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<bill bill-stage="Placed-on-Calendar-Senate" bill-type="olc" dms-id="H15C9484F549C4D06981400FB7675792A" key="H" public-print="no" public-private="public" stage-count="1" star-print="no-star-print">
	<form display="yes">
		<distribution-code display="yes">II</distribution-code>
		<calendar>Calendar No. 331</calendar>
		<congress display="yes">111th CONGRESS</congress>
		<session display="yes">2d Session</session>
		<legis-num display="yes">H. R. 4872</legis-num>
		<current-chamber display="yes">IN THE SENATE OF THE UNITED
		  STATES</current-chamber>
		<action>
			<action-date>March 23 (legislative day, March 19), 2010</action-date>
			<action-desc>Received and read the first time</action-desc>
		</action>
		<action>
			<action-date>March 23, 2010</action-date>
			<action-desc>Read the second time and placed on the
			 calendar</action-desc>
		</action>
		<legis-type display="yes">AN ACT</legis-type>
		<official-title display="yes">To provide for reconciliation pursuant to
		  Title II of the concurrent resolution on the budget for fiscal year 2010 (S.
		  Con. Res. 13).</official-title>
	</form>
	<legis-body display-enacting-clause="yes-display-enacting-clause" id="H385B002F88384639B2A921831083E96C" style="OLC"><pagebreak></pagebreak>
		<section commented="no" display-inline="no-display-inline" id="H7E9B3826B90346B7975966366CB03B4B" section-type="section-one"><enum>1.</enum><header display-inline="yes-display-inline">Short title; table of contents</header>
			<subsection commented="no" display-inline="no-display-inline" id="HE6D3EE9A15184EDBA282851F9392A603"><enum>(a)</enum><header display-inline="yes-display-inline">Short title</header><text display-inline="yes-display-inline">This Act may be cited as the
			 <quote><short-title>Health Care and Education
			 Reconciliation Act of 2010</short-title></quote>.</text>
			</subsection><subsection commented="no" display-inline="no-display-inline" id="H156742B0BDA34613A849DEBBC884AF43"><enum>(b)</enum><header display-inline="yes-display-inline">Table of contents</header><text display-inline="yes-display-inline">The table of contents of this Act is as
			 follows:</text>
				<toc container-level="legis-body-container" lowest-bolded-level="division-lowest-bolded" lowest-level="section" quoted-block="no-quoted-block" regeneration="yes-regeneration">
					<toc-entry bold="off" idref="H7E9B3826B90346B7975966366CB03B4B" level="section">Sec. 1. Short title;
				table of contents.</toc-entry>
					<toc-entry bold="off" idref="H1E0818F1169E43FCABDCC323396C7BF0" level="title">Title I—Coverage,
				Medicare, Medicaid, and Revenues</toc-entry>
					<toc-entry bold="off" idref="H1AFBE6FABAFE4B5085F909C714F53E7D" level="subtitle">Subtitle
				A—Coverage</toc-entry>
					<toc-entry bold="off" idref="H8F69222B21D54B48BEF3A48910292315" level="section">Sec. 1001. Tax
				credits.</toc-entry>
					<toc-entry bold="off" idref="HB1D4FD4B4344401283BCB9587B076C78" level="section">Sec. 1002. Individual
				responsibility.</toc-entry>
					<toc-entry bold="off" idref="H498AEF6D118142BD91460926ACDBC156" level="section">Sec. 1003. Employer
				responsibility.</toc-entry>
					<toc-entry bold="off" idref="HE7A2F90629AA4E31890BA06CAF415154" level="section">Sec. 1004. Income
				definitions.</toc-entry>
					<toc-entry bold="off" idref="HE7A2FB33B161477285904A3A1FA2B293" level="section">Sec. 1005. Implementation funding.</toc-entry>
					<toc-entry bold="off" idref="HF2A588FCEC544A4C8C588D8B0B845D34" level="subtitle">Subtitle
				B—Medicare</toc-entry>
					<toc-entry bold="off" idref="H5CC80C1997A345EF917E051BB947B376" level="section">Sec. 1101. Closing
				the medicare prescription drug <quote>donut hole</quote>.</toc-entry>
					<toc-entry bold="off" idref="H867E9366CF774F5E84251D0D28402081" level="section">Sec. 1102. Medicare
				Advantage payments.</toc-entry>
					<toc-entry bold="off" idref="HD859A75DF66C45FBAEFE49E0C2051E39" level="section">Sec. 1103. Savings
				from limits on MA plan administrative costs.</toc-entry>
					<toc-entry bold="off" idref="H0E6A0E57EB8C408F9300E7A95C393C1A" level="section">Sec. 1104. Disproportionate share hospital (DSH)
