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(Public Law 112–78), and section 2124 of the Unemploy-
ment Benefits Extension Act of 2012 (Public Law 112–96), 
is amended— 
(1) by striking ‘‘June 30, 2012’’ and inserting 
‘‘June 30, 2013’’; and 
(2) by striking ‘‘December 31, 2012’’ and insert-
ing ‘‘December 31, 2013’’. 
(b) CLARIFICATION ON AUTHORITY TO USE FUNDS.— 
Funds appropriated under either the first or second sen-
tence of clause (iv) of section 2(c)(2)(D) of the Railroad Un-
employment Insurance Act shall be available to cover the 
cost of additional extended unemployment benefits provided 
under such section 2(c)(2)(D) by reason of the amendments 
made by subsection (a) as well as to cover the cost of such 
benefits provided under such section 2(c)(2)(D), as in effect 
on the day before the date of enactment of this Act. 
(c) FUNDING
FOR ADMINISTRATION.—Out of any 
funds in the Treasury not otherwise appropriated, there are 
appropriated to the Railroad Retirement Board $250,000 
for administrative expenses associated with the payment of 
additional extended unemployment benefits provided under 
section 2(c)(2)(D) of the Railroad Unemployment Insur-
ance Act by reason of the amendments made by subsection 
(a), to remain available until expended.
† HR 8 EAS 
TITLE VI—MEDICARE AND 
OTHER HEALTH EXTENSIONS 
Subtitle A—Medicare Extensions 
SEC. 601. MEDICARE PHYSICIAN PAYMENT UPDATE. 
(a) IN GENERAL.—Section 1848(d) of the Social Secu-
rity Act (42 U.S.C. 1395w–4(d)) is amended by adding at 
the end the following new paragraph: 
‘‘(14) UPDATE FOR 2013.— 
‘‘(A) IN GENERAL.—Subject to paragraphs 
(7)(B), (8)(B), (9)(B), (10)(B), (11)(B), (12)(B), 
and (13)(B), in lieu of the update to the single 
conversion factor established in paragraph (1)(C) 
that would otherwise apply for 2013, the update 
to the single conversion factor for such year shall 
be zero percent. 
‘‘(B) NO EFFECT ON COMPUTATION OF CON-
VERSION
FACTOR
FOR
2014
AND
SUBSEQUENT 
YEARS.—The conversion factor under this sub-
section shall be computed under paragraph 
(1)(A) for 2014 and subsequent years as if sub-
paragraph (A) had never applied.’’. 
(b) ADVANCEMENT OF CLINICAL DATA REGISTRIES TO 
IMPROVE THE QUALITY OF HEALTH CARE.—
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(1) IN GENERAL.—Section 1848(m)(3) of the So-
cial Security Act (42 U.S.C. 1395w–4(m)(3)) is 
amended— 
(A) by redesignating subparagraph (D) as 
subparagraph (F); and 
(B) by inserting after subparagraph (C) the 
following new subparagraphs: 
‘‘(D) SATISFACTORY REPORTING MEASURES 
THROUGH PARTICIPATION IN A QUALIFIED CLIN-
ICAL DATA REGISTRY.—For 2014 and subsequent 
years, the Secretary shall treat an eligible profes-
sional as satisfactorily submitting data on qual-
ity measures under subparagraph (A) if, in lieu 
of reporting measures under subsection (k)(2)(C), 
the eligible professional is satisfactorily partici-
pating, as determined by the Secretary, in a 
qualified clinical data registry (as described in 
subparagraph (E)) for the year. 
‘‘(E) QUALIFIED
CLINICAL
DATA
REG-
ISTRY.— 
‘‘(i) IN GENERAL.—The Secretary shall 
establish requirements for an entity to be 
considered a qualified clinical data registry. 
Such requirements shall include a require-
ment that the entity provide the Secretary
† HR 8 EAS 
with such information, at such times, and 
in such manner, as the Secretary deter-
mines necessary to carry out this subsection. 
