Title IX — Additional Conforming Amendments

H.R. 3421 · 118th Congress · May 17, 2023 · Lineage

IX Additional Conforming Amendments

Sec. 901 Relationship to existing Federal health programs

(a)

Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP)—

(1)

In general— Notwithstanding any other provision of law and with respect to an individual eligible to enroll under this Act, subject to paragraphs (2) and (3)—

(A)

no benefits shall be available under title XVIII of the Social Security Act for any item or service furnished beginning on the date that is 2 years after the date of the enactment of this Act;

(B)

no individual is entitled to medical assistance under a State plan approved under title XIX of such Act for any item or service furnished on or after such date;

(C)

no individual is entitled to medical assistance under a State child health plan under title XXI of such Act for any item or service furnished on or after such date; and

(D)

no payment shall be made to a State under section 1903(a) or 2105(a) of such Act with respect to medical assistance or child health assistance for any item or service furnished on or after such date.

(2)

Transition— In the case of inpatient hospital services and extended care services during a continuous period of stay which began before the effective date of benefits under section 106, and which had not ended as of such date, for which benefits are provided under title XVIII of the Social Security Act, under a State plan under title XIX of such Act, or under a State child health plan under title XXI of such Act, the Secretary shall provide for continuation of benefits under such title or plan until the end of the period of stay.

(3)

School programs— All school related health programs, centers, initiatives, services, or other activities or work provided under title XIX or title XXI of the Social Security Act as of January 1, 2019, shall be continued and covered by the Medicare for All Program.

(b)

Federal employees health benefits program— No benefits shall be made available under chapter 89 of title 5, United States Code, with respect to items and services furnished to any individual eligible to enroll under this Act.

(c)

TRICARE Program—

(1)

Direct care component— Nothing in this Act shall affect the eligibility of beneficiaries under chapter 55 of title 10, United States Code, who are entitled to receive care furnished at facilities of the uniformed services under the TRICARE program for such care.

(2)

Purchased care component—

(A)

In general— Except as provided in subparagraph (B), no benefits shall be made available under the purchased care component of the TRICARE program for items or services furnished to any individual eligible to enroll under this Act.

(B)

TRICARE Overseas— During any period in which an individual is eligible for benefits under the TRICARE Overseas Program and is located in a TRICARE overseas region, the individual may receive benefits for items or services furnished to the individual under the purchased care component of such program during such period.

(d)

Treatment of benefits for veterans and Native Americans—

(1)

In general— Nothing in this Act shall affect the eligibility of veterans for the medical benefits and services provided under title 38, United States Code, or of Indians for the medical benefits and services provided by or through the Indian Health Service.

(2)

Reevaluation— No reevaluation of the Indian Health Service shall be undertaken without consultation with tribal leaders and stakeholders.

Sec. 902 Sunset of provisions related to the State Exchanges

Effective on the date that is 2 years after the date of the enactment of this Act, the Federal and State Exchanges established pursuant to title I of the Patient Protection and Affordable Care Act (Public Law 111–148) shall terminate, and any other provision of law that relies upon participation in or enrollment through such an Exchange, including such provisions of the Internal Revenue Code of 1986, shall cease to have force or effect.

Sec. 903 Sunset of provisions related to pay for performance programs

(a)

Effective on the date described in section 106(a), the Federal programs related to pay for performance programs and value-based purchasing shall terminate, and any other provision of law that relies upon participation in or enrollment in such program shall cease to have force or effect. Programs that shall terminate include—

(1)

the Merit-based Incentive Payment System established pursuant to subsection (q) of section 1848 of the Social Security Act (42 U.S.C. 1395w–4(q));

(2)

the incentives for meaningful use of certified EHR technology established pursuant to subsection (a)(7) of section 1848 of the Social Security Act (42 U.S.C. 1395w–4(a)(7));

(3)

the incentives for adoption and meaningful use of certified EHR technology established pursuant to subsection (o) of section 1848 of the Social Security Act (42 U.S.C. 1395w–4(o));

(4)

alternative payment models established under section 1833(z) of the Social Security Act (42 U.S.C. 1395(z)); and

(5)

the following programs as established pursuant to the following sections of the Patient Protection and Affordable Care Act:

(A)

Section 2701 (adult health quality measures).

(B)

Section 2702 (payment adjustments for health care acquired conditions).

(C)

Section 2706 (Pediatric Accountable Care Organization Demonstration Projects for the purposes of receiving incentive payments).

