TABLE OF CONTENTS OF TITLE

TABLE OF CONTENTS OF TITLE TITLE IV—MEDICARE, MEDICAID, AND OTHER HEALTH-RELATED PROGRAMS Subtitle A— Medicare Part 1— Relating Only to Part A Sec. 4001. Extension of reductions under sequester order. Sec. 4002. Basic hospital prospective payment rates. Sec. 4003. Increase in disproportionate share adjustment and reduction in indirect medical education payments. Sec. 4004. Provisions relating to wage index. Sec. 4005. Rural hospitals. Sec. 4006. Payments for hospital capital. Sec. 4007. Reporting hospital information. Sec. 4008. Other provisions relating to payment for inpatient hospital services. Sec. 4009. Miscellaneous provisions. Part 2— Provisions Relating to Parts A and B subpart a— health maintenance organization reforms Sec. 4011. Beneficiary protection. Sec. 4012. Payments for hospital services. Sec. 4013. Two-year extension on period for benefit stabilization. Sec. 4014. Civil money penalties and intermediate sanctions against HMOs/CMPs. Sec. 4015. Medicare payment demonstration projects. Sec. 4016. Delay in effective date in physician incentive rules for health maintenance organizations. Sec. 4017. GAO study and reports on medicare capitation. Sec. 4018. Special rules. 101 STAT. 1330–40 subpart b— home health quality Sec. 4021. Conditions of participation for home health agencies. Sec. 4022. Standard and extended survey. Sec. 4023. Enforcement. Sec. 4024. Requirement that individual be confined to home. Sec. 4025. Home health toll-free hotline and investigative unit. , Sec. 4026. Home health agency cost limits. Sec. 4027. Home health prospective payment demonstration project. subpart c— other provisions Sec. 4031. Payment cycle standards. Sec. 4032. Denials and reconsiderations of claims for home health services, extended care services, and post-hospital extended care services. Sec. 4033. Permitting disabled individuals to renew entitlement to medicare after gainful employment without a 2-year waiting period. Sec. 4034. Application of secondary payer provisions to governmental entities. Sec. 4035. Publication and notification of policies. Sec. 4036. End-stage renal disease amendments. Sec. 4037. Medicare hearings and appeals. Sec. 4038. Rural health medical education demonstration project. Sec. 4039. Miscellaneous and technical provisions. Part 3— Relating to Part B subpart a— provisions relating to payments for physicians’ servicesSec. 4041. Freeze in payments for physicians’ services; extension of sequester order. Sec. 4042. General update in payments for physicians’ services. Sec. 4043. Incentive payments for physicians’ services furnished in underserved areas. Sec. 4044. Adjustment in prevailing charge level for primary care services. Sec. 4045. Reduction in prevailing charge level for overpriced procedures. Sec. 4046. Limits on payment for ophthalmic ultrasound. Sec. 4047. Customary charges for primary care services of new physicians. Sec. 4048. Payment for physician anesthesia services. Sec. 4049. Fee schedules for radiologist services. Sec. 4050. Fee schedules for physician pathology services. Sec. 4051. Elimination of markup for certain purchased services. Sec. 4052. Collection of past-due amounts owed by physicians who breached contracts under the National Health Service Corps Scholarship Program. 99Copy read “Sec. 4052.”Sec. 4053. Elimination of 1975 floor for prevailing physician charges. 1010Copy read “Sec. 4053.”Sec. 4054. Application of maximum allowable actual charge (MAAC). 1111Copy read “Sec. 4054.”.Sec. 4055. Applying copayment and deductible to certain outpatient physicians’ services. 1212Copy read “Sec. 4055.”.Sec. 4056. Physician payment studies. subpart b— provisions relating to payments for other services Sec. 4061. Extension of reduction for other part B items and services payments under sequester order. Sec. 4062. Payments for durable medical equipment, prosthetic devices, orthotics, and prosthetics. Sec. 4063. Payment for intraocular lenses. Sec. 4064. Clinical diagnostic laboratory tests. Sec. 4065. Return on equity payments to outpatient departments. Sec. 4066. Payments to hospital outpatient departments for radiology. Sec. 4067. Updating maximum rate of payment per visit for independent rural health clinics. Sec. 4068. Payment for ambulatory surgery at eye, and eye and ear, specialty hospitals. subpart c— eligibility and benefits changes Sec. 4070. Coverage of mental health services. Sec. 4071. Coverage of influenza vaccine and its administration. Sec. 4072. Payment for therapeutic shoes for individuals with severe diabetic foot disease. Sec. 4073. Coverage of certified nurse-midwife services. 