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 123STA T .4 4 6PUBLIC LA W 111 –5—FE B.1 7, 2 0 0 9Unemploy men tI n sura n c e A ct , asa d ded b y subsect i on ( a ) , to remain a v ailable until e x pended .Subti t leB—As sist anc e forV ulnerable I n d i v iduals SEC.210 1.E M E RG E N C YFU N D F O R TA NF P ROGRAM. (a) TEMPORA R YFUND . — ( 1 )IN G ENERA L .— S ection 403 o f t h e Social Security Act (4 2 U.S. C . 6 03) is amended by addin g at the end the follo w ing

‘(c) E MERGEN C Y FUND.— ‘‘(1) E ST A B L I S H MENT.—There is established in the Treasury of the United States a fund which shall be k nown as the ‘Emergency Contingency Fund for State Temporary Assistance for N eedy Families P rograms ’ (in this subsection referred to as the ‘Emergency Fund’). ‘‘(2) D EPOSITS INTO F UND.— ‘‘(A) IN GENERAL.— O ut of any money in the Treasury of the United States not otherwise appropriated, there are appropriated for fiscal year 200 9, $5 ,000,000,000 for payment to the Emergency Fund. ‘‘( B )A V AILABILITY AND USE OF FUNDS.—The amounts appropriated to the Emergency Fund under subparagraph (A) shall remain available through fiscal year 2010 and shall be used to make grants to States in each of fiscal years 2009 and 2010 in accordance with the re q uirements of paragraph (3). ‘‘(C) L IMITATION.—In no case may the Secretary make a grant from the Emergency Fund for a fiscal year after fiscal year 2010. ‘‘(3) G RANTS.— ‘‘(A) GRANT RELATED TO CASELOAD INCREASES.— ‘‘(i) IN GENERAL.—For each calendar quarter in fiscal year 2009 or 2010, the Secretary shall make a grant from the Emergency Fund to each State that— ‘‘(I) requests a grant under this subparagraph for the quarter and ‘‘(II) meets the requirement of clause (ii) for the quarter. ‘‘(ii) CASELOAD INCREASE RE Q UIREMENT.—A State meets the requirement of this clause for a quarter if the average monthly assistance caseload of the State for the quarter exceeds the average monthly assistance caseload of the State for the corresponding quarter in the emergency fund base year of the State. ‘‘(iii) AMOUNT OF GRANT.—Sub j ect to paragraph (5), the amount of the grant to be made to a State under this subparagraph for a quarter shall be an amount equal to 8 0 percent of the amount (if any) by which the total expenditures of the State for basic assistance (as defined by the Secretary) in the quarter, whether under the State program funded under this part or as qualified State expenditures, exceeds the total expenditures of the State for such assistance for the corresponding quarter in the emergency fund base year of the State.


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 123STA T .4 4 7PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9‘ ‘ (B)GRANT R EL ATE D T OI N C REA S EDE XP ENDIT U RES F OR NON - RECURRENT S H ORT TER MB ENEFITS .— ‘‘( i ) I N G ENERAL.— Foreach ca l e nd ar qu ar t er in f i s cal y ear 20 0 9 or 20 1 0, the S ecretary shall m a k e a g rant from the E mergency Fund to each State that— ‘‘(I) requests a grant under this su bp aragraph for the quarter and ‘‘(II) meets the requirement of clause (ii) for the quarter. ‘‘(ii) N ON-RECURRENT SHORT TERM EXPENDITURE RE Q UIREMENT.— A State meets the requirement of this clause for a quarter if the total e x penditures of the State for non-recurrent short term benefits in the quarter, w hether under the State program funded under this part or as qualified State expenditures, exceeds the total expenditures of the State for non- recurrent short term benefits in the corresponding quarter in the emergency fund base year of the State. ‘‘(iii) AMOUNT OF GRANT.—Sub j ect to paragraph ( 5 ), the amount of the grant to be made to a State under this subparagraph for a quarter shall be an amount equal to 8 0 percent of the excess described in clause (ii). ‘‘( C ) GRANT RELATED TO INCREASED EXPENDITURES FOR SUBSIDI Z ED EMPLO Y MENT.— ‘‘(i) IN GENERAL.—For each calendar quarter in fiscal year 2009 or 2010, the Secretary shall make a grant from the Emergency Fund to each State that— ‘‘(I) requests a grant under this subparagraph for the quarter; and ‘‘(II) meets the requirement of clause (ii) for the quarter. ‘‘(ii) SUBSIDIZED EMPLOYMENT EXPENDITURE REQUIREMENT.—A State meets the requirement of this clause for a quarter if the total expenditures of the State for subsidi z ed employment in the quarter, whether under the State program funded under this part or as qualified State expenditures, exceeds the total such expenditures of the State in the cor- responding quarter in the emergency fund base year of the State. ‘‘(iii) AMOUNT OF GRANT.—Subject to paragraph (5), the amount of the grant to be made to a State under this subparagraph for a quarter shall be an amount equal to 80 percent of the excess described in clause (ii). ‘‘( 4 ) AUTHORITY TO MA K E NECESSARY AD J USTMENTS TO DATA AND COLLECT NEEDED DATA.—In determining the size of the caseload of a State and the expenditures of a State for basic assistance, non-recurrent short-term benefits, and subsidized employment, during any period for which the State requests funds under this subsection, and during the emergency fund base year of the State, the Secretary may make appropriate adjustments to the data, on a State-by-State basis, to ensure that the data are comparable with respect to the groups of families ser v ed and the types of aid provided. T he Secretary may develop a mechanism for collecting expenditure data,

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 123STA T .4 4 8PUBLIC LA W 111 –5—FE B.1 7, 2 0 0 9includ in gpro c e dure swh ich a llow St ates to m a k e reasona b le estimates , and ma y set deadlines f or making re v isions to the data .‘ ‘ (5)LIM I TA TI ON . —T he total amount payable to a single State under subsection (b) and this subsection for fiscal years 20 0 9 and 20 1 0 combined shall not e x ceed 50 percent of the annual State family assistance grant. ‘‘( 6 ) LIMITATION S ON U S E O F FUN D S.— A State to which an amount is paid under this subsection may use the amount only as authori z ed by section 4 04. ‘‘( 7 ) TIMIN G OF IM PL EMENTATION.—The Secretary shall implement this subsection as q uickly as reasonably possible, pursuant to appropriate guidance to States. ‘‘( 8 ) APPLI C ATION TO INDIAN T R I B ES.—This subsection shall apply to an I ndian tribe with an approved tribal family assist - ance plan under section 412 in the same manner as this sub- section applies to a State. ‘‘(9) D EFINITIONS.—In this subsection ‘‘(A) A V ERAGE MONT H L Y ASSISTANCE CASELOAD DEFINED.—The term ‘average monthly assistance caseload ’ means, with respect to a State and a quarter, the number of families receiving assistance during the quarter under the State program funded under this part or as qualified State expenditures, sub j ect to adjustment under paragraph (4). ‘‘( B ) E MERGENCY FUND BASE YEAR.— ‘‘(i) IN GENERAL.—The term ‘emergency fund base year’ means, with respect to a State and a category described in clause (ii), whichever of fiscal year 2007 or 2008 is the fiscal year in which the amount described by the category with respect to the State is the lesser. ‘‘(ii) C ATEGORIES DESCRIBED.—The categories described in this clause are the following: ‘‘(I) The average monthly assistance caseload of the State. ‘‘(II) The total expenditures of the State for non-recurrent short term benefits, whether under the State program funded under this part or as qualified State expenditures. ‘‘(III) The total expenditures of the State for subsidized employment, whether under the State program funded under this part or as qualified State expenditures. ‘‘(C) Q UALIFIED STATE E X PENDITURES.—The term ‘quali- fied State expenditures’ has the meaning given the term in section 409(a)(7).’’. (2) R EPEAL.—Effective O ctober 1, 2010, subsection (c) of section 40 3 of the Social Security Act (42 U .S.C. 603) (as added by paragraph (1)) is repealed, except that paragraph (9) of such subsection shall remain in effect until October 1, 2011, but only with respect to section 407(b)(3)(A)(i) of such Act. (b) TEMPORARY M ODIFICATION OF CASELOAD REDUCTION CREDIT.—Section 407(b)(3)(A)(i) of such Act (42 U.S.C. 607(b)(3)(A)(i)) is amended by inserting ‘‘(or if the immediately preceding fiscal year is fiscal year 2008, 2009, or 2010, then, at State option, during the emergency fund base year of the State Ef f ectiv e da te s.


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 123STA T .4 4 9PUBLIC LA W 111 –5—FE B.1 7, 2 0 09 withresp e c tt o the av era g e m o n th ly assistance caseloa d o f the S tate ( within the meaning of section 403 (c ) ( 9 )), e x cept that, if a State elects s u ch option for fiscal year 2 00 8, the emergency fund b ase year of the State with respect to such caseload shall be fiscal year 200 7 )) ’ ’ before ‘ ‘under the State’’ . (c) DISREGA R DF R OML IMI T ATIO N ON T OTA LP A Y MENTS TO TERRI - TORIES. — Section 1 108(a)(2) of the Social Security A ct (42 U .S. C . 1308(a)(2)) is amended by inserting ‘‘403(c)(3),’’ after ‘‘403(a)( 5 ),’’. (d) S U NSET O FO T H ER TEM P ORARY PRO V ISIONS.— (1) DISREGARD FROM LIMITATION ON TOTAL PAYMENTS TO TERRITORIES.— E ffective October 1, 2010, section 1108(a)(2) of the Social Security Act (42 U.S.C. 1308(a)(2)) is amended by stri k ing ‘‘403(c)(3),’’ (as added by subsection (c)). (2) CASELOAD REDU C TION CREDIT.—Effective October 1, 2011, section 407(b)(3)(A)(i) of such Act (42 U.S.C. 6 07(b)(3)(A)(i)) is amended by striking ‘‘(or if the immediately preceding fiscal year is fiscal year 2008, 2009, or 2010, then, at State option, during the emergency fund base year of the State with respect to the average monthly assistance caseload of the State (within the meaning of section 403(c)(9)), except that, if a State elects such option for fiscal year 2008, the emergency fund base year of the State with respect to such caseload shall be fiscal year 2007))’’ (as added by subsection (b)). SEC.210 2.E XT E N S IO NO F T A NFS UP P L E M ENTAL GR ANTS. (a) E X TENSION THROUGH FISCAL Y EAR 2010.—Section 7101(a) of the Deficit R eduction Act of 2005 (Public Law 109 – 171 120 Stat. 135), as amended by section 301(a) of the M edicare I mprove- ments for Patients and Providers Act of 2008 (Public Law 110– 275), is amended by striking ‘‘fiscal year 2009’’ and inserting ‘‘fiscal year 2010’’. (b) CONFORMING AMENDMENT.—Section 403(a)(3)( H )(ii) of the Social Security Act (42 U.S.C. 603(a)(3)(H)(ii)) is amended to read as follows ‘‘(ii) subparagraph ( G ) shall be applied as if ‘fiscal year 2010’ were substituted for ‘fiscal year 2001’; and’’. SEC. 210 3 . CLARIFICATION OF AUT H ORIT Y OF STATES TO USE TANF FUN D S CARRIED O V ER FROM PRIOR YEARS TO PROVIDE TANF B ENEFITS AND SERVICES. Section 404(e) of the Social Security Act (42 U.S.C. 604(e)) is amended to read as follows: ‘‘(e) AUTHORITY TO CARRY OVER CERTAIN AMOUNTS FOR B ENE- FITS OR SERVICES OR FOR FUTURE CONTINGENCIES.—A State or tribe may use a grant made to the State or tribe under this part for any fiscal year to provide, without fiscal year limitation, any benefit or service that may be provided under the State or tribal program funded under this part.’’. SEC. 210 4 . TEMPORARY RESUMPTION OF PRIOR CHILD SUPPORT LA W . During the period that begins on October 1, 2008, and ends on September 30, 2010, section 455(a)(1) of the Social Security Act (42 U.S.C. 655(a)(1)) shall be applied and administered as if the phrase ‘‘from amounts paid to the State under section 458 or’’ does not appear in such section. Timep e r i od.A pp l i cab ili ty . 42USC65 5 n ote. Ef fecti v e date s .


