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services directly would be impracticable and prohibitively 
expensive.’’. 
(b) CONFORMING
PAYMENT
PROVISION.—Section 
1814(i) (42 U.S.C. 1395f(i)) is amended by adding at the 
end the following new paragraph: 
‘‘(4) In the case of hospice care provided by a hospice 
program 
under 
arrangements 
under 
section 
1861(dd)(5)(D) made by another hospice program, the 
hospice program that made the arrangements shall bill 
and be paid for the hospice care.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to hospice care provided on or after 
the date of the enactment of this Act. 
SEC. 947. APPLICATION OF OSHA BLOODBORNE PATHO-
GENS STANDARD TO CERTAIN HOSPITALS. 
(a) IN GENERAL.—Section 1866 (42 U.S.C. 1395cc) 
is amended—
(1) in subsection (a)(1)—
(A) in subparagraph (R), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (S), by striking the 
period at the end and inserting ‘‘, and’’; and 
(C) by inserting after subparagraph (S) 
the following new subparagraph:
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‘‘(T) in the case of hospitals that are not other-
wise subject to the Occupational Safety and Health 
Act of 1970, to comply with the Bloodborne Patho-
gens standard under section 1910.1030 of title 29 of 
the Code of Federal Regulations (or as subsequently 
redesignated).’’; and 
(2) by adding at the end of subsection (b) the 
following new paragraph: 
‘‘(4)(A) A hospital that fails to comply with the re-
quirement of subsection (a)(1)(T) (relating to the 
Bloodborne Pathogens standard) is subject to a civil 
money penalty in an amount described in subparagraph 
(B), but is not subject to termination of an agreement 
under this section. 
‘‘(B) The amount referred to in subparagraph (A) is 
an amount that is similar to the amount of civil penalties 
that may be imposed under section 17 of the Occupational 
Safety and Health Act of 1970 for a violation of the 
Bloodborne Pathogens standard referred to in subsection 
(a)(1)(T) by a hospital that is subject to the provisions 
of such Act. 
‘‘(C) A civil money penalty under this paragraph shall 
be imposed and collected in the same manner as civil 
money penalties under subsection (a) of section 1128A are 
imposed and collected under that section.’’.
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(b) EFFECTIVE DATE.—The amendments made by 
this subsection (a) shall apply to hospitals as of July 1, 
2004. 
SEC. 948. BIPA-RELATED TECHNICAL AMENDMENTS AND 
CORRECTIONS. 
(a) TECHNICAL AMENDMENTS RELATING TO ADVI-
SORY COMMITTEE UNDER BIPA SECTION 522.—(1) Sub-
section (i) of section 1114 (42 U.S.C. 1314)—
(A) is transferred to section 1862 and added at 
the end of such section; and 
(B) is redesignated as subsection (j). 
(2) Section 1862 (42 U.S.C. 1395y) is amended—
(A) in the last sentence of subsection (a), by 
striking ‘‘established under section 1114(f)’’; and 
(B) in subsection (j), as so transferred and re-
designated—
(i) by striking ‘‘under subsection (f)’’; and 
(ii) by striking ‘‘section 1862(a)(1)’’ and 
inserting ‘‘subsection (a)(1)’’. 
(b) 
TERMINOLOGY
CORRECTIONS.—(1) 
Section 
1869(c)(3)(I)(ii) (42 U.S.C. 1395ff(c)(3)(I)(ii)), as 
amended by section 521 of BIPA, is amended—
(A) in subclause (III), by striking ‘‘policy’’ and 
inserting ‘‘determination’’; and
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(B) in subclause (IV), by striking ‘‘medical re-
view policies’’ and inserting ‘‘coverage determina-
tions’’. 
(2) Section 1852(a)(2)(C) (42 U.S.C. 1395w–
22(a)(2)(C)) is amended by striking ‘‘policy’’ and ‘‘POL-
ICY’’ and inserting ‘‘determination’’ each place it appears 
and ‘‘DETERMINATION’’, respectively. 
(c) REFERENCE CORRECTIONS.—Section 1869(f)(4) 
(42 U.S.C. 1395ff(f)(4)), as added by section 522 of 
BIPA, is amended—
(1) in subparagraph (A)(iv), by striking ‘‘sub-
clause (I), (II), or (III)’’ and inserting ‘‘clause (i), 
(ii), or (iii)’’; 
(2) in subparagraph (B), by striking ‘‘clause 
(i)(IV)’’ and ‘‘clause (i)(III)’’ and inserting ‘‘sub-
paragraph (A)(iv)’’ and ‘‘subparagraph (A)(iii)’’, re-
spectively; and 
(3) in subparagraph (C), by striking ‘‘clause 
(i)’’, ‘‘subclause (IV)’’ and ‘‘subparagraph (A)’’ and 
inserting ‘‘subparagraph (A)’’, ‘‘clause (iv)’’ and 
‘‘paragraph (1)(A)’’, respectively each place it ap-
pears. 