‘‘(ii) 
CONSIDERATIONS.—In 
estab-
lishing the requirements under clause (i), 
the Secretary shall consider whether an en-
tity— 
‘‘(I) has in place mechanisms for 
the transparency of data elements and 
specifications, risk models, and meas-
ures; 
‘‘(II) requires the submission of 
data from participants with respect to 
multiple payers; 
‘‘(III) provides timely perform-
ance reports to participants at the in-
dividual participant level; and 
‘‘(IV) supports quality improve-
ment initiatives for participants. 
‘‘(iii) MEASURES.—With respect to 
measures used by a qualified clinical data 
registry— 
‘‘(I) 
sections 
1890(b)(7) 
and 
1890A(a) shall not apply; and
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‘‘(II) measures endorsed by the en-
tity with a contract with the Secretary 
under section 1890(a) may be used. 
‘‘(iv) CONSULTATION.—In carrying out 
this subparagraph, the Secretary shall con-
sult with interested parties. 
‘‘(v) DETERMINATION.—The Secretary 
shall establish a process to determine wheth-
er or not an entity meets the requirements 
established under clause (i). Such process 
may involve one or both of the following: 
‘‘(I) A determination by the Sec-
retary. 
‘‘(II) A designation by the Sec-
retary of one or more independent or-
ganizations to make such determina-
tion.’’. 
(2) GAO STUDY AND REPORT ON INCORPORATING 
REGISTRY DATA INTO THE MEDICARE PROGRAM IN 
ORDER TO IMPROVE QUALITY AND EFFICIENCY.— 
(A) STUDY.—The Comptroller General of 
the United States shall conduct a study on the 
potential of clinical data registries to improve 
the quality and efficiency of care in the Medicare 
program, including through payment system in-
† HR 8 EAS 
centives. Such study shall include an analysis of 
the role of health information technology in fa-
cilitating clinical data registries and the use of 
data from such registries among private health 
insurers as well as other entities the Comptroller 
General determines appropriate. 
(B) REPORT.—Not later than November 15, 
2013, the Comptroller General of the United 
States shall submit to Congress a report on the 
study conducted under subparagraph (A), to-
gether with recommendations for such legislation 
and administrative action as the Comptroller 
General determines appropriate. 
SEC. 602. WORK GEOGRAPHIC ADJUSTMENT. 
Section 1848(e)(1)(E) of the Social Security Act (42 
U.S.C. 1395w–4(e)(1)(E)) is amended by striking ‘‘before 
January 1, 2013’’ and inserting ‘‘before January 1, 2014’’. 
SEC. 603. PAYMENT FOR OUTPATIENT THERAPY SERVICES. 
(a) EXTENSION.—Section 1833(g) of the Social Secu-
rity Act (42 U.S.C. 1395l(g)) is amended— 
(1) in paragraph (5)(A), in the first sentence, by 
striking ‘‘December 31, 2012’’ and inserting ‘‘Decem-
ber 31, 2013’’; and 
(2) in paragraph (6)—
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(A) by striking ‘‘December 31, 2012’’ and 
inserting ‘‘December 31, 2013’’; and 
(B) by inserting ‘‘or 2013’’ after ‘‘during 
2012’’. 
(b) APPLICATION OF THERAPY CAP TO THERAPY FUR-
NISHED AS PART OF OUTPATIENT CRITICAL ACCESS HOS-
PITAL SERVICES.—Section 1833(g)(6) of the Social Secu-
rity Act (42 U.S.C. 1395l(g)(6)), as amended by subsection 
(a), is amended— 
(1) by striking ‘‘In applying’’ and inserting ‘‘(A) 
In applying’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(B)(i) With respect to outpatient therapy services fur-
nished beginning on or after January 1, 2013, and before 
January 1, 2014, for which payment is made under section 
1834(g), the Secretary shall count toward the uniform dol-
lar limitations described in paragraphs (1) and (3) and 
the threshold described in paragraph (5)(C) the amount 
that would be payable under this part if such services were 
paid under section 1834(k)(1)(B) instead of being paid 
under section 1834(g). 
