EXPANDING ACCESS TO PRIMARY CARE SERVICES.

SEC. 133. EXPANDING ACCESS TO PRIMARY CARE SERVICES.(a) Revisions to the Medicare Medical Home Demonstration Project.—(1) Authority to expand.—Section 204(b) of division B of the Tax Relief and Health Care Act of 2006 (42 U.S.C. 1395b–1 note) is amended—(A) in paragraph (1), by striking “The project” and inserting “Subject to paragraph (3), the project”; and(B) by adding at the end the following new paragraph:“(3) Expansion.—The Secretary may expand the duration and the scope of the project under paragraph (1), to an extent determined appropriate by the Secretary, if the Secretary determines that such expansion will result in any of the following conditions being met:“(A) The expansion of the project is expected to improve the quality of patient care without increasing spending under the Medicare program (not taking into account amounts available under subsection (g)).“(B) The expansion of the project is expected to reduce spending under the Medicare program (not taking into account amounts available under subsection (g)) without reducing the quality of patient care.”.(2) Funding and application.—Section 204 of division B of the Tax Relief and Health Care Act of 2006 (42 U.S.C. 1395b–1 note) is amended by adding at the end the following new subsections:122 STAT. 2532 “(g) Funding From SMI Trust Fund.—There shall be available, from the Federal Supplementary Medical Insurance Trust Fund (under section 1841 of the Social Security Act (42 U.S.C. 1395t)), the amount of $100,000,000 to carry out the project.“(h) Application.—Chapter 35 of title 44, United States Code, shall not apply to the conduct of the project.”.(b) Application of Budget-Neutrality Adjustor to Conversion Factor.—Section 1848(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w–4(c)(2)(B)) is amended by adding at the end the following new clause:“(vi) Alternative application of budget-neutrality adjustment.—Notwithstanding subsection (d)(9)(A), effective for fee schedules established beginning with 2009, with respect to the 5-year review of work relative value units used in fee schedules for 2007 and 2008, in lieu of continuing to apply budget-neutrality adjustments required under clause (ii) for 2007 and 2008 to work relative value units, the Secretary shall apply such budget-neutrality adjustments to the conversion factor otherwise determined for years beginning with 2009.”.