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 123STA T .450PUBLIC LA W 111 – 5 —FE B.1 7, 200 9Subti t leC—Econ o m ic R eco v e ryPa yment s to Certain I n d ividuals SEC.2 2 01 .EC ON O MI C R ECO V ER YPA YMEN T TO RECIPIENTS O F SOCIA L SEC U RITY , SUPPLEMENTAL SECURITY INCOME, RAIL - ROA D RETIREMENT B ENEFITS, AND VETERANS DIS- ABILITY COMPENSATION OR PENSION BENEFITS. (a)AUTHORI T Y TO MAKEP AY M E N T S.— ( 1 ) EL I G I B ILITY.— (A) I N GENERAL.— Subject t op a r a g rap h ( 5 )( B ) , the Sec - retar y o f the T rea s ury sha l l di sburse a $2 5 0 pay m e n tto each indi v idual w ho, for any month during the 3 -month period ending with the month which ends prior to the month that includes the date of the enactment of this Act, is entitled to a benefit payment described in clause (i), (ii), or (iii) of subparagraph (B) or is eligible for a SSI cash benefit described in subparagraph ( C ). (B) BENE F IT P AYMENT D ES C RIBED.— F or purposes of subparagraph (A) (i) TITLE II BENEFIT.—A benefit payment described in this clause is a monthly insurance benefit payable (without regard to sections 202(j)(1) and 223(b) of the Social Security Act ( 4 2 U .S.C. 402(j)(1), 423(b)) under— (I) section 202(a) of such Act (42 U.S.C. 402(a)) (II) section 202(b) of such Act (42 U.S.C. 402(b)); (III) section 202(c) of such Act (42 U.S.C. 402(c)); (I V ) section 202(d)(1)(B)(ii) of such Act (42 U.S.C. 402(d)(1)(B)(ii)); (V) section 202(e) of such Act (42 U.S.C. 402(e)); (VI) section 202(f) of such Act (42 U.S.C. 402(f)); (VII) section 202(g) of such Act (42 U.S.C. 402(g)); (VIII) section 202(h) of such Act (42 U.S.C. 402(h)); (I X ) section 223(a) of such Act (42 U.S.C. 423(a)); (X) section 22 7 of such Act (42 U.S.C. 427); or (XI) section 22 8 of such Act (42 U.S.C. 428). (ii) R AILROAD RETIREMENT BENEFIT.—A benefit payment described in this clause is a monthly annuity or pension payment payable (without regard to section 5(a)(ii) of the Railroad Retirement Act of 1 9 74 (45 U.S.C. 231d(a)(ii))) under— (I) section 2(a)(1) of such Act (45 U.S.C. 231a(a)(1)); (II) section 2(c) of such Act (45 U.S.C. 231a(c)); (III) section 2(d)(1)(i) of such Act (45 U.S.C. 231a(d)(1)(i)); (IV) section 2(d)(1)(ii) of such Act (45 U.S.C. 231a(d)(1)(ii)); 26USC 6 4 2 8note.


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 123STA T .45 1 PUBLIC LA W 111 – 5 —FE B.1 7, 2 0 0 9(V)section2 ( d )( 1 )(iii)( C )o f s u c hA ct to a n adu l t disa b led child ( 45U.S .C. 2 3 1a(d)(1)(iii)(C)) (V I ) section 2(d)(1)(i v ) of such Act (45 U.S.C. 231a(d)(1)(iv)); (VII) section 2(d)(1)(v) of such Act (45 U.S.C. 231a(d)(1)(v)); o r (VIII) section 7 (b)(2) of such Act (45 U.S.C. 231f(b)(2)) w ith res p ect to an y of the benefit pay -m ents described in clause (i) of this subpara g raph. (iii) V ET E RANSB ENE FI T. — A benefit payment described in this clause is a compensation or pension payment payable under— (I) section 111 0, 1117, 1121, 1131, 1141, or 1151 of title 3 8, United States Code; (II) section 1310, 1312, 1313, 1315, 131 6 ,or 1318 of title 38, United States Code; (III) section 1513, 1521, 1533, 1536, 1537, 1541, 1542, or 1562 of title 38, United States Code; or (IV) section 1805, 1815, or 1821 of title 38, United States Code, to a veteran, surviving spouse, child, or parent as described in paragraph (2), (3), (4)(A)(ii), or (5) of sec- tion 101, title 38, United States Code, who received that benefit during any month within the 3 month period ending with the month which ends prior to the month that includes the date of the enactment of this Act. (C) SSI C AS H BENEFIT D ESCRIBED.—A SSI cash benefit described in this subparagraph is a cash benefit payable under section 1611 (other than under subsection (e)(1)( B ) of such section) or 161 9 (a) of the Social Security Act (42 U.S.C. 1382, 1382h). (2) R E QU IRE M ENT.—A payment shall be made under para- graph (1) only to individuals who reside in 1 of the 50 States, the D istrict of Columbia, P uerto Rico, G uam, the United States Virgin Islands, American Samoa, or the N orthern M ariana Islands. F or purposes of the preceding sentence, the determina- tion of the individual ’ s residence shall be based on the current address of record under a program specified in paragraph (1). (3) N O DOUB L E P A Y MENTS.—An individual shall be paid only 1 payment under this section, regardless of whether the individual is entitled to, or eligible for, more than 1 benefit or cash payment described in paragraph (1). (4) L IMITATION.—A payment under this section shall not be made— (A) in the case of an individual entitled to a benefit specified in paragraph (1)(B)(i) or paragraph (1)(B)(ii)(VIII) if, for the most recent month of such individual’s entitle- ment in the 3-month period described in paragraph (1), such individual’s benefit under such paragraph was not payable by reason of subsection ( x ) or (y) of section 202 the Social Security Act (42 U.S.C. 402) or section 1129A of such Act (42 U.S.C. 1320a-8a); (B) in the case of an individual entitled to a benefit specified in paragraph (1)(B)(iii) if, for the most recent month of such individual’s entitlement in the 3 month


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 123STA T .45 2 PUBLIC LA W 111 – 5 —FE B.1 7, 2 0 0 9period de sc ri b edi n p a ra g rap h(1), s u ch indi v idua l’ s bene f i t under such paragraph w as not pa y able, or was reduced, by reason of section 1 50 5,5 3 13, or 5313 B of title 3 8, U nited S tates C ode (C) in the case of an individual entitled to a benefit specified in paragraph (1)(C) if, for such m ost recent month, such individual’s benefit under such paragraph was not payable by reason of subsection (e)(1)( A ) or (e)( 4 ) of section 1 6 11 (4 2 U . S.C. 1382) or section 112 9 A of such Act (42 U.S.C. 1320a - 8a); or ( D ) in the case of any individual whose date of death occurs before the date on which the individual is certified under subsection (b) to receive a payment under this sec- tion. (5) TIM I NGA N D MANN EROFP A Y MEN TS . — (A) I N GENERA L .—The Secretary of the Treasury shall commence disbursing payments under this section at the earliest practicable date but in no event later than 120 days after the date of enactment of this Act. The Secretary of the Treasury may disburse any payment electronically to an individual in such manner as if such payment was a benefit payment or cash benefit to such individual under the applicable program described in subparagraph (B) or (C) of paragraph (1). (B) DEADLINE.— N o payments shall be disbursed under this section after December 31, 2010, regardless of any determinations of entitlement to, or eligibility for, such payments made after such date. (b) IDENTIFI C ATION OF R ECIPIENTS.—The Commissioner of Social Security, the Railroad Retirement Board, and the Secretary of V eterans Affairs shall certify the individuals entitled to receive payments under this section and provide the Secretary of the Treasury with the information needed to disburse such payments. A certification of an individual shall be unaffected by any subse- q uent determination or redetermination of the individual’s entitle- ment to, or eligibility for, a benefit specified in subparagraph (B) or (C) of subsection (a)(1). (c) TREATMENT OF P AYMENTS.— (1) PAYMENT TO B E DISREGARDED FOR P U RPOSES OF ALL FEDERAL AND FEDERALLY ASSISTED PROGRAMS.—A payment under subsection (a) shall not be regarded as income and shall not be regarded as a resource for the month of receipt and the following 9 months, for purposes of determining the eligi- bility of the recipient (or the recipient’s spouse or family) for benefits or assistance, or the amount or e x tent of benefits or assistance, under any F ederal program or under any State or local program financed in whole or in part with Federal funds. (2) PAYMENT NOT CONSIDERED INCOME FOR PURPOSES OF TA X ATION.—A payment under subsection (a) shall not be consid- ered as gross income for purposes of the Internal Revenue Code of 1986. (3) PAYMENTS PROTECTED FROM ASSIGNMENT.—The provi- sions of sections 20 7 and 1631(d)(1) of the Social Security Act (42 U.S.C. 407, 1383(d)(1)), section 14(a) of the Railroad Retirement Act of 1974 (45 U.S.C. 231m(a)), and section 5301 of title 38, United States Code, shall apply to any payment Ap p licab ili ty.T i me pe r i od. C erti f icatio n . D eadline.


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 123STA T .45 3 PUBLIC LA W 111 – 5 —FE B.1 7, 2 0 0 9madeun de rs u b se ctio n ( a ) asi f suc hp a y ment w as a benefit payment or cash benefit to such indi v idua l under the applicable pro g ram described in subparagraph ( B )or( C ) of subsection (a)( 1 ) . ( 4 ) PAYMENTS S UBJ E C TT O O F FSET. —N otwithstanding para - graph ( 3 ) , for purposes of section 3 7 1 6 of title 31, U nited S tates Code, any payment made under this section shall not be considered a benefit payment or cash benefit made under the applicable program described in subparagraph (B) or (C) of subsection (a)(1) and all amounts paid shall be sub j ect to offset to collect delin q uent debts. (d) PAYMENT TO R E PR ESENTAT IV E PAYEES AN DF IDUCIARIES.— (1) I N G ENERA L .—In any case in which an individual who is entitled to a payment under subsection (a) and whose benefit payment or cash benefit described in paragraph (1) of that subsection is paid to a representative payee or fiduciary, the payment under subsection (a) shall be made to the individual ’ s representative payee or fiduciary and the entire payment shall be used only for the benefit of the individual who is entitled to the payment. ( 2 ) A PPLICABILITY.— (A) PAYMENT ON T H E BASIS OF A TITLE II OR SSI BEN- EFIT.—Section 112 9 (a)(3) of the Social Security Act (42 U.S.C. 132 0 a –8 (a)(3)) shall apply to any payment made on the basis of an entitlement to a benefit specified in paragraph (1)(B)(i) or (1)(C) of subsection (a) in the same manner as such section applies to a payment under title II or XV I of such Act. (B) PAYMENT ON THE BASIS OF A RAILROAD RETIREMENT BENEFIT.—Section 13 of the Railroad Retirement Act (4 5 U.S.C. 231l) shall apply to any payment made on the basis of an entitlement to a benefit specified in paragraph (1)(B)(ii) of subsection (a) in the same manner as such section applies to a payment under such Act. (C) PAYMENT ON THE BASIS OF A VETERANS BENEFIT.— Sections 5502, 6106, and 6108 of title 38, United States Code, shall apply to any payment made on the basis of an entitlement to a benefit specified in paragraph (1)(B)(iii) of subsection (a) in the same manner as those sections apply to a payment under that title. (e) APPROPRIATION.— O ut of any sums in the T reasury of the United States not otherwise appropriated, the following sums are appropriated for the period of fiscal years 2009 through 2011, to remain available until e x pended, to carry out this section (1) For the Secretary of the Treasury, $ 131,000,000 for administrative costs incurred in carrying out this section, sec- tion 2202, section 36A of the Internal Revenue Code of 1986 (as added by this Act), and other provisions of this Act or the amendments made by this Act relating to the Internal Revenue Code of 1986. (2) For the Commissioner of Social Security— (A) such sums as may be necessary for payments to individuals certified by the Commissioner of Social Security as entitled to receive a payment under this section and (B) $90,000,000 for the Social Security Administration’s L imitation on Administrative E xpenses for costs incurred in carrying out this section.


