United States. Congress

“ Evaluations and reports required under Medicaid Integrity Program. Sec. 1753. Require providers and suppliers to adopt programs to reduce waste, fraud, and abuse. Sec. 1754. Overpayments. Sec. 1755. Managed Care Organizations. Sec. 1756. Termination of provider participation under Medicaid and CHIP if terminated under Medicare or other State plan or child health plan. Sec. 1757. Medicaid and CHIP exclusion from participation relating to certain ownership, control, and management affiliations. Sec. 1758. Requirement to report expanded set of data elements under MMIS to detect fraud and abuse. ”

“ TITLE I—IMPROVING HEALTH CARE VALUE Subtitle A—Provisions Related to Medicare PART A Part 1—Market Basket Updates Sec. 1101. Skilled Nursing Facility Payment Update. Sec. 1102. Inpatient Rehabilitation Facility Payment Update. Sec. 1103. Incorporating Productivity Improvements into Market Basket Updates that do not Already Incorporate Such Improvements. Part 2—Other Medicare PART A Provisions Sec. 1111. Payments to Skilled Nursing Facilities. Sec. 1112. Medicare DSH Report and Payment Adjustments in Response to Coverage Expansion. Sec. 1113. Extension of Hospice Regulation Moratorium. ”

“ Sec. 1114. Permitting Physician Assistants to Order Post-Hospital Extended Care Services and to Provide for Recognition of Attending Physician Assistants as Attending Physicians to Serve Hospice Patients. ”

“ Disclosure of Medicare Fraud and Abuse Hotline Number on Explanation of Benefits. TITLE VII—MEDICAID AND CHIP Subtitle A—Medicaid and Health Reform Sec. 1701. Eligibility for Individuals with Income Below 150 Percent of the Federal Poverty Level. Sec. 1702. Requirements and special rules for certain Medicaid eligible individuals. Sec. 1703. CHIP and Medicaid maintenance of eligibility. Sec. 1704. Reduction in Medicaid DSH. Sec. 1705. Expanded outstationing. Subtitle B—Prevention Sec. 1711. Required coverage of preventive services. ”

“ State option to disregard certain income in providing continued Medicaid coverage for certain individuals with extremely high prescription costs. Sec. 1739. Provisions relating to community living assistance services and supports (CLASS) . Sec. 1739A. Sense of Congress regarding Community First Choice Option to provide medicaid coverage of community-based attendant services and supports. Subtitle E—Financing Sec. 1741. Payments to pharmacists. Sec. 1742. Prescription drug rebates. Sec. 1743. Extension of prescription drug discounts to enrollees of medicaid managed care organizations. ”

“ Subtitle D—Coverage Sec. 1731. Optional medicaid coverage of low-income HIV-infected individuals. Sec. 1732. Extending transitional Medicaid Assistance (TMA) . Sec. 1733. Requirement of 12-month continuous coverage under certain CHIP programs. Sec. 1734. Preventing the application under CHIP of coverage waiting periods for certain children. Sec. 1735. Adult day health care services. Sec. 1736. Medicaid coverage for citizens of Freely Associated States. Sec. 1737. Continuing requirement of Medicaid coverage of nonemergency transportation to medically necessary services. ”

“ Extension of Reasonable Cost Contracts. Sec. 1165. Limitation of Waiver Authority for Employer Group Plans. Sec. 1166. Improving Risk Adjustment for Payments. Sec. 1167. Elimination of MA Regional Plan Stabilization Fund. Sec. 1168. Study Regarding the Effects of Calculating Medicare Advantage Payment Rates on a Regional Average of Medicare Fee for Service Rates. Part 2—Beneficiary Protections and Anti-Fraud Sec. 1171. Limitation on Cost-Sharing for Individual Health Services. Sec. 1172. Continuous Open Enrollment for Enrollees in Plans with Enrollment Suspension. ”