In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

Input: Consider Input: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Comprehensive Immunosuppressive Drug
Coverage for Kidney Transplant Patients Act of 2011''.

SEC. 2. EXTENDED MONTHS OF COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR
KIDNEY TRANSPLANT PATIENTS AND OTHER RENAL DIALYSIS
PROVISIONS.

(a) Medicare Entitlement to Immunosuppressive Drugs for Kidney
Transplant Recipients.--
(1) Kidney transplant recipients.--Section 226A(b)(2) of
the Social Security Act (42 U.S.C. 426-1(b)(2)) is amended by
inserting ''(except for eligibility for enrollment under part B
solely for purposes of coverage of immunosuppressive drugs
described in section 1861(s)(2)(J))'' before '', with the
thirty-sixth month''.
(2) Individuals eligible only for coverage of
immunosuppressive drugs.--
(A) Section 1836 of the Social Security Act (42
U.S.C. 1395o) is amended--
(i) by striking ''Every'' and inserting
''(a) In General.--Every''; and
(ii) by inserting at the end the following
new subsection:
''(b) Individuals Eligible for Immunosuppressive Drug Coverage.--
Beginning on January 1, 2012, every individual whose insurance benefits
under part A have ended (whether before, on, or after such date) by
reason of section 226A(b)(2) is eligible for enrollment in the
insurance program established by this part solely for purposes of
coverage of immunosuppressive drugs.''.
(B) Conforming amendment.--Sections 1837, 1838, and
1839 of the Social Security Act (42 U.S.C. 1395(p), 42
U.S.C. 1395(q), 42 U.S.C. 1395(r)) are each amended by
striking ''1836'' and inserting ''1836(a)'' each place
it appears.
(3) Enrollment for individuals only eligible for coverage
of immunosuppressive drugs.--Section 1837 of the Social
Security Act (42 U.S.C. 1395(p)) is amended by adding at the
end the following new subsection:
''(m)(1) Any individual who is eligible under section 1836(b) to
enroll in the medical insurance program established under this part for
purposes of coverage of immunosuppressive drugs may enroll only in such
manner and form as may be prescribed by regulations, and only during an
enrollment period described in this subsection.
''(2) An individual described in paragraph (1) may enroll beginning
on the first day of the third month before the month in which the
individual first satisfies section 1836(b).
''(3) An individual described in paragraph (1) whose entitlement
for hospital insurance benefits under part A ends by reason of section
226A(b)(2) on or after January 1, 2012, shall be deemed to have
enrolled in the medical insurance program established by this part for
purposes of coverage of immunosuppressive drugs.''.
(4) Coverage period for individuals only eligible for
coverage of immunosuppressive drugs.--
(A) In general.--Section 1838 of the Social
Security Act (42 U.S.C. 1395q) is amended by adding at
the end the following new subsection:
''(g) In the case of an individual described in section 1836(b),
the following rules shall apply:
''(1) In the case of such an individual who is deemed to
have enrolled in part B for coverage of immunosuppressive drugs
under section 1837(m)(3), such individual's coverage period
shall begin on the first day of the month in which the
individual first satisfies section 1836(b).
''(2) In the case of such an individual who enrolls in part
B for coverage of immunosuppressive drugs under section
1837(m)(2), such individual's coverage period shall begin on
the first day of the month in which the individual first
satisfies section 1836(b) or the month following the month in
which the individual so enrolls, whichever is later.
''(3) The provisions of subsections (b) and (d) shall apply
with respect to an individual described in paragraph (1) or
(2).
''(4) In addition to the reasons for termination under
subsection (b), the coverage period of an individual described
in paragraph (1) or (2) shall end when the individual becomes
entitled to benefits under this title under section 226(a),
226(b), or 226A.''.
(B) Conforming amendments.--Section 1838(b) of the
Social Security Act (42 U.S.C. 1395q(b)) is amended, in
the matter following paragraph (2), by adding ''or
section 1837(m)(3)'' after ''section 1837(f)'' each
place it appears.
(5) Premiums for individuals only eligible for coverage of
immunosuppressive drugs.--Section 1839 of the Social Security
Act (42 U.S.C. 1395r) is amended--
(A) in subsection (b), by adding at the end the
following new sentence: ''No increase in the premium
shall be effected for individuals who are enrolled
pursuant to section 1836(b) for coverage only of
immunosuppressive drugs.''; and
(B) by adding at the end the following new
subsection:
''(j) Determination of Premium for Individuals Only Eligible for
Coverage of Immunosuppressive Drugs.--The Secretary shall, during
September of each year, determine and promulgate a monthly premium rate
for the succeeding calendar year for individuals who enroll only for
the purpose of coverage of immunosuppressive drugs under section
1836(b). Such premium shall be equal to 35 percent of the monthly
actuarial rate for enrollees age 65 and over, determined according to
paragraph (1), for that succeeding calendar year. The monthly premium
of each individual enrolled for coverage of immunosuppressive drugs
under section 1836(b) for each month shall be the amount promulgated in
this subsection. Such amount shall be adjusted in accordance with
subsections (c) and (f).''.
(6) Government contribution.--Section 1844(a) of the Social
Security Act (42 U.S.C. 1395w(a)) is amended--
(A) in paragraph (3), by striking the period at the
end and inserting ''; plus'';
(B) by adding at the end the following new
paragraph:
''(4) a Government contribution equal to the estimated
aggregate reduction in premiums payable under part B that
results from establishing the premium at 35 percent of the
actuarial rate under section 1839(j) instead of 50 percent of
the actuarial rate for individuals who enroll only for the
purpose of coverage of immunosuppressive drugs under section
1836(b).''; and
(C) by adding at the end the following flush
matter:
''The Government contribution under paragraph (4) shall be
treated as premiums payable and deposited for purposes of
subparagraphs (A) and (B) of paragraph (1).''.
(7) Extension of secondary payer requirements for esrd
beneficiaries eligible for coverage of immunosuppressive
drugs.--Section 1862(b)(1)(C) of the Social Security Act (42
U.S.C. 1395(y)(b)(1)) is amended by adding at the end the
following new sentence: ''With regard to immunosuppressive
drugs furnished to an individual who enrolls for the purpose of
coverage of immunosuppressive drugs under section 1836(b) on or
after January 1, 2012, this subparagraph shall apply without
regard to any time limitation, except that when such individual
becomes entitled to benefits under this title under sections
226(a) or 226(b), or entitled to or eligible for benefits under
this title under section 226A, the provisions of subparagraphs
(A) and (B), and the time limitations under this subparagraph,
respectively, shall apply.''.
(8) Ensuring coverage under the medicare savings program.--
Section 1905(p)(1)(A) of the Social Security Act (42 U.S.C.
1396d(p)(1)(A)) is amended by inserting ''or an individual who
is enrolled under part B for the purpose of coverage of
immunosuppressive drugs under section 1836(b)'' after ''section
1818''.
(9) Part d.--Section 1860D-1(a)(3)(A) of the Social
Security Act (42 U.S.C. 1395w-101(a)(3)(A)) is amended by
inserting ''(but not including an individual enrolled solely
for coverage of immunosuppressive drugs under section
1836(b))'' before the period at the end.

