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under 
section 
1861(s)(2)(DD), 
the 
amounts paid shall be 80 percent of the 
lesser of: (i) the actual charge for the serv-
ices; or (ii) 75 percent of the amount de-
termined for payment of a psychologist 
under subparagraph (L)’’. 
(B) DEVELOPMENT OF CRITERIA WITH RE-
SPECT TO CONSULTATION WITH A PHYSICIAN.— 
The Secretary of Health and Human Services 
shall, taking into consideration concerns for pa-
tient confidentiality, develop criteria with re-
spect to payment for mental health counselor 
services for which payment may be made di-
rectly to the mental health counselor under part 
B of title XVIII of the Social Security Act (42 
U.S.C. 1395j et seq.) under which such a coun-
selor must agree to consult with a patient’s at-
tending or primary care physician in accordance 
with such criteria. 
(5) EXCLUSION
OF
MENTAL
HEALTH
COUN-
SELOR SERVICES FROM SKILLED NURSING FACILITY 
PROSPECTIVE
PAYMENT
SYSTEM.—Section 
1888(e)(2)(A)(ii) of the Social Security Act (42 
U.S.C. 1395yy(e)(2)(A)(ii)), as amended by sub-
section (a)(5), is amended by inserting ‘‘mental 
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health counselor services (as defined in section 
1861(ddd)(2)),’’ after ‘‘marriage and family thera-
pist services (as defined in subsection (eee)(1)),’’. 
(6) COVERAGE
OF
MENTAL
HEALTH
COUN-
SELOR
SERVICES
PROVIDED
IN
RURAL
HEALTH 
CLINICS AND FEDERALLY QUALIFIED HEALTH CEN-
TERS.—Section 1861(aa)(1)(B) of the Social Secu-
rity Act (42 U.S.C. 1395x(aa)(1)(B)), as amended 
by subsection (a)(6), is amended by striking ‘‘or by 
a marriage and family therapist (as defined in sub-
section (eee)(2)),’’ and inserting ‘‘by a marriage and 
family therapist (as defined in subsection (eee)(2)), 
or a mental health counselor (as defined in sub-
section (fff)(1)),’’. 
(7) INCLUSION
OF
MENTAL
HEALTH
COUN-
SELORS
AS
PRACTITIONERS
FOR
ASSIGNMENT
OF 
CLAIMS.—Section 1842(b)(18)(C) of the Social Se-
curity Act (42 U.S.C. 1395u(b)(18)(C)), as amended 
by subsection (a)(7), is amended by adding at the 
end the following new clause: 
‘‘(viii) A mental health counselor (as defined in 
section 1861(fff)(1)).’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2008. 
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SEC. 608. RENTAL AND PURCHASE OF POWER-DRIVEN 
WHEELCHAIRS. 
(a) IN GENERAL.—Section 1834(a)(7) of the Social 
Security Act (42 U.S.C. 1395m(a)(7)) is amended— 
(1) in subparagraph (A)— 
(A) in clause (i)(I), by striking ‘‘Except as 
provided in clause (iii), payment’’ and inserting 
‘‘Payment’’; 
(B) by striking clause (iii); and 
(C) in clause (iv)— 
(i) by redesignating such clause as 
clause (iii); and 
(ii) by striking ‘‘or in the case of a 
power-driven wheelchair for which a pur-
chase agreement has been entered into 
under clause (iii)’’; and 
(2) in subparagraph (C)(ii)(II), by striking ‘‘or 
(A)(iii)’’. 
(b) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraph (1), 
the amendments made by subsection (a) shall take 
effect on January 1, 2008, and shall apply to power- 
driven wheelchairs furnished on or after such date. 
(2) APPLICATION
TO
COMPETITIVE
ACQUISI-
TION.—The amendments made by subsection (a) 
shall not apply to contracts entered into under sec-
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tion 1847 of the Social Security Act (42 U.S.C. 
1395w–3) pursuant to a bid submitted under such 
section before October 1, 2007. 
SEC. 609. RENTAL AND PURCHASE OF OXYGEN EQUIPMENT. 