				payments.</toc-entry>
					<toc-entry bold="off" idref="HAE951CE953114D5EAADD23F096E3BDF3" level="section">Sec. 1105. Market
				basket updates.</toc-entry>
					<toc-entry bold="off" idref="H266AA572EC7F46C1B72E5FED53D1A1BE" level="section">Sec. 1106. Physician
				ownership-referral.</toc-entry>
					<toc-entry bold="off" idref="H21FB198F9681470F9CA0743546ACE849" level="section">Sec. 1107. Payment
				for imaging services.</toc-entry>
					<toc-entry bold="off" idref="H07605BE1D8254E1A871CFD8C06B8CD09" level="section">Sec. 1108. PE GPCI
				adjustment for 2010.</toc-entry>
					<toc-entry bold="off" idref="H9D5FDAA1A8B648D38BB3133375A9115F" level="section">Sec. 1109. Payment
				for qualifying hospitals.</toc-entry>
					<toc-entry bold="off" idref="H861CFCE88B1F4CB5B8C8CA1EABE66B36" level="subtitle">Subtitle
				C—Medicaid</toc-entry>
					<toc-entry bold="off" idref="H72E8FB605D70401F904A6B00645F5241" level="section">Sec. 1201. Federal
				funding for States.</toc-entry>
					<toc-entry bold="off" idref="HCB3D713BA019412DA350F5FAB3924B12" level="section">Sec. 1202. Payments
				to primary care physicians.</toc-entry>
					<toc-entry bold="off" idref="H9E913604AC3B47E588FF98C47B1E6D5A" level="section">Sec. 1203. Disproportionate share hospital
				payments.</toc-entry>
					<toc-entry bold="off" idref="HC597736792AF4EA09F30F623DA97C642" level="section">Sec. 1204. Funding
				for the territories.</toc-entry>
					<toc-entry bold="off" idref="H8AF2DB86DFE04B1AA7B06CA95687478C" level="section">Sec. 1205. Delay in
				Community First Choice option.</toc-entry>
					<toc-entry bold="off" idref="HE7415B813A264003A8FAC867D1F4CFED" level="section">Sec. 1206. Drug
				rebates for new formulations of existing drugs.</toc-entry>
					<toc-entry bold="off" idref="H8157382EFD774FA8952F0F1EB6CAFA3B" level="subtitle">Subtitle D—Reducing
				Fraud, Waste, and Abuse</toc-entry>
					<toc-entry bold="off" idref="HCA982B13280043518BFC021B0938C590" level="section">Sec. 1301. Community
				mental health centers.</toc-entry>
					<toc-entry bold="off" idref="HCBE4E31D48984B8AA52FEE7B209D96A9" level="section">Sec. 1302. Medicare
				prepayment medical review limitations.</toc-entry>
					<toc-entry bold="off" idref="H0E9F5351D77A413D921884A6CDC64B3F" level="section">Sec. 1303. Funding to
				fight fraud, waste, and abuse.</toc-entry>
					<toc-entry bold="off" idref="H9843BCA40AAA493C9F97DA600BEE2CEF" level="section">Sec. 1304. 90-day
				period of enhanced oversight for initial claims of DME suppliers.</toc-entry>
					<toc-entry bold="off" idref="H120E9C1B37E94BA3BA6371E564B405C7" level="subtitle">Subtitle
				E—Provisions relating to revenue</toc-entry>
					<toc-entry bold="off" idref="H18C1CBBE9E7248EB89C54EA1716B1BC7" level="section">Sec. 1401. High-cost
				plan excise tax.</toc-entry>
					<toc-entry bold="off" idref="H99AAA07D706A44C291A35F69E188850E" level="section">Sec. 1402. Unearned
				income Medicare contribution.</toc-entry>
					<toc-entry bold="off" idref="HFA8AB1958E644BF28EE8E44319FC3106" level="section">Sec. 1403. Delay of
				limitation on health flexible spending arrangements under cafeteria
				plans.</toc-entry>
					<toc-entry bold="off" idref="H5514FAD1B4234E13960E1EC9E0C3F508" level="section">Sec. 1404. Brand name
				pharmaceuticals.</toc-entry>
					<toc-entry bold="off" idref="H7AAC9D1EFEF248CD8E94E9BB35EE0B25" level="section">Sec. 1405. Excise tax
				on medical device manufacturers.</toc-entry>
					<toc-entry bold="off" idref="H2E4E79138D9745B08DACC30C066F9BE7" level="section">Sec. 1406. Health
				insurance providers.</toc-entry>
					<toc-entry bold="off" idref="H12BC44B84A874CF586ECE8197F31DBE4" level="section">Sec. 1407. Delay of
				elimination of deduction for expenses allocable to medicare part D
				subsidy.</toc-entry>
					<toc-entry bold="off" idref="H131850157EFE421985E49F6D5BBE077A" level="section">Sec. 1408. Elimination of unintended application of cellulosic
				biofuel producer credit.</toc-entry>
					<toc-entry bold="off" idref="H91F73F70D87546C599B8E15DDE90D449" level="section">Sec. 1409. Codification of economic substance doctrine and
				penalties.</toc-entry>