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 123STA T .45 4 PUBLIC LA W 111 – 5 —FE B.1 7, 2 0 0 9(3)FortheRail roa d Retire m e n t B oard — ( A ) suc hsumsasma yb e necessary f or p ayments to indi v iduals certified by the Railroad Retirement Board as entitled to receive a payment under this section and (B) $1,40 0,000 to the Railroad Retirement Board ’ s L imitation on Administration for administrative costs incurred in carryin g out this section . (4)(A) For the S ecretary of V eterans Affairs— (i) such sums as may be necessary for the C om - pensation and P ensions account, for payments to individuals certified by the Secretary of Veterans Affairs as entitled to receive a payment under this section; and (ii) $100,000 for the I nformation Systems T ech- nology account and $ 7 ,100,000 for the G eneral O per- ating Ex penses account for administrative costs incurred in carrying out this section. (B) The D epartment of Veterans Affairs Compensation and Pensions account shall hereinafter be available for payments authori z ed under subsection (a)(1)(A) to individuals entitled to a benefit payment described in subsection (a)(1)(B)(iii). SEC.2 2 0 2.S P EC IAL C R E D I TFO R CERTAI NG O V ERN M ENT RETIREES. (a) I N G E NE RAL .—In the case of an eligible individual, there shall be allo w ed as a credit against the tax imposed by subtitle A of the Internal Revenue Code of 1 986 for the first taxable year beginning in 2 009 an amount e q ual $2 5 0 ($500 in the case of a j oint return where both spouses are eligible individuals). (b) EL IG I B LE IN D I V ID U AL.—For purposes of this section— (1) IN GENERAL.—The term ‘ ‘eligible individual’’ means any individual— (A) who receives during the first taxable year beginning in 2009 any amount as a pension or annuity for service performed in the employ of the U nited States or any State, or any instrumentality thereof, which is not considered employment for purposes of chapter 21 of the Internal Revenue Code of 1986, and (B) who does not receive a payment under section 2201 during such taxable year. (2) IDEN T I F I C ATI O NNU M BER RE Q UIREMENT.—Such term shall not include any individual who does not include on the return of tax for the taxable year— (A) such individual’s social security account number, and (B) in the case of a joint return, the social security account number of one of the taxpayers on such return. For purposes of the preceding sentence, the social security account number shall not include a TI N (as defined in section 7701(a)(41) of the Internal Revenue Code of 1986) issued by the Internal Revenue Service. Any omission of a correct social security account number required under this subparagraph shall be treated as a mathematical or clerical error for purposes of applying section 6213(g)(2) of such Code to such omission. (c) TREATMENT OF CREDIT.— (1) REFUNDABLE CREDIT.— (A) IN GENERAL.—The credit allowed by subsection (a) shall be treated as allowed by subpart C of part IV of 26USC 6 4 2 8note.


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 123STA T .45 5 PUBLIC LA W 111 – 5 —FE B.1 7, 2 0 0 9subchapterAof chapter 1 of the In terna lR e v enue C o d e of1 986.(B) A P P RO PR IAT IO NS . —F or purposes of sect i on 1 324 (b)(2) of title 31 ,U nited S tates Code, the credit allo w ed b y subsection (a) shall be treated in the sa m e manner a refund from the credit allowed under section 36A of the Internal Revenue Code of 1986 (as added by this Act). (2) DEF I C IENC Y R UL ES.—For purposes of section 6211(b)(4)(A) of the Internal Revenue Code of 1986, the credit allowable by subsection (a) shall be treated in the same manner as the credit allowable under section 36A of the Internal Rev - enue Code of 1986 (as added by this Act). (d) REFUN D S DISRE G ARDED IN T H EAD M INISTRATION OF FEDERAL P ROGRAMS AND FEDERALLY ASSISTED PROGRAMS.—Any credit or refund allowed or made to any individual by reason of this section shall not be ta k en into account as income and shall not be taken into account as resources for the month of receipt and the followin g 2 months, for purposes of determining the eligibility of such indi- vidual or any other individual for benefits or assistance, or the amount or e x tent of benefits or assistance, under any Federal program or under any State or local program financed in whole or in part with Federal funds. TI T LE III —PR E M I U M AS SISTA NC E FO R CO B RA BENEFITS SEC.30 00. TABL E OF CO N TENTS. T he table of contents of this title is as follows
 * TI

T LE III —PR E M I U M AS SISTA NC E FO RCO B RA BENEFITS S ec.30 00. T abl e of co nt ent s . Sec. 300 1 . P r e miu m assistance for COBRA benefits. SEC. 300 1 . PR E MIU M ASSISTANCE FOR COBRA BENEFITS. (a) PREMIUM ASSISTANCE FOR C O BRA CONTINUATION CO V ERAGE FOR INDIVIDUALS AND THEIR FAMILIES.— (1) PROVISION OF PREMIUM ASSISTANCE.— (A) REDUCTION OF PREMIUMS PAYA B LE.—In the case of any premium for a period of coverage beginning on or after the date of the enactment of this Act for COBRA continuation coverage with respect to any assistance eligible individual, such individual shall be treated for pur- poses of any COBRA continuation provision as having paid the amount of such premium if such individual pays (or a person other than such individual ’ s employer pays on behalf of such individual) 3 5 percent of the amount of such premium (as determined without regard to this sub- section). (B) PLAN ENROLLMENT OPTION.— (i) IN GENERAL.— N otwithstanding the COBRA continuation provisions, an assistance eligible indi- vidual may, not later than 9 0 days after the date of notice of the plan enrollment option described in this subparagraph, elect to enroll in coverage under a plan offered by the employer involved, or the employee organi z ation involved (including, for this pur- pose, a j oint board of trustees of a multiemployer trust Deadlin e .26USC 6 43 2 n ot e. T i m e p e r iod.


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Page:United States Statutes at Large Volume 123.djvu/476

 123STA T .456PUBLIC LA W 111 – 5 —FE B.1 7, 2 0 0 9af f il ia tedw it hon eo rm ore m u ltiem p lo y er plan s), that is different than c o v era g e under the plan in which such individual was enrolled at the time the q ualifying event occurred, and such coverage shall b e treated as COBRA continuation coverage for purposes of the applicable COBRA continuation coverage provision .( ii) R EQUIR E M E NTS . — An assistance eligible indi - vidual may elect to enroll in different coverage as described in clause (i) only if— ( I ) the employer involved has made a deter- mination that such employer will permit assistance eligible individuals to enroll in different coverage as provided for this subparagraph (II) the premium for such different coverage does not e x ceed the premium for coverage in which the individual was enrolled at the time the quali- fying event occurred; (III) the different coverage in which the indi- vidual elects to enroll is coverage that is also offered to the active employees of the employer at the time at which such election is made; and (I V ) the different coverage is not— (aa) coverage that provides only dental, vision, counseling, or referral services (or a combination of such services); (bb) a flexible spending arrangement (as defined in section 106 (c)( 2 ) of the Internal Rev- enue Code of 1 98 6); or (cc) coverage that provides coverage for services or treatments furnished in an on-site medical facility maintained by the employer and that consists primarily of first-aid serv- ices, prevention and wellness care, or similar care (or a combination of such care). (C) P REMIUM REIM B URSEMENT.— F or provisions pro- viding the balance of such premium, see section 6 43 2of the Internal Revenue Code of 1986, as added by paragraph (12). (2) L IMIT A TI O NO FP ERIO D OF PREMIUM ASSISTAN C E.— (A) IN G ENERA L .—Paragraph (1)(A) shall not apply with respect to any assistance eligible individual for months of coverage beginning on or after the earlier of— (i) the first date that such individual is eligible for coverage under any other group health plan (other than coverage consisting of only dental, vision, coun- seling, or referral services (or a combination thereof), coverage under a flexible spending arrangement (as defined in section 106(c)(2) of the Internal Revenue Code of 1986), or coverage of treatment that is fur- nished in an on-site medical facility maintained by the employer and that consists primarily of first-aid services, prevention and wellness care, or similar care (or a combination thereof)) or is eligible for benefits under title X VIII of the S ocial Security Act, or (ii) the earliest of—


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Page:United States Statutes at Large Volume 123.djvu/477

 123STA T .457PUBLIC LA W 111 – 5 —FE B. 17 , 2 0 0 9(I)theda te w h ic hi s9mon ths a f te r the first da y of the first month that p ara g raph ( 1 )( A ) app l ies with respect to s u ch indi v idual , (II) the date following the e x piration of the maximum period of continuation coverage re q uired under the applica b le COBR A continuation cov - erage provision, or (III) the date following the expiration of the period of continuation coverage allowed under paragraph ( 4 )(B)(ii) . (B) TIM I NGOFEL IGI B ILI TY FO RAD DITIONAL C O V - ERAGE. —F or purposes of subparagraph (A)(i), an individual shall not be treated as eligible for coverage under a group health plan before the first date on which such individual could be covered under such plan. (C) N OTIFICATION RE QU IREMENT.—An assistance eligible individual shall notify in writing the group health plan with respect to which paragraph (1)(A) applies if such paragraph ceases to apply by reason of subparagraph (A)(i). S uch notice shall be provided to the group health plan in such time and manner as may be specified by the Sec- retary of L abor. ( 3 )A S SISTANCE ELIGIBLE INDIVIDUAL.—For purposes of this section, the term ‘ ‘assistance eligible individual ’ ’ means any qualified beneficiary if— (A) at any time during the period that begins with September 1, 20 0 8, and ends with D ecember 31, 2009, such qualified beneficiary is eligible for COBRA continu- ation coverage, (B) such qualified beneficiary elects such coverage, and (C) the qualifying event with respect to the COBRA continuation coverage consists of the involuntary termi- nation of the covered employee’s employment and occurred during such period. (4) EX TENSION OF ELECTION P ERIOD AND EFFECT ON COV- ERAGE.— (A) IN GENERAL.—For purposes of applying section 6 0 5 (a) of the Employee Retirement Income Security Act of 19 7 4, section 4980B(f)(5)(A) of the Internal Revenue Code of 1986, section 2205(a) of the P ublic H ealth Service Act, and section 8905a(c)(2) of title 5, U nited States Code, in the case of an individual who does not have an election of COBRA continuation coverage in effect on the date of the enactment of this Act but who would be an assistance eligible individual if such election were so in effect, such individual may elect the COBRA continuation coverage under the COBRA continuation coverage provisions con- taining such sections during the period beginning on the date of the enactment of this Act and ending 60 days after the date on which the notification required under paragraph (7)(C) is provided to such individual. (B) COMMENCEMENT OF COVERAGE NO REAC H -BAC K .— Any COBRA continuation coverage elected by a qualified beneficiary during an extended election period under subparagraph (A)— Defin i t i o n .T i m e p e r io d.