Output: Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2011 - Amends title II (Old Age, Survivors and Disability Benefits) (OASDI) of the Social Security Act (SSA) to extend the months of coverage of immunosuppressive drugs for kidney transplant patients.

Amends SSA title XVIII (Medicare) to make eligible for enrollment in Medicare part B (Supplementary Medical Insurance), solely for the purpose of such drug coverage, every individual whose insurance benefits under Medicare part A (Hospital Insurance) have ended by reason of a kidney transplant or the end of any requirement for a regular course of dialysis.

Directs the Secretary of Health and Human Services (HHS) to determine a monthly premium rate for such individuals equal to 35% of the monthly actuarial rate for enrollees age 65 and over. Prescribes a formula for detemination of a government contribution to such a premium.

Input: Consider Input: SECTION 1. SHORT TITLE; AMENDMENT OF 1986 CODE.

(a) Short Title.--This Act may be cited as the ''Tobacco Smuggling
Eradication Act of 2002''.

TITLE I--AMENDMENTS TO INTERNAL REVENUE CODE OF 1986

SEC. 101. AMENDMENT OF 1986 CODE.

Except as otherwise expressly provided, whenever in this title an
amendment or repeal is expressed in terms of an amendment to, or repeal
of, a section or other provision, the reference shall be considered to
be made to a section or other provision of the Internal Revenue Code of
1986.

SEC. 102. IMPROVED MARKING AND LABELING.

