Index for HR3962: Affordable Health Care for America Act

ACCOUNT impact of health care reforms carried out under division A in reducing number of uninsured individuals ;   2016 Secretary of Health and Human Services submitting to Congress report on Medicare dss taking into

ACCOUNT cost of method specified in subparagraph ;   Taking into

ACCOUNT recommendations described in report under section 1157 and notwithstanding geographic adjustments otherwise applying under section 1848(e) and sectioning 1886(d)(3)(e) of Social Security Act 42 USC 1395w-4(e), 1395ww(d)(3)(e)) ;   Taking into

ACCOUNT phase out ;   Amount specified in paragraph for area and year being amount specified in subsection for area and year adjusted to take into

ACCOUNT evaluation under subsection ;   2012 Secretary implementing necessary improvements to risk adjustment system under section 1853(a)(1)(c) of Social Security Act 42 USC 1395-23(a)(1)(c), taking into

ACCOUNT meaning given term by Health Choices Commissioner under section 116 of Affordable Health Care for America Act ;   Taking into

ACCOUNT recommendations of Telehealth Advisory Committee when adding or deleting services and establishing policies of Centers for Medicare and Medicaid Services regarding delivery of telehealth services ;   Secretary taking into

ACCOUNT costs of acquiring necessary equipment ;   Assessment of adequacy of Medicare payment rates for services taking into

ACCOUNT variations in empirical justification for Medicare dss attributable to hospital characteristics ;   Amount of Medicare dss payment to be amount based on recommendations of report under subsection and taking into

ACCOUNT workforce mobility between urban and rural areas ;   Recruitment and retention taking into

ACCREDITATION described in clause not applying for purposes of supplying diabetic testing supplies, canes and crutches in case of pharmacy enrolled under section 1866(j) as supplier of durable medical equipment, prosthetics, orthotics and supplies ;   Requirement for

ACCREDITATION organization determining if supplier complying with requirements under paragraph ;   Retaining supplier's provider or supplier number until independent

ACCREDITATION requirement for suppliers to qualify for bidding in competitive acquisition area under section 1847 ;   Nothing in clauses and construed as affecting application of

ADMINISTRATIVE costs and using estimate to adjust payments to PDP sponsors with respect to prescription drug plans under part and Ma organizations with respect to Ma-pd plans under part C ;   Secretary developing estimate of additional increased costs attributable to application of paragraph for increased drug utilization and financing and

ALL-condition measure of readmissions as determined appropriate by Secretary ;   Secretary expanding applicable conditions beyond 3 conditions For which measures endorsed as described in subparagraph as of date of enactment of subsection to additional 4 conditions so identified by Medicare Payment Advisory Commission in report to Congress in June 2007 and other conditions and procedures including

AMBULATORY surgical center to hospital after date of enactment of subsection ;   Hospital not converted from

AMBULATORY surgical facility as Secretary specifying ;   Subparagraph Secretary requiring reporting of additional data relating to quality of services furnished in

ANALYTIC contractors to identify and analyzing services identified under clause ;   Secretary using

ANGIOGRAPHIES, angiograms and endoscopies furnished ;   Term procedure rooms including rooms in which catheterizations,

ASSESSMENT including assessment of individual's physical and mental condition, cognitive and functional capacities, medication regimen and adherence, social and environmental needs and primary caregiver needs and resources  ;  

ASSESSMENT visit for individual referred for home health services under title XVIII of Social Security Act ;   Home health agency determining appropriate skilled therapist to make initial

CANCER surgical procedure ;   Secretary developing policies to ensure appropriate beneficiary access and utilization safeguards for items supplied to beneficiary prior to mastectomy or other breast

DISCHARGE from applicable hospital ;   Support beneficiary under section beginning on date of individual's admission to hospital for inpatient hospital services and ending at latest on last day of 90-day period beginning on date of individual's

BENEFICIARY access to bone mass measurement benefits in general and rural and minority communities specifically ;   Impact of Medicare payment changes since 2006 on

BENEFICIARY access to high quality equipment and supplies ;   Structuring acquisition program in order to promote fiscal responsibility when ensuring

BENEFICIARY cost sharing associated with application of subparagraph ;   Secretary establishing procedures fully to reimburse PDP sponsors with respect to prescription drug plans and Ma organizations with respect to Ma-pd plans for reduction in

BENEFICIARY data ;   Need and feasibility of including further gradations of diseases or conditions and multiple years of

BENEFICIARY payment ;   Discount not to be applied against negotiated price for purpose of calculating

BIDDING process ;   Recommendations on criteria to be factored into

BIOLOGICAL product manufactured by manufacturer not entering and effect for qualifying drugs discount agreement described in paragraph ;   Term covered part D drug not including drug or