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Page:United States Statutes at Large Volume 123.djvu/478

 123STA T .458PUBLIC LA W 111 – 5 —FE B.1 7, 2 0 0 9(i)shal l com m en ce w i t h the f i r st p erio d of co v era g e b eginning on or after the date of the enactment of this A ct , and (ii) shall not e x tend be y ond the period of COBR A contin u ation coverage that would have been re q uired under the applicable COBRA continuation coverage provision if the coverage had been elected as required under such provision . (C) PRE E XIST I NGCO N D ITIONS. —W ith respect to a quali - fied beneficiary who elects COBRA continuation coverage pursuant to subparagraph (A), the period— (i) beginning on the date of the qualifying event, and (ii) ending with the beginning of the period described in subparagraph (B)(i), shall be disregarded for purposes of determining the 63 - day periods referred to in section 701 (c)( 2 ) of the E mployee Retirement I ncome S ecurity Act of 1 9 7 4, section 9 8 01(c)(2) of the Internal Revenue Code of 1986, and section 2701(c)(2) of the Public H ealth Service Act. ( 5 )EX P EDITED RE V IE W O F DENI AL SOFPRE M I U M ASSIST- ANCE.—In any case in which an individual requests treatment as an assistance eligible individual and is denied such treat- ment by the group health plan, the Secretary of L abor (or the Secretary of Health and Human Services in connection with COBRA continuation coverage which is provided other than pursuant to part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974), in consultation with the Secretary of the T reasury, shall provide for expedited review of such denial. An individual shall be entitled to such review upon application to such Secretary in such form and manner as shall be provided by such Secretary. Such Secretary shall ma k e a determination regarding such individual ’ s eligibility within 15 business days after receipt of such individual’s application for review under this paragraph. Either Secretary’s determination upon review of the denial shall be de novo and shall be the final determination of such Secretary. A reviewing court shall grant deference to such Secretary’s determination. The provisions of this paragraph, paragraphs (1) through (4), and paragraph (7) shall be treated as provisions of title I of the Employee Retirement Income Security Act of 1974 for purposes of part 5 of subtitle B of such title. (6) D ISREGARD OF SU B SIDIES FOR PURPOSES OF FEDERAL AND STATE PROGRAMS.— N otwithstanding any other provision of law, any premium reduction with respect to an assistance eligible individual under this subsection shall not be considered income or resources in determining eligibility for, or the amount of assistance or benefits provided under, any other public ben- efit provided under F ederal law or the law of any State or political subdivision thereof. (7) NOTICES TO INDIVIDUALS.— (A) G ENERAL NOTICE.— (i) IN GENERAL.—In the case of notices provided under section 606(a)(4) of the Employee Retirement Income Security Act of 1974 (29 U .S.C. 1166(4)), section 4980B(f)(6)(D) of the Internal Revenue Code of 1986, section 2206(4) of the Public Health Service Act (42 Courts.De ter mina tion. Dea dl ine. Ap pli c ation.


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Page:United States Statutes at Large Volume 123.djvu/479

 123STA T .459PUBLIC LA W 111 – 5 —FE B.1 7, 2 0 09 U.S. C . 30 0 b b -6(4) ) ,orsecti o n89 0 5a ( f )( 2 )( A )oftit l e5, Unite d States Code, w it h res p ect to indi v id u als who, durin g the period described in paragraph (3)(A), beco m e entitled to elect C OBR A continuation coverage, the re q uirements of such sections shall not be treated as met unless such notices include an additional notification to the recipient of — ( I ) the availabilit y of premium reduction with respect to such coverage under this subsection, and (II) the option to enroll in different coverage if the employer permits assistance eligible individ- uals to elect enrollment in different coverage (as described in paragraph ( 1 )(B)). (ii) A LTERNA T IV EN O TI C E.—In the case of COBRA continuation coverage to which the notice provision under such sections does not apply, the Secretary of L abor, in consultation with the Secretary of the T reasury and the Secretary of H ealth and Human Services, shall, in consultation with administrators of the group health plans (or other entities) that provide or administer the COBRA continuation coverage involved, provide rules requiring the provision of such notice. (iii) F OR M .—The requirement of the additional notification under this subparagraph may be met by amendment of e x isting notice forms or by inclusion of a separate document with the notice otherwise required. (B) S P ECI F IC RE QU IREMENT S .— E ach additional notifica- tion under subparagraph (A) shall include— (i) the forms necessary for establishing eligibility for premium reduction under this subsection, (ii) the name, address, and telephone number nec- essary to contact the plan administrator and any other person maintaining relevant information in connection with such premium reduction, (iii) a description of the extended election period provided for in paragraph (4)(A), (iv) a description of the obligation of the qualified beneficiary under paragraph (2)(C) to notify the plan providing continuation coverage of eligibility for subse- quent coverage under another group health plan or eligibility for benefits under title XV III of the Social Security Act and the penalty provided under section 6 7 20C of the Internal Revenue Code of 1986 for failure to so notify the plan, (v) a description, displayed in a prominent manner, of the qualified beneficiary ’ s right to a reduced pre- mium and any conditions on entitlement to the reduced premium, and (vi) a description of the option of the qualified beneficiary to enroll in different coverage if the employer permits such beneficiary to elect to enroll in such different coverage under paragraph (1)(B). (C) N OTICE IN CONNECTION W IT H E X TEN D ED ELECTION PERIODS.—In the case of any assistance eligible individual Deadlin e .R e gu la t i o n s.


text: Dictionary of National Biography, 1885-1900/Montgomerie, Alexander (1556?-1610?)


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Page:United States Statutes at Large Volume 123.djvu/480

 123STA T .460PUBLIC LA W 111 –5—FE B.1 7, 200 9(oranyi n d i v id u a l d esc ri b ed in p ara g rap h ( 4) ( A )) w ho beca m een t itled to elect COBR A continuation coverage be f ore the date of the enactment of this Act , the adminis - trator of the group health plan (or other entity) involved shall provide (within 60 days after the date of enactment of this Act) for the additional notification re q uired to be provided under subparagraph (A) and failure to provide such notice shall be treated as a failure to meet the notice requirements under the applicable COBRA continuation provision . ( D ) MODELN O TIC E S . —N ot later than 3 0 days after the date of enactment of this Act— (i) the S ecretary of the L abor, in consultation with the Secretary of the T reasury and the Secretary of H ealth and Human Services, shall prescribe models for the additional notification required under this para- graph (other than the additional notification described in clause (ii)), and (ii) in the case of any additional notification pro- vided pursuant to subparagraph (A) under section 89 0 5 a(f)( 2 )(A) of title 5, U nited States Code, the Office of P ersonnel Management shall prescribe a model for such additional notification. (8) RE GU L A TIONS.—The Secretary of the Treasury may pre- scribe such regulations or other guidance as may be necessary or appropriate to carry out the provisions of this subsection, including the prevention of fraud and abuse under this sub- section, e x cept that the Secretary of Labor and the Secretary of Health and Human Services may prescribe such regulations (including interim final regulations) or other guidance as may be necessary or appropriate to carry out the provisions of para- graphs (5), ( 7 ), and (9). (9) OUT R EAC H .—The Secretary of Labor, in consultation with the Secretary of the Treasury and the Secretary of Health and Human Services, shall provide outreach consisting of public education and enrollment assistance relating to premium reduc- tion provided under this subsection. Such outreach shall target employers, group health plan administrators, public assistance programs, States, insurers, and other entities as determined appropriate by such Secretaries. Such outreach shall include an initial focus on those individuals electing continuation cov- erage who are referred to in paragraph (7)(C). I nformation on such premium reduction, including enrollment, shall also be made available on websites of the Departments of Labor, Treasury, and Health and Human Services. ( 1 0) DE F INITIONS.— F or purposes of this section— (A) AD M INISTRATOR.—The term ‘ ‘administrator ’ ’ has the meaning given such term in section 3(16)(A) of the E mployee Retirement Income Security Act of 1974. (B) COBRA CONTINUATION CO V ERAGE.—The term ‘‘COBRA continuation coverage’’ means continuation cov- erage provided pursuant to part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (other than under section 609), title X XII of the Public Health Service Act, section 4980B of the Internal Revenue Code of 1986 (other than subsection (f)(1) of such section insofar as it relates to pediatric vaccines), or section 8905a Webposting.D e adl ine.


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Page:United States Statutes at Large Volume 123.djvu/481

 123STA T .46 1 PUBLIC LA W 111 –5—FE B.1 7, 2 0 0 9ofti t le5,Un ite dS t a te sC ode, o ru nder a State p ro g ra m t h at pro v ides c ompara b le continuation coverage . Such term does not include coverage under a health fle x ible spending arrangement under a cafeteria plan w ithin the meaning of section 12 5ofthe I nternal R evenue Code of 1 986 . ( C ) C OB R ACONTI N UA TION PR O V I S ION. —T he term ‘ ‘COBRA continuation provision ’ ’ means the provisions of law described in subparagraph (B). ( D ) COV E RE D E M P L O Y EE.—The term ‘‘covered emplo y ee’’ has the meaning given such term in section 6 07 (2) of the E mployee Retirement Income Security Act of 197 4 . (E) Q UALI F IED B ENEFICIARY.—The term ‘‘ q ualified beneficiary’’ has the meaning given such term in section 607( 3 ) of the Employee Retirement Income Security Act of 1974. ( F ) G ROUP H EALTH PLAN.—The term ‘‘group health plan’’ has the meaning given such term in section 607(1) of the Employee Retirement Income Security Act of 1974. (G) STATE.—The term ‘‘State’’ includes the District of Columbia, the Commonwealth of P uerto Rico, the V irgin Islands, Guam, American Samoa, and the Commonwealth of the N orthern M ariana Islands. ( H ) PERIOD OF COVERA G E.—Any reference in this sub - section to a period of coverage shall be treated as a ref- erence to a monthly or shorter period of coverage with respect to which premiums are charged with respect to such coverage. (11) REPORTS.— (A) INTERIM REPORT.—The Secretary of the Treasury shall submit an interim report to the Committee on Edu- cation and L abor, the Committee on W ays and Means, and the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Edu- cation, Labor, and Pensions and the Committee on Finance of the Senate regarding the premium reduction provided under this subsection that includes— (i) the number of individuals provided such assist- ance as of the date of the report and (ii) the total amount of expenditures incurred (with administrative expenditures noted separately) in connection with such assistance as of the date of the report. (B) FINAL REPORT.—As soon as practicable after the last period of COBRA continuation coverage for which pre- mium reduction is provided under this section, the Sec- retary of the Treasury shall submit a final report to each Committee referred to in subparagraph (A) that includes— (i) the number of individuals provided premium reduction under this section; (ii) the average dollar amount (monthly and annually) of premium reductions provided to such individuals; and (iii) the total amount of expenditures incurred (with administrative expenditures noted separately) in connection with premium reduction under this section. (12) COBRA PREMIUM ASSISTANCE.—


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Page:United States Statutes at Large Volume 123.djvu/482

 123STA T .46 2 PUBLIC LA W 111 –5—FE B.1 7, 2 0 0 9(A)INGE NE RAL.—SubchapterBof chapter 65 of the I n terna lR e v enue C o d eof 198 6, a s a m ended b y th i s Act, is amended by addin g at the end the follo w ing new section

‘ SEC.6432 .C OBRAP RE MIU M ASSIS T A N CE. ‘ ‘(a) IN G ENERAL.— T he person to whom premiums are payable under C O BRA continuation coverage shall be reimbursed as pro - vided in subsection (c) for the amount of premiums not paid by assistance eligible individuals by reason of section 30 0 2 (a) of the H ealth Insurance Assistance for the U nemployed Act of 2009. ‘‘(b) P ER SO N E N TI TLE D TO REI MBU RSEMENT.— F or purposes of subsection (a), e x cept as otherwise provided by the Secretary, the person to whom premiums are payable under COBRA continuation coverage shall be treated as being— ‘‘(1) in the case of any group health plan which is a multi- employer plan (as defined in section 3(3 7 ) of the Employee Retirement Income Security Act of 197 4 ), the plan, ‘‘(2) in the case of any group health plan not described in paragraph (1)— ‘‘(A) which is sub j ect to the COBRA continuation provi- sions contained in— ‘‘(i) the Internal Revenue Code of 1986, ‘‘(ii) the Employee Retirement Income Security Act of 1974, ‘‘(iii) the Public Health Service Act, or ‘‘(iv) title 5, United States Code, or ‘‘(B) under which some or all of the coverage is not provided by insurance, the employer maintaining the plan, and ‘‘(3) in the case of any group health plan not described in paragraph (1) or (2), the insurer providing the coverage under the group health plan. ‘‘(c) M ET H ODO F REIMBURSEMENT.—Except as otherwise pro- vided by the Secretary— ‘‘(1) TREATMENT AS P A Y MENT OF PAYROLL TA X ES.—Each per- son entitled to reimbursement under subsection (a) (and filing a claim for such reimbursement at such time and in such manner as the Secretary may re q uire) shall be treated for purposes of this title and section 1324(b)(2) of title 31, United States Code, as having paid to the Secretary, on the date that the assistance eligible individual ’ s premium payment is received, payroll taxes in an amount equal to the portion of such reimbursement which relates to such premium. To the extent that the amount treated as paid under the preceding sentence exceeds the amount of such person’s liability for such taxes, the Secretary shall credit or refund such excess in the same manner as if it were an overpayment of such taxes. ‘‘(2) O V ERSTATEMENTS.—Any overstatement of the reimbursement to which a person is entitled under this section (and any amount paid by the Secretary as a result of such overstatement) shall be treated as an underpayment of payroll taxes by such person and may be assessed and collected by the Secretary in the same manner as payroll taxes. ‘‘(3) REIMBURSEMENT C ONTINGENT ON PAYMENT OF REMAINING PREMIUM.— N o reimbursement may be made under this section to a person with respect to any assistance eligible individual until after the reduced premium required under 26USC 6 43 2.


