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‘‘(iii) BASELINE
NUMBER
OF
OPER-
ATING
ROOMS, PROCEDURE
ROOMS, AND
BEDS.—In this paragraph, the term ‘base-
line number of operating rooms, procedure
rooms, and beds’ means the number of oper-
ating rooms, procedure rooms, and beds of
the applicable hospital as of the date of en-
actment of this subsection.
‘‘(D) INCREASE LIMITED TO FACILITIES ON
THE MAIN CAMPUS OF THE HOSPITAL.—Any in-
crease in the number of operating rooms, proce-
dure rooms, and beds of an applicable hospital
pursuant to this paragraph may only occur in
facilities on the main campus of the applicable
hospital.
‘‘(E) APPLICABLE HOSPITAL.—In this para-
graph, the term ‘‘applicable hospital’’ means a
hospital—
‘‘(i) that is located in a county in
which the percentage increase in the popu-
lation during the most recent 5-year period
(as of the date of the application under sub-
paragraph (A)) is at least 150 percent of
the percentage increase in the population
growth of the State in which the hospital is
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located during that period, as estimated by
Bureau of the Census;
‘‘(ii) whose annual percent of total in-
patient admissions that represent inpatient
admissions under the program under title
XIX is equal to or greater than the average
percent with respect to such admissions for
all hospitals located in the county in which
the hospital is located;
‘‘(iii) 
that 
does 
not 
discriminate
against beneficiaries of Federal health care
programs and does not permit physicians
practicing at the hospital to discriminate
against such beneficiaries;
‘‘(iv) that is located in a State in
which the average bed capacity in the State
is less than the national average bed capac-
ity; and
‘‘(v) that has an average bed occu-
pancy rate that is greater than the average
bed occupancy rate in the State in which
the hospital is located.
‘‘(F) PROCEDURE
ROOMS.—In this sub-
section, the term ‘procedure rooms’ includes
rooms in which catheterizations, angiographies,
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angiograms, and endoscopies are performed, ex-
cept such term shall not include emergency
rooms or departments (exclusive of rooms in
which 
catheterizations, 
angiographies,
angiograms, and endoscopies are performed).
‘‘(G) PUBLICATION OF FINAL DECISIONS.—
Not later than 60 days after receiving a complete
application under this paragraph, the Secretary
shall publish in the Federal Register the final de-
cision with respect to such application.
‘‘(H) LIMITATION ON REVIEW.—There shall
be no administrative or judicial review under
section 1869, section 1878, or otherwise of the
process under this paragraph (including the es-
tablishment of such process).
‘‘(4) COLLECTION OF OWNERSHIP AND INVEST-
MENT INFORMATION.—For purposes of subparagraphs
(A)(i) and (D)(i) of paragraph (1), the Secretary
shall collect physician ownership and investment in-
formation for each hospital.
‘‘(5) PHYSICIAN OWNER DEFINED.—For purposes
of this subsection, the term ‘physician owner’ means
a physician (or an immediate family member of such
physician) with a direct or an indirect ownership in-
terest in the hospital.’’.
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(b) ENFORCEMENT.—
(1) ENSURING COMPLIANCE.—The Secretary of
Health and Human Services shall establish policies
and procedures to ensure compliance with the require-
ments described in subsection (i)(1) of section 1877 of
the Social Security Act, as added by subsection
(a)(3), beginning on the date such requirements first
apply. Such policies and procedures may include un-
announced site reviews of hospitals.
(2) AUDITS.—Beginning not later than January
1, 2010, the Secretary of Health and Human Services
shall conduct audits to determine if hospitals violate
the requirements referred to in paragraph (1).
SEC. 6003. Medicare Improvement Fund.—
Title XVIII of the Social Security Act (42 U.S.C. 1395
et seq.) is amended by adding at the end the following new
section:
‘‘MEDICARE IMPROVEMENT FUND
‘‘SEC. 1898. (a) ESTABLISHMENT.—The Secretary
shall establish under this title a Medicare Improvement
Fund (in this section referred to as the ‘Fund’) which shall
be available to the Secretary to make improvements under
the original fee-for-service program under parts A and B
for individuals entitled to, or enrolled for, benefits under
part A or enrolled under part B.
