Sec. 3. Delay in implementation of Medicaid outpatient hospital services regula-
tion. 
Sec. 4. Delay in phase out of the Medicare hospice budget neutrality adjust-
ment factor. 
Sec. 5. Treatment of certain Medicaid family demonstration project. 
Sec. 6. Medicaid Improvement Fund technical correction. 
Sec. 7. Funding for the Medicare Improvement Fund. 
SEC. 2. TEMPORARY NON-APPLICATION OF MEDICARE 
PHASED-OUT 
INDIRECT 
MEDICAL 
EDU-
CATION ADJUSTMENT FACTOR. 
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, during the period beginning on October 1, 
2008, and ending on March 31, 2009, section 412.322 of 
title 42, Code of Federal Regulations, shall be applied 
without regard to paragraph (c) of such section. 
(b) NO EFFECT ON SUBSEQUENT PERIODS.—Noth-
ing in subsection (a) shall be construed as having any ef-
fect on the application of section 412.322 of title 42, Code 
of Federal Regulations, after March 31, 2009. 
SEC. 3. DELAY IN IMPLEMENTATION OF MEDICAID OUT-
PATIENT HOSPITAL SERVICES REGULATION. 
Notwithstanding any other provision of law, during 
the 6-month period that begins on the date of enactment 
of this Act, the Secretary of Health and Human Services 
shall not finalize or otherwise implement provisions con-
tained in the proposed rule published on September 28, 
2007, on pages 55158 through 55166 of volume 72, Fed-
eral Register (relating to parts 440 and 447 of title 42, 
Code of Federal Regulations). 
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SEC. 4. DELAY IN PHASE OUT OF THE MEDICARE HOSPICE 
BUDGET NEUTRALITY ADJUSTMENT FACTOR. 
Notwithstanding any other provision of law, including 
the provisions contained in the final rule published on Au-
gust 8, 2008, on pages 46464 through 46522 of volume 
73, Federal Register (relating to part 418 of title 42, Code 
of Federal Regulations), the Secretary of Health and 
Human Services shall not phase out or eliminate the budg-
et neutrality adjustment factor in the Medicare hospice 
wage index prior to April 1, 2009. 
SEC. 5. TREATMENT OF CERTAIN MEDICAID FAMILY DEM-
ONSTRATION PROJECT. 
The Secretary of Health and Human Services, acting 
through the Administrator of the Centers for Medicare & 
Medicaid Services and upon the request of the State of 
California, shall extend approval, and full Federal finan-
cial participation, of the State’s Medicaid family planning 
demonstration project, which was approved under a waiver 
pursuant to section 1115 of the Social Security Act, until 
June 30, 2009, under the eligibility requirements and 
processes that were in place for such project as of the date 
before the first extension period for such project. 
SEC. 6. MEDICAID IMPROVEMENT FUND TECHNICAL COR-
RECTION. 
(a) IN GENERAL.—Section 1941(b)(1)(B) of the So-
cial Security Act, as added by section 7002(b) of the Sup-
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plemental Appropriations Act, 2008, is amended by insert-
ing ‘‘each of’’ after ‘‘for’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect as if included in the enact-
ment of the Supplemental Appropriations Act, 2008 (Pub-
lic Law 110–252). 
SEC. 7. FUNDING FOR THE MEDICARE IMPROVEMENT 
FUND. 
Section 1898(b)(1) of the Social Security Act, as 
added by section 7002(a) of the Supplemental Appropria-
tions Act, 2008 (Public Law 110–252) and as amended 
by section 188(a)(2) of the Medicare Improvements for 
Patients and Providers Act of 2008 (Public Law 110–275) 
and by section 6 of the QI Program Supplemental Fund-
ing Act of 2008, is amended by striking ‘‘$2,290,000,000’’ 
and inserting ‘‘$2,590,000,000’’. 
Æ 
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