(a) In General.--Subsection (b) of section 5723 (relating to marks,
labels, and notices) is amended--
(1) by striking '', if any,'' and
(2) by adding at the end the following: ''Such marks,
labels, and notices shall include marks and notices relating to
the following:
''(1) Identification.--The Secretary shall promulgate
regulations that require each manufacturer or importer of
tobacco products to legibly print a unique serial number on all
packages of tobacco products manufactured or imported for sale
or distribution. Such serial number shall be designed to enable
the Secretary to identify the manufacturer or importer of the
product, and the location and date of manufacture or
importation. The Secretary shall determine the size and
location of the serial number.
''(2) Marking requirements for exports.--Each package of a
tobacco product that is exported shall be marked for export
from the United States. The Secretary shall promulgate
regulations to determine the size and location of the mark and
under what circumstances a waiver of this paragraph shall be
granted.''.
(b) Sales on Indian Reservations.--Section 5723 is amended by
adding at the end the following new subsections:
''(f) Sales on Indian Reservations.--The Secretary, in consultation
with the Secretary of the Interior, shall promulgate regulations that
require that each package of a tobacco product that is sold on an
Indian reservation (as defined in section 403(9) of the Indian Child
Protection and Family Violence Prevention Act (25 U.S.C. 3202(9)) be
labeled as such. Such regulations shall include requirements for the
size and location of the label.
''(g) Definition of Package.--For purposes of this section, the
term 'package' means the innermost sealed container irrespective of the
material from which such container is made, in which a tobacco product
is placed by the manufacturer and in which such tobacco product is
offered for sale to a member of the general public.''.

SEC. 103. WHOLESALERS REQUIRED TO HAVE PERMIT.

Section 5712 (relating to application for permit) is amended by
inserting '', wholesaler,'' after ''manufacturer''.

SEC. 104. CONDITIONS OF PERMIT.

Subsection (a) of section 5713 (relating to issuance of permit) is
amended to read as follows:
''(a) Issuance.--
''(1) In general.--A person shall not engage in business as
a manufacturer, wholesaler, or importer of tobacco products or
as an export warehouse proprietor without a permit to engage in
such business. Such permit shall be issued in such form and in
such manner as the Secretary shall by regulation prescribe, to
every person properly qualified under sections 5711 and 5712. A
new permit may be required at such other time as the Secretary
shall by regulation prescribe.
''(2) Conditions.--The issuance of a permit under this
section shall be conditioned upon the compliance with the
requirements of this chapter and the Contraband Cigarette
Trafficking Act (18 U.S.C. chapter 114), and any regulations
issued pursuant to such statutes.''.

SEC. 105. RECORDS TO BE MAINTAINED.

Section 5741 (relating to records to be maintained) is amended--
(1) by inserting ''(a) In General.--'' before ''Every
manufacturer'',
(2) by inserting ''every wholesaler,'' after ''every
importer,'',
(3) by striking ''such records'' and inserting ''records
concerning the chain of custody of the tobacco products and
such other records'', and
(4) by adding at the end the following new subsection:
''(b) Retailers.--Retailers shall maintain records of receipt of
tobacco products, and such records shall be available to the Secretary
for inspection and audit. An ordinary commercial record or invoice
shall satisfy the requirements of this subsection if such record shows
the date of receipt, from whom tobacco products were received, and the
quantity of tobacco products received.''.

SEC. 106. REPORTS.

Section 5722 (relating to reports) is amended--
(1) by inserting ''(a) In General.--'' before ''Every
manufacturer'', and
(2) by adding at the end the following new subsection:
''(b) Reports By Export Warehouse Proprietors.--
''(1) In general.--Prior to exportation of tobacco products
from the United States, the export warehouse proprietor shall
submit a report (in such manner and form as the Secretary may
by regulation prescribe) to enable the Secretary to identify
the shipment and assure that it reaches its intended
destination.
''(2) Agreements with foreign governments.--Notwithstanding
section 6103 of this title, the Secretary is authorized to
enter into agreements with foreign governments to exchange or
share information contained in reports received from export
warehouse proprietors of tobacco products if--
''(A) the Secretary believes that such agreement
will assist in--
''(i) ensuring compliance with the
provisions of this chapter or regulations
promulgated thereunder, or
''(ii) preventing or detecting violations
of the provisions of this chapter or
regulations promulgated thereunder, and
''(B) the Secretary obtains assurances from such
government that the information will be held in
confidence and used only for the purposes specified in
clauses (i) and (ii) of subparagraph (A).
No information may be exchanged or shared with any government
that has violated such assurances.''.

