To provide for the extension of transitional medical assistance (TMA), the abstinence education program, and the qualifying individuals (QI) program, and for other purposes.

SECTION 1. SHORT TITLE.
    This Act may be cited as the ``TMA, Abstinence Education, and QI 
Programs Extension Act of 2007''.
SEC. 2. EXTENSION OF TRANSITIONAL MEDICAL ASSISTANCE (TMA) AND 
ABSTINENCE EDUCATION PROGRAM THROUGH DECEMBER 31, 2007.
    Section 401 of division B of the Tax Relief and Health Care Act of 
2006 (Public Law 109-432), as amended by section 1 of Public Law 110-
48, is amended--
        (1) by striking ``September 30'' and inserting ``December 31'';
        (2) by striking ``for fiscal year 2006'' and inserting ``for 
    fiscal year 2007'';
        (3) by striking ``the fourth quarter of fiscal year 2007'' and 
    inserting ``the first quarter of fiscal year 2008''; and
        (4) by striking ``the fourth quarter of fiscal year 2006'' and 
    inserting ``the first quarter of fiscal year 2007''.
SEC. 3. EXTENSION OF QUALIFYING INDIVIDUAL (QI) PROGRAM THROUGH 
DECEMBER 2007.
    (a) Through December 2007.--Section 1902(a)(10)(E)(iv) of the 
Social Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended by 
striking ``September 2007'' and inserting ``December 2007''.
    (b) Extending Total Amount Available for Allocation.--Section 
1933(g) of such Act (42 U.S.C. 1396u-3(g)) is amended--
        (1) in paragraph (2)--
            (A) by striking ``and'' at the end of subparagraph (F);
            (B) by striking the period at the end of subparagraph (G) 
        and inserting ``; and''; and
            (C) by adding at the end the following new subparagraph:
            ``(H) for the period that begins on October 1, 2007, and 
        ends on December 31, 2007, the total allocation amount is 
        $100,000,000.''; and
        (2) in paragraph (3), in the matter preceding subparagraph (A), 
    by striking ``or (F)'' and inserting ``(F), or (H)''.
    (c) Effective Date.--The amendments made by this section shall be 
effective as of September 30, 2007.
SEC. 4. EXTENSION OF SSI WEB-BASED ASSET DEMONSTRATION PROJECT TO THE 
MEDICAID PROGRAM.
    (a) In General.--Beginning on October 1, 2007, and ending on 
September 30, 2012, the Secretary of Health and Human Services shall 
provide for the application to asset eligibility determinations under 
the Medicaid program under title XIX of the Social Security Act of the 
automated, secure, web-based asset verification request and response 
process being applied for determining eligibility for benefits under 
the Supplemental Security Income (SSI) program under title XVI of such 
Act under a demonstration project conducted under the authority of 
section 1631(e)(1)(B)(ii) of such Act (42 U.S.C. 1383(e)(1)(B)(ii)).
    (b) Limitation.--Such application shall only extend to those States 
in which such demonstration project is operating and only for the 
period in which such project is otherwise provided.
    (c) Rules of Application.--For purposes of carrying out subsection 
(a), notwithstanding any other provision of law, information obtained 
from a financial institution that is used for purposes of eligibility 
determinations under such demonstration project with respect to the 
Secretary of Health and Human Services under the SSI program may also 
be shared and used by States for purposes of eligibility determinations 
under the Medicaid program. In applying section 1631(e)(1)(B)(ii) of 
the Social Security Act under this subsection, references to the 
Commissioner of Social Security and benefits under title XVI of such 
Act shall be treated as including a reference to a State described in 
subsection (b) and medical assistance under title XIX of such Act 
provided by such a State.
SEC. 5. 6-MONTH DELAY IN REQUIREMENT TO USE TAMPER-RESISTANT 
PRESCRIPTION PADS UNDER MEDICAID.
    Effective as if included in the enactment of section 7002(b) of the 
U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq 
Accountability Appropriations Act, 2007 (Public Law 110-28, 121 Sta. 
187), paragraph (2) of such section is amended by striking ``September 
30, 2007'' and inserting ``March 31, 2008''.
SEC. 6. ADDITIONAL FUNDING FOR THE MEDICARE PHYSICIAN ASSISTANCE AND 
QUALITY INITIATIVE FUND.
    Section 1848(l)(2) of the Social Security Act (42 U.S.C. 1395w-
4(l)(2)) is amended--
        (1) in subparagraph (A), by adding at the end the following: 
    ``In addition, there shall be available to the Fund for 
    expenditures during 2009 an amount equal to $325,000,000 and for 
    expenditures during or after 2013 an amount equal to 
    $60,000,000.''; and
        (2) in subparagraph (B)--
            (A) in the heading, by striking ``furnished during 2008'';
            (B) by striking ``specified in subparagraph (A)'' and 
        inserting ``specified in the first sentence of subparagraph 
        (A)''; and
            (C) by inserting after ``furnished during 2008'' the 
        following: ``and for the obligation of the entire first amount 
        specified in the second sentence of such subparagraph for 
        payment with respect to physicians' services furnished during 
        2009 and of the entire second amount so specified for payment 
        with respect to physicians' services furnished on or after 
        January 1, 2013''.
SEC. 7. LIMITATION ON IMPLEMENTATION FOR FISCAL YEARS 2008 AND 2009 OF 
A PROSPECTIVE DOCUMENTATION AND CODING ADJUSTMENT IN RESPONSE TO THE 
IMPLEMENTATION OF THE MEDICARE SEVERITY DIAGNOSIS RELATED GROUP (MS-
DRG) SYSTEM UNDER THE MEDICARE PROSPECTIVE PAYMENT SYSTEM FOR INPATIENT 
HOSPITAL SERVICES.
    (a) In General.--In implementing the final rule published on August 
22, 2007, on pages 47130 through 48175 of volume 72 of the Federal 
Register, the Secretary of Health and Human Services (in this section 
referred to as the ``Secretary'') shall apply prospective documentation 
and coding adjustments (made in response to the implementation of a 
Medicare Severity Diagnosis Related Group (MS-DRG) system under the 
hospital inpatient prospective payment system under section 1886(d) of 
the Social Security Act (42 U.S.C. 1395ww(d)) of--
        (1) for discharges occurring during fiscal year 2008, 0.6 
    percent rather than the 1.2 percent specified in such final rule; 
    and
        (2) for discharges occurring during fiscal year 2009, 0.9 
    percent rather than the 1.8 percent specified in such final rule.
    (b) Subsequent Adjustments.--
        (1) In general.--Notwithstanding any other provision of law, if 
    the Secretary determines that implementation of such Medicare 
    Severity Diagnosis Related Group (MS-DRG) system resulted in 
    changes in coding and classification that did not reflect real 
    changes in case mix under section 1886(d) of the Social Security 
    Act (42 U.S.C. 1395ww(d)) for discharges occurring during fiscal 
    year 2008 or 2009 that are different than the prospective 
    documentation and coding adjustments applied under subsection (a), 
    the Secretary shall--
            (A) make an appropriate adjustment under paragraph 
        (3)(A)(vi) of such section 1886(d); and
            (B) make an additional adjustment to the standardized 
        amounts under such section 1886(d) for discharges occurring 
        only during fiscal years 2010, 2011, and 2012 to offset the 
        estimated amount of the increase or decrease in aggregate 
        payments (including interest as determined by the Secretary) 
        determined, based upon a retrospective evaluation of claims 
        data submitted under such Medicare Severity Diagnosis Related 
        Group (MS-DRG) system, by the Secretary with respect to 
        discharges occurring during fiscal years 2008 and 2009.
        (2) Requirement.--Any adjustment under paragraph (1)(B) shall 
    reflect the difference between the amount the Secretary estimates 
    that implementation of such Medicare Severity Diagnosis Related 
    Group (MS-DRG) system resulted in changes in coding and 
    classification that did not reflect real changes in case mix and 
    the prospective documentation and coding adjustments applied under 
    subsection (a). An adjustment made under paragraph (1)(B) for 
    discharges occurring in a year shall not be included in the 
    determination of standardized amounts for discharges occurring in a 
    subsequent year.
        (3) Rule of construction.--Nothing in this section shall be 
    construed as--
            (A) requiring the Secretary to adjust the average 
        standardized amounts under paragraph (3)(A)(vi) of such section 
        1886(d) other than as provided under this section; or
            (B) providing authority to apply the adjustment under 
        paragraph (1)(B) other than for discharges occurring during 
        fiscal years 2010, 2011, and 2012.
        (4) Judicial review.--There shall be no administrative or 
    judicial review under section 1878 of the Social Security Act (42 
    U.S.C. 1395oo) or otherwise of any determination or adjustments 
    made under this subsection.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.

