I
105TH CONGRESS
1ST SESSION
H. R. 2962
To amend title XVIII of the Social Security Act to provide for a wrap-
around payment under the Medicare Program for community health
center services to account for reductions in payments attributable to
individuals covered under managed care plans.
IN THE HOUSE OF REPRESENTATIVES
NOVEMBER 8, 1997
Mr. RANGEL (for himself and Mr. STARK) introduced the following bill; which
was referred to the Committee on Commerce, and in addition to the Com-
mittee on Ways and Means, for a period to be subsequently determined
by the Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to provide
for a wrap-around payment under the Medicare Program
for community health center services to account for re-
ductions in payments attributable to individuals covered
under managed care plans.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. WRAP-AROUND PAYMENT FOR COMMUNITY
HEALTH 
CENTERS 
øAND 
RURAL 
HEALTH
CLINICS¿ UNDER THE MEDICARE PROGRAM.
(a) IN GENERAL.—Section 1833(a)(3) of the Social
Security Act (42 U.S.C. 1395l(a)(3)) is amended—
(1) by inserting ‘‘(A)’’ after ‘‘(3)’’;
(2) by inserting ‘‘other than services described
in subparagraph (B)’’ after ‘‘1832(a)(2)(D)’’;
(3) by adding at the end the following:
‘‘(B) in the case of services described in section
1832(a)(2)(D) furnished to an individual enrolled
with an eligible organization under a risk-sharing
contract under section 1876 or Medicare+Choice or-
ganization under part C pursuant to a subcontract
or participation agreement with the organization, an
amount (if any) by which the amount of payment
that would have been provided under subparagraph
(A) with respect to the services if the individual had
not been so enrolled and the amount of the pay-
ments provided under such contract with respect to
such services;’’.
(b) CONFORMING AMENDMENT TO CONTRACT RE-
QUIREMENT.—
(1) IN GENERAL.—Section 1857(e) of the So-
cial Security Act (42 U.S.C. 1395w–27(e)) is
amended by adding at the end the following:
‘‘(3) NONDISCRIMINATION
IN
PAYMENT
FOR
CENTER SERVICES.—The contract shall provide that
in the case of a Medicare+Choice organization that
has entered into a contract with a center or clinic
for the provision of services described in section
1832(a)(2)(D), that the organization shall provide
payment that is not less than the level and amount
of payment which the organization would make for
the services if the services were furnished by a pro-
vider which is not a Federally-qualified health center
or a rural health clinic;’’.
(2) APPLICATION
TO
ELIGIBLE
ORGANIZA-
TIONS.—Section 1876(k)(4) of such Act (42 U.S.C.
1395mm(k)(4)) is amended by adding at the end the
following:
‘‘(E) The requirement of nondiscrimination in
payment for center and clinic services under section
1857(e)(3).’’.
(3) ADDITIONAL CONFORMING AMENDMENTS.—
(A) Section 1851(i)(1) of such Act (42
U.S.C. 1395w–21(i)(1)) is amended by insert-
ing ‘‘1857(e)(3),’’ after ‘‘1853(h),’’.
(B) Section 1876(a)(3) of such Act (42
U.S.C. 1395mm(a)(3)) is amended by striking
‘‘and 
(c)(7)’’ 
and 
inserting 
‘‘(c)(7), 
and
(k)(4)(E)’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to services furnished on or after
October 1, 1999.
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