					<toc-entry bold="off" idref="H103C3E4CC0D54EFBB9414FF1884A2F03" level="section">Sec. 1410. Time for
				payment of corporate estimated taxes.</toc-entry>
					<toc-entry bold="off" idref="H63199770F32A49D0B71AF3269B3041F7" level="subtitle">Subtitle F—Other
				provisions</toc-entry>
					<toc-entry bold="off" idref="HAD88D9AE10F041F0B99E13FCACC8D561" level="section">Sec. 1501. Community
				college and career training grant program.</toc-entry>
					<toc-entry bold="off" idref="H8B185C5A218C4A54BCC6F0E0D91EC4A0" level="title">Title II—Education and
				Health</toc-entry>
					<toc-entry bold="off" idref="H9E7E928A33B74533AC0292BE93ED1637" level="subtitle">Subtitle
				A—Education</toc-entry>
					<toc-entry bold="off" idref="H699EA4C12DB64B42BCCE4CC77603CDFF" level="section">Sec. 2001. Short
				title; references.</toc-entry>
					<toc-entry bold="off" idref="HFF93992C56514BFD99D8992E0BBEC998" level="part">Part I—Investing in
				students and families</toc-entry>
					<toc-entry bold="off" idref="H65CEECDFE0CD4778BF2AC634DF0BD2BE" level="section">Sec. 2101. Federal
				Pell Grants.</toc-entry>
					<toc-entry bold="off" idref="HDEB6F008722D4F53AEC12F7495A225B5" level="section">Sec. 2102. College
				access challenge grant program.</toc-entry>
					<toc-entry bold="off" idref="HA7234D93713D45ABA2E7C32624DE8FEA" level="section">Sec. 2103. Investment
				in historically black colleges and universities and minority-serving
				institutions.</toc-entry>
					<toc-entry bold="off" idref="H0FEA0ABBAEE745D0926A48AB8386D52D" level="part">Part II—Student loan
				reform</toc-entry>
					<toc-entry bold="off" idref="HE771A22FD5524099AD1FEFF9782B092C" level="section">Sec. 2201. Termination of Federal Family Education Loan
				appropriations.</toc-entry>
					<toc-entry bold="off" idref="H0C1827DD9AF24832AB748F6D44EF70D0" level="section">Sec. 2202. Termination of Federal loan insurance
				program.</toc-entry>
					<toc-entry bold="off" idref="HC0A4169FA7FD4998AE9030C2474BE109" level="section">Sec. 2203. Termination of applicable interest
				rates.</toc-entry>
					<toc-entry bold="off" idref="H49345F88574140438004DF8A7DD6EA77" level="section">Sec. 2204. Termination of Federal payments to reduce student
				interest costs.</toc-entry>
					<toc-entry bold="off" idref="HFCABF35A92494E988DCDD4CC427A41C8" level="section">Sec. 2205. Termination of FFEL PLUS Loans.</toc-entry>
					<toc-entry bold="off" idref="HCC12509D459D4463BCEF72D756F01BA4" level="section">Sec. 2206. Federal
				Consolidation Loans.</toc-entry>
					<toc-entry bold="off" idref="HDA061D0D167340F5863C549C25F06F09" level="section">Sec. 2207. Termination of Unsubsidized Stafford Loans for
				middle-income borrowers.</toc-entry>
					<toc-entry bold="off" idref="H41A09FDA848E403384F16F17D2B125FE" level="section">Sec. 2208. Termination of special allowances.</toc-entry>
					<toc-entry bold="off" idref="H0B4F536E12964435ACFFA76482E653B4" level="section">Sec. 2209. Origination of Direct Loans at institutions outside
				the United States.</toc-entry>
					<toc-entry bold="off" idref="H4CBBC6F15E9C4FC9A82D545FC1E6B623" level="section">Sec. 2210. Conforming
				amendments.</toc-entry>
					<toc-entry bold="off" idref="H0F30634A9F554C58B682BBA7FB454D8F" level="section">Sec. 2211. Terms and
				conditions of loans.</toc-entry>
					<toc-entry bold="off" idref="HC4E811C3CF6643E9B19D1C70E765CF00" level="section">Sec. 2212. Contracts;
				mandatory funds.</toc-entry>
					<toc-entry bold="off" idref="HB6B2F0C2E4904EF1B35B6FACF074E5D7" level="section">Sec. 2213. Income-based repayment.</toc-entry>
					<toc-entry bold="off" idref="H8AFEC46BFF59401DAA103FDEF373438B" level="subtitle">Subtitle
				B—Health</toc-entry>
					<toc-entry bold="off" idref="HC566B488D63343ED887FBD83852A5AFC" level="section">Sec. 2301. Insurance
				reforms.</toc-entry>
					<toc-entry bold="off" idref="H48DA459E92F748EBB2469EE6B8D6F83E" level="section">Sec. 2302. Drugs
				purchased by covered entities.</toc-entry>
					<toc-entry bold="off" idref="H7D6F17D438304275B27D8034FC4FD23B" level="section">Sec. 2303. Community
				health centers.</toc-entry>
				</toc>