SEC. 107. FRAUDULENT OFFENSES.

(a) In General.--Subsection (a) of section 5762 (relating to
fraudulent offenses) is amended by striking paragraph (1) and
redesignating paragraphs (2) through (6) as paragraphs (1) through (5),
respectively.
(b) Offenses Relating to Distribution of Tobacco Products.--Section
5762 is amended--
(1) by redesignating subsection (b) as subsection (c),
(2) in subsection (c) (as so redesignated), by inserting
''or (b)'' after ''(a)'', and
(3) by inserting after subsection (a) the following new
subsection:
''(b) Offenses Relating to Distribution of Tobacco Products.--It
shall be unlawful--
''(1) for any person to engage in the business as a
manufacturer or importer of tobacco products or cigarette
papers and tubes, or to engage in the business as a wholesaler
or an export warehouse proprietor, without filing the bond and
obtaining the permit where required by this chapter or
regulations thereunder;
''(2) for a manufacturer, importer, or wholesaler permitted
under this chapter intentionally to ship, transport, deliver,
or receive any tobacco products from or to any person other
than a person permitted under this chapter or a retailer,
except a permitted importer may receive foreign tobacco
products from a foreign manufacturer or a foreign distributor
that have not previously entered the United States;
''(3) for any person (other than the original manufacturer
of such tobacco products or an export warehouse proprietor
authorized to receive any tobacco products that have previously
been exported and returned to the United States) to receive any
tobacco products that have previously been exported and
returned to the United States;
''(4) for any export warehouse proprietor intentionally to
ship, transport, sell, or deliver for sale any tobacco products
to any person other than the original manufacturer of such
tobacco products, another export warehouse proprietor, or a
foreign purchaser;
''(5) for any person (other than a manufacturer or an
export warehouse proprietor permitted under this chapter)
intentionally to ship, transport, receive, or possess, for
purposes of resale, any tobacco product in packages marked
pursuant to regulations issued under section 5723, other than
for direct return to a manufacturer for repacking or for re-
exportation or to an export warehouse proprietor for re-
exportation;
''(6) for any manufacturer, importer, export warehouse
proprietor, or wholesaler permitted under this chapter to make
intentionally any false entry in, to fail willfully to make
appropriate entry in, or to fail willfully to maintain properly
any record or report that such person is required to keep as
required by this chapter or the regulations promulgated
thereunder; and
''(7) for any person to alter, mutilate, destroy,
obliterate, or remove any mark or label required under this
chapter upon a tobacco product held for sale, except pursuant
to regulations of the Secretary authorizing relabeling for
purposes of compliance with the requirements of this section or
of State law.
Any person violating any of the provisions of this subsection shall,
upon conviction, be fined as provided in section 3571 of title 18,
United States Code, imprisoned for not more than 5 years, or both.''.
(c) Intentionally Defined.--Section 5762 is amended by adding at
the end the following:
''(d) Definition of Intentionally.--For purposes of this section
and section 5761, the term 'intentionally' means doing an act, or
omitting to do an act, deliberately, and not due to accident,
inadvertence, or mistake, regardless of whether the person knew that
the act or omission constituted an offense.''.

SEC. 108. CIVIL PENALTIES.

Subsection (a) of section 5761 (relating to civil penalties) is
amended--
(1) by striking ''willfully'' and inserting
''intentionally'', and
(2) by striking ''$1,000'' and inserting ''$10,000''.

SEC. 109. DEFINITIONS.

(a) Export Warehouse Proprietor.--Subsection (i) of section 5702
(relating to definition of export warehouse proprietor) is amended by
inserting before the period the following: ''or any person engaged in
the business of exporting tobacco products from the United States for
purposes of sale or distribution. Any duty free store that sells,
offers for sale, or otherwise distributes to any person in any single
transaction more than 30 packages of cigarettes, or its equivalent for
other tobacco products as the Secretary shall by regulation prescribe,
shall be deemed an export warehouse proprietor under this chapter''.
(b) Retailer; Wholesaler.--Section 5702 is amended by adding at the
end the following:
''(p) Retailer.--The term 'retailer' means any dealer who sells, or
offers for sale, any tobacco product at retail. The term 'retailer'
includes any duty-free store that sells, offers for sale, or otherwise
distributes at retail in any single transaction 30 or less packages, or
its equivalent for other tobacco products.
''(q) Wholesaler.--The term 'wholesaler' means any person engaged
in the business of purchasing tobacco products for resale at wholesale,
or any person acting as an agent or broker for any person engaged in
the business of purchasing tobacco products for resale at wholesale.''.

