did not participate in such drug dis-
count program; and 
‘‘(II) the actual Medicaid inpa-
tient reimbursement payable to the 
hospital for the cost reporting period. 
‘‘(ii) MEDICAID
INPATIENT
REIM-
BURSEMENT
DEFINED.—For purposes of 
this subsection, the term ‘Medicaid inpa-
tient reimbursement’ means the total pay-
ments received by the hospital under the 
State plan under title XIX of the Social 
Security Act for providing inpatient serv-
ices to Medicaid recipients. 
‘‘(3) REQUIREMENTS.— 
‘‘(A) IN GENERAL.—A hospital shall not be 
required to provide a credit under paragraph 
(1) to a State unless, not later than 30 days 
after receiving the information described in sub-
paragraph (B), the State calculates in accord-
ance with paragraph (2) the amount of the 
credit owed by the hospital under paragraph (1) 
and provides the hospital with both the amount 
of such credit so owed and an explanation of 
how the State calculated such credit. 
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‘‘(B) HOSPITAL PROVISION OF INFORMA-
TION.—Not later than 30 days after the date of 
the filing of the most recently filed Medicare 
cost report of a hospital described in paragraph 
(1), the hospital shall provide the State involved 
with the information described in subpara-
graphs (C)(i)(I) and (D) of paragraph (2). 
With respect to each covered drug purchased 
during the cost reporting period, the hospital 
shall provide the National Drug Code, date of 
purchase, and the number of units purchased. 
Submission of such information shall not be re-
quired if a covered drug has not been assigned 
a National Drug Code at the time of purchase. 
‘‘(C) ACCESS
TO
AMP
AND
REBATE 
DATA.—The Secretary shall establish a system 
for giving States access to the information nec-
essary for them to calculate credits under para-
graph (2), with respect to covered drugs, in-
cluding the average manufacturer price and re-
bate percentage for such covered drugs. 
‘‘(D) 
CREDIT
OFFSET.—Paragraph 
(2)(A)(ii) shall be applied, with respect to a 
credit owed by a hospital under paragraph (1), 
only if, not later than 30 days after filing the 
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most recent Medicare cost report, the hospital 
submits to the State involved— 
‘‘(i) a request for the State to apply 
such paragraph and to calculate the 
amount described in such paragraph in ac-
cordance with paragraph (2)(E); and 
‘‘(ii) the data needed by the State to 
determine the amount of the Medicaid in-
patient reimbursement described in para-
graph (2)(E)(i)(I) for such hospital. 
‘‘(E) DISPUTES.—A State and hospital de-
scribed in paragraph (1) shall have access to 
the same State dispute resolution procedures 
and system applicable to Medicaid reimburse-
ment matters under title XIX of the Social Se-
curity Act. 
‘‘(4) PAYMENT
DEADLINE.—A hospital shall 
provide to a State the credits owed by such hospital 
under paragraph (1) not later than 60 days after 
the hospital receives the information described in 
paragraph (3)(A). 
‘‘(5) OPT
OUT.—A hospital shall not be re-
quired to provide a credit under paragraph (1) to a 
State if the hospital and State agree to an alter-
native arrangement. 
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‘‘(6) OFFSET AGAINST MEDICAL ASSISTANCE.— 
Amounts received by a State under this subsection 
shall be considered to be a reduction in the amount 
expended under the State plan for medical assist-
ance for purposes of section 1903(a)(1) of the Social 
Security Act. 
‘‘(7) MEDICAID
RECIPIENT
DEFINED.—For 
purposes of this subsection, the term ‘Medicaid re-
cipient’ means, with respect to a State, an individual 
who receives benefits under the State plan under 
title XIX of the Social Security Act.’’. 
(c) CONFORMING AMENDMENTS.—Section 1927 of 
the Social Security Act (42 U.S.C. 1396r–8) is amended— 
(1) in subsection (a)(5)— 
(A) in subparagraph (A), by striking ‘‘cov-
ered outpatient drugs’’ and inserting ‘‘covered 
drugs (as defined in section 340B(b)(2) of the 
Public Health Service Act)’’; and 
(B) by striking subparagraphs (D) and 
(E); and 
(2) in subsection (c)(1)(C)(i)— 
(A) 
by 
redesignating 
subclauses 
(II) 
through (VI) as subclauses (III) through (VII), 
respectively; and 
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(B) by inserting after subclause (I) the fol-
lowing: 
‘‘(II) any prices charged for a 
covered drug, as defined in section 
340B(b)(2) of the Public Health Serv-
ice Act;’’. 
SEC. 3. PROHIBITION AGAINST DUPLICATE DISCOUNTS 
FOR PHYSICIAN ADMINISTERED DRUGS. 
Section 340B(a)(5)(A) of the Public Health Service 
Act (42 U.S.C. 256b) is amended by adding at the end 
the following: 
‘‘(iii) 
PHYSICIAN
ADMINISTERED 
DRUGS.—A hospital described in subpara-
graph (L), (M), (N), or (O) of paragraph 
(4) shall not be required under section 
1927(a)(7) of the Social Security Act to 
report National Drug Code numbers for 
drugs administered by a physician (or 
under a physician’s supervision) if the 
State is precluded from seeking a rebate 
on such drugs because such drugs were 
purchased at a discount under this section. 
Nothing in this clause shall relieve a hos-
pital of its obligation to submit National 
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Drug Codes in accordance with subsection 
(c)(3)(B).’’. 
SEC. 4. CONTINUED INCLUSION OF ORPHAN DRUGS IN DEF-
INITION OF COVERED OUTPATIENT DRUGS; 
TECHNICAL AMENDMENT. 
(a) IN GENERAL.—Section 340B of the Public 
Health Service Act (42 U.S.C. 256b) is amended by strik-
ing subsection (e). 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to drugs purchased on or after 
March 30, 2010. 
SEC. 5. APPLICATION OF RULES FOR DETERMINING PRO-
VIDER-BASED STATUS FOR CERTAIN ENTI-
TIES. 
Notwithstanding any other provision of law, in mak-
ing determinations of provider-based status under title 
XVIII of the Social Security Act, the facility or organiza-
tion shall be treated as satisfying any requirements and 
standards for geographic location in relation to a hospital 
or a critical access hospital if the facility or organization 
is described in subparagraph (L), (M), (N), or (O) of sec-
tion 340B(a)(4) of the Public Health Service Act (42 
U.S.C. 256b(a)(4)). 
Æ 
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