(a) IN GENERAL.—Section 1834(a)(5)(F) of the So-
cial Security Act (42 U.S.C. 1395m(a)(5)(F)) is amend-
ed— 
(1) in clause (i)— 
(A) by striking ‘‘Payment’’ and inserting 
‘‘Subject to clause (iii), payment’’; and 
(B) by striking ‘‘36 months’’ and inserting 
‘‘18 months’’; 
(2) in clause (ii)(I), by striking ‘‘36th contin-
uous month’’ and inserting ‘‘18th continuous 
month’’; and 
(3) by adding at the end the following new 
clause: 
‘‘(iii) SPECIAL
RULE
FOR
OXYGEN 
GENERATING
PORTABLE
EQUIPMENT.—In 
the case of oxygen generating portable 
equipment referred to in the final rule pub-
lished in the Federal Register on Novem-
ber 9, 2006 (71 Fed. Reg. 65897–65899), 
in applying clauses (i) and (ii)(I) each ref-
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erence to ‘18 months’ is deemed a ref-
erence to ‘36 months’.’’. 
(b) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraph (3), 
the amendments made by subsection (a) shall apply 
to oxygen equipment furnished on or after January 
1, 2008. 
(2) TRANSITION.—In the case of an individual 
receiving oxygen equipment on December 31, 2007, 
for which payment is made under section 1834(a) of 
the Social Security Act (42 U.S.C. 1395m(a)), the 
18-month period described in paragraph (5)(F)(i) of 
such section, as amended by subsection (a), shall 
begin on January 1, 2008, but in no case shall the 
rental period for such equipment exceed 36 months. 
(3) APPLICATION
TO
COMPETITIVE
ACQUISI-
TION.—The amendments made by subsection (a) 
shall not apply to contracts entered into under sec-
tion 1847 of the Social Security Act (42 U.S.C. 
1395w–3) pursuant to a bid submitted under such 
section before October 1, 2007. 
(c) STUDY AND REPORT.— 
(1) STUDY.—The Secretary of Health and 
Human Services shall conduct a study to examine 
the service component and the equipment component 
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of the provision of oxygen to Medicare beneficiaries. 
The study shall assess— 
(A) the type of services provided and vari-
ation across suppliers in providing such serv-
ices; 
(B) whether the services are medically nec-
essary or affect patient outcomes; 
(C) whether the Medicare program pays 
appropriately for equipment in connection with 
the provision of oxygen; 
(D) whether such program pays appro-
priately for necessary services; 
(E) whether such payment in connection 
with the provision of oxygen should be divided 
between equipment and services, and if so, how; 
and 
(F) how such payment rate compares to a 
competitively bid rate. 
(2) REPORT.—Not later than 18 months after 
the date of the enactment of this Act, the Secretary 
of Health and Human Services shall submit to Con-
gress a report on the study conducted under para-
graph (1). 
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SEC. 610. ADJUSTMENT FOR MEDICARE MENTAL HEALTH 
SERVICES. 
(a) IN GENERAL.—For purposes of payment for serv-
ices furnished under the physician fee schedule under sec-
tion 1848 of the Social Security Act (42 U.S.C. 1395w– 
4) during the applicable period, the Secretary of Health 
and Human Services shall increase the amount otherwise 
payable for applicable services by 5 percent. 
(b) DEFINITIONS.—For purposes of subsection (a): 
(1) APPLICABLE PERIOD.—The term ‘‘applica-
ble period’’ means the period beginning on January 
1, 2008, and ending on December 31 of the year be-
fore the effective date of the first review after Janu-
ary 1, 2008, of work relative value units conducted 
under section 1848(c)(2)(B)(i) of the Social Security 
Act. 
(2) APPLICABLE SERVICES.—The term ‘‘appli-
cable services’’ means procedure codes for services— 
(A) in the categories of psychiatric thera-
peutic procedures furnished in office or other 
outpatient facility settings, or inpatient hos-
pital, partial hospital or residential care facility 
settings; and 
(B) which cover insight oriented, behavior 
modifying, or supportive psychotherapy and 
interactive 
psychotherapy 
services 
in 
the 
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Healthcare Common Procedure Coding System 
established by the Secretary of Health and 
Human Services under section 1848(c)(5) of 
such Act. 
