Ensuring Medicaid and Medicare Access to Providers Act

“(F) Exception for certain Medicare and Medicaid providers

“(i) In general—In the case of any month beginning in 2014 or 2015, the term applicable large employer shall not include any employer who is a specified Medicare and Medicaid provider with respect to the calendar year in which such month begins.

“(ii) Specified Medicare and Medicaid provider—The term “specified Medicare and Medicaid provider” means, with respect to any calendar year, any employer if the total specified Medicare and Medicaid payments received by such employer during the applicable period equals or exceeds 60 percent of the total gross receipts of such employer for such period.

“(iii) Specified Medicare and Medicaid payments—The term “specified Medicare and Medicaid payments” means—

“(I) any payment made to the employer under title XIX of the Social Security Act for the furnishing of items and services included as medical assistance (as defined in section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a))) under such title, and

“(II) any payment made to the employer under title XVIII of such Act for the furnishing of items and services to individuals entitled to benefits under part A of such title or enrolled under part B of such title, including dual eligible individuals (as defined in section 1915(h)(2)(B) of such Act (42 U.S.C. 1396n(h)(2)(B))).

“(iv) Treatment of payment for items and services furnished through a health plan—In applying clause (iii) with respect to the payment for items and services furnished to individuals enrolled in a health plan under a contract under title XVIII or XIX of the Social Security Act, payment for such items and services under such plan shall be treated as payment under such respective title.

“(v) Applicable period

“(I) In general—For purposes of this subparagraph, the term “applicable period” means, with respect to any calendar year, the 3 taxable years ending before the beginning of such calendar year.

“(II) Application of certain rules—Rules similar to the rules of subparagraphs (A), (C), and (D) of section 448(c)(3) shall apply for purposes of this clause.

“(III) Special rule for first taxable year of existence—In the case of an employer no taxable year of which ends before the beginning of the calendar year, the applicable period for such calendar year shall be the period beginning on the date that such employer came into existence and ending with the close of such calendar year.”