. 15602. ELIMINATION OF FORMULA-DRIVEN OVERPAY-
MENTS FOR CERTAIN OUTPATIENT HOSPITAL
SERVICES.
(a) 
AMBULATORY
SURGICAL
CENTER
PROCE-
DURES.—Section 
1833(i)(3)(B)(i)(II) 
(42 
U.S.C.
1395l(i)(3)(B)(i)(II)) is amended—
(1) by striking ‘‘of 80 percent’’; and
(2) by striking the period at the end and insert-
ing the following: ‘‘, less the amount a provider may
charge as described in clause (ii) of section
1866(a)(2)(A).’’.
(b) RADIOLOGY SERVICES AND DIAGNOSTIC PROCE-
DURES.—Section 
1833(n)(1)(B)(i)(II) 
(42 
U.S.C.
1395l(n)(1)(B)(i)(II)) is amended—
(1) by striking ‘‘of 80 percent’’; and
Subtitle A, Part 1
‘‘(4) REVIEW.—The Secretary periodically shall
review State programs approved under paragraph
(1) to determine if they continue to provide for cer-
tification and enforcement described in such para-
graph. If the Secretary finds that a State program
no longer so provides, before making a final deter-
mination, the Secretary shall provide the State an
opportunity to adopt such a plan of correction as
would permit the State program to meet the require-
ments of paragraph (1). If the Secretary makes a
final determination that the State program, after
such an opportunity, fails to meet such require-
ments, the provisions of subsection (b) shall apply to
MedicarePlus organizations and products in the
State.
‘‘(5) EFFECT OF NO STATE PROGRAM.—Begin-
ning on the date standards are established under
section 1856, in the case of organizations and prod-
ucts in States in which a certification program has
not been approved and in operation under paragraph
(1), the Secretary shall establish a process for the
certification of MedicarePlus organizations (other
than union sponsors, Taft-Hartley sponsors, and
provider-sponsored organizations) and products of
such organizations as meeting such standards.
‘‘(A) IN
GENERAL.—Subject to the suc-
ceeding provisions of this paragraph and taking 
into account, as available and applicable, para-
graph (1)(G), the Secretary shall develop a 
methodology for assessing the total performance 
of each MIPS eligible professional according to 
performance standards under paragraph (3) 
with respect to applicable measures and activi-
ties specified in paragraph (2)(B) with respect 
to each performance category applicable to such 
professional for a performance period (as estab-
lished under paragraph (4)) for a year. Using 
such methodology, the Secretary shall provide 
for a composite assessment (using a scoring 
scale of 0 to 100) for each such professional for 
the performance period for such year. In this 
subsection such a composite assessment for 
such a professional with respect to a perform-
ance period shall be referred to as the ‘com-
posite performance score’ for such professional 
for such performance period. 
‘‘(B) INCENTIVE
TO
REPORT; ENCOUR-
AGING USE OF CERTIFIED EHR TECHNOLOGY 
FOR REPORTING QUALITY MEASURES.— 
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10 MIPS eligible professionals to elect, 
with respect to a performance period for a 
year, for such individual MIPS eligible pro-
fessional or all such MIPS eligible profes-
sionals in such group practice, respectively, 
to be a virtual group under this subpara-
graph with at least one other such indi-
vidual MIPS eligible professional or group 
practice making such an election. Such a 
virtual group may be based on geographic 
areas or on provider specialties defined by 
nationally recognized multispecialty boards 
of certification or equivalent certification 
boards and such other eligible professional 
groupings in order to capture classifica-
tions of providers across eligible profes-
sional organizations and other practice 
areas or categories. 
‘‘(iii) REQUIREMENTS.—The process 
under clause (ii)— 
‘‘(I) shall provide that an election 
under such clause, with respect to a 
performance period, shall be made be-
fore or during the beginning of such 
performance period and may not be 
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105
Subtitle A, Part 1
‘‘(ii) to an individual or to any other
entity under this part;
‘‘(F) fails to comply with the requirements
of section 1852(f)(3); or
‘‘(G) employs or contracts with any indi-
vidual or entity that is excluded from participa-
tion under this title under section 1128 or
1128A for the provision of health care, utiliza-
tion review, medical social work, or administra-
tive services or employs or contracts with any
entity for the provision (directly or indirectly)
through such an excluded individual or entity of
such services;
the Secretary may provide, in addition to any other
remedies authorized by law, for any of the remedies
described in paragraph (2).