‘‘(ii) Nothing in clause (i) shall be construed as chang-
ing the method of payment for outpatient therapy services 
under section 1834(g).’’.
† HR 8 EAS 
(c) BENEFICIARY PROTECTIONS.—Section 1833(g)(5) 
of the Social Security Act (42 U.S.C. 1395l(g)(5)) is amend-
ed by adding at the end the following new subparagraph: 
‘‘(D) With respect to services furnished on or after 
January 1, 2013, where payment may not be made as a 
result of application of paragraphs (1) and (3), section 
1879 shall apply in the same manner as such section ap-
plies to a denial that is made by reason of section 
1862(a)(1).’’. 
(d) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human Serv-
ices may implement the provisions of, and the amendments 
made by, this section by program instruction or otherwise. 
SEC. 604. AMBULANCE ADD-ON PAYMENTS. 
(a) GROUND AMBULANCE.—Section 1834(l)(13)(A) of 
the Social Security Act (42 U.S.C. 1395m(l)(13)(A)) is 
amended— 
(1) in the matter preceding clause (i), by strik-
ing ‘‘January 1, 2013’’ and inserting ‘‘January 1, 
2014’’; and 
(2) in each of clauses (i) and (ii), by striking 
‘‘January 1, 2013’’ and inserting ‘‘January 1, 2014’’ 
each place it appears. 
(b) AIR AMBULANCE.—Section 146(b)(1) of the Medi-
care Improvements for Patients and Providers Act of 2008
† HR 8 EAS 
(Public Law 110–275), as amended by sections 3105(b) and 
10311(b) of the Patient Protection and Affordable Care Act 
(Public Law 111–148), section 106(b) of the Medicare and 
Medicaid Extenders Act of 2010 (Public Law 111–309), sec-
tion 306(b) of the Temporary Payroll Tax Cut Continu-
ation Act of 2011 (Public Law 112–78), and section 3007(b) 
of the Middle Class Tax Relief and Job Creation Act of 2012 
(Public Law 112–96), is amended by striking ‘‘December 
31, 2012’’ and inserting ‘‘June 30, 2013’’. 
(c) 
SUPER
RURAL
AMBULANCE.—Section 
1834(l)(12)(A) of the Social Security Act (42 U.S.C. 
1395m(l)(12)(A)) is amended in the first sentence by strik-
ing ‘‘January 1, 2013’’ and inserting ‘‘January 1, 2014’’. 
(d) STUDIES OF AMBULANCE COSTS.— 
(1) IN GENERAL.—The Secretary of Health and 
Health and Human Services (in this subsection re-
ferred to as the ‘‘Secretary’’) shall conduct a study of 
each of the following: 
(A) A study that analyzes data on existing 
cost reports for ambulance services furnished by 
hospitals and critical access hospitals, including 
variation by characteristics of such providers of 
services. 
(B) A study of the feasibility of obtaining 
cost data on a periodic basis from all ambulance
† HR 8 EAS 
providers of services and suppliers for potential 
use in examining the appropriateness of the 
Medicare add-on payments for ground ambu-
lance services furnished under the fee schedule 
under section 1834(l) of the Social Security Act 
(42 U.S.C. 1395m(l)) and in preparing for fu-
ture reform of such payment system. 
(2) COMPONENTS OF ONE OF THE STUDIES.—In 
conducting the study under paragraph (1)(B), the 
Secretary shall— 
(A) consult with industry on the design of 
such cost collection efforts; 
(B) explore use of cost surveys and cost re-
ports to collect appropriate cost data and the pe-
riodicity of such cost data collection; 
(C) examine the feasibility of development 
of a standard cost reporting tool for providers of 
services and suppliers of ground ambulance serv-
ices; and 
(D) examine the ability to furnish such cost 
data by various types of ambulance providers of 
services and suppliers, especially by rural and 
super-rural providers of services and suppliers. 
