Medicare Presidential Budget Savings Extension Act of 1995

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Presidential Budget Savings 
Extension Act of 1995''.

     TITLE I--PROVISIONS RELATING TO PART A OF THE MEDICARE PROGRAM

SEC. 101. MAINTAINING SAVINGS RESULTING FROM TEMPORARY FREEZE ON 
              PAYMENT INCREASES FOR SKILLED NURSING FACILITY SERVICES.

    (a) Basing Updates to Per Diem Cost Limits on Limits for Fiscal 
Year 1993.--
            (1) In general.--The last sentence of section 1888(a) of 
        the Social Security Act (42 U.S.C. 1395yy(a)) is amended by 
        adding at the end the following: ``(except that such updates 
        may not take into account any changes in the routine service 
        costs of skilled nursing facilities occurring during cost 
        reporting periods which began during fiscal year 1994 or fiscal 
        year 1995).''.
            (2) No exceptions permitted based on amendment.--The 
        Secretary of Health and Human Services shall not consider the 
        amendment made by paragraph (1) in making any adjustments 
        pursuant to section 1888(c) of the Social Security Act.
    (b) Payments Determined on Prospective Basis.--Any change made by 
the Secretary of Health and Human Services in the amount of any 
prospective payment paid to a skilled nursing facility under section 
1888(d) of the Social Security Act for cost reporting periods beginning 
on or after October 1, 1995, may not take into account any changes in 
the costs of services occurring during cost reporting periods which 
began during fiscal year 1994 or fiscal year 1995.

    TITLE II--PROVISIONS RELATING TO PART B OF THE MEDICARE PROGRAM

SEC. 201. SETTING THE PART B PREMIUM AT 25 PERCENT OF PROGRAM 
              EXPENDITURES PERMANENTLY.

    (a) In General.--Section 1839(a)(3) of the Social Security Act (42 
U.S.C. 1395r(a)(3)) is amended by striking ``The monthly premium'' and 
all that follows through ``November 1.'' and inserting the following: 
``The monthly premium shall be equal to 50 percent of the monthly 
actuarial rate for enrollees age 65 and over, as determined according 
to paragraph (1), for that succeeding calendar year.''.
    (b) Conforming Amendments.--Section 1839 of such Act (42 U.S.C. 
1395r) is amended--
            (1) in subsection (a)(2), by striking ``(b) and (e)'' and 
        inserting ``(b), (c), (e), and (f)'';
            (2) in the last sentence of subsection (a)(3), by striking 
        ``and the derivation of the dollar amounts specified in this 
        paragraph''; and
            (3) in subsection (e)--
                    (A) by striking ``(1)(A) Notwithstanding'' and all 
                that follows through ``(B)'',
                    (B) by striking paragraph (2), and
                    (C) by redesignating clauses (i) through (v) as 
                paragraphs (1) through (5).

TITLE III--PROVISIONS RELATING TO PARTS A AND B OF THE MEDICARE PROGRAM

SEC. 301. PERMANENT EXTENSION OF CERTAIN SECONDARY PAYER PROVISIONS.

    (a) Data Match.--
            (1) Section 1862(b)(5)(C) of the Social Security Act (42 
        U.S.C. 1395y(b)(5)(C)) is amended by striking clause (iii).
            (2) Section 6103(l)(12) of the Internal Revenue Code of 
        1986 is amended by striking subparagraph (F).
    (b) Application to Disabled Individuals in Large Group Health 
Plans.--
            (1) In general.--Section 1862(b)(1)(B) of the Social 
        Security Act (42 U.S.C. 1395y(b)(1)(B)) is amended--
                    (A) in clause (i), by striking ``clause (iv)'' and 
                inserting ``clause (iii)'',
                    (B) by striking clause (iii), and
                    (C) by redesignating clause (iv) as clause (iii).
            (2) Conforming amendments.--Paragraphs (1) through (3) of 
        section 1837(i) of such Act (42 U.S.C. 1395p(i)) and the second 
        sentence of section 1839(b) of such Act (42 U.S.C. 1395r(b)) 
        are each amended by striking ``1862(b)(1)(B)(iv)'' each place 
        it appears and inserting ``1862(b)(1)(B)(iii)''.
    (c) Period of Application to Individuals with End Stage Renal 
Disease.--Section 1862(b)(1)(C) of the Social Security Act (42 U.S.C. 
1395y(b)(1)(C)) is amended--
            (1) in the first sentence, by striking ``12-month'' each 
        place it appears and inserting ``18-month'', and
            (2) by striking the second sentence.

SEC. 302. MAINTAINING SAVINGS RESULTING FROM TEMPORARY FREEZE ON 
              PAYMENT INCREASES FOR HOME HEALTH SERVICES.

    (a) Basing Updates to Per Visit Cost Limits on Limits for Fiscal 
Year 1993.--Section 1861(v)(1)(L)(iii) of the Social Security Act (42 
U.S.C. 1395x(v)(1)(L)(iii)) is amended by adding at the end the 
following sentence: ``In establishing limits under this subparagraph, 
the Secretary may not take into account any changes in the costs of the 
provision of services furnished by home health agencies with respect to 
cost reporting periods which began on or after July 1, 1994, and before 
July 1, 1996.''.
    (b) No Exceptions Permitted Based on Amendment.--The Secretary of 
Health and Human Services shall not consider the amendment made by 
subsection (a) in making any exemptions and exceptions pursuant to 
section 1861(v)(1)(L)(ii) of the Social Security Act.

Summary: TABLE OF CONTENTS: 
     Title I:  Provisions Relating to Part A of the Medicare 
          Program 
     Title II:  Provisions Relating to Part B of the Medicare 
          Program 
     Title III:  Provisions Relating to Parts A and B of the 
          Medicare Program 
Medicare Presidential Budget Savings Extension Act of 1995 - 
Title I:  Provisions Relating to Part A of the Medicare Program
 - Amends part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act to prohibit updates on per diem cost limits on extended care services of skilled nursing facilities from taking into account any changes in routine service costs of such facilities occurring during cost reporting periods beginning during FY 1994 or 1995. 
Bars any change made by the Secretary of Health and Human Services in the amount of prospective payments to such facilities for cost reporting periods beginning on or after October 1, 1995, from taking into account changes in the costs of services occurring during cost reporting periods beginning in FY 1994 or 1995. 
Title II:  Provisions Relating to Part B of the Medicare Program
 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to permanently set the monthly premium under the Supplementary Medical Insurance program at 50 percent of the monthly actuarial rate for enrollees age 65 and over. 
Title III:  Provisions Relating to Parts A and B of the Medicare Program
 - Makes permanent specified Medicare secondary payer provisions currently scheduled to expire in FY 1998, including those with respect to disabled individuals in large group health plans and individuals with end-stage renal disease. 
Prohibits the Secretary, in establishing cost limits on home health services, from taking into account any changes in the costs of home health agency services with respect to cost reporting periods which began between July 1, 1994, and July 1, 1996.