‘‘(2) REMEDIES.—The remedies described in
this paragraph are—
‘‘(A) civil money penalties of not more
than $25,000 for each determination under
paragraph (1) or, with respect to a determina-
tion under subparagraph (D) or (E)(i) of such
paragraph, of not more than $100,000 for each
such determination, plus, with respect to a de-
termination under paragraph (1)(B), double the
I 
113TH CONGRESS 
2D SESSION 
H. R. 4095 
To increase, effective as of December 1, 2014, the rates of compensation 
for veterans with service-connected disabilities and the rates of depend-
ency and indemnity compensation for the survivors of certain disabled 
veterans, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 26, 2014 
Mr. RUNYAN (for himself and Ms. TITUS) introduced the following bill; which 
was referred to the Committee on Veterans’ Affairs 
A BILL 
To increase, effective as of December 1, 2014, the rates 
of compensation for veterans with service-connected dis-
abilities and the rates of dependency and indemnity com-
pensation for the survivors of certain disabled veterans, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veterans’ Compensa-
tion Cost-of-Living Adjustment Act of 2014’’. 
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151
Subtitle A, Part 4
(2) CONSULTANTS.—The Commission may pro-
cure such temporary and intermittent services of
consultants under section 3109(b) of title 5, United
States Code, as the Commission determines to be
necessary to carry out the duties of the Commission.
(e) POWERS.—
(1) HEARINGS
AND
OTHER
ACTIVITIES.—For
the purpose of carrying out its duties, the Commis-
sion may hold such hearings and undertake such
other activities as the Commission determines to be
necessary to carry out its duties.
(2) STUDIES BY GAO.—Upon the request of the
Commission, the Comptroller General shall conduct
such studies or investigations as the Commission de-
termines to be necessary to carry out its duties.
(3) COST
ESTIMATES
BY
CONGRESSIONAL
BUDGET OFFICE.—
(A) Upon the request of the Commission,
the Director of the Congressional Budget Office
shall provide to the Commission such cost esti-
mates as the Commission determines to be nec-
essary to carry out its duties.
(B) The Commission shall reimburse the
Director of the Congressional Budget Office for
expenses relating to the employment in the of-
129
Subtitle A, Part 2
‘‘(5) 
SPECIAL
RULE
FOR
MEDICAREPLUS
MSA’S.—An 
individual 
for 
whose 
benefit 
a
MedicarePlus MSA (within the meaning of section
137(b)) is established shall be exempt from the tax
imposed by this section with respect to any trans-
action concerning such account (which would other-
wise be taxable under this section) if, with respect
to such transaction, the account ceases to be a
MedicarePlus MSA by reason of the application of
section 137(c)(2) to such account.’’
(2) Paragraph (1) of section 4975(e) of such
Code is amended to read as follows:
‘‘(1) PLAN.—For purposes of this section, the
term ‘plan’ means—
‘‘(A) a trust described in section 401(a)
which forms a part of a plan, or a plan de-
scribed in section 403(a), which trust or plan is
exempt from tax under section 501(a),
‘‘(B) an individual retirement account de-
scribed in section 408(a),
‘‘(C) an individual retirement annuity de-
scribed in section 408(b),
‘‘(D) a medical savings account described
in section 220(d),
Subtitle A, Part 1
sored organization (as defined in section 1854(a))
except to the extent provided under section 1857(c).
‘‘(c) PREPAID PAYMENT.—A MedicarePlus organiza-
tion shall be compensated (except for deductibles, coinsur-
ance, and copayments) for the provision of health care
services to enrolled members by a payment which is paid
on a periodic basis without regard to the date the health
care services are provided and which is fixed without re-
gard to the frequency, extent, or kind of health care serv-
ice actually provided to a member.
‘‘(d) ASSUMPTION OF FULL FINANCIAL RISK.—The
MedicarePlus organization shall assume full financial risk
on a prospective basis for the provision of the health care
services (other than hospice care) for which benefits are
required to be provided under section 1852(a)(1), except
that the organization—
‘‘(1) may obtain insurance or make other ar-
rangements for the cost of providing to any enrolled
member such services the aggregate value of which
exceeds $5,000 in any year,
‘‘(2) may obtain insurance or make other ar-
rangements for the cost of such services provided to
its enrolled members other than through the organi-
zation because medical necessity required their pro-
(F) in paragraph (7)(A), as so redesig-
nated by subparagraph (C) of this paragraph, 
by striking ‘‘subtitle C of the’’ and inserting 
‘‘subtitle C of title I of the’’; and 
(G) in paragraph (10), as so redesignated 
by subparagraph (C) of this paragraph, by 
striking ‘‘(6), or (7)’’ and inserting ‘‘(7), or 
(8)’’. 