(d) OTHER CORRECTIONS.—Effective as if included 
in the enactment of section 521(c) of BIPA, section
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1154(e) (42 U.S.C. 1320c–3(e)) is amended by striking 
paragraph (5). 
(e) EFFECTIVE DATE.—Except as otherwise pro-
vided, the amendments made by this section shall be effec-
tive as if included in the enactment of BIPA. 
SEC. 949. CONFORMING AUTHORITY TO WAIVE A PROGRAM 
EXCLUSION. 
The first sentence of section 1128(c)(3)(B) (42 
U.S.C. 1320a–7(c)(3)(B)) is amended to read as follows: 
‘‘Subject to subparagraph (G), in the case of an exclusion 
under subsection (a), the minimum period of exclusion 
shall be not less than five years, except that, upon the 
request of the administrator of a Federal health care pro-
gram (as defined in section 1128B(f)) who determines 
that the exclusion would impose a hardship on individuals 
entitled to benefits under part A of title XVIII or enrolled 
under part B of such title, or both, the Secretary may 
waive the exclusion under subsection (a)(1), (a)(3), or 
(a)(4) with respect to that program in the case of an indi-
vidual or entity that is the sole community physician or 
sole source of essential specialized services in a commu-
nity.’’.
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SEC. 950. TREATMENT OF CERTAIN DENTAL CLAIMS. 
(a) IN GENERAL.—Section 1862 (42 U.S.C. 1395y) 
is amended by adding after subsection (g) the following 
new subsection: 
‘‘(h)(1) Subject to paragraph (2), a group health plan 
(as defined in subsection (a)(1)(A)(v)) providing supple-
mental or secondary coverage to individuals also entitled 
to services under this title shall not require a medicare 
claims determination under this title for dental benefits 
specifically excluded under subsection (a)(12) as a condi-
tion of making a claims determination for such benefits 
under the group health plan. 
‘‘(2) A group health plan may require a claims deter-
mination under this title in cases involving or appearing 
to involve inpatient dental hospital services or dental serv-
ices expressly covered under this title pursuant to actions 
taken by the Secretary.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect on the date that is 60 days 
after the date of the enactment of this Act. 
SEC. 951. FURNISHING HOSPITALS WITH INFORMATION TO 
COMPUTE DSH FORMULA. 
Beginning not later than 1 year after the date of the 
enactment of this Act, the Secretary shall arrange to fur-
nish to subsection (d) hospitals (as defined in section 
1886(d)(1)(B) of the Social Security Act, 42 U.S.C.
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1395ww(d)(1)(B)) the data necessary for such hospitals 
to compute the number of patient days used in computing 
the disproportionate patient percentage under such section 
for that hospital for the current cost reporting year. Such 
data shall also be furnished to other hospitals which would 
qualify for additional payments under part A of title 
XVIII of the Social Security Act on the basis of such data. 
SEC. 952. REVISIONS TO REASSIGNMENT PROVISIONS. 
(a) IN GENERAL.—Section 1842(b)(6)(A) (42 U.S.C. 
1395u(b)(6)(A)) is amended by striking ‘‘or (ii) (where 
the service was provided in a hospital, critical access hos-
pital, clinic, or other facility) to the facility in which the 
service was provided if there is a contractual arrangement 
between such physician or other person and such facility 
under which such facility submits the bill for such serv-
ice,’’ and inserting ‘‘or (ii) where the service was provided 
under a contractual arrangement between such physician 
or other person and an entity (as defined by the Sec-
retary), to the entity if, under the contractual arrange-
ment, the entity submits the bill for the service and the 
contractual arrangement meets such other program integ-
rity and other safeguards as the Secretary may determine 
to be appropriate,’’. 
(b) CONFORMING AMENDMENT.—The second sen-
tence of section 1842(b)(6) (42 U.S.C. 1395u(b)(6)) is
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amended by striking ‘‘except to an employer or facility’’ 
and inserting ‘‘except to an employer, entity, or other per-
son’’. 
(c) EFFECTIVE DATE.—The amendments made by 
section shall apply to payments made on or after the date 
of the enactment of this Act. 
SEC. 953. OTHER PROVISIONS. 
(a) GAO REPORTS ON THE PHYSICIAN COMPENSA-
TION.—
(1) SUSTAINABLE GROWTH RATE
AND UP-
DATES.—Not later than 6 months after the date of 
the enactment of this Act, the Comptroller General 
of the United States shall submit to Congress a re-
port on the appropriateness of the updates in the 
conversion factor under subsection (d)(3) of section 
1848 of the Social Security Act (42 U.S.C. 1395w–
4), including the appropriateness of the sustainable 
growth rate formula under subsection (f) of such 
section for 2002 and succeeding years. Such report 
shall examine the stability and predictability of such 
updates and rate and alternatives for the use of such 
rate in the updates. 