			</subsection></section><title commented="no" id="H1E0818F1169E43FCABDCC323396C7BF0" level-type="subsequent"><enum>I</enum><header display-inline="yes-display-inline">Coverage, Medicare, Medicaid, and
			 Revenues</header>
			<subtitle commented="no" id="H1AFBE6FABAFE4B5085F909C714F53E7D" level-type="subsequent"><enum>A</enum><header display-inline="yes-display-inline">Coverage</header>
				<section commented="no" display-inline="no-display-inline" id="H8F69222B21D54B48BEF3A48910292315" section-type="subsequent-section"><enum>1001.</enum><header display-inline="yes-display-inline">Tax credits</header>
					<subsection commented="no" display-inline="no-display-inline" id="HDF389C30A2E94886B5344ACCFE7F2383"><enum>(a)</enum><header display-inline="yes-display-inline">Premium tax credits</header><text display-inline="yes-display-inline">Section 36B of the Internal Revenue Code of
			 1986, as added by section 1401 of the Patient Protection and Affordable Care
			 Act and amended by section 10105 of such Act, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H1C417B601887443BA06706C03B5D5CFA"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (b)(3)(A)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H8F73A45F468D48C0AC112AA5E3BCA424"><enum>(A)</enum><text display-inline="yes-display-inline">in clause (i), by striking <quote>with
			 respect to any taxpayer</quote> and all that follows up to the end period and
			 inserting: “for any taxable year shall be the percentage such that the
			 applicable percentage for any taxpayer whose household income is within an
			 income tier specified in the following table shall increase, on a sliding scale
			 in a linear manner, from the initial premium percentage to the final premium
			 percentage specified in such table for such income tier:</text>
								<quoted-block display-inline="no-display-inline" id="H32F16BBBC30D4FFA8EA8D83A7E545A61" style="OLC">
									<table blank-lines-after="0" blank-lines-before="0" colsep="0" frame="none" line-rules="no-gen" rowsep="0" rule-weights="0.0.0.0.0.4" table-type="">
										<tgroup cols="3" no-carding="1" rowsep="0"><colspec coldef="txt-no-ldr" colname="column1" colnum="0" colwidth="78pts" min-data-value="74"></colspec><colspec align="center" coldef="txt-no-ldr" colname="column3" colnum="1" colwidth="53pts" min-data-value="50"></colspec><colspec align="center" coldef="txt-no-ldr" colname="column4" colnum="2" colwidth="53pts" min-data-value="50"></colspec>
											<thead>
												<row><entry align="left" colname="column1" morerows="0" namest="column1">In the case of household income (expressed as a percent of
						poverty line) within the following income tier:</entry><entry colname="column3" morerows="0" namest="column3">The initial premium percentage is—</entry><entry colname="column4" morerows="0" namest="column4">The final premium percentage
						is—</entry>
												</row>
											</thead>
											<tbody>
												<row><entry colname="column1" leader-modify="clr-ldr">Up to
						133%</entry><entry colname="column3" leader-modify="clr-ldr">2.0%</entry><entry colname="column4" leader-modify="clr-ldr">2.0%</entry>
												</row>
												<row><entry colname="column1" leader-modify="clr-ldr">133% up to
						150%</entry><entry colname="column3" leader-modify="clr-ldr">3.0%</entry><entry colname="column4" leader-modify="clr-ldr">4.0%</entry>
												</row>
												<row><entry colname="column1" leader-modify="clr-ldr">150% up to
						200%</entry><entry colname="column3" leader-modify="clr-ldr">4.0%</entry><entry colname="column4" leader-modify="clr-ldr">6.3%</entry>
												</row>
												<row><entry colname="column1" leader-modify="clr-ldr">200% up to
						250%</entry><entry colname="column3" leader-modify="clr-ldr">6.3%</entry><entry colname="column4" leader-modify="clr-ldr">8.05%</entry>
												</row>
												<row><entry colname="column1" leader-modify="clr-ldr">250% up to
						300%</entry><entry colname="column3" leader-modify="clr-ldr">8.05%</entry><entry colname="column4" leader-modify="clr-ldr">9.5%</entry>
												</row>
												<row><entry colname="column1" leader-modify="clr-ldr">300% up to