101 STAT. 1330–41 Sec. 4074. Coverage of social worker services furnished by a health maintenance organization to its members. Sec. 4075. Clarification of coverage of drugs used in immunosuppressive therapy. Sec. 4076. Services of a physician assistant. Sec. 4077. Psychologist services in clinics. Sec. 4078. Provision of offsite comprehensive outpatient rehabilitation services. Sec. 4079. Demonstration projects to provide payment on a prepaid, capitated basis for community nursing and ambulatory care furnished to medicare beneficiaries. Sec. 4080. Part B premium. subpart d— other provisions Sec. 4081. Submission of claims to supplemental insurance carriers. Sec. 4082. Revision of part B hearings. Sec. 4083. Provisions relating to Physician Payment Review Commission. Sec. 4084. Technical amendments related to certified registered nurse anesthetists. Sec. 4085. Miscellaneous and technical provisions. Part 4— Peer Review organizations Sec. 4091. Contract provisions. Sec. 4092. Preference in contracting with in-State organizations. Sec. 4093. Requiring reasonable notice and opportunity for discussion prior to denial of claim. Sec. 4094. Peer1313Copy read “reer”. review norms and education. Sec. 4095. Pre-exclusion hearings. Sec. 4096. Limitation of beneficiary liability for services disallowed by peer review organizations. Sec. 4097. Separate funding levels. Subtitle B— Medicaid Part 1— Eligibility and Benefits. Sec. 4101. Medicaid benefits for poor children and pregnant women. Sec. 4102. Home and community-based services for the elderly. Sec. 4103. Physicians’ services furnished by dentists. Sec. 4104. Optional medicaid coverage of individuals in certain States receiving only optional State1414Copy read “states”, and “state”, respectively. supplementary payments. Sec. 4105. Miscellaneous SSI-related amendments. Sec. 4106. Clarification of coverage of clinic services furnished to homeless outside facility. Sec. 4107. Medically needy income levels for certain 2-member couples in California.1515Copy read “California.”. Part 2— Other Provisions Sec. 4111. Increasing the maximum annual medicaid payments that may be made to the commonwealths and territories. Sec. 4112. Adjustment in medicaid payment for inpatient hospital services furnished by disproportionate share hospitals. Sec. 4113. HMO-related provisions. Sec. 4114. Medicaid waiver for hospice care for AIDS patients. Sec. 4115. State demonstration projects. Sec. 4116. Waiver authority under the medicaid program for the Northern Mariana Islands.1616Copy read “northern mariana islands.”. Sec. 4117. Delay quality control sanctions for medicaid. Sec. 4118. Technical and miscellaneous amendments. Subtitle C— Nursing Home Reform Part 1— Medicare Program Sec. 4201. Requirements for skilled nursing facilities. Sec. 4202. Survey and certification process. Sec. 4203. Enforcement process. Sec. 4204. Effective dates. Sec. 4205. Annual report. Sec. 4206. Construction. 101 STAT. 1330–42 Part 2— Medicaid Program Sec. 4211. Requirements for nursing facilities. Sec. 4212. Survey and certification process. Sec. 4213. Enforcement process. Sec. 4214. Effective dates. Sec. 4215. Annual report. Sec. 4216. Construction. Sec. 4217. Final regulations with respect to plans of correction or reduction. Sec. 4218. Medicaid certifications and recertifications for certain services. Subtitle D— Vaccine Compensation Sec. 4301. Short title, reference. Sec. 4302. Effective date. Sec. 4303. Compensation. Sec. 4304. Petitions. Sec. 4305. Citizen’s actions. Sec. 4306. Vaccine administrators.16a16aCopy read “Vacine”. Sec. 4307. Court jurisdiction. Subtitle E— Rural Health Sec. 4401. Office of Rural Health Policy. Sec. 4402. Impact analyses of medicare rules and regulations on small rural hospitals. Sec. 4403. Set aside for experiments and demonstration projects relating to rural health care issues.