SEC. 110. EFFECTIVE DATE.

The amendments made by this title shall take effect on January 1,
2003.

TITLE II--AMENDMENTS TO THE CONTRABAND CIGARETTE TRAFFICKING ACT

SEC. 201. AMENDMENTS TO THE CONTRABAND CIGARETTE TRAFFICKING ACT.

(a) Definitions.--Section 2341 of title 18, United States Code, is
amended--
(1) in paragraph (2)--
(A) by striking ''60,000'' and inserting
''30,000'', and
(B) by inserting ''or importer'' after ''as a
manufacturer'';
(2) in paragraph (4), by striking ''and'' at the end;
(3) in paragraph (5), by striking the period and inserting
a semicolon; and
(4) by adding at the end the following:
''(6) the term 'tobacco product' means cigars, cigarettes,
smokeless tobacco, and pipe tobacco (as such terms are defined
in section 5701 of the Internal Revenue Code of 1986); and
''(7) the term 'contraband tobacco product' means a
quantity of tobacco product that is equivalent to or more than
30,000 cigarettes as determined by regulation, which bear no
evidence of the payment of applicable State tobacco taxes in
the State where such tobacco products are found, if such State
requires a stamp, impression, or other indication to be placed
on packages or other containers of product to evidence payment
of tobacco taxes.''
(b) Unlawful Acts.--Section 2342 of title 18, United States Code,
is amended--
(1) in subsection (a), by inserting ''or contraband tobacco
products'' before the period;
(2) by amending subsection (b) to read as follows:
''(b)(1) It shall be unlawful for any person--
''(A) knowingly to make any false statement or
representation with respect to the information required by this
chapter to be kept in the records or reports of any person who
ships, sells, or distributes--
''(i) any quantity of cigarettes in excess of
30,000 in a single transaction or in a series of
related transactions, or
''(ii) tobacco products in such equivalent
quantities as shall be determined by regulation, or
''(B) knowingly to fail to maintain records or reports,
alter or obliterate required markings, or interfere with any
inspection, required under this chapter, with respect to such
quantity of cigarettes or other tobacco products.''; and
(3) by adding at the end the following:
''(c) It shall be unlawful for any person knowingly to transport
tobacco products under a false bill of lading or without any bill of
lading.''.
(c) Recordkeeping.--Section 2343 of title 18, United States Code,
is amended--
(1) in subsection (a), by striking ''60,000 in a single
transaction'' and inserting ''30,000 in a single transaction or
in a series of related transactions, or, in the case of other
tobacco products an equivalent quantity as determined by
regulation,'';
(2) by amending the last sentence of subsection (a) to read
as follows: ''Except as provided in subsection (c) of this
section, nothing contained herein shall authorize the Secretary
to require reporting under this section.'';
(3) in subsection (b), by striking ''60,000 in a single
transaction'' and inserting ''30,000 in a single transaction or
in a series of related transactions, or, in the case of other
tobacco products an equivalent quantity as determined by
regulation,''; and
(4) by adding at the end the following:
''(c)(1) Any person who ships, sells, or distributes tobacco
products for resale in interstate commerce, whereby such tobacco
products are shipped into a State taxing the sale or use of such
tobacco products or who advertises or offers tobacco products for such
sale or transfer and shipment shall--
''(A) first file with the tobacco tax administrator of the
State into which such shipment is made or in which such
advertisement or offer is disseminated, a statement setting for
the person's name, and trade name (if any), and the address of
the person's principal place of business and of any other place
of business; and
''(B) not later than the 10th of each calendar month, file
with the tobacco tax administrator of the State into which such
shipment is made a memorandum or a copy of the invoice covering
each and every shipment of tobacco products made during the
previous calendar month into such State; the memorandum or
invoice in each case to include the name and address of the
person to whom the shipment was made, the brand, and the
quantity thereof.
''(2) The fact that any person ships or delivers for shipment any
tobacco products shall, if such shipment is into a State in which such
person has filed a statement with the tobacco tax administrator under
paragraph (1)(A) of this subsection, be presumptive evidence that such
tobacco products were sold, shipped, or distributed for resale by such
person.
''(3) For purposes of this subsection--
''(A) the term 'use' in addition to its ordinary meaning,
means consumption, storage, handling, or disposal of tobacco
products; and
''(B) the term 'tobacco tax administrator' means the State
official authorized to administer tobacco tax laws of the
State.''.
(d) Penalties.--Section 2344 of title 18, United States Code, is
amended--
(1) in subsection (b), by inserting ''or (c)'' after
''section 2342(b)'' and by inserting ''or (c)'' after section
2343(a)''; and
(2) by striking subsection (c) and inserting the following
new subsection:
''(c) Any contraband cigarettes or contraband tobacco products
involved in any violation of the provisions of this chapter shall be
subject to seizure and forfeiture, and all provisions of section
9703(o) of title 31, United States Code, shall, so far as applicable,
extend to seizures and forfeitures under the provisions of this
chapter.''
(e) Repeal.--The Act of October 19, 1949, entitled ''An Act to
assist States in collecting sales and use taxes on cigarettes'', 63
Stat. 884 (chapter 10A of title 15, U.S.C.), is hereby repealed.

