H.Res. 594: H.R. 3162 - Children's Health and Medicare Protection Act of 2007

 

COMMITTEE ACTION: REPORTED BY  RECORD VOTE of 8-4 on Wednesday August 1, 2007 (Legislative Day of Tuesday, July 31, 2007).
FLOOR ACTION: ADOPTED BY A RECORD VOTE OF 224 - 97 AFTER AGREEING TO THE PREVIOUS QUESTION BY THE YEAS AND NAYS 228 - 190 on Wednesday, August 1, 2007.

MANAGERS:CASTOR/SESSIONS

110th Congress 
1st Session

H.RES. 594

[Report No. 110-285]

 

 

H.R. 3162 - Children's Health and Medicare Protection Act of 2007

  1. Closed rule.
  2. Provides 2 hours of debate in the House with one hour equally divided and controlled by the Chairman and Ranking Minority Member of the Committee on Ways and Means and one hour equally divided and controlled by the Chairman and Ranking Minority Member of the Committee on Energy and Commerce.
  3. Waives all points of order against consideration of the bill except those arising under clauses 9 or 10 of Rule XXI.
  4. Provides that the amendment in the nature of a substitute recommended by the Committee on Ways and Means now printed in the bill, modified by the amendment printed in the report of the Committee on Rules to accompany this resolution, shall be considered as adopted and the bill, as amended, shall be considered as read.  
  5. Waives all points of order against provisions in the bill, as amended.
  6. Provides one motion to recommit with or without instructions.
  7. Provides that, notwithstanding the operation of the previous question, the Chair may postpone further consideration of the bill to a time designated by the Speaker.

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RESOLUTION

            Resolved, That upon the adoption of this resolution it shall be in order to consider in the House the bill (H.R. 3162) to amend titles XVIII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes.  All points of order against consideration of the bill are waived except those arising under clause 9 or 10 of rule XXI.  The amendment in the nature of a substitute recommended by the Committee on Ways and Means now printed in the bill, modified by the amendment printed in the report of the Committee on Rules accompanying this resolution, shall be considered as adopted.  The bill, as amended, shall be considered as read.  All points of order against provisions of the bill, as amended, are waived.  The previous question shall be considered as ordered on the bill, as amended, to final passage without intervening motion except: (1) two hours of debate, with one hour equally divided and controlled by the chairman and ranking minority member of the Committee on Ways and Means and one hour equally divided and controlled by the chairman and ranking minority member of the Committee on Energy and Commerce; and (2) one motion to recommit with or without instructions.

            Sec. 2.  During consideration of H.R. 3162 pursuant to this resolution, notwithstanding the operation of the previous question, the Chair may postpone further consideration of the bill to such time as may be designated by the Speaker.

SUMMARY OF AMENDMENT CONSIDERED AS ADOPTED 

 

The following changes are reflected in the amendment. 

 

Amendments to Title I – Children’s Health Insurance Program

 

1.       Amends Sec 104 to increase the percentage of CHIP allotment “qualifying States” may spend from 30 percent to 100 percent.

2.       Adds section 115 to require States with Separate State CHIP programs to provide 12 months of continuous eligibility for targeted low income children in families with incomes under 200% of the federal poverty level under XXI.

3.       Amends section 111(a)(3)(A) to sunset the outreach performance bonus at the end of FY 2013 and require a GAO study of the effectiveness of the outreach bonus at enrolling eligible but uninsured children.

4.       Amends section 131 to allow for coverage of children under CHIP to age 21.

5.       Adds a new section 135 to make clear that nothing in the act allows Federal payment for individuals who are not legal residents.

6.       Adds a new section 136 to require audits to enforce citizenship restrictions on eligibility for Medicaid and CHIP benefits. This replaces the previous audit requirement in section 143.

7.       Amends 151 (a)(2)(B) to require the new pediatric health quality measurement program to collect data on efforts to reduce hospitalization rate of premature infants.

 

Amendments to Title II – Medicare Beneficiary Improvements

 

1.       Amends section 211(a)(2)(D) by changing the indexing of the asset test from $1000 and $2000 per year to the consumer price index.

2.       Amends section 213(a) to clarify applicants’ ability to self-certify income and resources for purposes of qualifying for the Part D low-income subsidy. Also clarifies that SSA can verify eligibility with existing data, but without the need for additional documentation from applicants, except in extraordinary circumstances. Also makes required technical changes to account for this clarification.

3.       Amends section 213(d) to clarify that SSA will provide beneficiaries with a simplified application form and will accept and deliver these applications to the states.

4.       Amends section 217 to increase the cost-sharing limitation from 2.5 percent of annual income to 5 percent of annual income.