‘‘(b) FUNDING.—
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‘‘(1) IN GENERAL.—There shall be available to
the Fund, for expenditures from the Fund for services
furnished during fiscal year 2014, $3,340,000,000.
‘‘(2) 
PAYMENT
FROM
TRUST
FUNDS.—The
amount specified under paragraph (1) shall be avail-
able to the Fund, as expenditures are made from the
Fund, from the Federal Hospital Insurance Trust
Fund and the Federal Supplementary Medical Insur-
ance Trust Fund in such proportion as the Secretary
determines appropriate.
‘‘(3) FUNDING
LIMITATION.—Amounts in the
Fund shall be available in advance of appropriations
but only if the total amount obligated from the Fund
does not exceed the amount available to the Fund
under paragraph (1). The Secretary may obligate
funds from the Fund only if the Secretary determines
(and the Chief Actuary of the Centers for Medicare &
Medicaid Services and the appropriate budget officer
certify) that there are available in the Fund sufficient
amounts to cover all such obligations incurred con-
sistent with the previous sentence.’’.
SEC. 6004. MORATORIUM ON AUGUST 17, 2007 CMS
DIRECTIVE. Notwithstanding any other provision of law,
the Secretary of Health and Human Services shall not,
prior to April 1, 2009, finalize, implement, enforce, or oth-
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erwise take any action to give effect to any or all compo-
nents of the State Health Official Letter 07–001, dated Au-
gust 17, 2007, issued by the Director of the Center for Med-
icaid and State Operations in the Centers for Medicare &
Medicaid Services regarding certain requirements under the
State Children’s Health Insurance Program (CHIP) relat-
ing to the prevention of the substitution of health benefits
coverage for children (commonly referred to as ‘‘crowd-out’’)
and the enforcement of medical support orders (or to any
similar administrative actions that reflect the same or simi-
lar policies set forth in such letter). Any change made on
or after August 17, 2007, to a Medicaid or CHIP State
plan or waiver to implement, conform to, or otherwise ad-
here to the requirements or policies in such letter shall not
apply prior to April 1, 2009.
SEC. 6005. ADJUSTMENT
TO PAQI FUND. Section
1848(l)(2) of the Social Security Act (42 U.S.C. 1395w–
4(l)(2)), as amended by section 101(a)(2) of the Medicare,
Medicaid, and SCHIP Extension Act of 2007 (Public Law
110–173), is amended—
(1) in subparagraph (A)(i)—
(A) 
in 
subclause 
(III), 
by 
striking
‘‘$4,960,000,000’’ 
and 
inserting
‘‘$3,940,000,000’’; and
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(B) by adding at the end the following new
subclause:
‘‘(IV) For expenditures during
2014, 
an 
amount 
equal 
to
$3,750,000,000.’’;
(2) in subparagraph (A)(ii), by adding at the
end the following new subclause:
‘‘(IV) 2014.—The amount avail-
able for expenditures during 2014 shall
only be available for an adjustment to
the update of the conversion factor
under subsection (d) for that year.’’;
and
(3) in subparagraph (B)—
(A) in clause (ii), by striking ‘‘and’’ at the
end;
(B) in clause (iii), by striking the period at
the end and inserting ‘‘; and’’; and
(C) by adding at the end the following new
clause:
‘‘(iv) 2014 for payment with respect to
physicians’ 
services 
furnished 
during
2014.’’.
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TITLE VII—ACCOUNTABILITY AND COMPETITION
IN GOVERNMENT CONTRACTING
CHAPTER 1—CLOSE THE CONTRACTOR FRAUD
LOOPHOLE
SHORT TITLE
SEC. 7101. This chapter may be cited as the ‘‘Close
the Contractor Fraud Loophole Act’’.
REVISION OF THE FEDERAL ACQUISITION REGULATION
SEC. 7102. The Federal Acquisition Regulation shall
be amended within 180 days after the date of the enactment
of this Act pursuant to FAR Case 2007–006 (as published
at 72 Fed Reg. 64019, November 14, 2007) or any follow-
on FAR case to include provisions that require timely noti-
fication by Federal contractors of violations of Federal
criminal law or overpayments in connection with the
award or performance of covered contracts or subcontracts,
including those performed outside the United States and
those for commercial items.