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Page:United States Statutes at Large Volume 123.djvu/483

 123STA T .46 3 PUBLIC LA W 111 –5—FE B.1 7, 2 0 0 9section30 0 2(a) ( 1 )( A )o f s u c h Act w ith r es p ect to such in d i v idua l has b een received .‘ ‘(d) DEFIN I T I O N S . —F or purposes of this section— ‘‘(1) PAYR O L LTA X ES.— T he ter m ‘pa y roll ta x es ’ means— ‘‘(A) amounts re q uired to be deducted and withheld for the payroll period under section 3 4 02 (relatin g to wage withholding) , ‘‘( B ) amounts required to be deducted for the payroll period under section 3102 (relating to F IC A employee taxes), and ‘‘(C) amounts of the taxes imposed for the payroll period under section 3111 (relating to FICA employer taxes). ‘‘(2) PERSON.—The term ‘person’ includes any governmental entity. ‘‘(e) R E P ORTIN G .— E ach person entitled to reimbursement under subsection (a) for any period shall submit such reports (at such time and in such manner) as the S ecretary may require, including— ‘‘(1) an attestation of involuntary termination of employ - ment for each covered employee on the basis of whose termi- nation entitlement to reimbursement is claimed under sub- section (a), ‘‘(2) a report of the amount of payroll taxes offset under subsection (a) for the reporting period and the estimated offsets of such taxes for the subsequent reporting period in connection with reimbursements under subsection (a), and ‘‘(3) a report containing the TI N s of all covered employees, the amount of subsidy reimbursed with respect to each covered employee and qualified beneficiaries, and a designation with respect to each covered employee as to whether the subsidy reimbursement is for coverage of 1 individual or 2 or more individuals. ‘‘(f) REG U LATIONS.—The Secretary shall issue such regulations or other guidance as may be necessary or appropriate to carry out this section, including— ‘‘(1) the requirement to report information or the establish- ment of other methods for verifying the correct amounts of reimbursements under this section, and ‘‘(2) the application of this section to group health plans that are multiemployer plans (as defined in section 3(3 7 )of the Employee Retirement Income Security Act of 1 9 74).’’. (B) SO C IAL SECURITY TRUST FUN D S H ELD HAR M LESS.— In determining any amount transferred or appropriated to any fund under the Social Security Act, section 6 432 of the Internal Revenue Code of 19 8 6 shall not be ta k en into account. (C) CLERICAL AMENDMENT.—The table of sections for subchapter B of chapter 6 5 of the Internal Revenue Code of 1986 is amended by adding at the end the following new item

‘ Sec.6432 . COBRApr e miu m as sis t a n ce. ’ ’. (D) EFFECTI V E DATE.—The amendments made by this paragraph shall apply to premiums to which subsection (a)(1)(A) applies. (E) SPECIAL RULE.— (i) IN GENERAL.—In the case of an assistance eligible individual who pays, with respect to the first


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 123STA T .46 4 PUBLIC LA W 111 –5—FE B.1 7, 2 0 0 9period o fCOBRAc o nt in ua tion co v era g eto wh ich s u b- section ( a ) ( 1 )(A) app l iesorthei m mediatel y subse q uent period , the full premium amount for such coverage, the person to whom such payment is payable shall — ( I )ma k e a reimbursement payment to such individual for the amount of such premium paid ine x cess of the amount required to be paid under subsection (a)(1)(A) or (II) provide credit to the individual for such amount in a manner that reduces one or more subsequent premium payments that the individual is required to pay under such subsection for the coverage involved . (ii) R EIMBURS I NG EM PLOY ER.—A person to which clause (i) applies shall be reimbursed as provided for in section 6432 of the Internal Revenue Code of 1 98 6 for any payment made, or credit provided, to the employee under such clause. (iii) PA YMEN T OR C RE D ITS.— U nless it is reasonable to believe that the credit for the excess payment in clause (i)(II) will be used by the assistance eligible individual within 18 0 days of the date on which the person receives from the individual the payment of the full premium amount, a person to which clause (i) applies shall make the payment required under such clause to the individual within 60 days of such payment of the full premium amount. If, as of any day within the 180-day period, it is no longer reason- able to believe that the credit will be used during that period, payment equal to the remainder of the credit outstanding shall be made to the individual within 60 days of such day. (13) PENALTY F OR FAILURE TO NOTIFY H EALTH PLAN OF CESSATION OF ELIGIBILITY FOR PREMIUM ASSISTANCE.— (A) IN GENERAL.—Part I of subchapter B of chapter 68 of the Internal Revenue Code of 1986 is amended by adding at the end the following new section

‘ SEC.6720 C. P E NALTYFOR FA I L U RE TO NOTIFY H EALTH PLAN OF CESSATION OF ELI G I B ILITY FOR COBRA PRE M IUM ASSISTANCE. ‘ ‘(a) IN G ENERAL.—Any person required to notify a group health plan under section 3002(a)(2)(C)) of the H ealth Insurance Assistance for the Unemployed Act of 2009 who fails to make such a notification at such time and in such manner as the S ecretary of L abor may require shall pay a penalty of 110 percent of the premium reduction provided under such section after termination of eligibility under such subsection. ‘‘(b) REASONABLE CAUSE EX CEPTION.— N o penalty shall be imposed under subsection (a) with respect to any failure if it is shown that such failure is due to reasonable cause and not to willful neglect. ’ ’. 26USC 6 7 2 0 C .Timep e r i od . D e a d l i n e s.


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 123STA T .465PUBLIC LA W 111 – 5 —FE B.1 7, 2 0 0 9(B)CLERICA LA M E ND MEN T.—Thetabl e ofs e c t i o n sof p a r t I ofs u bchapter B of chapter 68 of such Co d eis a m ended b y addin g at the end the follo w ing new item

‘ Sec.6720C . P e naltyfor fa i l u re to notify h ealth p lan of ce s sation of eli g i b ility for C OBRA pre m ium assistance. ’ ’. (C) EF FECTI V E DATE.—The amendments made by this paragraph shall apply to failures occurring after the date of the enactment of this A ct. ( 14 )C O ORDINATION W IT H HCTC.— (A) IN G ENERAL.— S ubsection (g) of section 35 of the Internal R e v enue Code of 1 9 86 is amended by redesignating paragraph (9) as paragraph (1 0 ) and inserting after para - graph (8) the following new paragraph: ‘ ‘(9) C O BRA P REMI U MA S SISTANCE.—In the case of an assist- ance eligible individual who receives premium reduction for COBRA continuation coverage under section 300 2 (a) of the H ealth Insurance Assistance for the U nemployed Act of 2009 for any month during the ta x able year , such individual shall not be treated as an eligible individual, a certified individual, ora q ualifying family member for purposes of this section or section 7 527 with respect to such month. ’ ’. (B) EFFECTIVE DATE.—The amendment made by subparagraph (A) shall apply to taxable years ending after the date of the enactment of this Act. (15) E X CLUSION OF CO B RA PREMIUM ASSISTANCE FROM GROSS INCOME.— (A) IN GENERAL.— P art III of subchapter B of chapter 1 of the Internal Revenue Code of 1986 is amended by inserting after section 139B the following new section: ‘ ‘ SEC.139 C.C OBRAP RE MIU M ASSIS T A N CE. ‘‘In the case of an assistance eligible individual (as defined in section 3002 of the Health Insurance Assistance for the Unemployed Act of 2009), gross income does not include any pre- mium reduction provided under subsection (a) of such section.’’. (B) CLERICAL AMENDMENT.—The table of sections for part III of subchapter B of chapter 1 of such Code is amended by inserting after the item relating to section 139B the following new item: ‘‘Sec. 139 C. COBRA premium assistance.’’. (C) EFFECTIVE DATE.—The amendments made by this paragraph shall apply to taxable years ending after the date of the enactment of this Act. (b) ELIMINATION OF PREMIUM SUBSID Y FOR HIGH-INCOME INDIVIDUALS.— (1) RECAPTURE OF SUBSIDY FOR HIGH-INCOME INDIVID- UALS.—If— (A) premium assistance is provided under this section with respect to any COBRA continuation coverage which covers the taxpayer, the taxpayer’s spouse, or any dependent (within the meaning of section 152 of the Internal Revenue Code of 1986, determined without regard to subsections (b)(1), (b)(2), and (d)(1)(B) thereof) of the taxpayer during any portion of the taxable year, and (B) the taxpayer’s modified ad j usted gross income for such taxable year exceeds $ 125,000 ($250,000 in the case of a joint return), 26USC139 C . 26USC3 5.


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 123STA T .46 6 PUBLIC LA W 111 –5—FE B.1 7, 2 0 0 9then the t aximpos e dbyc hapte r1 o f s u ch C ode w ith respect to the taxpayer for such taxab l e year shall be increased by the amount of such assistance .(2)PHASE-INOFR E C A PTU RE. — ( A ) I N G ENERA L .—In the case of a taxpayer whose modified ad j usted g ross income for the taxable year does not exceed $ 1 45,0 00 ($2 9 0,000 in the case of a joint return), the increase in the tax imposed under paragraph (1) shall not exceed the phase-in percentage of such increase (deter- mined without regard to this paragraph). ( B ) PHASE-IN PERCENTAGE.— F or purposes of this sub- section, the term ‘ ‘phase-in percentage ’ ’ means the ratio (expressed as a percentage) obtained by di v iding— (i) the excess of described in subparagraph (B) of paragraph (1), by (ii) $20,000 ($40,000 in the case of a joint return). ( 3 ) O PTION FOR HIGH-INCO M EIN D I V IDUALS TO W AIVE ASSIST- ANCE AND AVOID RECAPTURE.— N otwithstanding subsection (a)(3), an individual shall not be treated as an assistance eligible individual for purposes of this section and section 6 432 of the Internal R evenue Code of 19 8 6 if such individual— (A) ma k es a permanent election (at such time and in such form and manner as the S ecretary of the T reasury may prescribe) to waive the right to the premium assistance provided under this section, and (B) notifies the entity to whom premiums are reimbursed under section 6432(a) of such Code of such election. (4) M ODIFIED AD J USTED GROSS INCOME.—For purposes of this subsection, the term ‘‘modified adjusted gross income’’ means the adjusted gross income (as defined in section 62 of the Internal Revenue Code of 1986) of the taxpayer for the taxable year increased by any amount excluded from gross income under section 911, 931, or 933 of such Code. (5) CREDITS NOT ALLOWED AGAINST TA X, ETC.—For purposes determining regular tax liability under section 26(b) of such Code, the increase in tax under this subsection shall not be treated as a tax imposed under chapter 1 of such Code. (6) REGULATIONS.—The Secretary of the Treasury shall issue such regulations or other guidance as are necessary or appropriate to carry out this subsection, including re q uirements that the entity to whom premiums are reimbursed under section 6432(a) of the Internal Revenue Code of 1986 report to the Secretary, and to each assistance eligible individual, the amount of premium assistance provided under subsection (a) with respect to each such individual. ( 7 ) E FFECTIVE DATE.—The provisions of this subsection shall apply to taxable years ending after the date of the enact- ment of this Act.