5.       Amends effective date of section 223.

6.       Changes paragraph (c)(3) of section 231 to clarify the definition of future patient record systems; adds a new subparagraph (f)(2)(E) to facilitate the collection of racial and ethnicity data.

7.       Amends section 233 to clarify the scope of the demonstration.

 

Amendments to Title III – Physicians’ Service Payment Reform

 

1.        Amends section 301 by clarifying the formula for excluding services not covered under the physician fee schedule from the target growth rates, changing the allowable growth rate for the primary care and preventive services category from three percent to two-and-a-half percent, and by freezing the update in years after 2012.  

2.        Amends section 304 to clarify the definition of efficient areas; conforms language in section 309 to reflect changes made in the bill as reported by the Committee on Ways and Means; adds language in section 905 directing CMS to report on the specific needs of communities serving vulnerable populations.

 

Amendments to Title IV – Medicare Advantage Reform

 

1.       Amends section 431 by adding authority for Severe and Disabling Chronic Condition Special Needs Plans (SDCC-SNPs). Provides that SDCC-SNPS must enroll 90% beneficiaries with specific chronic conditions as indicated by MA risk adjustment data; serve beneficiaries with one or more of six specific severe chronic conditions; have an average risk score of 1.35 or greater; manage a MA chronic care improvement program that excels such programs in regular MA plans; and maintain a network of providers to meet the needs of enrollees with severe and disabling conditions.

2.       Amends section 431 to clarify a provision referring to Medicare-Medicaid demonstration programs in Massachusetts, Minnesota and Wisconsin .

3.       Amends section 411(h) to clarify a provision that provides financial support for State Health Insurance Assistance Programs.

 

Amendments to Title V – Provisions Relating to Medicare Part A

 

1.       Amends section 503(c) to clarify the treatment of satellites facilities for long-stay cancer hospitals.  Modifies the title for the section setting forth Medicare payments for long-stay cancer hospitals. 

2.       Amends section 504 to modify the formula for disproportionate share hospital payments for hospitals located in Puerto Rico . 

3.       Amends section 505(b) to streamline language pertaining to one PPS-exempt cancer hospital.

4.       Amends section 508(c) to streamline language pertaining to geographic reclassifications and to allow for geographic reclassification of certain hospitals. 

 

Amendments to Title VI – Other Provisions Relating to Medicare Part B

 

1.       Amends sections 608(b) and 609(c) to extend the date by which contracts entered into under the competitive acquisition program are exempt from these sections. The date for the exemption is extended to October 1, 2007. 

2.       Amends section 612(c) to clarify that certain inhalation drugs are appropriately reimbursed. Specifically the amendment clarifies that generic albuterol be reimbursed at the lower of its current or historic level, and that brand name levalbuterol be reimbursed at the lower of its current or historic level.

3.       Amends section 612(b) to clarify that Competitive Acquisition Program vendors may deliver drugs to a main office or satellite office as designated by the prescribing physician, and that physicians may be allowed to transport drugs to the site of administration if all applicable laws and regulations are followed.

 

Amendments to Title VII – Provisions Relating to Medicare Parts A and B

 

1.       Amends section 705 to modify criteria for reallocation of graduate medical education residency slots from hospital closures and provision of additional residency slots. 

2.       Adds section 706 providing for a study of the effect of home health remote monitoring on patient outcomes.

3.       Adds section 707 providing for a demonstration project testing effectiveness of home health telemonitoring and other telehealth technologies.  

 

Amendments to Title VIII – Medicaid

 

1.       Amends section 801(a)(1) to extend the TMA program until 2011, rather than 2009.

2.       Amends section 812(a) to change the applicable percentage to 22.1.

3.       Strikes section 812(b).

4.       Adds a new section 812 to extend the automated web-based asset verification demonstration to Medicaid, in the States in which the demonstration is operating.

 

Amendments to Title IX – Miscellaneous

 

1.       Amends section 904(a) to clarify the number of members and their terms of appointment on the Comparative Effectiveness Research Commission, and to clarify the terms of appointment of the members of the Coordinating Council for Health Services Research. 

2.       Amends section 904(b) to clarify that the term ‘specified health insurance policy’ does not include any insurance if substantially all of its coverage is of excepted benefits described in section 9832(c).

3.       Adds a new section 909 to the act allowing Congressional Support Agencies (MedPAC, GAO, and CBO) to obtain from CMS necessary data about the Medicare Part D program.

4.       Adds a new section 910 to reauthorize the Title V Social Security Act abstinence education programs with provisions to ensure that medically or scientifically accurate information is provided; that States have the flexibility to teach abstinence-only education programs OR abstinence-plus education programs; and that funded programs are proven effective at decreasing teen pregnancy rates and rates of STDs and HIV/AIDS.

TEXT OF THE AMENDMENT CONSIDERED AS ADOPTED