(c) OMBUDSMAN REGULATIONS.—Section 713 of the 
Older Americans Act of 1965 (42 U.S.C. 3058h) is 
amended— 
(1) in paragraph (1), by striking ‘‘paragraphs 
(1) and (2) of section 712(f)’’ and inserting ‘‘sub-
paragraphs (A) and (B) of section 712(f)(1)’’; and 
(2) in paragraph (2), by striking ‘‘subpara-
graphs (A) through (D) of section 712(f)(3)’’ and 
inserting ‘‘clauses (i) through (vi) of section 
712(f)(1)(C)’’. 
(d) PREVENTION OF ELDER ABUSE, NEGLECT, AND 
EXPLOITATION.—Section 721 of the Older Americans Act 
of 1965 (42 U.S.C. 3058i) is amended— 
(1) in subsection (b)— 
(A) in the matter preceding paragraph (1), 
by striking ‘‘(including financial exploitation)’’; 
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‘‘(I) shall make available timely 
(such as quarterly) confidential feed-
back to MIPS eligible professionals on 
the performance of such professionals 
with respect to the performance cat-
egories under clauses (i) and (ii) of 
paragraph (2)(A); and 
‘‘(II) may make available con-
fidential feedback to each such profes-
sional on the performance of such 
professional with respect to the per-
formance categories under clauses (iii) 
and (iv) of such paragraph. 
‘‘(ii) MECHANISMS.—The Secretary 
may use one or more mechanisms to make 
feedback available under clause (i), which 
may include use of a web-based portal or 
other mechanisms determined appropriate 
by the Secretary. With respect to the per-
formance category described in paragraph 
(2)(A)(i), feedback under this subpara-
graph shall, to the extent an eligible pro-
fessional chooses to participate in a data 
registry for purposes of this subsection (in-
cluding registries under subsections (k) 
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(3) 
COORDINATION
CONFORMING
AMEND-
MENTS.—Section 1833 of the Social Security Act 
(42 U.S.C. 1395l) is further amended— 
(A) in subsection (x)(3), by adding at the 
end the following new sentence: ‘‘The amount 
of the additional payment for a service under 
this subsection and subsection (z) shall be de-
termined without regard to any additional pay-
ment for the service under subsection (z) and 
this subsection, respectively.’’; and 
(B) in subsection (y)(3), by adding at the 
end the following new sentence: ‘‘The amount 
of the additional payment for a service under 
this subsection and subsection (z) shall be de-
termined without regard to any additional pay-
ment for the service under subsection (z) and 
this subsection, respectively.’’. 
(4) ENCOURAGING DEVELOPMENT AND TEST-
ING OF CERTAIN MODELS.—Section 1115A(b)(2) of 
the Social Security Act (42 U.S.C. 1315a(b)(2)) is 
amended— 
(A) in subparagraph (B), by adding at the 
end the following new clauses: 
‘‘(xxi) Focusing primarily on physi-
cians’ services (as defined in section 
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HR 2491 EAS
of such beneficiaries to participate in a demonstra-
tion project under this section.
(e) DURATION.—
(1) IN
GENERAL.—The demonstration projects
conducted under this section shall be conducted for a
5-year period, subject to annual review and approval
by the Secretary.
(2) TERMINATION.—The Secretary may, with 90
days’ notice, terminate any demonstration project
conducted under this section that is not in substantial
compliance with the terms of the application ap-
proved by the Secretary under this section.
(f) OVERSIGHT.—The Secretary shall establish quality
standards for evaluating and monitoring the demonstration
projects conducted under this section. Such quality stand-
ards shall include reporting requirements which contain the
following:
(1) A description of the demonstration project.
(2) An analysis of beneficiary satisfaction under
such project.
(3) An analysis of the quality of the services de-
livered under the project.
(4) A description of the savings to the
MediGrant and medicare programs as a result of the
demonstration project.
I 
113TH CONGRESS 
2D SESSION 
H. R. 4020 
To amend the Internal Revenue Code of 1986 to allow certain discharged 
student loan debt to be included in gross income ratably over 15 years 
and to disregard such income in determining eligibility for Federal 
means-tested programs. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 6, 2014 
Ms. PINGREE of Maine introduced the following bill; which was referred to the 
Committee on Ways and Means 
A BILL 
To amend the Internal Revenue Code of 1986 to allow cer-
tain discharged student loan debt to be included in gross 
income ratably over 15 years and to disregard such in-
come in determining eligibility for Federal means-tested 
programs. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Student Loan Forgive-
ness Tax Repayment Act of 2014’’. 
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