Physician Payment and Therapy Relief Act of 2010

Bill: 111-hr-5712
Sponsor: Rep. Levin, Sander M. [D-MI-12]
Introduced: 2010-07-13 in the House
Policy area: Health
Subjects: Appropriations
Child health
Department of Health and Human Services
Government employee pay, benefits, personnel management
Government information and archives
Government trust funds
Health care costs and insurance
Health care coverage and access
Health facilities and institutions
Intergovernmental relations
Long-term, rehabilitative, and terminal care
Medicaid
Medical education
Medicare
Military medicine
Military personnel and dependents
Poverty and welfare assistance
Prescription drugs
State and local finance
Veterans' medical care

Summary:
action_date: 2010-07-13
text: 
Veterans', Seniors', and Children's Health Technical Corrections Act of 2010 - Amends the Patient Protection and Affordable Care Act (PPACA) to apply to elections made on and after enactment of PPACA the 12-month special Medicare part B (Supplementary Medical Insurance) enrollment period (under title XVIII [Medicare] of the Social Security Act [SSA]) for military retirees, their spouses (including widows/widowers), and dependent children, who are otherwise eligible for TRICARE (the health care plan under the Department of Defense [DOD]) and entitled to Medicare part A (Hospital Insurance) based on disability or end stage renal disease (ESRD), but who have declined Medicare part B (Supplementary Medical Insurance).
 
Repeals the delay until FY2012 of the implementation of Version 4 of the Resource Utilization Groups (RUG-IV) for purposes of reimbursing skilled nursing facilities under Medicare. Allows RUG-IV to go into effect on October 1, 2010.
 
Revises specified requirements for reallocating unused residency positions to qualifying hospitals for primary care residents, for purposes of payments to hospitals for graduate medical education (GME) costs, to apply them to hospitals which are members of the same affiliated group. Makes the reference level for each such hospital the reference resident level with respect to the cost reporting period that results in the smallest difference between such level and the otherwise applicable resident limit.
 
Amends Public Health Service Act and SSA title XIX (Medicaid) to require the inclusion of orphan drugs for rare diseases or conditions among covered outpatient drugs under the 340B drug discount program (which limits the cost of covered outpatient drugs to certain federal grantees) for eligible children's hospitals.
 
Makes technical corrections to SSA titles XIX and XXI (Children's Health Insurance Program) (CHIP). 
 
Repeals the requirement that Medicaid agencies exclude individuals or entities from participating in Medicaid for a specified period of time if the entity or individual owns, controls, or manages an entity that: (1) has failed to repay overpayments during a specified period; (2) is suspended, excluded, or terminated from participation in any Medicaid program; or (3) is affiliated with an individual or entity that has been suspended, excluded, or terminated from Medicaid participation.
 
Delays until calendar 2014 the increase from 100% to 133% of the income official poverty line applicable to a family of the size involved of the income level the state is required to establish with respect to a Medicaid group containing children born after September 30, 1983 (or, at the option of a State, after any earlier date), who have attained six years of age but have not attained 19 years of age.
 
 
Amends the Children's Health Insurance Program Reauthorization Act of 2009 with respect to the requirement that the Secretary of Health and Human Services (HHS) calculate or publish any national or state-specific error rate based on the application of the federal payment error rate measurement (PERM) requirements to CHIP. Declares that the Secretary of Health and Human Services is not required to calculate or publish a national or a state-specific error rate for FY2009 or FY2010.
 
Revises requirements for CHIP coverage of the children of state employees as targeted low-income children. Repeals the requirement that the hardship exception in favor of such a child, where the annual aggregate amount of premiums and cost-sharing imposed for coverage of the child's family would exceed 5% of the family's income for the year involved, be determined only on a case-by-case basis.
 
 
Revises requirements for calculation of the net average allowable costs of a state in the formula for determination of federal payments to states to encourage the adoption and use of certified electronic health record (EHR) technology.
 

 
Makes appropriations to the Secretary of HHS for the Centers for Medicare and Medicaid Services Program Management Account with respect to Medicare claims reprocessing.
 
Amends the Tax Relief and Health Care Act of 2006, as modified by other federal law, to extend through FY2011 section 508 hospital reclassifications. (&quot;Section 508&quot; refers to Section 508 of the Medicare Modernization Act of 2003, which allows the temporary reclassification of a hospital with a low Medicare area wage index, for reimbursement purposes, to a nearby location with a higher Medicare area wage index, so that the &quot;Section 508 hospital&quot; will receive the higher Medicare reimbursement rate.)
 