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Page:United States Statutes at Large Volume 123.djvu/487

 123STA T .467PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9TI T LE I V—M E D I CAR EA N D MEDICAID H EALTH IN FO RMATION TECH - NOLO GY; MI S CELLANEO U S MEDICARE P ROVISIONS SEC.40 0 1 . TABL E OF CO N TENTS OF T I TLE. Thetabl e ofc o n tent s of th i s title is as follo w s
 * TI

T LE I V—M E D I CAR EA N D MEDICAID H EALTH IN FO RMATION TECHNOLO GY; MI S CELLANEO U S MEDICARE P ROVISIONS S ec.40 0 1 . T abl e of co nt ent s oft i tle. S u btitle A—Me d ica r e Incenti v es Sec. 4101. Incentives for eli g ible p rofessionals. Sec. 410 2 . Incentives for h ospitals. Sec. 410 3 . Treat m ent of pa y ments and savings; implementation funding. Sec. 4104. Studies and reports on health information technology. Subtitle B —Medicaid Incentives Sec. 4201. Medicaid provider HIT adoption and operation payments; implementa - tion funding. Subtitle C—Miscellaneous Medicare Provisions Sec. 4301. Moratoria on certain Medicare regulations. Sec. 4302. Long-term care hospital technical corrections. S ubti t le A—Me d i car eI n centi v e s SEC. 4101. INCENTI V ES FO R ELI G IBLE P ROFESSIONALS. ( a )INCE N TIV E PAYM ENT S.—S ection 184 8 of the Social Sec ur it yA ct (4 2U .S. C . 1 395 w – 4)isa m en d ed by addin g at the end the following new subsection: ‘ ‘(o) INCENTIVES FOR A D O P TION AND M EANIN G F UL USE OF CER - TIFIED EHR TEC H NOLOGY.— ‘‘(1) INCENTIVE PAYMENTS.— ‘‘(A) IN GENERAL.— ‘‘(i) IN GENERAL.—Sub j ect to the succeeding sub- p aragraphs of this paragraph , with respect to co v ered professional services furnished by an eligible profes- sional during a payment year (as defined in subpara- graph (E)), if the eligible professional is a meaningful EHR user (as determined under paragraph (2)) for the EHR reporting period with respect to such year, in addition to the amount otherwise paid under this part, there also shall be paid to the eligible professional (or to an employer or facility in the cases described in clause (A) of section 1842(b)( 6 )), from the F ederal Supplementary Medical Insurance Trust Fund estab- lished under section 1841 an amount e q ual to 7 5 per- cent of the Secretary ’ s estimate (based on claims sub- mitted not later than 2 months after the end of the payment year) of the allowed charges under this part for all such covered professional services furnished by the eligible professional during such year. ‘‘(ii) N O INCENTIVE PAYMENTS W ITH RESPECT TO YEARS AFTER 2016 .—No incentive payments may be Deadlin e .H eal thI n form ation T e c hnolo gy for E conomic and C linical Health A ct.


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Page:United States Statutes at Large Volume 123.djvu/488

 123STA T .468PUBLIC LA W 111 –5—FE B.1 7, 2 0 0 9madeun de rthis su b se c ti o n w ith res p ecttoa y ear a f ter 2016.‘ ‘ (B)LIM I TA TI ONS ON AMO U NTS O F IN CE NTI V E P A Y- MENTS. — ‘‘(i) I N G ENE R A L .—In no case sha l l the amount of the incenti v e payment provided under this para- g raph for an eligible professional for a payment year e x ceed the applicable amount specified under this subparagraph with respect to such eligible professional and such year. ‘‘(ii) A MOUNT.— S ub j ect to clauses (iii) through (v) , the applicable amount specified in this subparagraph for an eligible professional is as follows ‘‘(I) F or the first payment year for such profes- sional, $ 1 5 ,000 (or, if the first payment year for such eligible professional is 2011 or 2012, $1 8 ,000). ‘‘(II) For the second payment year for such professional, $12,000. ‘‘(III) For the third payment year for such professional, $8,000. ‘‘(I V ) For the fourth payment year for such professional, $ 4 ,000. ‘‘(V) For the fifth payment year for such profes- sional, $2,000. ‘‘(VI) For any succeeding payment year for such professional, $0. ‘‘(iii) PH ASE D O W N FOR ELIGI B LE PROFESSIONALS FIRST ADOPTING EHR AFTER 2013 .—If the first payment year for an eligible professional is after 201 3, then the amount specified in this subparagraph for a pay- ment year for such professional is the same as the amount specified in clause (ii) for such payment year for an eligible professional whose first payment year is 2013. ‘‘(iv) INCREASE FOR CERTAIN ELIGIBLE PROFES- SIONALS.—In the case of an eligible professional who predominantly furnishes services under this part in an area that is designated by the Secretary (under section 332(a)(1)(A) of the Public H ealth Service Act) as a health professional shortage area, the amount that would otherwise apply for a payment year for such professional under subclauses (I) through (V) of clause (ii) shall be increased by 10 percent. In imple- menting the preceding sentence, the Secretary may, as determined appropriate, apply provisions of sub- sections (m) and (u) of section 1833 in a similar manner as such provisions apply under such subsection. ‘‘(v) N O INCENTIVE PAYMENT IF FIRST ADOPTING AFTER 201 4 .—If the first payment year for an eligible professional is after 2014 then the applicable amount specified in this subparagraph for such professional for such year and any subse q uent year shall be $0. ‘‘( C ) NON-APPLICATION TO HOSPITAL-BASED ELIGIBLE PROFESSIONALS.— ‘‘(i) IN GENERAL.—No incentive payment may be made under this paragraph in the case of a hospital- based eligible professional.


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 123STA T .469PUBLIC LA W 111 –5—FE B.1 7, 2 0 09 ‘ ‘ (i i )HOSPITAL-B AS ED ELI G IBLE P R O F ESSIO N AL .—Forpu rpo se so fcla use (i) ,th e ter m ‘hospital- b ase d eli g ible professio n al ’ means, w ith respect to co v ered profes- sional services furnished b y an eligible professional during the E H R reporting period for a payment year, an eligible professional, such as a pathologist, anesthe- siologist, or emergency physician, who furnishes substantially all of such services in a hospital setting (whether inpatient or outpatient) and through the use of the facilities and e q uipment, including qualified elec- tronic health records, of the hospital. T he determina- tion of whether an eligible professional is a hospital- based eligible professional shall be made on the basis of the site of service (as defined by the S ecretary) and without regard to any employment or billing arrangement between the eligible professional and any other provider. ‘‘( D ) P A YM ENT.— ‘‘(i) FORM OF PAYMENT.—The payment under this paragraph may be in the form of a single consolidated payment or in the form of such periodic installments as the Secretary may specify. ‘‘(ii) C OORDINATION OF APPLI C ATION OF LIMITATION FOR PROFESSIONALS IN DIFFERENT PRACTICES.— I n the case of an eligible professional furnishing covered professional services in more than one practice (as specified by the Secretary), the Secretary shall estab- lish rules to coordinate the incentive payments, including the application of the limitation on amounts of such incentive payments under this paragraph, among such practices. ‘‘(iii) COORDINATION W IT H MEDICAID.—The Sec- retary shall see k , tothema x imum extent practicable, to avoid duplicative requirements from Federal and State governments to demonstrate meaningful use of certified EHR technology under this title and title X IX. The Secretary may also ad j ust the reporting periods under such title and such subsections in order to carry out this clause. ‘‘(E) PAYMENT YEAR DEFINED.— ‘‘(i) IN GENERAL.—For purposes of this subsection, the term ‘payment year’ means a year beginning with 201 1. ‘‘(ii) FIRST, SECOND, ETC. PAYMENT YEAR.—The term ‘first payment year’ means, with respect to cov- ered professional services furnished by an eligible professional, the first year for which an incentive pay- ment is made for such services under this subsection. The terms ‘second payment year’, ‘third payment year’, ‘fourth payment year’, and ‘fifth payment year’ mean, with respect to covered professional services furnished by such eligible professional, each successive year immediately following the first payment year for such professional. ‘‘(2) M EANINGF U L EHR USER.— ‘‘( A ) IN GENERAL.—For purposes of paragraph (1), an eligible professional shall be treated as a meaningful EHR Regulations.


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 123STA T .470PUBLIC LA W 111 –5—FE B. 17 , 200 9userfo r anEHR re p or ti n g perio d forapa ym ent year ( or, for purposes of su b se c tion (a ) ( 7 ), for an EHR reporting period under suc h subsection for a year) if each of the fo l lo w ing re q uirements is met

‘(i) MEANI N GFUL U S E O F C E RT IFIE D E H R TECH - NOLOG Y.—T he eligible professional demonstrates to the satisfaction of the S ecretary, in accordance with subparagraph ( C )(i), that during such period the profes- sional is using certified EHR technology in a meaning- ful manner, which shall include the use of electronic prescribing as determined to be appropriate by the Secretary. ‘‘(ii) I NFOR M ATION E X CHANGE.—The eligible profes- sional demonstrates to the satisfaction of the Secretary, in accordance with subparagraph (C)(i), that during such period such certified EHR technology is connected in a manner that pro v ides, in accordance with law and standards applicable to the e x change of informa- tion, for the electronic exchange of health information to improve the quality of health care, such as pro- moting care coordination. ‘‘(iii) RE P ORTING ON MEASURES USING EHR.—Sub- j ect to subparagraph ( B )(ii) and using such certified EHR technology, the eligible professional submits information for such period, in a form and manner specified by the Secretary, on such clinical quality measures and such other measures as selected by the Secretary under subparagraph (B)(i). The Secretary may provide for the use of alternative means for meeting the requirements of clauses (i), (ii), and (iii) in the case of an eligible professional furnishing covered professional services in a group practice (as defined by the Secretary). The Secretary shall see k to improve the use of electronic health records and health care quality over time by requiring more stringent measures of mean- ingful use selected under this paragraph. ‘‘(B) REPORTING ON MEASURES.— ‘‘(i) SELECTION.—The Secretary shall select meas- ures for purposes of subparagraph ( A )(iii) but only consistent with the following: ‘‘(I) The Secretary shall provide preference to clinical quality measures that have been endorsed by the entity with a contract with the Secretary under section 1890 (a). ‘‘(II) P rior to any measure being selected under this subparagraph, the Secretary shall publish in the F ederal Register such measure and provide for a period of public comment on such measure. ‘‘(ii) L IMITATION.—The Secretary may not require the electronic reporting of information on clinical quality measures under subparagraph (A)(iii) unless the Secretary has the capacity to accept the informa- tion electronically, which may be on a pilot basis. ‘‘(iii) COORDINATION OF REPORTING OF INFORMA- TION.—In selecting such measures, and in establishing the form and manner for reporting measures under subparagraph (A)(iii), the Secretary shall seek to avoid Fed e ralR e gist er ,pub li c ati on.