Summary: TMA, Abstinence Education, and QI Programs Extension Act of 2007 - (Sec. 2) Amends the Tax Relief and Health Care Act of 2006, as amended, to extend transitional medical assistance (TMA) and the abstinence education program through December 31, 2007.

(Sec. 3) Amends title XIX (Medicaid) of the Social Security Act (SSA) to extend through December 2007: (1) the qualifying individual (QI) program; and (2) a specified allocation of funds for state coverage of Medicare cost-sharing for additional low-income Medicare beneficiaries.

(Sec. 4) Directs the Secretary of Health and Human Services, for FY2008-FY2012, to provide for the application to asset eligibility determinations under the Medicaid program of the automated, secure, web-based asset verification request and response process being applied for determining eligibility for Supplemental Security Income benefits under a specified demonstration project authorized by SSA title XVI (Supplemental Security Income) (SSI)

Limits such application to those states in which such a demonstration project is operating and only for the period in which it is otherwise provided.

(Sec. 5) Amends the U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act, 2007 to delay for six months, from September 30, 2007, through March 31, 2008, the effective date of the requirement to use tamper-resistant prescription pads to prescribe covered outpatient drugs under the Medicaid program.

(Sec. 6) Amends SSA title XVIII (Medicare) to provide additional funding for the Medicare Physician Assistance and Quality Initiative Fund for expenditures during FY2009 and during or after FY2013.

(Sec. 7) Directs the Secretary of Health and Human Services, in implementing a specified rule, to apply certain prospective documentation and coding (PDC) adjustments (made in response to the implementation of the Medicare Severity Diagnosis Related Group (MS-DRG) system under the Medicare prospective payment system (PPS) for inpatient hospital services) for discharges occurring during FY2008 and FY2009.

Reduces the percentage specified in such rule for discharges occurring: (1) during FY2008 from 1.2% to 0.6%; and (2) during FY2009 from 1.8% to 0.9%.

Directs the Secretary to make further specified PDC adjustments, as well as additional adjustments in FY2010-FY2012, if the implementation of the MS-DRG system resulted in changes in coding and classification that did not reflect real changes in case mix for FY2008 or FY2009 discharges that are different than the PDC adjustments applied under this section.