DEFINITION
SEC. 7103. In this chapter, the term ‘‘covered contract’’
means any contract in an amount greater than $5,000,000
and more than 120 days in duration.
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CHAPTER 2—GOVERNMENT FUNDING
TRANSPARENCY
SHORT TITLE
SEC. 7201. This chapter may be cited as the ‘‘Govern-
ment Funding Transparency Act of 2008’’.
FINANCIAL DISCLOSURE REQUIREMENTS FOR CERTAIN
RECIPIENTS OF FEDERAL AWARDS
SEC. 7202. (a) DISCLOSURE REQUIREMENTS.—Sec-
tion 2(b)(1) of the Federal Funding Accountability and
Transparency Act (Public Law 109–282; 31 U.S.C. 6101
note) is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (E);
(2) by redesignating subparagraph (F) as sub-
paragraph (G); and
(3) by inserting after subparagraph (E) the fol-
lowing new subparagraph:
‘‘(F) the names and total compensation of
the five most highly compensated officers of the
entity if—
‘‘(i) the entity in the preceding fiscal
year received—
‘‘(I) 80 percent or more of its an-
nual gross revenues in Federal awards;
and
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HR 2642 EAS2
‘‘(II) $25,000,000 or more in an-
nual gross revenues from Federal
awards; and
‘‘(ii) the public does not have access to
information about the compensation of the
senior executives of the entity through peri-
odic reports filed under section 13(a) or
15(d) of the Securities Exchange Act of
1934 (15 U.S.C. 78m(a), 78o(d)) or section
6104 of the Internal Revenue Code of
1986.’’.
(b) REGULATIONS REQUIRED.—The Director of the Of-
fice of Management and Budget shall promulgate regula-
tions to implement the amendment made by this chapter.
Such regulations shall include a definition of ‘‘total com-
pensation’’ that is consistent with regulations of the Securi-
ties and Exchange Commission at section 402 of part 229
of title 17 of the Code of Federal Regulations (or any subse-
quent regulation).
TITLE VIII
GENERAL PROVISIONS—THIS ACT
AVAILABILITY OF FUNDS
SEC. 8001. No part of any appropriation contained
in this Act shall remain available for obligation beyond the
current fiscal year unless expressly so provided herein.
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EMERGENCY DESIGNATION
SEC. 8002. Each amount in each title of this Act is
designated as an emergency requirement and necessary to
meet emergency needs pursuant to subsections (a) and (b)
of section 204 of S. Con. Res. 21 (110th Congress), the con-
current resolution on the budget for fiscal year 2008.
AVOIDANCE OF U.S. PAYROLL TAX CONTRIBUTIONS
SEC. 8003. None of the funds in this Act may be used
by any Federal agency for a contract with any United
States corporation which hires United States employees
through foreign offshore subsidiaries for purposes of avoid-
ing United States payroll tax contributions for such em-
ployees.
EXPLANATORY STATEMENT
SEC. 8004. The explanatory statement printed in the
Senate section of the Congressional Record on May 19,
2008, submitted by the Chairman of the Committee on Ap-
propriations of the Senate regarding the amendments of the
Senate to the House amendments to the Senate amendment
to the bill H.R. 2642, making appropriations for military
construction, the Department of Veterans Affairs, and re-
lated agencies for the fiscal year ending September 30,
2008, and for other purposes, submitted by the Chairman
of the Committee on Appropriations of the Senate, shall
have the same effect with respect to the allocation of funds
and implementation of titles I through XIII of this Act as
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if it were a report to the Senate on a bill reported by the
Committee on Appropriations.
SHORT TITLE
SEC. 8005. This Act may be cited as the ‘‘Supple-
mental Appropriations Act, 2008’’.
Attest:
Secretary.
110TH CONGRESS
2D SESSION
H. R. 2642
SENATE AMENDMENTS TO
HOUSE AMENDMENTS TO
SENATE AMENDMENT