250 
ber 31, 2009, the DSH allotment for Ten-
nessee for such portion of the fiscal year, 
notwithstanding such table or terms, shall 
be 1⁄4 of the amount specified in the first 
sentence for fiscal year 2007.’’; 
(B) in clause (ii), by striking ‘‘or for a pe-
riod in fiscal year 2008’’ and inserting ‘‘, 2008, 
2009, or for a period in fiscal year 2010’’; 
(C) in clause (iv)— 
(i) in the heading, by striking ‘‘FISCAL 
YEAR 2007 AND FISCAL YEAR 2008’’ and in-
serting ‘‘FISCAL YEARS 2007 THROUGH 2009 
AND THE FIRST CALENDAR QUARTER OF 
FISCAL YEAR 2010’’; 
(ii) in subclause (I), by striking ‘‘or 
for a period in fiscal year 2008’’ and in-
serting ‘‘, 2008, 2009, or for a period in 
fiscal year 2010’’; and 
(iii) in subclause (II), by striking ‘‘or 
for a period in fiscal year 2008’’ and in-
serting ‘‘, 2008, 2009, or for a period in 
fiscal year 2010’’; and 
(3) in subparagraph (B)(i)— 
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251 
(A) in the first sentence, by striking ‘‘fiscal 
year 2007’’ and inserting ‘‘each of fiscal years 
2007 through 2009’’; and 
(B) by striking the second sentence and in-
serting the following: ‘‘Only with respect to fis-
cal year 2010 for the period ending on Decem-
ber 31, 2009, the DSH allotment for Hawaii 
for such portion of the fiscal year, notwith-
standing the table set forth in paragraph (2), 
shall be $2,500,000.’’. 
SEC. 203. PHARMACY REIMBURSEMENT UNDER MEDICAID. 
(a) DELAY IN NEW PAYMENT LIMITS FOR MULTIPLE 
SOURCE DRUGS UNDER MEDICAID.—Notwithstanding 
paragraphs (4) and (5) of subsection (e) of section 1927 
of the Social Security Act (42 U.S.C. 1396r–8) or part 
447 of title 42, Code of Federal Regulations (as in effect 
on the date of the enactment of this Act), the Secretary 
of Health and Human Services shall not require a State 
to establish prior to September 30, 2009, payment limits 
for multiple source drugs under a State Medicaid plan 
that do not exceed the specific upper limit established 
under section 447.514(b) of title 42, Code of Federal Reg-
ulations (as so in effect) and shall permit any State to 
continue to receive Federal financial participation for pay-
ments for such drugs that do not exceed the specific upper 
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252 
limit that would have applied to such payments under sec-
tion 447.332 of title 42, Code of Federal Regulations (as 
in effect on December 31, 2006). 
(b) TEMPORARY SUSPENSION
OF UPDATED PUB-
LICLY AVAILABLE AMP DATA.—Notwithstanding clause 
(v) of section 1927(b)(3)(D) of the Social Security Act (42 
U.S.C. 1396r–8(b)(3)(D)), the Secretary of Health and 
Human Services shall not, prior to September 30, 2009, 
make publicly available any AMP disclosed to the Sec-
retary. 
(c) DEFINITIONS.—In this subsection: 
(1) The term ‘‘multiple source drug’’ has the 
meaning given that term in section 1927(k)(7)(A)(i) 
of the Social Security Act (42 U.S.C. 1396r– 
8(k)(7)(A)(i)); and 
(2) The term ‘‘AMP’’ has the meaning given 
‘‘average manufacturer price’’ in section 1927(k)(1) 
of the Social Security Act (42 U.S.C. 1396r– 
8(k)(1)) and ‘‘AMP’’ in section 447.504(a) of title 
42, Code of Federal Regulations (as in effect on the 
date of the enactment of this Act). 
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253 
SEC. 204. REVIEW OF ADMINISTRATIVE CLAIM DETERMINA-
TIONS. 