(3) REPORTS.—
† HR 8 EAS 
(A) EXISTING
COST
REPORTS.—Not later 
than October 1, 2013, the Secretary shall submit 
a report to Congress on the study conducted 
under paragraph (1)(A), together with rec-
ommendations for such legislation and adminis-
trative action as the Secretary determines appro-
priate. 
(B) OBTAINING COST DATA.—Not later than 
July 1, 2014, the Secretary shall submit a report 
to Congress on the study conducted under para-
graph (1)(B), together with recommendations for 
such legislation and administrative action as the 
Secretary determines appropriate. 
SEC. 605. EXTENSION OF MEDICARE INPATIENT HOSPITAL 
PAYMENT ADJUSTMENT FOR LOW-VOLUME 
HOSPITALS. 
Section 1886(d)(12) of the Social Security Act (42 
U.S.C. 1395ww(d)(12)) is amended— 
(1) in subparagraph (B), in the matter pre-
ceding clause (i), by striking ‘‘2013’’ and inserting 
‘‘2014’’; 
(2) in subparagraph (C)(i), by striking ‘‘and 
2012’’ each place it appears and inserting ‘‘, 2012, 
and 2013’’; and
† HR 8 EAS 
(3) in subparagraph (D), by striking ‘‘and 
2012’’ and inserting ‘‘, 2012, and 2013’’. 
SEC. 606. EXTENSION OF THE MEDICARE-DEPENDENT HOS-
PITAL (MDH) PROGRAM. 
(a) EXTENSION OF PAYMENT METHODOLOGY.—Sec-
tion 1886(d)(5)(G) of the Social Security Act (42 U.S.C. 
1395ww(d)(5)(G)) is amended— 
(1) in clause (i), by striking ‘‘October 1, 2012’’ 
and inserting ‘‘October 1, 2013’’; and 
(2) in clause (ii)(II), by striking ‘‘October 1, 
2012’’ and inserting ‘‘October 1, 2013’’. 
(b) CONFORMING AMENDMENTS.— 
(1) EXTENSION
OF
TARGET
AMOUNT.—Section 
1886(b)(3)(D) of the Social Security Act (42 U.S.C. 
1395ww(b)(3)(D)) is amended— 
(A) in the matter preceding clause (i), by 
striking ‘‘October 1, 2012’’ and inserting ‘‘Octo-
ber 1, 2013’’; and 
(B) in clause (iv), by striking ‘‘through fis-
cal year 2012’’ and inserting ‘‘through fiscal 
year 2013’’. 
(2) PERMITTING
HOSPITALS
TO
DECLINE
RE-
CLASSIFICATION.—Section 13501(e)(2) of the Omni-
bus Budget Reconciliation Act of 1993 (42 U.S.C.
† HR 8 EAS 
1395ww note) is amended by striking ‘‘through fiscal 
year 2012’’ and inserting ‘‘through fiscal year 2013’’. 
SEC. 607. EXTENSION FOR SPECIALIZED MEDICARE ADVAN-
TAGE PLANS FOR SPECIAL NEEDS INDIVID-
UALS. 
Section 1859(f)(1) of the Social Security Act (42 
U.S.C. 1395w–28(f)(1)) is amended by striking ‘‘2014’’ and 
inserting ‘‘2015’’. 
SEC. 608. EXTENSION OF MEDICARE REASONABLE COST 
CONTRACTS. 
Section 1876(h)(5)(C)(ii) of the Social Security Act 
(42 U.S.C. 1395mm(h)(5)(C)(ii)) is amended, in the matter 
preceding subclause (I), by striking ‘‘January 1, 2013’’ and 
inserting ‘‘January 1, 2014’’. 
SEC. 609. PERFORMANCE IMPROVEMENT. 