(c) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human 
Services may implement this section by program instruc-
tion or otherwise. 
SEC. 611. EXTENSION OF BRACHYTHERAPY SPECIAL RULE. 
Section 1833(t)(16)(C) of the Social Security Act (42 
U.S.C. 1395l(t)(16)(C)) is amended by striking ‘‘2008’’ 
and inserting ‘‘2009’’. 
SEC. 612. PAYMENT FOR PART B DRUGS. 
(a) 
APPLICATION
OF
CONSISTENT
VOLUME 
WEIGHTING IN COMPUTATION OF ASP.—In order to as-
sure that payments for drugs and biologicals under section 
1847A of the Social Security Act (42 U.S.C. 1395w–3a) 
are correct and consistent with law, the Secretary of 
Health and Human Services shall, for payment for drugs 
and biologicals furnished on or after July 1, 2008, com-
pute the volume-weighted average sales price using equa-
tion #2 (specified in appendix A of the report of the In-
spector General of the Department of Health and Human 
Services on ‘‘Calculation of Volume-Weighted Average 
Sales Price for Medicare Part B Prescription Drugs’’ 
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(February 2006; OEI–03–05–00310)) used by the Office 
of Inspector General to calculate a volume-weighted ASP. 
(b) IMPROVEMENTS IN THE COMPETITIVE ACQUISI-
TION PROGRAM (CAP).— 
(1) CONTINUOUS
OPEN
ENROLLMENT; AUTO-
MATIC
REENROLLMENT
WITHOUT
NEED
FOR
RE-
APPLICATION.—Subsection 
(a)(1)(A) 
of 
section 
1847B of the Social Security Act (42 U.S.C. 
1395w–3b) is amended— 
(A) in clause (ii), by striking ‘‘annually’’ 
and inserting ‘‘on an ongoing basis’’; 
(B) in clause (iii), by striking ‘‘an annual 
selection’’ and inserting ‘‘a selection (which 
may be changed on an annual basis)’’; and 
(C) by adding at the end the following: 
‘‘An election and selection described in clauses 
(ii) and (iii) shall continue to be effective with-
out the need for any periodic reelection or re-
application or selection.’’. 
(2) PERMITTING APPROPRIATE DELIVERY AND 
TRANSPORT
OF
DRUGS.—Subsection (b)(4)(E) of 
such section is amended— 
(A) by striking ‘‘or’’ at the end of clause 
(i); 
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(B) by striking the period at the end of 
clause (ii) and inserting a semicolon; and 
(C) by adding at the end the following new 
clauses: 
‘‘(iii) prevent a contractor from deliv-
ering drugs to a satellite office designated 
by the prescribing physician; or 
‘‘(iv) prevent a contractor from allow-
ing a selecting physician to transport 
drugs or biologicals to the site of adminis-
tration consistent with State law and other 
applicable laws and regulations.’’. 
(3) PHYSICIAN OUTREACH AND EDUCATION.— 
Subsection (a)(1) of such section is amended by add-
ing at the end the following new subparagraph: 
‘‘(E) PHYSICIAN
OUTREACH
AND
EDU-
CATION.—The Secretary shall conduct a pro-
gram of outreach to education physicians con-
cerning the program and the ongoing oppor-
tunity of physicians to elect to obtain drugs and 
biologicals under the program.’’. 
(4) REBIDDING OF CONTRACTS.—The Secretary 
of Health and Human Services shall provide for the 
rebidding of contracts under section 1847B(c) of the 
Social Security Act (42 U.S.C. 1395w–3b(c)) only 
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for periods on or after the expiration of the contract 
in effect under such section as of the date of the en-
actment of this Act, except in the case of a con-
tractor terminated as a result of the application of 
section 1847B(b)(2)(B) of such Act. 