Output: Tobacco Smuggling Eradication Act of 2002 - Amends chapter 52 (Tobacco Products and Cigarette Papers and Tubes) of the Internal Revenue Code to require all packages of tobacco products to carry a unique legibly printed serial number by which the Secretary of the Treasury can identify the manufacturer or importer and the location and date of manufacture or importation. Requires tobacco products sold on Indian reservations to be labeled as such.Requires a tobacco wholesaler to have a permit and to maintain certain records.Requires export warehouse proprietors to file certain reports with the Secretary. Authorizes the Secretary to enter into certain tobacco related information agreements with foreign countries.Establishes new offenses relating to the distribution of tobacco.Raises the $1,000 civil penalty under chapter 52 to $10,000.Amends the Contraband Cigarette Trafficking Act to: (1) expand the applicability of such Act from cigarettes only to "tobacco product" (cigars, cigarettes, smokeless tobacco, and pipe tobacco); (2) define "contraband tobacco product" as a quantity of tobacco product that is equivalent to or more than 30,000 cigarettes (currently, 60,000) which bear no evidence of the payment of applicable State tobacco taxes; (3) establish new unlawful acts; and (4) require additional recordkeeping.Repeals Federal law provisions concerning reports required to State tobacco tax administrators by individuals engaged in interstate cigarette commerce.

Input: Consider Input: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Medicare Ambulance Payment Reform
Act of 2001''.

SEC. 2. AMBULANCE PAYMENT RATES.