						400%</entry><entry colname="column3" leader-modify="clr-ldr">9.5%</entry><entry colname="column4" leader-modify="clr-ldr">9.5%</entry>
												</row>
											</tbody>
										</tgroup></table>
									<after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE22C4C43CB3E4ED4A7C34DCC54775F93"><enum>(B)</enum><text display-inline="yes-display-inline">by striking clauses (ii) and (iii), and
			 inserting the following:</text>
								<quoted-block display-inline="no-display-inline" id="H7C0C7801B75046A5BB51C984137E57C9" style="OLC">
									<clause commented="no" display-inline="no-display-inline" id="HDD63B769CA7342EDB5B38BD0BF6A31B7"><enum>(ii)</enum><header display-inline="yes-display-inline">Indexing</header>
										<subclause commented="no" display-inline="no-display-inline" id="H8AC9A271AA27489ABE36205CD627E97A"><enum>(I)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subject to subclause (II), in the case of
				taxable years beginning in any calendar year after 2014, the initial and final
				applicable percentages under clause (i) (as in effect for the preceding
				calendar year after application of this clause) shall be adjusted to reflect
				the excess of the rate of premium growth for the preceding calendar year over
				the rate of income growth for the preceding calendar year.</text>
										</subclause><subclause commented="no" display-inline="no-display-inline" id="H708ADB63EE654E488A493C9DE3B38F8E"><enum>(II)</enum><header display-inline="yes-display-inline">Additional adjustment</header><text display-inline="yes-display-inline">Except as provided in subclause (III), in
				the case of any calendar year after 2018, the percentages described in
				subclause (I) shall, in addition to the adjustment under subclause (I), be
				adjusted to reflect the excess (if any) of the rate of premium growth estimated
				under subclause (I) for the preceding calendar year over the rate of growth in
				the consumer price index for the preceding calendar year.</text>
										</subclause><subclause commented="no" display-inline="no-display-inline" id="HCD2BCA0714214E6983B29D5A976AC1E4"><enum>(III)</enum><header display-inline="yes-display-inline">Failsafe</header><text display-inline="yes-display-inline">Subclause (II) shall apply for any calendar
				year only if the aggregate amount of premium tax credits under this section and
				cost-sharing reductions under section 1402 of the Patient Protection and
				Affordable Care Act for the preceding calendar year exceeds an amount equal to
				0.504 percent of the gross domestic product for the preceding calendar
				year.</text>
										</subclause></clause><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDD8DDB91A729404981B4702D32B14F23"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (c)(2)(C)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H0605926D6AB04741B5344B7593FDEFDA"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>9.8 percent</quote> in
			 clauses (i)(II) and (iv) and inserting <quote>9.5 percent</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H38DEE035120542AB8A169FE527608E3B"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote>(b)(3)(A)(iii)</quote>
			 in clause (iv) and inserting <quote>(b)(3)(A)(ii)</quote>.</text>
							</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HD7795E478B924F8B83FA4ED2A066B337"><enum>(b)</enum><header display-inline="yes-display-inline">Cost sharing</header><text display-inline="yes-display-inline">Section 1402(c) of the Patient Protection
			 and Affordable Care Act is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HAE80871AB7004412B87842E5973B7E23"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1)(B)(i)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H51D9B757162D42D8B993758F3AEE1B2E"><enum>(A)</enum><text display-inline="yes-display-inline">in subclause (I), by striking
			 <quote>90</quote> and inserting <quote>94</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H623DE933222140C59CED933F1D99A79A"><enum>(B)</enum><text display-inline="yes-display-inline">in subclause (II)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H05A2ED8695414277B06F8A240534203D"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>80</quote> and inserting