(a) EXTENSION OF FUNDING FOR CONTRACT WITH 
CONSENSUS-BASED
ENTITY
REGARDING
PERFORMANCE 
MEASUREMENT.— 
(1) IN GENERAL.—Section 1890(d) of the Social 
Security Act (42 U.S.C. 1395aaa(d)) is amended by 
striking ‘‘fiscal years 2009 through 2012’’ and insert-
ing ‘‘fiscal years 2009 through 2013’’. 
(2) REVISION TO DUTIES.—Section 1890(b) of 
the Social Security Act (42 U.S.C. 1395aaa(b)) is 
amended by striking paragraph (4).
† HR 8 EAS 
(b) PROVIDING DATA FOR PERFORMANCE IMPROVE-
MENT IN A TIMELY MANNER.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (in this subsection referred to as the 
‘‘Secretary’’) shall develop a strategy to provide data 
for performance improvement in a timely manner to 
applicable providers under the Medicare program 
under title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.), including with respect to the 
provision of the following: 
(A) Utilization data, including such data 
for items and services under parts A, B, and D 
of the Medicare program. 
(B) Feedback on quality data submitted by 
the applicable provider under the Medicare pro-
gram. 
(2) CONSIDERATIONS.—In developing the strat-
egy under paragraph (1), the Secretary shall con-
sider— 
(A) the type of applicable provider receiving 
the data; 
(B) the frequency of providing the data so 
that it can be the most relevant in improving 
provider performance; 
(C) risk adjustment methods;
† HR 8 EAS 
(D) presentation of the data in a meaning-
ful manner and easily understandable format; 
(E) with respect to utilization data, the 
provision of data that the Secretary determines 
would be useful to improve the performance of 
the type of applicable provider involved; and 
(F) administrative costs involved with pro-
viding data. 
(3) SUBMISSION AND AVAILABILITY OF INITIAL 
STRATEGY.—Not later than 1 year after the date of 
the enactment of this Act, the Secretary shall— 
(A) submit to the relevant committees of 
Congress the strategy described in paragraph (1); 
and 
(B) post such strategy on the website of the 
Centers for Medicare & Medicaid Services. 
(4) STRATEGY UPDATE.— 
(A) FEEDBACK FROM STAKEHOLDERS.—The 
Secretary shall seek feedback from stakeholders 
on the initial strategy submitted under para-
graph (3). 
(B) STRATEGY
UPDATE.—The Secretary 
shall—
† HR 8 EAS 
(i) update the strategy described in 
paragraph (1) based on the feedback sub-
mitted under subparagraph (A); and 
(ii) not later than 18 months after the 
date of the enactment of this Act— 
(I) submit such updated strategy 
to the relevant committees of Congress; 
and 
(II) post such updated strategy on 
the website of the Centers for Medicare 
& Medicaid Services. 
(5) GAO STUDY AND REPORT ON PRIVATE SEC-
TOR INFORMATION SHARING ACTIVITIES.— 
(A) STUDY.—The Comptroller General of 
the United States (in this paragraph referred to 
as the ‘‘Comptroller General’’) shall conduct a 
study on information sharing activities. Such 
study shall include an analysis of— 
(i) how private sector entities share 
timely data with hospitals, physicians, and 
other providers and what lessons can be 
learned from those activities; 
(ii) how the Medicare program cur-
rently shares data with providers, including 
what data is provided and to which pro-
† HR 8 EAS 
viders, and what divisions within the Cen-
ters for Medicare & Medicaid Services over-
see those efforts; 
(iii) what, if any, differences there are 
between the private sector and the Medicare 
program under title XVIII of the Social Se-
curity Act (42 U.S.C. 1395 et seq.) in terms 
of sharing data; and 
(iv) what, if any, barriers there are for 
the Centers for Medicare & Medicaid Serv-
ices to sharing timely data with applicable 
providers and recommendations to elimi-
nate or reduce such barriers. 
