134 
mentary Medical Insurance Trust Fund under 
section 1841. 
‘‘(D) FUNDING LIMITATION.—Amounts in 
the Fund shall be available in advance of appro-
priations in accordance with subparagraph (B) 
but only if the total amount obligated from the 
Fund does not exceed the amount available to 
the Fund under subparagraph (A). The Sec-
retary may obligate funds from the Fund only 
if the Secretary determines (and the Chief Ac-
tuary of the Centers for Medicare & Medicaid 
Services and the appropriate budget officer cer-
tify) that there are available in the Fund suffi-
cient amounts to cover all such obligations in-
curred consistent with the previous sentence. 
‘‘(E) CONSTRUCTION.—In the case that 
expenditures from the Fund are applied to, or 
otherwise affect, a conversion factor under sub-
section (d) for a year, the conversion factor 
under such subsection shall be computed for a 
subsequent year as if such application or effect 
had never occurred.’’. 
(e) IMPLEMENTATION.—For purposes of imple-
menting the provisions of, and amendments made by, this 
section, the Secretary of Health and Human Services shall 
VerDate Aug 31 2005 
04:12 Dec 08, 2006
Jkt 059200
PO 00000
Frm 00134
Fmt 6652
Sfmt 6201
E:\BILLS\H6408.IH
H6408
hmoore on PROD1PC68 with HMBILLS
135 
provide for the transfer, from the Federal Supplementary 
Medical Insurance Trust Fund established under section 
1841 of the Social Security Act (42 U.S.C. 1395t), of 
$60,000,000 to the Centers for Medicare & Medicaid Serv-
ices Program Management Account for the period of fiscal 
years 2007, 2008, and 2009. 
SEC. 102. EXTENSION OF FLOOR ON MEDICARE WORK GEO-
GRAPHIC ADJUSTMENT. 
Section 1848(e)(1)(E) of the Social Security Act (42 
U.S.C. 1395w–4(e)(1)(E)) is amended by striking ‘‘before 
January 1, 2007’’ and inserting ‘‘before January 1, 
2008’’. 
SEC. 103. UPDATE TO THE COMPOSITE RATE COMPONENT 
OF THE BASIC CASE-MIX ADJUSTED PRO-
SPECTIVE PAYMENT SYSTEM FOR DIALYSIS 
SERVICES. 
(a) IN GENERAL.—Section 1881(b)(12)(G) of the So-
cial Security Act (42 U.S.C. 1395rr(b)(12)(G)) is amend-
ed to read as follows: 
‘‘(G) The Secretary shall increase the amount of the 
composite rate component of the basic case-mix adjusted 
system under subparagraph (B) for dialysis services— 
‘‘(i) furnished on or after January 1, 2006, and 
before April 1, 2007, by 1.6 percent above the 
VerDate Aug 31 2005 
04:12 Dec 08, 2006
Jkt 059200
PO 00000
Frm 00135
Fmt 6652
Sfmt 6201
E:\BILLS\H6408.IH
H6408
hmoore on PROD1PC68 with HMBILLS
136 
amount of such composite rate component for such 
services furnished on December 31, 2005; and 
‘‘(ii) furnished on or after April 1, 2007, by 1.6 
percent above the amount of such composite rate 
component for such services furnished on March 31, 
2007.’’. 
(b) GAO REPORT ON HOME DIALYSIS PAYMENT.— 
Not later than January 1, 2009, the Comptroller General 
of the United States shall submit to Congress a report 
on the costs for home hemodialysis treatment and patient 
training for both home hemodialysis and peritoneal dialy-
sis. Such report shall also include recommendations for 
a payment methodology for payment under section 1881 
of the Social Security Act (42 U.S.C. 1395rr) that meas-
ures, and is based on, the costs of providing such services 
and takes into account the case mix of patients. 
SEC. 104. EXTENSION OF TREATMENT OF CERTAIN PHYSI-
CIAN PATHOLOGY SERVICES UNDER MEDI-
CARE. 
Section 542(c) of the Medicare, Medicaid, and 
SCHIP Benefits Improvement and Protection Act of 2000 
(as enacted into law by section 1(a)(6) of Public Law 106– 
554), as amended by section 732 of the Medicare Prescrip-
tion Drug, Improvement, and Modernization Act of 2003 
VerDate Aug 31 2005 
04:12 Dec 08, 2006
Jkt 059200
PO 00000
Frm 00136
Fmt 6652
Sfmt 6201
E:\BILLS\H6408.IH
H6408
hmoore on PROD1PC68 with HMBILLS
137 
(Public Law 108–173), is amended by striking ‘‘and 
2006’’ and inserting ‘‘, 2006, and 2007’’. 
SEC. 105. EXTENSION OF MEDICARE REASONABLE COSTS 
PAYMENTS FOR CERTAIN CLINICAL DIAG-
NOSTIC LABORATORY TESTS FURNISHED TO 
HOSPITAL PATIENTS IN CERTAIN RURAL 
AREAS. 
Effective as if included in the enactment of section 
416 of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (42 U.S.C. 1395l–4), sub-
section (b) of such section is amended by striking ‘‘2-year 
period’’ and inserting ‘‘3-year period’’. 
SEC. 106. HOSPITAL MEDICARE REPORTS AND CLARIFICA-
TIONS. 
(a) CORRECTION OF MID-YEAR RECLASSIFICATION 
EXPIRATION.—Notwithstanding any other provision of 
law, in the case of a subsection (d) hospital (as defined 
for purposes of section 1886 of the Social Security Act 
(42 U.S.C. 1395ww)) with respect to which a reclassifica-
tion of its wage index for purposes of such section would 
(but for this subsection) expire on March 31, 2007, such 
reclassification of such hospital shall be extended through 
September 30, 2007. The previous sentence shall not be 
effected in a budget-neutral manner. 
VerDate Aug 31 2005 
04:12 Dec 08, 2006
Jkt 059200
PO 00000
Frm 00137
Fmt 6652
Sfmt 6201
E:\BILLS\H6408.IH
H6408
hmoore on PROD1PC68 with HMBILLS
138 
(b) REVISION
OF
THE MEDICARE WAGE INDEX 
CLASSIFICATION SYSTEM.— 
(1) MEDPAC REPORT.— 
(A) IN GENERAL.—The Medicare Payment 
Advisory Commission shall submit to Congress, 
by not later than June 30, 2007, a report on 
its study of the wage index classification system 
applied under Medicare prospective payment 
systems, including under section 1886(d)(3)(E) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395ww(d)(3)(E)). Such report shall include 
any alternatives the Commission recommends to 
the method to compute the wage index under 
such section. 
(B) FUNDING.—Out of any funds in the 
Treasury not otherwise appropriated, there are 
appropriated to the Medicare Payment Advisory 
Commission, $2,000,000 for fiscal year 2007 to 
carry out this paragraph. 
(2) PROPOSAL TO REVISE THE HOSPITAL WAGE 
INDEX CLASSIFICATION SYSTEM.—The Secretary of 
Health and Human Services, taking into account the 
recommendations described in the report under 
paragraph (1), shall include in the proposed rule 
published under section 1886(e)(5)(A) of the Social 
VerDate Aug 31 2005 
04:12 Dec 08, 2006
Jkt 059200
PO 00000
Frm 00138
Fmt 6652
Sfmt 6201
E:\BILLS\H6408.IH
H6408
hmoore on PROD1PC68 with HMBILLS