(a) Payment Rates.--
(1) In general.--Section 1834(l)(3) of the Social Security
Act (42 U.S.C. 1395m(l)(3)) is amended to read as follows:
''(3) Payment rates.--
''(A) In general.--Subject to any adjustment under
subparagraph (B) and paragraph (9) and the full payment
of a national mileage rate pursuant to subparagraph
(2)(E), in establishing such fee schedule, the
following rules shall apply:
''(i) Payment rates in 2002.--
''(I) Ground ambulance services.--
In the case of ground ambulance
services furnished under this part in
2002, the Secretary shall set the
payment rates under the fee schedule
for such services at a rate based on
the average costs (as determined by the
Secretary on the basis of the most
recent and reliable information
available) incurred by full cost
ambulance suppliers in providing
nonemergency basic life support
ambulance services covered under this
title, with adjustments to the rates
for other ground ambulance service
levels to be determined based on the
rule established under paragraph (1).
For the purposes of the preceding
sentence, the term 'full cost ambulance
supplier' means a supplier for which
volunteers or other unpaid staff
comprise less than 20 percent of the
supplier's total staff and which
receives less than 20 percent of space
and other capital assets free of
charge.
''(II) Other ambulance services.--
In the case of ambulance services not
described in subclause (I) that are
furnished under this part in 2002, the
Secretary shall set the payment rates
under the fee schedule for such
services based on the rule established
under paragraph (1).
''(ii) Payment rates in subsequent years
for all ambulance services.--In the case of any
ambulance service furnished under this part in
2003 or any subsequent year, the Secretary
shall set the payment rates under the fee
schedule for such service at amounts equal to
the payment rate under the fee schedule for
that service furnished during the previous
year, increased by the percentage increase in
the Consumer Price Index for all urban
consumers (United States city average) for the
12-month period ending with June of the
previous year.
''(B) Adjustment in rural rates.--For years
beginning with 2004, the Secretary, after taking into
consideration the recommendations contained in the
report submitted under section 221(b)(3) the Medicare,
Medicaid, and SCHIP Benefits Improvements and
Protection Act of 2000, shall adjust the fee schedule
payment rates that would otherwise apply under this
subsection for ambulance services provided in low
density rural areas based on the increased cost (if
any) of providing such services in such areas.''.
(2) Conforming amendment.--Section 221(c) of the Medicare,
Medicaid, and SCHIP Benefits Improvement and Protection Act of
2000 (114 Stat. 2763A-487), as enacted into law by section
1(a)(6) of Public Law 106-554, is repealed.
(3) Technical amendment.--
(A) In general.--Paragraph (8) of section 1834(l)
of the Social Security Act (42 U.S.C. 1395m(l)), as
added by section 221(a) of the Medicare, Medicaid, and
SCHIP Benefits Improvement and Protection Act of 2000
(114 Stat. 2763A-487), as enacted into law by section
1(a)(6) of Public Law 106-554, is redesignated as
paragraph (9).
(B) Effective date.--The amendment made by
subparagraph (A) shall take effect as if included in
the enactment of such section 221(a).
(b) Use of Medical Conditions for Coding Ambulance Services.--
Section 1834(l)(7) of the Social Security Act (42 U.S.C. 1395m(l)(7))
is amended to read as follows:
''(7) Coding system.--
''(A) In general.--The Secretary shall, in
accordance with section 1173(c)(1)(B), establish a
system or systems for the coding of claims for
ambulance services for which payment is made under this
subsection, including a code set specifying the medical
condition of the individual who is transported and the
level of service that is appropriate for the
transportation of an individual with that medical
condition.
''(B) Medical conditions.--The code set established
under subparagraph (A) shall--
''(i) take into account the list of medical
conditions developed in the course of the
negotiated rulemaking process conducted under
paragraph (1); and
''(ii) notwithstanding any other provision
of law, be adopted as a standard code set under
section 1173(c).''.

SEC. 3. PRUDENT LAYPERSON STANDARD FOR EMERGENCY AMBULANCE SERVICES
UNDER MEDICARE AND MEDICAID.

(a) Ambulance Services for Medicare Fee-For-Service
Beneficiaries.--Section 1861(s)(7) of the Social Security Act (42
U.S.C. 1395x(s)(7)) is amended by inserting before the semicolon at the
end the following: '', except that such regulations shall not fail to
treat ambulance services as medical and other health services solely
because the ultimate diagnosis of the individual receiving the
ambulance services results in the conclusion that ambulance services
were not necessary, as long as the request for ambulance services is
made after the sudden onset of a medical condition that would be
classified as an emergency medical condition (as defined in section
1852(d)(3)(B)).''.
(b) Ambulance Services for Medicare+Choice Enrollees.--Section
1852(d)(3)(A) of the Social Security Act (42 U.S.C. 1395w-22(d)(3)(A))
is amended by inserting ''(including the services described in section
1861(s)(7))'' after ''outpatient services'' in the matter preceding
clause (i).
(c) Ambulance Services in Medicaid Managed Care Plans.--Section
1932(b)(2)(B) of the Social Security Act (42 U.S.C. 1396u-2(b)(2)(B))
is amended by inserting ''(including the services described in section
1861(s)(7) (if covered by the State plan))'' after ''outpatient
services'' in the matter preceding clause (i).
(d) Effective Date.--The amendments made by this section shall
apply with respect to services provided on and after the date of
enactment of the Act.
Output: Medicare Ambulance Payment Reform Act of 2001 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to revise requirements for payment for ambulance services concerning: (1) the establishment of a fee schedule; and (2) the coding system specifying the medical condition of the individual transported by an ambulance and the appropriate level of transportation service.Amends SSA titles XVIII (Medicare) (including part C (Medicare+Choice) of the Medicare program) and XIX (Medicaid) to establish a prudent layperson standard for justification of emergency ambulance services under Medicare and Medicaid.