(a) IN GENERAL.—Section 1116 of the Social Secu-
rity Act (42 U.S.C. 1316) is amended by adding at the 
end the following new subsection: 
‘‘(e)(1) Whenever the Secretary determines that any 
item or class of items on account of which Federal finan-
cial participation is claimed under title XIX shall be dis-
allowed for such participation, the State shall be entitled 
to and upon request shall receive a reconsideration of the 
disallowance, provided that such request is made during 
the 60-day period that begins on the date the State re-
ceives notice of the disallowance. 
‘‘(2)(A) A State may appeal a disallowance of a claim 
for federal financial participation under title XIX by the 
Secretary, or an unfavorable reconsideration of a disallow-
ance, during the 60-day period that begins on the date 
the State receives notice of the disallowance or of the unfa-
vorable reconsideration, in whole or in part, to the Depart-
mental Appeals Board, established in the Department of 
Health and Human Services (in this paragraph referred 
to as the ‘Board’), by filing a notice of appeal with the 
Board. 
‘‘(B) The Board shall consider a State’s appeal of 
a disallowance of such a claim (or of an unfavorable recon-
sideration of a disallowance) on the basis of such docu-
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254 
mentation as the State may submit and as the Board may 
require to support the final decision of the Board. In de-
ciding whether to uphold a disallowance of such a claim 
or any portion thereof, the Board shall be bound by all 
applicable laws and regulations and shall conduct a thor-
ough review of the issues, taking into account all relevant 
evidence. The Board’s decision of an appeal under sub-
paragraph (A) shall be the final decision of the Secretary 
and shall be subject to reconsideration by the Board only 
upon motion of either party filed during the 60-day period 
that begins on the date of the Board’s decision or to judi-
cial review in accordance with subparagraph (C). 
‘‘(C) A State may obtain judicial review of a decision 
of the Board by filing an action in any United States Dis-
trict Court located within the appealing State (or, if sev-
eral States jointly appeal the disallowance of claims for 
Federal financial participation under section 1903, in any 
United States District Court that is located within any 
State that is a party to the appeal) or the United States 
District Court for the District of Columbia. Such an ac-
tion may only be filed— 
‘‘(i) if no motion for reconsideration was filed 
within the 60-day period specified in subparagraph 
(B), during such 60-day period; or 
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255 
‘‘(ii) if such a motion was filed within such pe-
riod, during the 60-day period that begins on the 
date of the Board’s decision on such motion.’’. 
(b) CONFORMING AMENDMENT.—Section 1116(d) of 
such Act (42 U.S.C. 1316(d)) is amended by striking ‘‘or 
XIX,’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section take effect on the date of the enactment of 
this Act and apply to any disallowance of a claim for Fed-
eral financial participation under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.) made on or after 
such date or during the 60-day period prior to such date. 
TITLE III—MISCELLANEOUS 
SEC. 301. EXTENSION OF TANF SUPPLEMENTAL GRANTS. 
(a) EXTENSION THROUGH FISCAL YEAR 2009.—Sec-
tion 7101(a) of the Deficit Reduction Act of 2005 (Public 
Law 109–171; 120 Stat. 135) is amended by striking ‘‘fis-
cal year 2008’’ and inserting ‘‘fiscal year 2009’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
403(a)(3)(H)(ii) of the Social Security Act (42 U.S.C. 
603(a)(3)(H)(ii)) is amended to read as follows: 
‘‘(ii) subparagraph (G) shall be ap-
plied as if ‘fiscal year 2009’ were sub-
stituted for ‘fiscal year 2001’; and’’. 
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256 
SEC. 302. 70 PERCENT FEDERAL MATCHING FOR FOSTER 
CARE AND ADOPTION ASSISTANCE FOR THE 
DISTRICT OF COLUMBIA. 
(a) IN GENERAL.—Section 474(a) of the Social Secu-
rity Act (42 U.S.C. 674(a)) is amended in each of para-
graphs (1) and (2) by striking ‘‘(as defined in section 
1905(b) of this Act)’’ and inserting ‘‘(which shall be as 
defined in section 1905(b), in the case of a State other 
than the District of Columbia, or 70 percent, in the case 
of the District of Columbia)’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect on October 1, 2008, and 
shall apply to calendar quarters beginning on or after that 
date. 