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Page:United States Statutes at Large Volume 123.djvu/491

 123STA T .47 1 PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9redun d a n to rdu plic ati v e reportin g ot h er w i s ere q uired , including reporting under su b section (k) ( 2 )( C ) .‘ ‘(C) DEMONSTRA T I ONO F MEANIN G F UL USE OF C ERTIFIE D E H R TECHNOLOG Y AND INFORMATION E X CHANGE. — ‘‘(i) I N GENERAL.— A pro f essional m a y satisfy the demonstration requirement of clauses (i) and (ii) of subparagraph (A) through means specified by the S ec - retary, which may include— ‘‘(I) an attestation ‘‘(II) the submission of claims with appropriate coding (such as a code indicating that a patient encounter was documented using certified EHR technology); ‘‘(III) a survey response; ‘‘(I V ) reporting under subparagraph (A)(iii); and ‘‘(V) other means specified by the Secretary. ‘‘(ii) U SE OF P ART D DATA.— N otwithstanding sec- tions 1860 D – 1 5 (d)(2)( B ) and 1860D–15(f)(2), the Sec- retary may use data regarding drug claims submitted for purposes of section 1860D–15 that are necessary for purposes of subparagraph (A). ‘‘( 3 ) APPLICATION.— ‘‘(A) P HYSICIAN REPORTING SYSTEM RULES.—Paragraphs (5), (6), and (8) of subsection (k) shall apply for purposes of this subsection in the same manner as they apply for purposes of such subsection. ‘‘(B) COORDINATION W ITH OTHER PAYMENTS.— T he provi- sions of this subsection shall not be taken into account in applying the provisions of subsection (m) of this section and of section 1833(m) and any payment under such provi- sions shall not be taken into account in computing allow- able charges under this subsection. ‘‘(C) L IMITATIONS ON RE V IEW.—There shall be no administrative or j udicial review under section 186 9, sec- tion 18 7 8, or otherwise, of— ‘‘(i) the methodology and standards for determining payment amounts under this subsection and payment adjustments under subsection (a)(7)(A), including the limitation under paragraph (1)(B) and coordination under clauses (ii) and (iii) of paragraph (1)(D); ‘‘(ii) the methodology and standards for deter- mining a meaningful EHR user under paragraph (2), including selection of measures under paragraph (2)(B), specification of the means of demonstrating meaningful EHR use under paragraph (2)(C), and the hardship e x ception under subsection (a)(7)(B); ‘‘(iii) the methodology and standards for deter- mining a hospital-based eligible professional under paragraph (1)(C); and ‘‘(iv) the specification of reporting periods under paragraph (5) and the selection of the form of payment under paragraph (1)(D)(i). ‘‘(D) POSTING ON WE B SITE.—The Secretary shall post on the Internet website of the Centers for M edicare & Medicaid Services, in an easily understandable format, a list of the names, business addresses, and business phone


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Page:United States Statutes at Large Volume 123.djvu/492

 123STA T .47 2 PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9numbersofth ee lig ible p rofession a ls w ho are meaningful EHR users an d, as determined appropriate b y the S e c- retary, of group practices recei v ing incentive payments under paragraph (1).‘ ‘( 4 ) CERTIF IE D E H RTE C H NOL O GY DEFINED. —F or purposes of this section, the term ‘certified EHR technology ’ means a q ualified electronic health record (as defined in section 30 00(13) of the P ublic Health Service A ct) that is certified pursuant to section 3001(c)( 5 ) of such Act as meeting standards adopted under section 3004 of such Act that are applicable to the type of record involved (as determined by the Secretary, such as an ambulatory electronic health record for office-based physi- cians or an inpatient hospital electronic health record for hos- pitals). ‘‘(5) D EFINITION S .—For purposes of this subsection ‘‘(A) CO V ERED P ROFESSION A L SERVICES.— T he term ‘cov- ered professional services’ has the meaning given such term in subsection ( k )(3). ‘‘( B ) EHR REPORTING PERIOD.—The term ‘EHR reporting period’ means, with respect to a payment year, any period (or periods) as specified by the Secretary. ‘‘(C) ELIGI B LE PROFESSIONAL.—The term ‘eligible professional’ means a physician, as defined in section 1 86 1(r).’’. (b) I NCENTIVE PAY M ENT AD JU STMENT.—Section 1848(a) of the Social Security Act (4 2U .S.C. 13 9 5w – 4(a)) is amended by adding at the end the following new paragraph: ‘‘( 7 ) INCENTIVES FOR MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY.— ‘‘(A) ADJUSTMENT.— ‘‘(i) IN GENERAL.—Sub j ect to subparagraphs (B) and (D), with respect to covered professional services furnished by an eligible professional during 2015 or any subsequent payment year, if the eligible profes- sional is not a meaningful EHR user (as determined under subsection (o)(2)) for an EHR reporting period for the year, the fee schedule amount for such services furnished by such professional during the year (including the fee schedule amount for purposes of determining a payment based on such amount) shall be equal to the applicable percent of the fee schedule amount that would otherwise apply to such services under this subsection (determined after application of paragraph (3) but without regard to this paragraph). ‘‘(ii) APPLICABLE PERCENT.—Subject to clause (iii), for purposes of clause (i), the term ‘applicable percent’ means— ‘‘(I) for 2015, 99 percent (or, in the case of an eligible professional who was subject to the application of the payment adjustment under sec- tion 1848(a)(5) for 2014, 98 percent) ‘‘(II) for 2016, 98 percent; and ‘‘(III) for 2017 and each subsequent year, 97 percent. ‘‘(iii) AUTHORITY TO DECREASE APPLICABLE PERCENTAGE FOR 2018 AND SUBSE Q UENT YEARS.—For 2018 and each subsequent year, if the Secretary finds


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Page:United States Statutes at Large Volume 123.djvu/493

 123STA T .47 3 PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9tha tth epro port i o n o f e l i g i b le profe s sionals w ho are m eaningf u l EHR users ( as d etermined under sub - se c tion (o ) ( 2 )) is less than 75 percent , the applicable percent shall be decreased b y1 percentage point from the applicable percent in the preceding year, but in no case shall the applicable percent be less than 9 5 percent .‘ ‘( B ) SIGN I F I CA N TH A RDS HI PEX CEPTI O N. —T he Secretary may, on a case-by-case basis, e x empt an eligible profes- sional from the application of the payment ad j ustment under subparagraph ( A ) if the Secretary determines, sub- ject to annual renewal, that compliance with the re q uire- ment for being a meaningful EHR user would result in a significant hardship, such as in the case of an eligible professional who practices in a rural area without sufficient I nternet access. In no case may an eligible professional be granted an exemption under this subparagraph for more than 5 years. ‘‘( C ) APP L ICATION OF PH Y SICIAN REPORTING SYSTE M R U LES.— P aragraphs (5), ( 6 ),and( 8 ) of subsection ( k ) shall apply for purposes of this paragraph in the same manner as they apply for purposes of such subsection. ‘‘( D ) N ON-APPLICATION TO HOSPITAL- B ASED ELIGIBLE PROFESSIONALS.—No payment adjustment may be made under subparagraph (A) in the case of hospital-based eligible professionals (as defined in subsection (o)(1)(C)(ii)). ‘‘(E) DEFINITIONS.— F or purposes of this paragraph ‘‘(i) CO V ERED PROFESSIONAL SERVICES.—The term ‘co v ered professional services ’ has the meaning given such term in subsection (k)( 3 ). ‘‘(ii) EHR REPORTING PERIOD.—The term ‘EHR reporting period’ means, with respect to a year, a period (or periods) specified by the Secretary. ‘‘(iii) ELIGIBLE PROFESSIONAL.—The term ‘eligible professional’ means a physician, as defined in section 1861(r).’’. (c) APPLICATION TO CERTAIN M A-AFFILIATED ELIGIBLE PROFES- SIONALS.—Section 1853 of the Social Security Act ( 4 2 U .S.C. 1395w – 23) is amended by adding at the end the following new subsection: ‘‘(l) APPLICATION OF ELIGIBLE PROFESSIONAL INCENTIVES FOR CERTAIN MA O RGANI Z ATIONS FOR ADOPTION AND MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY.— ‘‘(1) IN GENERAL.—Subject to paragraphs (3) and (4), in the case of a qualifying MA organi z ation, the provisions of sections 1848(o) and 1848(a)(7) shall apply with respect to eligible professionals described in paragraph (2) of the organiza- tion who the organization attests under paragraph (6) to be meaningful EHR users in a similar manner as they apply to eligible professionals under such sections. Incentive pay- ments under paragraph (3) shall be made to and payment adjustments under paragraph (4) shall apply to such qualifying organizations. ‘‘(2) ELIGIBLE PROFESSIONAL DESCRIBED.— W ith respect to a qualifying MA organization, an eligible professional described in this paragraph is an eligible professional (as defined for purposes of section 1848(o)) who— ‘‘(A)(i) is employed by the organization or


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 123STA T .47 4 PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9‘ ‘ (i i ) ( I )i semploy e db y , o r is a par tn ero f , an entity t h at thro ug h c ontract w ith the organi z ation furnishes at least 80 percent of the entity ’ s M edicare patient care ser v- ices to enrollees of such organization and ‘‘(II) furnishes at least 80 percent of the professional services of the eligible professional covered under this title to enrollees of the organization; and ‘‘( B ) furnishes, on average, at least 2 0 hours per wee k of patient care services . ‘‘( 3 ) ELIG I B L EPROF E S SIO NA LIN C EN T I V EPA YM ENTS. — ‘‘( A ) IN GENERAL.—In applying section 1 8 4 8(o) under paragraph (1), instead of the additional payment amount under section 1848(o)(1)(A) and sub j ect to subparagraph (B), the S ecretary may substitute an amount determined by the Secretary to the e x tent feasible and practical to be similar to the estimated amount in the aggregate that would be payable if payment for services furnished by such professionals was payable under part B instead of this part. ‘‘(B) AVOI D ING D U PLICATION OF PAYMENTS.— ‘‘(i) IN GENERAL.—In the case of an eligible profes- sional described in paragraph (2)— ‘‘(I) that is eligible for the maximum incentive payment under section 1848(o)(1)(A) for the same payment period, the payment incentive shall be made only under such section and not under this subsection; and ‘‘(II) that is eligible for less than such max- imum incentive payment for the same payment period, the payment incentive shall be made only under this subsection and not under section 1848(o)(1)(A). ‘‘(ii) MET H ODS.—In the case of an eligible profes- sional described in paragraph (2) who is eligible for an incentive payment under section 1848(o)(1)(A) but is not described in clause (i) for the same payment period, the Secretary shall develop a process— ‘‘(I) to ensure that duplicate payments are not made with respect to an eligible professional both under this subsection and under section 1848(o)(1)(A); and ‘‘(II) to collect data from Medicare Advantage organizations to ensure against such duplicate pay- ments. ‘‘( C ) F I X ED SCHEDULE FOR APPLICATION OF LIMITATION ON INCENTIVE PAYMENTS FOR ALL ELIGIBLE PROFES- SIONALS.—In applying section 1848(o)(1)(B)(ii) under subparagraph (A), in accordance with rules specified by the Secretary, a q ualifying MA organization shall specify a year (not earlier than 2011) that shall be treated as the first payment year for all eligible professionals with respect to such organization. ‘‘(4) P AYMENT AD J USTMENT.— ‘‘(A) IN GENERAL.—In applying section 1848(a)( 7 ) under paragraph (1), instead of the payment adjustment being an applicable percent of the fee schedule amount for a year under such section, subject to subparagraph ( D ), the Deadlin e .


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 123STA T .475PUBLIC LA W 111 – 5 —FE B. 17 , 2 0 0 9payment a djus tment unde r para g rap h(1) sha l l b ee q ual t o the per c ent spec if ied in subparagraph ( B ) for such year of the payment amount other w ise pro v ided under this sec - tion for such year .‘ ‘(B) SPECIF IE D PE R CE NT . —T he percent specified under this subparagraph for a year is 1 0 0 percent minus a number of percentage points equal to the product of— ‘‘(i) the number of percentage points by which the applicable percent (under section 1 84 8(a)( 7 )( A )(ii)) for the year is less than 100 percent and ‘‘(ii) the M edicare physician e x penditure proportion specified in subparagraph ( C ) for the year. ‘‘(C) MEDIC A REP HYS ICIAN E X PENDIT U RE PR O PORTION.— The Medicare physician expenditure proportion under this subparagraph for a year is the Secretary ’ s estimate of the proportion , of the expenditures under parts A and B that are not attributable to this part, that are attrib- utable to expenditures for physicians’ services. ‘‘( D ) APP L ICATION OF PAY M ENT AD J USTMENT.— I n the case that a qualifying MA organi z ation attests that not all eligible professionals of the organization are meaningful EHR users with respect to a year, the Secretary shall apply the payment adjustment under this paragraph based on the proportion of all such eligible professionals of the organization that are not meaningful EHR users for such year. ‘‘( 5 ) Q UALIFYIN G MA ORGANI Z ATION DEFINED.—In this sub- section and subsection (m), the term ‘qualifying MA organiza- tion’ means a Medicare Advantage organization that is orga- nized as a health maintenance organization (as defined in sec- tion 2 7 9 1(b)( 3 ) of the P ublic Health Service Act). ‘‘( 6 ) MEANINGFUL EHR USER ATTESTATION.— F or purposes of this subsection and subsection (m), a qualifying MA organiza- tion shall submit an attestation, in a form and manner specified by the Secretary which may include the submission of such attestation as part of submission of the initial bid under section 1854(a)(1)(A)(iv), identifying— ‘‘(A) whether each eligible professional described in paragraph (2), with respect to such organization is a mean- ingful EHR user (as defined in section 1848(o)(2)) for a year specified by the Secretary; and ‘‘(B) whether each eligible hospital described in sub- section (m)(1), with respect to such organization, is a mean- ingful EHR user (as defined in section 1886(n)(3)) for an applicable period specified by the Secretary. ‘‘(7) POSTING ON W E B SITE.—The Secretary shall post on the Internet website of the Centers for Medicare & Medicaid Services, in an easily understandable format, a list of the names, business addresses, and business phone numbers of— ‘‘(A) each qualifying MA organization receiving an incentive payment under this subsection for eligible profes- sionals of the organization; and ‘‘(B) the eligible professionals of such organization for which such incentive payment is based. ‘‘(8) L IMITATION ON RE V IEW.—There shall be no administra- tive or judicial review under section 1869, section 1878, or otherwise, of— At t es t a t ion.