(D)

Section 3002(b) (42 U.S.C. 1395w–4(a)(8)) (incentive payments for quality reporting).

(E)

Section 3001(a) (42 U.S.C. 1395ww(o)) (Hospital Value-Based Purchasing).

(F)

Section 3006 (value-based purchasing program for skilled nursing facilities and home health agencies).

(G)

Section 3007 (42 U.S.C. 1395w–4(p)) (value based payment modifier under physician fee schedule).

(H)

Section 3008 (42 U.S.C. 1395ww(p)) (payment adjustments for health care-acquired condition).

(I)

Section 3022 (42 U.S.C. 1395jjj) (Medicare shared savings programs).

(J)

Section 3023 (42 U.S.C. 1395cc–4) (National Pilot Program on Payment Bundling).

(K)

Section 3024 (42 U.S.C. 1395cc–5) (Independence at home demonstration program).

(L)

Section 3025 (42 U.S.C. 1395ww(q)) (hospital readmissions reduction program).

(M)

Section 10301 (plans for value-based purchasing program for ambulatory surgical centers).

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May 17, 2023viewing Introduced in House Ms. Jayapal (for herself, Mrs. Dingell, Ms. Adams, Ms. Balint, Ms. Barragán, Mr. Beyer, Mr. Blumenauer, Ms. Bonamici, Mr. Bowman, Mr. Boyle of Pennsylvania, Ms. Brown, Ms. Bush, Mr. Carbajal, Mr. Cárdenas, Mr. Carson, Mr. Carter of Louisiana, Mr. Cartwright, Mr. Casar, Mrs. Cherfilus-McCormick, Ms. Chu, Mr. Cicilline, Ms. Clarke of New York, Mr. Cleaver, Mr. Cohen, Ms. Crockett, Mr. Davis of Illinois, Ms. DeGette, Mr. Deluzio, Mr. DeSaulnier, Mr. Doggett, Ms. Escobar, Mr. Espaillat, Mrs. Foushee, Ms. Lois Frankel of Florida, Mr. Frost, Mr. Garamendi, Mr. Robert Garcia of California, Mr. García of Illinois, Mr. Goldman of New York, Mr. Gomez, Mr. Green of Texas, Mr. Grijalva, Mr. Harder of California, Mrs. Hayes, Mr. Higgins of New York, Ms. Hoyle of Oregon, Mr. Huffman, Mr. Ivey, Mr. Jackson of Illinois, Ms. Jackson Lee, Ms. Jacobs, Mr. Johnson of Georgia, Ms. Kamlager-Dove, Mr. Keating, Ms. Kelly of Illinois, Mr. Khanna, Ms. Lee of California, Ms. Lee of Pennsylvania, Ms. Leger Fernandez, Mr. Levin, Mr. Lieu, Ms. McCollum, Mr. McGarvey, Mr. McGovern, Mr. Meeks, Ms. Meng, Mr. Mfume, Mr. Mullin, Mr. Nadler, Mrs. Napolitano, Mr. Neguse, Ms. Norton, Ms. Ocasio-Cortez, Ms. Omar, Mr. Pallone, Mr. Panetta, Mr. Payne, Ms. Pingree, Mr. Pocan, Ms. Porter, Ms. Pressley, Mr. Quigley, Mrs. Ramirez, Mr. Raskin, Mr. Sablan, Ms. Salinas, Ms. Sánchez, Mr. Sarbanes, Ms. Schakowsky, Mr. Schiff, Mr. Scott of Virginia, Mr. Sherman, Mr. Smith of Washington, Ms. Stansbury, Mr. Swalwell, Mr. Takano, Mr. Thanedar, Mr. Thompson of California, Mr. Thompson of Mississippi, Ms. Titus, Ms. Tlaib, Ms. Tokuda, Mr. Tonko, Mr. Torres of New York, Mrs. Trahan, Mr. Vargas, Ms. Velázquez, Ms. Waters, Mrs. Watson Coleman, Ms. Wild, Ms. Williams of Georgia, Ms. Wilson of Florida, and Ms. Lofgren) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and the Workforce, Rules, Oversight and Accountability, Armed Services, and the Judiciary, 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

Title IX — Additional Conforming Amendments

IX Additional Conforming Amendments

Sec. 901 Relationship to existing Federal health programs

Sec. 902 Sunset of provisions related to the State Exchanges

Sec. 903 Sunset of provisions related to pay for performance programs

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