(B) REPORT.—Not later than 8 months 
after the date of the enactment of this Act, the 
Comptroller General shall submit to the relevant 
committees of Congress a report containing the 
results of the study conducted under subpara-
graph (A), together with recommendations for 
such legislation and administrative action as the 
Comptroller General determines appropriate. 
(6) DEFINITIONS.—In this subsection: 
(A) APPLICABLE
PROVIDER.—The term 
‘‘applicable provider’’ means the following:
100 
† HR 8 EAS 
(i) A critical access hospital (as de-
fined in section 1861(mm)(1) of the Social 
Security Act (42 U.S.C. 1395xx(mm)(1))). 
(ii) A hospital (as defined in section 
1861(e) of such Act (42 U.S.C. 1395x(e))). 
(iii) A physician (as defined in section 
1861(r) of such Act (42 U.S.C. 1395x(r))). 
(iv) Any other provider the Secretary 
determines should receive the information 
described in subsection (a). 
(B) 
PERFORMANCE
IMPROVEMENT.—The 
term ‘‘performance improvement’’ means im-
provements in quality, reducing per capita costs, 
and other criteria the Secretary determines ap-
propriate. 
SEC. 610. EXTENSION OF FUNDING OUTREACH AND ASSIST-
ANCE FOR LOW-INCOME PROGRAMS. 
(a) ADDITIONAL FUNDING FOR STATE HEALTH INSUR-
ANCE PROGRAMS.—Subsection (a)(1)(B) of section 119 of 
the Medicare Improvements for Patients and Providers Act 
of 2008 (42 U.S.C. 1395b–3 note), as amended by section 
3306 of the Patient Protection and Affordable Care Act 
Public Law 111–148), is amended— 
(1) in clause (i), by striking ‘‘and’’ at the end;
101 
† HR 8 EAS 
(2) in clause (ii), by striking the period at the 
end and inserting ‘‘; and’’; and 
(3) by inserting after clause (ii) the following 
new clause: 
‘‘(iii) 
for 
fiscal 
year 
2013, 
of 
$7,500,000.’’. 
(b) ADDITIONAL FUNDING FOR AREA AGENCIES ON 
AGING.—Subsection (b)(1)(B) of such section 119, as so 
amended, is amended— 
(1) in clause (i), by striking ‘‘and’’ at the end; 
(2) in clause (ii), by striking the period at the 
end and inserting ‘‘; and’’; and 
(3) by inserting after clause (ii) the following 
new clause: 
‘‘(iii) 
for 
fiscal 
year 
2013, 
of 
$7,500,000.’’. 
(c) ADDITIONAL FUNDING FOR AGING AND DISABILITY 
RESOURCE CENTERS.—Subsection (c)(1)(B) of such section 
119, as so amended, is amended— 
(1) in clause (i), by striking ‘‘and’’ at the end; 
(2) in clause (ii), by striking the period at the 
end and inserting ‘‘; and’’; and 
(3) by inserting after clause (ii) the following 
new clause:
102 
† HR 8 EAS 
‘‘(iii) 
for 
fiscal 
year 
2013, 
of 
$5,000,000.’’. 
(d) ADDITIONAL FUNDING FOR CONTRACT WITH THE 
NATIONAL CENTER FOR BENEFITS AND OUTREACH EN-
ROLLMENT.—Subsection (d)(2) of such section 119, as so 
amended, is amended— 
(1) in clause (i), by striking ‘‘and’’ at the end; 
(2) in clause (ii), by striking the period at the 
end and inserting ‘‘; and’’; and 
(3) by inserting after clause (ii) the following 
new clause: 
‘‘(iii) 
for 
fiscal 
year 
2013, 
of 
$5,000,000.’’. 
Subtitle B—Other Health 
Extensions 
SEC. 621. EXTENSION OF THE QUALIFYING INDIVIDUAL (QI) 
PROGRAM. 
