US Codex
Pub. L.
Notes

Title I — Medicare Extenders

113th Congress · Approved Apr 1, 2014 · 128 Stat. 1040 · Lineage

TITLE I Medicare Extenders

SEC. 101. Physician Payment Update.

Section 1848(d) of the Social Security Act (42 U.S.C. 1395w–4(d)) is amended—
(1)
in paragraph (15)—
(A)
in the heading, by striking “ January through march of”;
(B)
in subparagraph (A), by striking “ for the period beginning on January 1, 2014, and ending on March 31, 2014”; and
(C)
in subparagraph (B)—
(i)
in the heading, by striking “ remaining portion of 2014 and”; and
(ii)
by striking “ the period beginning on April 1, 2014, and ending on December 31, 2014, and for”; and
(2)
by adding at the end the following new paragraph:

“(16) Update for january through march of 2015.—

“(A) In general.—Subject to paragraphs (7)(B), (8)(B), (9)(B), (10)(B), (11)(B), (12)(B), (13)(B), (14)(B), and (15)(B), in lieu of the update to the single conversion factor established in paragraph (1)(C) that would otherwise apply for 2015 for the period beginning on January 1, 2015, and ending on March 31, 2015, the update to the single conversion factor shall be 0.0 percent.

“(B) No effect on computation of conversion factor for remaining portion of 2015 and subsequent years.—The conversion factor under this subsection shall be computed under paragraph (1)(A) for the period beginning on April 1, 2015, and ending on December 31, 2015, and for 2016 and subsequent years as if subparagraph (A) had never applied.”

SEC. 102. Extension of Work Gpci Floor.

Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 1395w–4(e)(1)(E)) is amended by striking “ April 1, 2014” and inserting “ April 1, 2015”.

SEC. 103. Extension of Therapy Cap Exceptions Process.

Section 1833(g) of the Social Security Act (42 U.S.C. 1395l(g)) is amended—
(1)
in paragraph (5)(A), in the first sentence, by striking “ March 31, 2014” and inserting “ March 31, 2015”; and
(2)
in paragraph (6)(A)—
(A)
by striking “ March 31, 2014” and inserting “ March 31, 2015”; and
(B)
by striking “ 2012, 2013, or the first three months of 2014” and inserting “ 2012, 2013, 2014, or the first three months of 2015”.

SEC. 104. Extension of Ambulance Add-Ons.

(a)
Ground Ambulance.— Section 1834(l)(13)(A) of the Social Security Act (42 U.S.C. 1395m(l)(13)(A)) is amended by striking “ April 1, 2014” and inserting “ April 1, 2015” each place it appears.
(b)
Super Rural Ground Ambulance.— Section 1834(l)(12)(A) of the Social Security Act (42 U.S.C. 1395m(l)(12)(A)) is amended, in the first sentence, by striking “ April 1, 2014” and inserting “ April 1, 2015”.

SEC. 105. Extension of Increased Inpatient Hospital Payment Adjustment for Certain Low-Volume Hospitals.

Section 1886(d)(12) of the Social Security Act (42 U.S.C. 1395ww(d)(12)) is amended—
(1)
in subparagraph (B), in the matter preceding clause (i), by striking “ in the portion of fiscal year 2014 beginning on April 1, 2014, fiscal year 2015, and subsequent fiscal years” and inserting “ in fiscal year 2015 (beginning on April 1, 2015), fiscal year 2016, and subsequent fiscal years”;
(2)
in subparagraph (C)(i), by striking “ fiscal years 2011, 2012, and 2013, and the portion of fiscal year 2014 before” and inserting “ fiscal years 2011 through 2014 and fiscal year 2015 (before April 1, 2015),” each place it appears; and
(3)
in subparagraph (D), by striking “ fiscal years 2011, 2012, and 2013, and the portion of fiscal year 2014 before April 1, 2014,” and inserting “ fiscal years 2011 through 2014 and fiscal year 2015 (before April 1, 2015),”.

SEC. 106. Extension of the Medicare-Dependent Hospital (mdh) Program.