(2) PHYSICIAN COMPENSATION GENERALLY.—
Not later than 12 months after the date of the en-
actment of this Act, the Comptroller General shall
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submit to Congress a report on all aspects of physi-
cian compensation for services furnished under title 
XVIII of the Social Security Act, and how those as-
pects interact and the effect on appropriate com-
pensation for physician services. Such report shall 
review alternatives for the physician fee schedule 
under section 1848 of such title (42 U.S.C. 1395w–
4). 
(b) ANNUAL PUBLICATION OF LIST OF NATIONAL 
COVERAGE DETERMINATIONS.—The Secretary shall pro-
vide, in an appropriate annual publication available to the 
public, a list of national coverage determinations made 
under title XVIII of the Social Security Act in the pre-
vious year and information on how to get more informa-
tion with respect to such determinations. 
(c) GAO REPORT
ON FLEXIBILITY
IN APPLYING 
HOME HEALTH CONDITIONS OF PARTICIPATION TO PA-
TIENTS WHO ARE NOT MEDICARE BENEFICIARIES.—Not 
later than 6 months after the date of the enactment of 
this Act, the Comptroller General of the United States 
shall submit to Congress a report on the implications if 
there were flexibility in the application of the medicare 
conditions of participation for home health agencies with 
respect to groups or types of patients who are not medi-
care beneficiaries. The report shall include an analysis of
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the potential impact of such flexible application on clinical 
operations and the recipients of such services and an anal-
ysis of methods for monitoring the quality of care provided 
to such recipients. 
(d) OIG REPORT ON NOTICES RELATING TO USE OF 
HOSPITAL LIFETIME RESERVE DAYS.—Not later than 1 
year after the date of the enactment of this Act, the In-
spector General of the Department of Health and Human 
Services shall submit a report to Congress on—
(1) the extent to which hospitals provide notice 
to medicare beneficiaries in accordance with applica-
ble requirements before they use the 60 lifetime re-
serve days described in section 1812(a)(1) of the So-
cial Security Act (42 U.S.C. 1395d(a)(1)); and 
(2) the appropriateness and feasibility of hos-
pitals providing a notice to such beneficiaries before 
they completely exhaust such lifetime reserve days. 
SEC. 954. TEMPORARY SUSPENSION OF OASIS REQUIRE-
MENT FOR COLLECTION OF DATA ON NON-
MEDICARE AND NON-MEDICAID PATIENTS. 
(a) IN GENERAL.—During the period described in 
subsection (b), the Secretary may not require, under sec-
tion 4602(e) of the Balanced Budget Act of 1997 or other-
wise under OASIS, a home health agency to gather or sub-
mit information that relates to an individual who is not
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eligible for benefits under either title XVIII or title XIX 
of the Social Security Act (such information in this section 
referred to as ‘‘non-medicare/medicaid OASIS informa-
tion’’). 
(b) PERIOD OF SUSPENSION.—The period described 
in this subsection—
(1) begins on the date of the enactment of this 
Act; and 
(2) ends on the last day of the 2nd month be-
ginning after the date as of which the Secretary has 
published final regulations regarding the collection 
and use by the Centers for Medicare & Medicaid 
Services of non-medicare/medicaid OASIS informa-
tion following the submission of the report required 
under subsection (c). 
(c) REPORT.—
(1) STUDY.—The Secretary shall conduct a 
study on how non-medicare/medicaid OASIS infor-
mation is and can be used by large home health 
agencies. Such study shall examine—
(A) whether there are unique benefits from 
the analysis of such information that cannot be 
derived from other information available to, or 
collected by, such agencies; and
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‘‘(iv) CONTENTS OF NOTICE.—A notice required 
under this subparagraph shall—
‘‘(I) state that an application that contains 
data from bioavailability or bioequivalence stud-
ies has been submitted under this subsection for 
the drug with respect to which the certification 
is made to obtain approval to engage in the 
commercial manufacture, use, or sale of the 
drug before the expiration of the patent re-
ferred to in the certification; and 
‘‘(II) include a detailed statement of the 
factual and legal basis of the opinion of the ap-
plicant that the patent is invalid or will not be 
infringed.’’; and 
(B) by adding at the end the following sub-
paragraph: 
‘‘(D)(i) An applicant may not amend or supplement 
an application to seek approval of a drug referring to a 
different listed drug from the listed drug identified in the 
application as submitted to the Secretary. 
‘‘(ii) With respect to the drug for which an applica-
tion is submitted, nothing in this subsection prohibits an 
applicant from amending or supplementing the application 
to seek approval of a different strength.’’; and 
(2) in paragraph (5)—