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 123STA T .476PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9‘ ‘ (A)them eth od o l o gyan d s tanda r ds f or determ i ning p ayment amo u nts and payment ad j ustments under this su b se c tion , including a v oiding duplication of payments under paragraph ( 3 )( B ) and the specification of rules for the fi x ed schedule for application of limitation on incentive payments for all eligible professionals under paragraph (3)( C ) ‘‘(B) the methodology and standards for determining eligible professionals under paragraph ( 2 ); and ‘‘(C) the methodology and standards for determining a meaningful EHR user under section 184 8(o)(2), including specification of the means of demonstrating meaningful EHR use under section 1848(o)(3)(C) and selection of meas - ures under section 1848(o)(3)(B) .’ ’. (d) STUDYAN DR EPOR TRE L AT I N G TO M A O RGANI Z ATION S . — (1) STUDY.— T he Secretary of Health and Human Services shall conduct a study on the extent to w hich and manner in which payment incentives and adjustments (such as under sections 1848(o) and 1848(a)( 7 ) of the Social Security Act) could be made available to professionals, as defined in 18 6 1(r), who are not eligible for H I T incentive payments under section 1848(o) and receive payments for Medicare patient services nearly-exclusively through contractual arrangements with one or more Medicare Advantage organi z ations, or an intermediary organization or organizations with contracts with Medicare Advantage organizations. Such study shall assess approaches for measuring meaningful use of q ualified EHR technology among such professionals and mechanisms for delivering incen- tives and adjustments to those professionals, including through incentive payments and adjustments through Medicare Advan- tage organizations or intermediary organizations. (2) REPORT.— N ot later than 12 0 days after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report on the findings and the conclusions of the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Secretary determines appropriate. (e) CON F OR M ING AMENDMENTS.—Section 18 5 3 of the Social Security Act (42 U .S.C. 13 9 5w – 23) is amended— (1) in subsection (a)(1)(A), by stri k ing ‘‘and (i)’’ and inserting ‘‘(i), and (l)’’; (2) in subsection (c)— (A) in paragraph (1)( D )(i), by striking ‘‘section 1886(h)’’ and inserting ‘‘sections 1848(o) and 1886(h)’’; and (B) in paragraph (6)(A), by inserting after ‘‘under part B,’’ the following ‘‘excluding expenditures attributable to subsections (a)(7) and (o) of section 1848,’’; and (3) in subsection (f), by inserting ‘‘and for payments under subsection (l)’’ after ‘‘with the organization’’. (f) CONFORMING AMENDMENTS TO E- P RES C RI B ING.— (1) Section 1848(a)(5)(A) of the Social Security Act (42 U.S.C. 1395w–4(a)(5)(A)) is amended— (A) in clause (i), by striking ‘‘or any subsequent year’’ and inserting ‘‘, 2013 or 2014’’; and (B) in clause (ii), by striking ‘‘and each subsequent year’’.


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 123STA T .47 7 PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9(2)Section184 8( m )(2) o fsu c hA ct (42 U. S. C . 1 395w– 4(m)(2)) is a men d ed — (A) in su bp a r a g raph (A) , b y stri k ing ‘ ‘ F or2 0 09 ’ ’ and inserting ‘‘Sub j ect to subparagraph ( D ), for 2009’’ and ( B ) by adding at the end the fo l lowing new subpara - graph ‘‘(D) LIM I TA TI ONW IT HRESP E C T TO EHR INCENTI V EPA Y - MENTS.— T he pro v isions of this paragraph shall not apply to an eligible professional (or, in the case of a group practice under paragraph (3)(C), to the group practice) if, for the EHR reporting period the eligible professional (or group practice) receives an incentive payment under subsection (o)(1)(A) with respect to a certified EHR technology (as defined in subsection (o)(4)) that has the capability of elec- tronic prescribing.’’. SEC.4102 . IN CEN T I V ES FORH OS P IT AL S. (a) I NCENTIVE P AYMENT.— (1) IN G ENERA L .—Section 188 6 of the Social Security Act (42 U.S.C. 1395ww) is amended by adding at the end the following new subsection: ‘‘(n) INCENTIVES F ORA D OPTION AND M EANINGF U L USE OF CER- TIFIED EHR TECHNOLOGY.— ‘‘(1) IN GENERAL.—Subject to the succeeding provisions of this subsection, with respect to inpatient hospital services fur- nished by an eligible hospital during a payment year (as defined in paragraph (2)( G )), if the eligible hospital is a meaningful EHR user (as determined under paragraph (3)) for the EHR reporting period with respect to such year, in addition to the amount otherwise paid under this section, there also shall be paid to the eligible hospital, from the Federal Hospital Insurance Trust Fund established under section 181 7 ,an amount e q ual to the applicable amount specified in paragraph (2)(A) for the hospital for such payment year. ‘‘(2) PAYMENT AMOUNT.— ‘‘(A) IN GENERAL.—Subject to the succeeding subpara- graphs of this paragraph, the applicable amount specified in this subparagraph for an eligible hospital for a payment year is equal to the product of the following: ‘‘(i) INITIAL AMOUNT.—The sum of— ‘‘(I) the base amount specified in subparagraph (B); plus ‘‘(II) the discharge related amount specified in subparagraph (C) for a 12-month period selected by the Secretary with respect to such payment year. ‘‘(ii) MEDICARE SHARE.—The Medicare share as specified in subparagraph (D) for the eligible hospital for a period selected by the Secretary with respect to such payment year. ‘‘(iii) TRANSITION FACTOR.—The transition factor specified in subparagraph (E) for the eligible hospital for the payment year. ‘‘(B) BASE AMOUNT.—The base amount specified in this subparagraph is $ 2,000,000. ‘‘(C) DISCHARGE RELATED AMOUNT.—The discharge related amount specified in this subparagraph for a 12-


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 123STA T .478PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9monthperi o ds e l e c ted by the S ecret a ry shall be determined asthes u mo f the amount , estimated based upon total dischar g es for the eligible hospital ( regardless of any source of payment ) for the period, for each discharge up to the 23, 0 00th discharge as follo w s

‘(i) F or the first through 1 ,1 49 th discharge, $ 0 . ‘‘(ii) For the 1,1 5 0th through the 23,000th dis - charge, $200. ‘‘(iii) For any discharge greater than the 23,000th, $0. ‘‘( D ) MEDICAR E SH ARE. —T he Medicare share specified under this subparagraph for an eligible hospital for a period selected by the Secretary for a payment year is e q ual to the fraction— ‘‘(i) the numerator of which is the sum (for such period and with respect to the eligible hospital) of— ‘‘( I ) the estimated number of inpatient-bed- days (as established by the Secretary) which are attributable to indi v iduals with respect to whom payment may be made under part A; and ‘‘(II) the estimated number of inpatient-bed- days (as so established) which are attributable to individuals who are enrolled with a Medicare Advantage organi z ation under part C ‘‘(ii) the denominator of which is the product of— ‘‘(I) the estimated total number of inpatient- bed-days with respect to the eligible hospital during such period; and ‘‘(II) the estimated total amount of the eligible hospital ’ s charges during such period, not including any charges that are attributable to charity care (as such term is used for purposes of hospital cost reporting under this title), divided by the estimated total amount of the hospital’s charges during such period. Insofar as the Secretary determines that data are not avail- able on charity care necessary to calculate the portion of the formula specified in clause (ii)(II), the Secretary shall use data on uncompensated care and may ad j ust such data so as to be an appropriate pro x y for charity care including a downward adjustment to eliminate bad debt data from uncompensated care data. In the absence of the data necessary, with respect to a hospital, for the Secretary to compute the amount described in clause (ii)(II), the amount under such clause shall be deemed to be 1. In the absence of data, with respect to a hospital, necessary to compute the amount described in clause (i)(II), the amount under such clause shall be deemed to be 0. ‘‘( E ) TRA N SI T I O N F ACTOR S P ECIFIED.— ‘‘(i) IN G ENERA L .—Subject to clause (ii), the transi- tion factor specified in this subparagraph for an eligible hospital for a payment year is as follows: ‘‘(I) For the first payment year for such hos- pital, 1. ‘‘(II) For the second payment year for such hospital, 3⁄4 . Dat a .
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 123STA T .479PUBLIC LA W 111 –5—FE B. 17 , 2 0 09 ‘ ‘ (I II )Forthe th i r dpaym e n t year f or suc h hospita l,1⁄2. ‘‘(I V ) For the fourth payment year for such hospital, 1⁄ 4 . ‘‘(V) For any succeedin g payment year for such hospital, 0 . ‘‘(ii) PHASEDOWNF O R E LIG I B LE HOS P I T ALS FIRST ADOPTING EHR AFTER 2013 . — If the first payment year for an eligi b le hospital is after 2 0 13, then the transition factor specified in this subparagraph for a payment year for such hospital is the same as the amount specified in clause (i) for such payment year for an eligible hospital for w hich the first payment year is 2013. If the first payment year for an eligible hospital is after 201 5 then the transition factor specified in this subparagraph for such hospital and for such year and any subse q uent year shall be 0. ‘‘(F) FOR M OF PA Y MENT.— T he payment under this sub - section for a payment year may be in the form of a single consolidated payment or in the form of such periodic install- ments as the S ecretary may specify. ‘‘( G ) PAYMENT YEAR DEFINED.— ‘‘(i) IN GENERAL.—For purposes of this subsection, the term ‘payment year ’ means a fiscal year beginning with fiscal year 2011. ‘‘(ii) FIRST, SE C OND, ETC. PAYMENT YEAR.—The term ‘first payment year’ means, with respect to inpatient hospital ser v ices furnished by an eligible hos- pital, the first fiscal year for which an incentive pay- ment is made for such services under this subsection. The terms ‘second payment year’, ‘third payment year’, and ‘fourth payment year’ mean, with respect to an eligible hospital, each successive year immediately fol- lowing the first payment year for that hospital. ‘‘(3) M EANINGF U L EHR USER.— ‘‘( A ) IN GENERAL.—For purposes of paragraph (1), an eligible hospital shall be treated as a meaningful EHR user for an EHR reporting period for a payment year (or, for purposes of subsection (b)(3)( B )(i x ), for an EHR reporting period under such subsection for a fiscal year) if each of the following requirements are met ‘‘(i) MEANINGFUL USE OF CERTIFIED EHR TECH- NOLOGY.—The eligible hospital demonstrates to the satisfaction of the Secretary, in accordance with subparagraph ( C )(i), that during such period the hos- pital is using certified EHR technology in a meaningful manner. ‘‘(ii) INFORMATION E X CHANGE.—The eligible hos- pital demonstrates to the satisfaction of the Secretary, in accordance with subparagraph (C)(i), that during such period such certified EHR technology is connected in a manner that provides, in accordance with law and standards applicable to the exchange of informa- tion, for the electronic exchange of health information to improve the quality of health care, such as pro- moting care coordination.