(c) TREATMENT
OF
CERTAIN
DRUGS.—Section 
1847A(b) of the Social Security Act (42 U.S.C. 1395w– 
3a(b)) is amended— 
(1) in paragraph (1), by inserting ‘‘paragraph 
(6) and’’ after ‘‘Subject to’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(6) SPECIAL RULE.—Beginning with January 
1, 2008, the payment amount for— 
‘‘(A) each single source drug or biological 
described in section 1842(o)(1)(G) (including a 
single source drug or biological that is treated 
as a multiple source drug because of the appli-
cation of subsection (c)(6)(C)(ii)) is the lower 
of— 
‘‘(i) the payment amount that would 
be determined for such drug or biological 
applying such subsection; or 
‘‘(ii) the payment amount that would 
have been determined for such drug or bio-
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logical if such subsection were not applied; 
and 
‘‘(B) a multiple source drug (excluding a 
drug or biological that is treated as a multiple 
source drug because of the application of such 
subsection) is the lower of— 
‘‘(i) the payment amount that would 
be determined for such drug or biological 
taking into account the application of such 
subsection; or 
‘‘(ii) the payment amount that would 
have been determined for such drug or bio-
logical if such subsection were not ap-
plied.’’. 
(d) EFFECTIVE DATE.—Except as otherwise pro-
vided, the amendments made by this section shall apply 
to drugs furnished on or after January 1, 2008. 
Subtitle B—Extension of Medicare 
Rural Access Protections 
SEC. 621. 2-YEAR EXTENSION OF FLOOR ON MEDICARE 
WORK GEOGRAPHIC ADJUSTMENT. 
Section 1848(e)(1)(E) of such Act (42 U.S.C. 
1395w–4(e)(1)(E)) is amended by striking ‘‘2008’’ and in-
serting ‘‘2010’’. 
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SEC. 622. 2-YEAR EXTENSION OF SPECIAL TREATMENT OF 
CERTAIN PHYSICIAN PATHOLOGY SERVICES 
UNDER MEDICARE. 
Section 542(c) of the Medicare, Medicaid, and 
SCHIP Benefits Improvement and Protection Act of 
2000, as amended by section 732 of the Medicare Pre-
scription Drug, Improvement, and Modernization Act of 
2003, and section 104 of the Medicare Improvements and 
Extension Act of 2006 (division B of Public Law 109– 
432), is amended by striking ‘‘and 2007’’ and inserting 
‘‘2007, 2008, and 2009’’. 
SEC. 623. 2-YEAR EXTENSION OF MEDICARE REASONABLE 
COSTS PAYMENTS FOR CERTAIN CLINICAL 
DIAGNOSTIC 
LABORATORY 
TESTS 
FUR-
NISHED TO HOSPITAL PATIENTS IN CERTAIN 
RURAL AREAS. 
Section 416(b) of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 
108–173; 117 Stat. 2282; 42 U.S.C. 1395l–4(b)), as 
amended by section 105 of the Medicare Improvement and 
Extension Act of 2006 (division B of Public Law 109– 
432), is amended by striking ‘‘3-year’’ and inserting ‘‘5- 
year’’. 
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SEC. 624. 2-YEAR EXTENSION OF MEDICARE INCENTIVE 
PAYMENT PROGRAM FOR PHYSICIAN SCAR-
CITY AREAS. 
(a) IN GENERAL.—Section 1833(u)(1) of the Social 
Security Act (42 U.S.C. 1395l(u)(1)) is amended by strik-
ing ‘‘2008’’ and inserting ‘‘2010’’. 
(b) TRANSITION.—With respect to physicians’ serv-
ices furnished during 2008 and 2009, for purposes of sub-
section (a), the Secretary of Health and Human Services 
shall use the primary care scarcity areas and the specialty 
care scarcity areas (as identified in section 1833(u)(4)) 
that the Secretary was using under such subsection with 
respect to physicians’ services furnished on December 31, 
2007. 
SEC. 625. 2-YEAR EXTENSION OF MEDICARE INCREASE PAY-
MENTS FOR GROUND AMBULANCE SERVICES 
IN RURAL AREAS. 
Section 1834(l)(13) of the Social Security Act (42 
U.S.C. 1395m(l)(13)) is amended— 
(1) in subparagraph (A)— 
(A) in the matter before clause (i), by 
striking ‘‘furnished on or after July 1, 2004, 
and before January 1, 2007,’’; 
(B) in clause (i), by inserting ‘‘for services 
furnished on or after July 1, 2004, and before 
January 1, 2007, and on or after January 1, 
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