CANCER surgical procedure ;   Secretary developing policies to ensure appropriate beneficiary access and utilization safeguards for items supplied to beneficiary prior to mastectomy or other breast

CAPITAL contributions making at time ownership or investment interest obtained ;   Investment interest of owner or investor being directly proportional to owner or investor's

CAPITATION rates described in subsection ;   Indirect costs of medical education from

ANGIOGRAPHIES, angiograms and endoscopies furnished ;   Term procedure rooms including rooms in which catheterizations,

CERTIFICATION to Secretary ;   Secretary revoking waiver granted under paragraph if State insurance commissioner submiting

INCOME beneficiaries ;   Secretary of Health and Human Services submitting to Congress report evaluating adequacy of risk adjustment system under section 1853(a)(1)(c) of Social Security Act 42 USC 1395-23(a)(1)(c) in predicting costs for beneficiaries with chronic or co-morbid conditions, beneficiaries dually-eligible for Medicare and Medicaid and non-Medicaid eligible low-

CHRONIC condition qualifying individual as individual described in subsection for plan and ending on date on which individual enrolling plan on basis of condition ;   During special election period consisting of period For which individual having

CHRONIC diseases ;   Measures of health functioning and survival for patients with

CIVIL money penalty under subparagraphs and same manner as provisions applying to penalty or proceeding under section 1128a(a) ;   Provisions of section 1128a and other than subsection applying to

CIVIL money penalty in amount not to exceed $100,000 for item of false information ;   Sponsor being subject to

CLASSIFIATIONS groups exceeding costs incurred by other hospitals furnishing services under subsection ;   Secretary conducting study to determine if costs incurred by hospitals described in section 1886(d)(1)(b)(v) with respect to ambulatory payment

HEALTH records ;   2012 Secretary developing plan to integrate clinical reporting on quality measures under subsection with reporting requirements under subsection relating to meaningful use of electronic

CLINICAL quality measures endorsed by entity with contract with Secretary under section 1890(a) ;   Secretary providing preference to

ENVIRONMENTAL needs and primary caregiver needs and resources ;   Assessment including assessment of individual's physical and mental condition, cognitive and functional capacities, medication regimen and adherence, social and

COMPENSATION arrangements ;   Entity providing covered items or services For which payment to be made under title providing Secretary with information concerning entity's ownership, investment and

COMPETITIVE acquisition area under section 1847 ;   Nothing in clauses and construed as affecting application of accreditation requirement for suppliers to qualify for bidding in

COMPLIANCE, penalties and program evaluations, investigations and audits being similar to terms and conditions for rebate agreements under paragraphs and section 1927(b) ;   Secretary establishing terming and conditioning of agreement relating to

COMPLIANCE ;   Secretary establishing terming and conditioning of agreement including terming and conditions relating to

HEALTH Care ;   Sec 1160, implementation and congressional Review of proposal to revise medicare payments to promote high Value

CONSTITUTIONAL right of House to change rules at time ;   Full recognition of

CONTRACT under section 1890(a) of Social Security Act but adopting and applying measures under paragraph without ;   Secretary seeking endorsement of measures by entity with

CONTRACT with Institute of Medicine of National Academy of Science to conduct comprehensive empirical study and providing recommendations as appropriate ;   Secretary of Health and Human Services entering into

CONTRACT with Secretary under section 1890(a) ;   Secretary providing preference to clinical quality measures endorsed by entity with

CONTRACT with Ma organization under section including terms informing organization of provisions in subsection ;   Secretary requiring that

CONTRACT entered with PDP sponsor under part with respect to prescription drug plan requiring that sponsor complying with subparagraphs  ;  

CONTRACT with State Medicaid agency ;   Approving by Centers for Medicare and Medicaid Services as dual eligible special needs planning and offers integrated Medicare and Medicaid services under

CONTRACT year ;   Secretary not permitting enrollment of new enrollees under plan for coverage during second succeeding

CREDENTIALING and not relieving hospital from applicable privileging requirements ;   Paragraph only applying to

CREDENTIALING materials prepared by another hospital ;   Hospital accepting

CREDENTIALING package compiled by another facility ;   Nothing in subsection to be construed to require hospital to accept

CUMULATIVE ICL phase ;   Initial coverage limit otherwise computed without regard to paragraph to be increased by

DEBT ;   Make additional payment to hospital by amount estimated based on amount of uncompensated care provided by hospital based on criteria for uncompensated care as determined by Secretary excluding bad

DISTRIBUTION associated with transportation costs ;   Demographic characteristics of individuals served and geographic