(a)
In General.— Section 1886(d)(5)(G) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(G)) is amended—
(1)
in clause (i), by striking “ April 1, 2014” and inserting “ April 1, 2015”; and
(2)
in clause (ii)(II), by striking “ April 1, 2014” and inserting “ April 1, 2015”.
(b)
Conforming Amendments.—
(1)
Extension of target amount.— Section 1886(b)(3)(D) of the Social Security Act (42 U.S.C. 1395ww(b)(3)(D)) is amended—
(A)
in the matter preceding clause (i), by striking “ April 1, 2014” and inserting “ April 1, 2015”; and
(B)
in clause (iv), by striking “ through fiscal year 2013 and the portion of fiscal year 2014 before April 1, 2014” and inserting “ through fiscal year 2014 and the portion of fiscal year 2015 before April 1, 2015”.
(2)
Permitting hospitals to decline reclassification.— Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 1993 (42 U.S.C. 1395ww note) is amended by striking “ through the first 2 quarters of fiscal year 2014” and inserting “ through the first 2 quarters of fiscal year 2015”.

SEC. 107. Extension for Specialized Medicare Advantage Plans for Special Needs Individuals.

Section 1859(f)(1) of the Social Security Act (42 U.S.C. 1395w–28(f)(1)) is amended by striking “ 2016” and inserting “ 2017”.

SEC. 108. Extension of Medicare Reasonable Cost Contracts.

Section 1876(h)(5)(C)(ii) of the Social Security Act (42 U.S.C. 1395mm(h)(5)(C)(ii)) is amended, in the matter preceding subclause (I), by striking “ January 1, 2015” and inserting “ January 1, 2016”.

SEC. 109. Extension of Funding for Quality Measure Endorsement, Input, and Selection.

Section 1890(d) of the Social Security Act (42 U.S.C. 1395aaa(d)) is amended—
(1)
by inserting “ (1)” before “ For purposes”; and
(2)
by adding at the end the following new paragraph:

“(2) For purposes of carrying out this section and section 1890A (other than subsections (e) and (f)), the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 and the Federal Supplementary Medical Insurance Trust Fund under section 1841, in such proportion as the Secretary determines appropriate, to the Centers for Medicare & Medicaid Services Program Management Account of $5,000,000 for fiscal year 2014 and $15,000,000 for the first 6 months of fiscal year 2015. Amounts transferred under the preceding sentence shall remain available until expended.”

SEC. 110. Extension of Funding Outreach and Assistance for Low-Income Programs.

(a)
Additional Funding for State Health Insurance Programs.— Subsection (a)(1)(B) of section 119 of the Medicare Improvements for Patients and Providers Act of 2008 (42 U.S.C. 1395b–3 note), as amended by section 3306 of the Patient Protection and Affordable Care Act Public Law 111–148), section 610 of the American Taxpayer Relief Act of 2012 (Public Law 112–240), and section 1110 of the Pathway for SGR Reform Act of 2013 (Public Law 113–67), is amended—
(1)
in clause (iii), by striking “ and” at the end;
(2)
by striking clause (iv); and
(3)
by adding at the end the following new clauses:

“(iv) for fiscal year 2014, of $7,500,000; and

“(v) for the portion of fiscal year 2015 before April 1, 2015, of $3,750,000.”

(b)
Additional Funding for Area Agencies on Aging.— Subsection (b)(1)(B) of such section 119, as so amended, is amended—
(1)
in clause (iii), by striking “ and” at the end;
(2)
by striking clause (iv); and
(3)
by inserting after clause (iii) the following new clauses:

“(iv) for fiscal year 2014, of $7,500,000; and

“(v) for the portion of fiscal year 2015 before April 1, 2015, of $3,750,000.”

(c)
Additional Funding for Aging and Disability Resource Centers.— Subsection (c)(1)(B) of such section 119, as so amended, is amended—
(1)
in clause (iii), by striking “ and” at the end;
(2)
by striking clause (iv); and
(3)
by inserting after clause (iii) the following new clauses:

“(iv) for fiscal year 2014, of $5,000,000; and

“(v) for the portion of fiscal year 2015 before April 1, 2015, of $2,500,000.”