(a) EXTENSION.—Section 1902(a)(10)(E)(iv) of the 
Social Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is 
amended by striking ‘‘2012’’ and inserting ‘‘2013’’. 
(b) EXTENDING TOTAL AMOUNT AVAILABLE FOR AL-
LOCATION.—Section 1933(g) of such Act (42 U.S.C. 1396u– 
3(g)) is amended— 
(1) in paragraph (2)—
103 
† HR 8 EAS 
(A) in subparagraph (Q), by striking ‘‘and’’ 
after the semicolon; 
(B) in subparagraph (R), by striking the 
period at the end and inserting a semicolon; and 
(C) by adding at the end the following new 
subparagraphs: 
‘‘(S) for the period that begins on January 
1, 2013, and ends on September 30, 2013, the 
total allocation amount is $485,000,000; and 
‘‘(T) for the period that begins on October 
1, 2013, and ends on December 31, 2013, the 
total allocation amount is $300,000,000.’’; and 
(2) in paragraph (3), in the matter preceding 
subparagraph (A), by striking ‘‘or (R)’’ and inserting 
‘‘(R), or (T)’’. 
SEC. 622. EXTENSION OF TRANSITIONAL MEDICAL ASSIST-
ANCE (TMA). 
Sections 1902(e)(1)(B) and 1925(f) of the Social Secu-
rity Act (42 U.S.C. 1396a(e)(1)(B), 1396r–6(f)) are each 
amended by striking ‘‘2012’’ and inserting ‘‘2013’’. 
SEC. 623. EXTENSION OF MEDICAID AND CHIP EXPRESS 
LANE OPTION. 
Section 1902(e)(13)(I) of the Social Security Act (42 
U.S.C. 1396a(e)(13)(I)) is amended by striking ‘‘2013’’ and 
inserting ‘‘2014’’.
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† HR 8 EAS 
SEC. 624. EXTENSION OF FAMILY-TO-FAMILY HEALTH IN-
FORMATION CENTERS. 
Section 501(c)(1)(A)(iii) of the Social Security Act (42 
U.S.C. 701(c)(1)(A)(iii)) is amended by striking ‘‘2012’’ 
and inserting ‘‘2013’’. 
SEC. 625. EXTENSION OF SPECIAL DIABETES PROGRAM FOR 
TYPE I DIABETES AND FOR INDIANS. 
(a) SPECIAL DIABETES PROGRAMS FOR TYPE I DIA-
BETES.—Section 330B(b)(2)(C) of the Public Health Serv-
ice Act (42 U.S.C. 254c–2(b)(2)(C)) is amended by striking 
‘‘2013’’ and inserting ‘‘2014’’. 
(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 ‘‘2013’’ and 
inserting ‘‘2014’’. 
Subtitle C—Other Health 
Provisions 
SEC. 631. IPPS DOCUMENTATION AND CODING ADJUST-
MENT FOR IMPLEMENTATION OF MS-DRGS. 
(a) RULE OF CONSTRUCTION AND CLARIFICATION.— 
(1) RULE OF CONSTRUCTION.—Nothing in the 
amendments made by subsection (b) shall be construed 
as changing the existing authority under section 
1886(d) of the Social Security Act (42 U.S.C. 
1395ww(d)) to make prospective documentation and 
coding adjustments to the standardized amounts
105 
† HR 8 EAS 
under such section 1886(d) to correct for changes in 
the coding or classification of discharges that do not 
reflect real changes in case mix. 
(2) CLARIFICATION.—Effective on the date of the 
enactment of this section, except as provided in sec-
tion 7(b)(1)(B)(ii) of the TMA, Abstinence Education, 
and QI Programs Extension Act of 2007, as added by 
subsection (b)(2)(A)(ii)(IV) of this section, the Sec-
retary of Health and Human Services shall not have 
authority to fully recoup past overpayments related to 
documentation and coding changes from fiscal years 
2008 and 2009. 