PROSTHETICS, orthotics and supplies ;   Requirement for accreditation described in clause not applying for purposes of supplying diabetic testing supplies, canes and crutches in case of pharmacy enrolled under section 1866(j) as supplier of durable medical equipment,

RELATIVE value units under subsection with respect to advanced diagnostic imaging services ;   Consistent with methodolology for computing number of practice expense

DISCHARGE of individual from hospital and other services determined appropriate by Secretary ;   Term post acute services meaning services For which payment to be made under Medicare program furnished by skilled nursing facilities, inpatient rehabilitation facilities, long term care hospitals, hospital based outpatient rehabilitation facilities and home health agencies to individual after

DISCRETIONARY treatment decisions being made to be characterized as different from best available medical evidence ;   Evaluation of extent to which variation to be attributed to physician and practitioner discretion in making treatment decisions and degree to which

DISPROPORTIONATE share hospitals ;   Term Medicare dss meaning adjustments in payments under section 1886(d)(5)(f) of Social Security Act 42 USC 1395ww(d)(5)(f) for inpatient hospital services furnished by

DISSEMINATION ;   Mailings or other methods of communication facilitating large-scale

DRUG coverage to part D eligible individual enrolled under program ;   Provisions of paragraph of section 1860d-12(c) applying without regard to paragraph of section in case of Pace program electing to provide qualified prescription

DRUG means with respect to prescription drug plan or Ma-pd plan ;   Term qualifying

DRUG plan or organization offering Ma-pd plan ;   Nothing in subsection to be construed as preventing sponsor of prescription

DRUG application ;   Including drug product marketed by cross-licensed producers or distributors operating under new

RENTAL period Ends ;   Sec 1141a, election to Take ownership or Decline ownership of certain item of complex durable medical equipment after 13-month capped

ECONOMIC factors including race, ethnicity, gender, age, income and educational status  ;  

ECONOMY-wide private nonfarm business multi-factor productivity ;   Productivity offset in form of reduction in increase or changing equal to percentage change in 10-year moving average of annual

CAPITATION rates described in subsection ;   Indirect costs of medical education from

ECONOMIC factors including race, ethnicity, gender, age, income and educational status  ;  

ELIGIBILITY for coverage of home health services under title XVIII of Social Security Act on basis of need for occupational therapy ;   Nothing in subsection to be construed to provide for initial

ENDORSEMENT described in subparagraph but applying measures without ;   Secretary seeking

ENDOSCOPIES furnished ;   Term procedure rooms including rooms in which catheterizations, angiographies, angiograms and

ENVIRONMENTAL needs and primary caregiver needs and resources ;   Assessment including assessment of individual's physical and mental condition, cognitive and functional capacities, medication regimen and adherence, social and

INCOME and educational status ;   Economic factors including race, ethnicity, gender, age,

EXPENDITURES and expansion of pilot program resulting in estimated spending to be less ;   Demonstration program and pilot program reducing program

BENEFICIARY data ;   Need and feasibility of including further gradations of diseases or conditions and multiple years of

FINANCIAL interest to be affected by advice given to Secretary with respect to matter ;   Advisory committee member not participating with respect to particular matter considered in advisory committee meeting if member having

FINANCIAL recoveries ;   Secretary authorized to take actions including pursuit of

FINANCING issues ;   Representatives of foundations and other nonprofit entities conducting or supported research on Medicare

BENEFICIARY access to high quality equipment and supplies ;   Structuring acquisition program in order to promote fiscal responsibility when ensuring

FISCAL year involved ;   Rate computed for previous fiscal year increased by skilled nursing facility market basket percentage change for

FISCAL year to be available until expended ;   Amounts appropriated under paragraph for

FISCAL year to be available until expended ;   Amounts appropriated under paragraph for

FISCAL year to be available until expended ;   Amounts appropriated under paragraph for

FISCAL year 2009 and inserting for fiscal years 2009 and 2010 ;   Striking for

FISCAL year 2010 by appropriate recalibration factor as proposed in proposed rule for Medicare skilled nursing facilities issued by Secretary ;   Secretary adjusting case mix indexes under section 1888(e)(4)(g)(i) of Social Security Act 42 USC 1395yy(e)(4)(g)(i) for

FISCAL year 2010 ;   Funds in Treasury not otherwise appropriated appropriated to Secretary of Health and Human Services for Centers for Medicare and Medicaid Services programming Management Account $5,000,000 for fiscal year beginning with

FISCAL year 2010 ;   Purposes of implementation of amendment making by subsection for

FISCAL year 2011 ;   Amendments making by subsections and applying to annual increases effected for fiscal years beginning with

FISCAL year 2011 and ending with fiscal year 2019 ;   Period beginning with

FISCAL year 2011 rulemaking cycle for purposes of implementation beginning for fiscal year ;   Secretary including result of analysis under subparagraph in