SEC. 303. EXTENSION OF SPECIAL DIABETES GRANT PRO-
GRAMS. 
(a) SPECIAL DIABETES PROGRAMS FOR TYPE I DIA-
BETES.—Section 330B(b)(2)(C) of the Public Health 
Service Act (42 U.S.C. 254c–2(b)(2)) is amended by strik-
ing ‘‘2009’’ and inserting ‘‘2011’’. 
(b) SPECIAL DIABETES PROGRAMS FOR INDIANS.— 
Section 330C(c)(2)(C) of the Public Health Service Act 
(42 U.S.C. 254c–3(c)(2)(C)) is amended by striking 
‘‘2009’’ and inserting ‘‘2011’’. 
(c) REPORT ON GRANT PROGRAMS.—Section 4923(b) 
of the Balanced Budget Act of 1997 (42 U.S.C. 1254c– 
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257 
2 note), as amended by section 931(c) of the Medicare, 
Medicaid, and SCHIP Benefits Improvement and Protec-
tion Act of 2000, as enacted into law by section 1(a)(6) 
of Public Law 106–554, and section 1(c) of Public Law 
107–360, is amended— 
(1) in paragraph (1), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (2)— 
(A) by striking ‘‘a final report’’ and insert-
ing ‘‘a second interim report’’; and 
(B) by striking the period at the end and 
inserting ‘‘; and’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(3) a report on such evaluation not later than 
January 1, 2011.’’. 
SEC. 304. IOM REPORTS ON BEST PRACTICES FOR CON-
DUCTING SYSTEMATIC REVIEWS OF CLIN-
ICAL EFFECTIVENESS RESEARCH AND FOR 
DEVELOPING CLINICAL PROTOCOLS. 
(a) SYSTEMATIC REVIEWS OF CLINICAL EFFECTIVE-
NESS RESEARCH.— 
(1) STUDY.—Not later than 60 days after the 
date of the enactment of this Act, the Secretary of 
Health and Human Services shall enter into a con-
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258 
tract with the Institute of Medicine of the National 
Academies (in this section referred to as the ‘‘Insti-
tute’’) under which the Institute shall conduct a 
study to identify the methodological standards for 
conducting systematic reviews of clinical effective-
ness research on health and health care in order to 
ensure that organizations conducting such reviews 
have information on methods that are objective, sci-
entifically valid, and consistent. 
(2) REPORT.—Not later than 18 months after 
the effective date of the contract under paragraph 
(1), the Institute, as part of such contract, shall 
submit to the Secretary of Health and Human Serv-
ices and the appropriate committees of jurisdiction 
of Congress a report containing the results of the 
study conducted under paragraph (1), together with 
recommendations for such legislation and adminis-
trative action as the Institute determines appro-
priate. 
(3) PARTICIPATION.—The contract under para-
graph (1) shall require that stakeholders with exper-
tise in conducting clinical effectiveness research par-
ticipate on the panel responsible for conducting the 
study under paragraph (1) and preparing the report 
under paragraph (2). 
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259 
(b) CLINICAL PROTOCOLS.— 
(1) STUDY.—Not later than 60 days after the 
date of the enactment of this Act, the Secretary of 
Health and Human Services shall enter into a con-
tract with the Institute of Medicine of the National 
Academies (in this section referred to as the ‘‘Insti-
tute’’) under which the Institute shall conduct a 
study on the best methods used in developing clinical 
practice guidelines in order to ensure that organiza-
tions developing such guidelines have information on 
approaches that are objective, scientifically valid, 
and consistent. 
(2) REPORT.—Not later than 18 months after 
the effective date of the contract under paragraph 
(1), the Institute, as part of such contract, shall 
submit to the Secretary of Health and Human Serv-
ices and the appropriate committees of jurisdiction 
of Congress a report containing the results of the 
study conducted under paragraph (1), together with 
recommendations for such legislation and adminis-
trative action as the Institute determines appro-
priate. 
(3) PARTICIPATION.—The contract under para-
graph (1) shall require that stakeholders with exper-
tise in making clinical recommendations participate 
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