(b) ADJUSTMENT.—Section 7 of the TMA, Abstinence 
Education, and QI Programs Extension Act of 2007 (Public 
Law 110–90; 121 Stat. 986) is amended— 
(1) in the heading, by striking ‘‘LIMITATION’’ 
and all that follows through ‘‘ADJUSTMENT’’ and 
inserting ‘‘DOCUMENTATION
AND
CODING
AD-
JUSTMENTS’’; and 
(2) in subsection (b)— 
(A) in paragraph (1)— 
(i) in the matter before subparagraph 
(A)— 
(I) by striking ‘‘or 2009’’ and in-
serting ‘‘, 2009, or 2010’’; and
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† HR 8 EAS 
‘‘(II) the payment rate that would 
otherwise apply under this subsection 
for linear accelerator based stereotactic 
radiosurgery, complete course of ther-
apy in one session (identified as of 
January 1, 2013, by HCPCS code 
G0173 (and any succeeding code) and 
reimbursed as of such date under APC 
0067 (and any succeeding classifica-
tion group)), 
the payment rate for the service described in 
subclause (I) shall be reduced to an amount 
equal to the payment rate for the service de-
scribed in subclause (II). 
‘‘(ii) HOSPITAL
DESCRIBED.—A hos-
pital described in this clause is a hospital 
that is not— 
‘‘(I) located in a rural area (as 
defined in section 1886(d)(2)(D)); 
‘‘(II) classified as a rural referral 
center under section 1886(d)(5)(C); or 
‘‘(III) a sole community hospital 
(as 
defined 
in 
section 
1886(d)(5)(D)(iii)).
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† HR 8 EAS 
(1) HEARINGS AND OTHER ACTIVITIES.—For the 
purpose of carrying out its duties, the Commission 
may hold such hearings and undertake such other ac-
tivities as the Commission determines to be necessary 
to carry out its duties. 
(2) STUDIES
BY
GENERAL
ACCOUNTING
OF-
FICE.—Upon the request of the Commission, the 
Comptroller General of the United States shall con-
duct such studies or investigations as the Commission 
determines to be necessary to carry out its duties. 
(3) COST ESTIMATES BY CONGRESSIONAL BUDG-
ET OFFICE.—Upon the request of the Commission, the 
Director of the Congressional Budget Office shall pro-
vide to the Commission such cost estimates as the 
Commission determines to be necessary to carry out 
its duties. 
(4) DETAIL OF FEDERAL EMPLOYEES.—Upon the 
request of the Commission, the head of any Federal 
agency is authorized to detail, without reimburse-
ment, any of the personnel of such agency to the Com-
mission to assist the Commission in carrying out its 
duties. Any such detail shall not interrupt or other-
wise affect the civil service status or privileges of the 
Federal employee.
127 
† HR 8 EAS 
(5) TECHNICAL ASSISTANCE.—Upon the request 
of the Commission, the head of a Federal agency shall 
provide such technical assistance to the Commission 
as the Commission determines to be necessary to 
carry out its duties. 
(6) USE OF MAILS.—The Commission may use 
the United States mails in the same manner and 
under the same conditions as Federal agencies. 
(7) OBTAINING INFORMATION.—The Commission 
may secure directly from any Federal agency infor-
mation necessary to enable it to carry out its duties, 
if the information may be disclosed under section 552 
of title 5, United States Code. Upon request of the 
Chairman of the Commission, the head of such agency 
shall furnish such information to the Commission. 
(8) ADMINISTRATIVE SUPPORT SERVICES.—Upon 
the request of the Commission, the Administrator of 
General Services shall provide to the Commission on 
a reimbursable basis such administrative support 
services as the Commission may request. 
(f) COMMISSION CONSIDERATION.— 
(1) APPROVAL
OF
REPORT
AND
LEGISLATIVE 
LANGUAGE.— 
(A) IN GENERAL.—Not later than 6 months 
after appointment of the members of the Com-