Modifies amounts available to the Medicare Improvement Fund for expenditures from the Fund for services furnished during FY2014 and FY2015.
 


action_date: 2010-07-14
text: 

(This measure has not been amended since it was introduced. The summary of that version is repeated here.)

 
Veterans', Seniors', and Children's Health Technical Corrections Act of 2010 - (Sec. 2) Amends the Patient Protection and Affordable Care Act (PPACA) to apply to elections made on and after enactment of PPACA the 12-month special Medicare part B (Supplementary Medical Insurance) enrollment period (under title XVIII [Medicare] of the Social Security Act [SSA]) for military retirees, their spouses (including widows/widowers), and dependent children, who are otherwise eligible for TRICARE (the health care plan under the Department of Defense [DOD]) and entitled to Medicare part A (Hospital Insurance) based on disability or end stage renal disease (ESRD), but who have declined Medicare part B (Supplementary Medical Insurance).
 
(Sec. 3) Repeals the delay until the beginning of FY2012 of the implementation of Version 4 of the Resource Utilization Groups (RUG-IV) for purposes of reimbursing skilled nursing facilities under Medicare. Allows RUG-IV to go into effect on October 1, 2010.
 
(Sec. 4) Revises specified requirements for reallocating unused residency positions to qualifying hospitals for primary care residents, for purposes of payments to hospitals for graduate medical education (GME) costs, to apply them to hospitals which are members of the same affiliated group. Makes the reference level for each such hospital the reference resident level with respect to the cost reporting period that results in the smallest difference between such level and the otherwise applicable resident limit.
 
(Sec. 5) Amends Public Health Service Act and SSA title XIX (Medicaid) to require the inclusion of orphan drugs for rare diseases or conditions among covered outpatient drugs under the 340B drug discount program (which limits the cost of covered outpatient drugs to certain federal grantees) for eligible children's hospitals.
 
 (Sec. 6) Makes technical corrections to SSA titles XIX and XXI (Children's Health Insurance Program) (CHIP). 
 
Repeals the requirement that Medicaid agencies exclude individuals or entities from participating in Medicaid for a specified period of time if the entity or individual owns, controls, or manages an entity that: (1) has failed to repay overpayments during a specified period; (2) is suspended, excluded, or terminated from participation in any Medicaid program; or (3) is affiliated with an individual or entity that has been suspended, excluded, or terminated from Medicaid participation.
 
Delays until calendar 2014 the increase from 100% to 133% of the income official poverty line applicable to a family of the size involved of the income level the state is required to establish with respect to a Medicaid group containing children born after September 30, 1983 (or, at the option of a State, after any earlier date), who have attained six years of age but have not attained 19 years of age.
 
 
Amends the Children's Health Insurance Program Reauthorization Act of 2009 with respect to the requirement that the Secretary of Health and Human Services (HHS) calculate or publish any national or state-specific error rate based on the application of the federal payment error rate measurement (PERM) requirements to CHIP. Declares that the Secretary of Health and Human Services is not required to calculate or publish a national or a state-specific error rate for FY2009 or FY2010.
 
Revises requirements for CHIP coverage of the children of state employees as targeted low-income children. Repeals the requirement that the hardship exception in favor of such a child, where the annual aggregate amount of premiums and cost-sharing imposed for coverage of the child's family would exceed 5% of the family's income for the year involved, be determined only on a case-by-case basis.
 
 
Revises requirements for calculation of the net average allowable costs of a state in the formula for determination of federal payments to states to encourage the adoption and use of certified electronic health record (EHR) technology.
 

 
(Sec. 7) Makes appropriations to the Secretary of HHS for the Centers for Medicare and Medicaid Services Program Management Account with respect to Medicare claims reprocessing.
 
(Sec. 8) Amends the Tax Relief and Health Care Act of 2006, as modified by other federal law, to extend through FY 2011 section 508 hospital reclassifications. (&quot;Section 508&quot; refers to Section 508 of the Medicare Modernization Act of 2003, which allows the temporary reclassification of a hospital with a low Medicare area wage index, for reimbursement purposes, to a nearby location with a higher Medicare area wage index, so that the &quot;Section 508 hospital&quot; will receive the higher Medicare reimbursement rate.)
 