FISCAL year 2012 and subsequent fiscal year of subsection in manner similar to manner in which section applying with respect to fiscal year to applicable hospital as described in section 1886(p)(2) ;   Adjustment factor described in section 1886(p)(3) applying to payments with respect to critical access hospital with respect to cost reporting period beginning in

FISCAL year 2014 ;   Additional expenditures resulting from implementation of subsection of section 1158 of Affordable Health Care for America Act for period before

FISCAL year 2019 ;   Period beginning with fiscal year 2011 and ending with

FISCAL years 2009 and 2010 ;   Striking for fiscal year 2009 and inserting for

FRAUD and Abuse ;   Revocation of waiver upon finding of

GENERAL fund of Treasury not otherwise appropriated $10,000,000 to carry out that section ;   Appropriating from amounts in

GEOGRAPHIC adjustment factors established under sections 1848(e) and 1886(d)(3)(e) of Social Security Act 42 USC 1395w-4(e) ;   Accuracy of

GEOGRAPHIC adjustment factors used in systems ;   Proposals to revise

GEOGRAPHIC area ;   Service area of plan to be limited to senior housing facility in

GEOGRAPHIC basis rather than using county boundaries ;   Administrator of Centers for Medicare and Medicaid Services conducting study to determine potential effects of calculating Medicare Advantage payment rates on more aggregated

INSTEAD applying index in effect for county on date  ;  

GEOGRAPHIC measurement including micro areas within larger areas ;   Evaluation of extent and range of variation using various units of

GEOGRAPHIC regions ;   Ensuring that membership of Advisory Committee representing balance of specialties and

HEALTH care outcomes and consensus-based measures of health care quality ;   Evaluation of extent to which variations in spending correlated with patient access to care, insurance status, distribution of health care resources,

HEALTH care programs and not permitting physicians practicing at hospital to discriminate against beneficiaries ;   Not discriminating against beneficiaries of Federal

HEALTH care quality ;   Evaluation of extent to which variations in spending correlated with patient access to care, insurance status, distribution of health care resources, health care outcomes and consensus-based measures of

HEALTH care reforms carried out under division A in reducing number of uninsured individuals ;   2016 Secretary of Health and Human Services submitting to Congress report on Medicare dss taking into account impact of

DISTRIBUTION of health care resources, health care outcomes and consensus-based measures of health care quality ;   Evaluation of extent to which variations in spending correlated with patient access to care, insurance status,

HEALTH care services to low-income patient populations including coordinated and comprehensive care by safety net providers to reduce unnecessary use of items and services furnished in emergency departments ;   Term collaborative care network meaning consortium of health care providers providing comprehensive range of coordinated and integrated

HEALTH market basket percentage increases for years beginning with 2011 ;   Amendments making by subsection applying to home

HEALTH outcomes ;   Basing on evidence of effectiveness in reducing hospital readmissions and improving

HEALTH plans for provision of home infusion therapy and applicability to Medicare program ;   Recommendations on structure of payment system under Medicare program for home infusion therapy including analysis of payment methodologies used under Medicare Advantage plans and private

HEALTH records ;   2012 Secretary developing plan to integrate clinical reporting on quality measures under subsection with reporting requirements under subsection relating to meaningful use of electronic

HEALTH team members as appropriate ;   Development of evidence-based plan of transitional care for individual developed after consulations with individual and individual's primary caregiver and other

DISCHARGE from applicable hospital or critical access hospital ;   Claim submitted post-acute care provider under title XVIII of Social Security Act indicating that individual readmitted to hospital post-acute care provider or admitted from home and care of home health agency within 30 days of initial

HEALTH, skilled nursing facility and other services ;   Cost-sharing for post acute care bundle to be treated relative to current rules for cost-sharing for inpatient hospital, home

HEALTH agencies in effort to explain variation in Medicare margins for agencies ;   Medicare Payment Advisory Commission conducting study regarding variation in performance of home

ASSESSMENT visit for individual referred for home health services under title XVIII of Social Security Act ;   Home health agency determining appropriate skilled therapist to make initial

HEALTH services for individual ;   Not requiring skilled nursing care as long as skilled service included as part of plan of care for home

FOR-service Medicare program under title XVIII of Social Security Act, Medicare Advantage under part C of title united States Code and private payers including analysis of scope of services provided by home infusion therapy providers to patients in programs ;   Scope of coverage for home infusion therapy in fee-

HOME infusion therapy ;   Benefits and costs of providing coverage under Medicare program including calculation of potential savings achieved through avoided or shortened hospital and nursing home stays as result of Medicare coverage of

HOSPITAL ;   2010 during rate year ending in 2010 or subsequent rate year for