PROCESS FOR EXPEDITED ACCESS TO REVIEW.

SEC. 932. PROCESS FOR EXPEDITED ACCESS TO REVIEW. (a) Expedited Access to Judicial Review.—(1) In general.—Section 1869(b) (42 U.S.C. 1395ff(b)) is amended—(A) in paragraph (1)(A), by inserting “, subject to paragraph (2),” before “to judicial review of the Secretary’s final decision”; and(B) by adding at the end the following new paragraph:“(2) Expedited access to judicial review.—“(A) In general.—The Secretary shall establish a process under which a provider of services or supplier that furnishes an item or service or an individual entitled to benefits under part A or enrolled under part B, or both, who has filed an appeal under paragraph (1) (other than an appeal filed under paragraph (1)(F)(i)) may obtain access to judicial review when a review entity (described in subparagraph (D)), on its own motion or at the request of the appellant, determines that the Departmental Appeals Board does not have the authority to decide the question of law or regulation relevant to the matters in controversy and that there is no material issue of fact in dispute. The appellant may make such request only once with respect to a question of law or regulation for a specific matter in dispute in a case of an appeal.“(B) Prompt determinations.—If, after or coincident with appropriately filing a request for an administrative hearing, the appellant requests a determination by the appropriate review entity that the Departmental Appeals Board does not have the authority to decide the question of law or regulations relevant to the matters in controversy and that there is no material issue of fact in dispute, and if such request is accompanied by the documents and materials as the appropriate review entity shall require for purposes of making such determination, such review entity shall make a determination on the request in writing within 60 days after the date such review entity receives the request and such accompanying documents and materials. Such a determination by such review entity shall be considered a final decision and not subject to review by the Secretary.“(C) Access to judicial review.—“(i) In general.—If the appropriate review entity—117 STAT. 2400“(I) determines that there are no material issues of fact in dispute and that the only issues to be adjudicated are ones of law or regulation that the Departmental Appeals Board does not have authority to decide; or“(II) fails to make such determination within the period provided under subparagraph (B),then the appellant may bring a civil action as described in this subparagraph. “(ii) Deadline for filing.—Such action shall be filed, in the case described in—“(I) clause (i)(I), within 60 days of the date of the determination described in such clause; or“(II) clause (i)(II), within 60 days of the end of the period provided under subparagraph (B) for the determination.“(iii) Venue.—Such action shall be brought in the district court of the United States for the judicial district in which the appellant is located (or, in the case of an action brought jointly by more than one applicant, the judicial district in which the greatest number of applicants are located) or in the District Court for the District of Columbia.“(iv) Interest on any amounts in controversy.—Where a provider of services or supplier is granted judicial review pursuant to this paragraph, the amount in controversy (if any) shall be subject to annual interest beginning on the first day of the first month beginning after the 60-day period as determined pursuant to clause (ii) and equal to the rate of interest on obligations issued for purchase by the Federal Supplementary Medical Insurance Trust Fund for the month in which the civil action authorized under this paragraph is commenced, to be awarded by the reviewing court in favor of the prevailing party. No interest awarded pursuant to the preceding sentence shall be deemed income or cost for the purposes of determining reimbursement due providers of services or suppliers under this title.“(D) Review entity defined.—For purposes of this subsection, the term ‘review entity’ means an entity of up to three reviewers who are administrative law judges or members of the Departmental Appeals Board selected for purposes of making determinations under this paragraph.”.(2) Conforming amendment.—Section 1869(b)(1)(F)(ii) (42 U.S.C. 1395ff(b)(1)(F)(ii)) is amended to read as follows:“(ii) Reference to expedited access to judicial review.—For the provision relating to expedited access to judicial review, see paragraph (2).”.(b) Application to Provider Agreement Determinations.—Section 1866(h)(1) (42 U.S.C. 1395cc(h)(1)) is amended—(1) by inserting “(A)” after “(h)(1)”; and(2) by adding at the end the following new subparagraph:“(B) An institution or agency described in subparagraph (A) that has filed for a hearing under subparagraph (A) shall have expedited access to judicial review under this subparagraph in 117 STAT. 2401 the same manner as providers of services, suppliers, and individuals entitled to benefits under part A or enrolled under part B, or both, may obtain expedited access to judicial review under the process established under section 1869(b)(2). Nothing in this subparagraph shall be construed to affect the application of any remedy imposed under section 1819 during the pendency of an appeal under this subparagraph.”. (c) Expedited Review of Certain Provider Agreement Determinations.—(1) Termination and certain other immediate remedies.—Section 1866(h)(1) (42 U.S.C. 1395cc(h)(1)), as amended by subsection (b), is amended by adding at the end the following new subparagraph:“(C)(i) The Secretary shall develop and implement a process to expedite proceedings under this subsection in which—“(I) the remedy of termination of participation has been imposed; “(II) a remedy described in clause (i) or (iii) of section 1819(h)(2)(B) has been imposed, but only if such remedy has been imposed on an immediate basis; or“(III) a determination has been made as to a finding of substandard quality of care that results in the loss of approval of a skilled nursing facility’s nurse aide training program.“(ii) Under such process under clause (i), priority shall be provided in cases of termination described in clause (i)(I).“(iii) Nothing in this subparagraph shall be construed to affect the application of any remedy imposed under section 1819 during the pendency of an appeal under this subparagraph.”.(2) Waiver of disapproval of nurse-aide training programs.—Sections 1819(f)(2) and section 1919(f)(2) (42 U.S.C. 1395i–3(f)(2) and 1396r(f)(2)) are each amended—(A) in subparagraph (B)(iii), by striking “subparagraph (C)” and inserting “subparagraphs (C) and (D)”; and(B) by adding at the end the following new subparagraph:“(D) Waiver of disapproval of nurse-aide training programs.—Upon application of a nursing facility, the Secretary may waive the application of subparagraph (B)(iii)(I)(c) if the imposition of the civil monetary penalty was not related to the quality of care provided to residents of the facility. Nothing in this subparagraph shall be construed as eliminating any requirement upon a facility to pay a civil monetary penalty described in the preceding sentence.”.(3) Increased financial support.—In addition to any amounts otherwise appropriated, to reduce by 50 percent the average time for administrative determinations on appeals under section 1866(h) of the Social Security Act (42 U.S.C. 1395cc(h)), there are authorized to be appropriated (in appropriate part from the Federal Hospital Insurance Trust Fund, established under section 1817 of the Social Security Act (42 U.S.C. 1395i), and the Federal Supplementary Medical Insurance Trust Fund, established under section 1841 of such Act (42 U.S.C. 1395t)) to the Secretary such additional sums for fiscal year 2004 and each subsequent fiscal year as may be necessary. The purposes for which such amounts are available include increasing the number of administrative law judges 117 STAT. 2402 (and their staffs) and the appellate level staff at the Departmental Appeals Board of the Department of Health and Human Services and educating such judges and staffs on long-term care issues.(d) Effective Date.—The amendments made by this section shall apply to appeals filed on or after October 1, 2004.