(d)
Additional Funding for Contract With the National Center for Benefits and Outreach Enrollment.— Subsection (d)(2) of such section 119, as so amended, is amended—
(1)
in clause (iii), by striking “ and” at the end;
(2)
by striking clause (iv); and
(3)
by inserting after clause (iii) the following new clauses:

“(iv) for fiscal year 2014, of $5,000,000; and

“(v) for the portion of fiscal year 2015 before April 1, 2015, of $2,500,000.”

SEC. 111. Extension of Two-Midnight Rule.

(a)
Continuation of Certain Medical Review Activities.— The Secretary of Health and Human Services may continue medical review activities described in the notice entitled “Selecting Hospital Claims for Patient Status Reviews: Admissions On or After October 1, 2013”, posted on the Internet website of the Centers for Medicare & Medicaid Services, through the first 6 months of fiscal year 2015 for such additional hospital claims as the Secretary determines appropriate.
(b)
Limitation.— The Secretary of Health and Human Services shall not conduct patient status reviews (as described in such notice) on a post-payment review basis through recovery audit contractors under section 1893(h) of the Social Security Act (42 U.S.C. 1395ddd(h)) for inpatient claims with dates of admission October 1, 2013, through March 31, 2015, unless there is evidence of systematic gaming, fraud, abuse, or delays in the provision of care by a provider of services (as defined in section 1861(u) of such Act (42 U.S.C. 1395x(u))).

SEC. 112. Technical Changes to Medicare Ltch Amendments.

(a)
In General.— Subclauses (I) and (II) of section 1886(m)(6)(C)(iv) of the Social Security Act (42 U.S.C. 1395ww(m)(6)(C)(iv)) are each amended by striking “ discharges” and inserting “ Medicare fee-for-service discharges”.
(b)
MMSEA Correction.— Section 114(d) of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (42 U.S.C. 1395ww note), as amended by sections 3106(b) and 10312(b) of Public Law 111–148 and by section 1206(b)(2) of the Pathway for SGR Reform Act of 2013 (division B of Public Law 113–67), is amended—
(1)
in paragraph (1), in the matter preceding subparagraph (A), by striking “ January 1, 2015,” and inserting “ on the date of the enactment of paragraph (7) of this subsection”;
(2)
in paragraph (6), by striking “ January 1, 2015,” and inserting “ on the date of the enactment of paragraph (7) of this subsection”; and
(3)
by adding at the end the following new paragraph:

“(7) Additional exception for certain long-term care hospitals.—The moratorium under paragraph (1)(A) shall not apply to a long-term care hospital that—

“(A) began its qualifying period for payment as a long-term care hospital under section 412.23(e) of title 42, Code of Federal Regulations, on or before the date of enactment of this paragraph;

“(B) has a binding written agreement as of the date of the enactment of this paragraph with an outside, unrelated party for the actual construction, renovation, lease, or demolition for a long-term care hospital, and has expended, before such date of enactment, at least 10 percent of the estimated cost of the project (or, if less, $2,500,000); or

“(C) has obtained an approved certificate of need in a State where one is required on or before such date of enactment.”

(c)
Additional Amendments.— Section 1206(a) of the Pathway for SGR Reform Act of 2013 (division B of Public Law 113–67) is amended—
(1)
in paragraph (2)(A), by striking “ Assessment” and inserting “ Advisory”; and
(2)
in paragraph (3)(B), by striking “ shall not apply to a hospital that is classified as of December 10, 2013, as a subsection (d) hospital (as defined in section 1886(d)(1)(B) of the Social Security Act, 42 U.S.C. 1395ww(d)(1)(B))” and inserting “ shall only apply to a hospital that is classified as of December 10, 2013, as a long-term care hospital (as defined in section 1861(ccc) of the Social Security Act, 42 U.S.C. 1395x(ccc))”.
(d)
Effective Date.— The amendments made by this section are effective as of the date of the enactment of this Act.