(Sec. 9) Modifies amounts available to the Medicare Improvement Fund, for expenditures from the Fund for services furnished during FY2014 and FY2015.

action_date: 2010-11-18
text: 
Physician Payment and Therapy Relief Act of 2010 - Amends title XVIII (Medicare) of the Social Security Act to continue the existing 2.2% physician payment update that expires November 30, 2010, for an additional month through December 31, 2010.
 
Applies a 20% reduction, rather than the current 25% reduction, in the discount for certain multiple therapy services furnished on or after January 1, 2011. Exempts reduced expenditures attributable to the multiple procedure payment reduction from budget-neutrality requirements.
 
Declares that the budgetary effects of this Act, for purposes of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled &quot;Budgetary Effects of PAYGO Legislation&quot; for this Act, provided that such statement has been submitted prior to the vote on passage.

action_date: 2010-11-30
text: 

(This measure has not been amended since it was passed by the Senate on November 18, 2010. The summary of that version is repeated here.) 
 
 
Physician Payment and Therapy Relief Act of 2010 - Amends title XVIII (Medicare) of the Social Security Act to continue the existing 2.2% physician payment update that expires November 30, 2010, for an additional month through December 31, 2010. 
Applies a 20% reduction, rather than the current 25% reduction, in the discount for certain multiple therapy services furnished on or after January 1, 2011. Exempts reduced expenditures attributable to the multiple procedure payment reduction from budget-neutrality requirements.
 
Declares that the budgetary effects of this Act, for purposes of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled &quot;Budgetary Effects of PAYGO Legislation&quot; for this Act, provided that such statement has been submitted prior to the vote on passage.


Legislative actions:
action_date: 2010-11-30
text: Became Public Law No: 111-286.
action_date: 2010-11-30
text: Became Public Law No: 111-286.
action_date: 2010-11-30
text: Signed by President.
action_date: 2010-11-30
text: Signed by President.
action_date: 2010-11-29
text: Presented to President.
action_date: 2010-11-29
text: Presented to President.
action_date: 2010-11-29
text: Cleared for White House.
action_date: 2010-11-29
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2010-11-29
text: On motion that the House suspend the rules and agree to the Senate amendments Agreed to by voice vote. (text as House agreed to Senate amendment: CR H7618)
action_date: 2010-11-29
text: Resolving differences -- House actions: On motion that the House suspend the rules and agree to the Senate amendments Agreed to by voice vote.(text as House agreed to Senate amendment: CR H7618)
action_date: 2010-11-29
text: DEBATE - The House proceeded with forty minutes of debate on the Senate amendments to H.R.5712.
action_date: 2010-11-29
text: Mr. Pallone moved that the House suspend the rules and agree to the Senate amendments. (consideration: CR H7618-7621)
action_date: 2010-11-19
text: Message on Senate action sent to the House.
action_date: 2010-11-18
text: Passed Senate with an amendment and an amendment to the Title by Unanimous Consent.
action_date: 2010-11-18
text: Passed/agreed to in Senate: Passed Senate with an amendment and an amendment to the Title by Unanimous Consent.
action_date: 2010-11-18
text: Measure laid before Senate by unanimous consent. (consideration: CR S8046)
action_date: 2010-07-19
text: Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 465.
action_date: 2010-07-15
text: Received in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time.
action_date: 2010-07-14
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2010-07-14
text: On motion to suspend the rules and pass the bill Agreed to by voice vote. (text: CR H5563-5564)
action_date: 2010-07-14
text: Passed/agreed to in House: On motion to suspend the rules and pass the bill Agreed to by voice vote.(text: CR H5563-5564)
action_date: 2010-07-14
text: DEBATE - The House proceeded with forty minutes of debate on H.R. 5712.
action_date: 2010-07-14
text: Considered under suspension of the rules. (consideration: CR H5563-5565)
action_date: 2010-07-14
text: Mr. Stark moved to suspend the rules and pass the bill.
action_date: 2010-07-13
text: Referred to House Ways and Means
action_date: 2010-07-13
text: Referred to House Budget
action_date: 2010-07-13
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on the Budget, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2010-07-13
text: Referred to House Energy and Commerce
action_date: 2010-07-13
text: Sponsor introductory remarks on measure. (CR E1308)
action_date: 2010-07-13
text: Introduced in House
action_date: 2010-07-13
text: Introduced in House

Enacted as: number: 111-286