			 <quote>87</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H98B7357061C94CFC92463AD65AD17C0D"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>and</quote>; and</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF5C57EFD0D554B01A0FC7351B9AF1AB8"><enum>(C)</enum><text display-inline="yes-display-inline">by striking subclause (III) and inserting
			 the following:</text>
								<quoted-block display-inline="no-display-inline" id="H14CE16F8BE7F49FDB2A9351B72C82F94" style="OLC">
									<subclause commented="no" display-inline="no-display-inline" id="HDF780885EA6B4E58B9FFFDF03BFF7C1C"><enum>(III)</enum><text display-inline="yes-display-inline">73 percent in the case of an eligible
				insured whose household income is more than 200 percent but not more than 250
				percent of the poverty line for a family of the size involved; and</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="H03CB228E6E9E43F9846B1AA4516FFBB5"><enum>(IV)</enum><text display-inline="yes-display-inline">70 percent in the case of an eligible
				insured whose household income is more than 250 percent but not more than 400
				percent of the poverty line for a family of the size
				involved.</text>
									</subclause><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5010028F2C5247B6A263F81628371230"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (2)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H5858904F5E544E4EBE475C0AC213A388"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (A)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H6A72DEAA050F4F4EB56F22145943CC54"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>90</quote> and inserting
			 <quote>94</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HD8A3E0FAA1D8457F8FDC1E98A6DD0168"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>and</quote>;</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H811A760E274A48748BC9F2205BBE8550"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (B)—</text>
								<clause commented="no" display-inline="no-display-inline" id="HF276143A0A9049EAB360B57D45F06088"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>80</quote> and inserting
			 <quote>87</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H9FC5A483CDF54FF9A1253804D81950A3"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking the period and inserting
			 <quote>; and</quote>; and</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD7798A57918E482EA35F8B5539DFA425"><enum>(C)</enum><text display-inline="yes-display-inline">by inserting after subparagraph (B) the
			 following new subparagraph:</text>
								<quoted-block display-inline="no-display-inline" id="H69D6884A09B442E99F7D54DE78AA183C" style="OLC">
									<subparagraph commented="no" display-inline="no-display-inline" id="HD72BE2BB13D846D3ABE812B951C32B48"><enum>(C)</enum><text display-inline="yes-display-inline">in the case of an eligible insured whose
				household income is more than 200 percent but not more than 250 percent of the
				poverty line for a family of the size involved, increase the plan’s share of
				the total allowed costs of benefits provided under the plan to 73 percent of
				such
				costs.</text>
									</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph></paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="HB1D4FD4B4344401283BCB9587B076C78" section-type="subsequent-section"><enum>1002.</enum><header display-inline="yes-display-inline">Individual responsibility</header>
					<subsection commented="no" display-inline="no-display-inline" id="H3B0DFD605D0547A4A7F0059EEF07962D"><enum>(a)</enum><header display-inline="yes-display-inline">Amounts</header><text display-inline="yes-display-inline">Section 5000A(c) of the Internal Revenue
			 Code of 1986, as added by section 1501(b) of the Patient Protection and
			 Affordable Care Act and amended by section 10106 of such Act, is
			 amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HA53073F149614A1ABC3122A7CDBA6A4D"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (2)(B)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H91A6C5C1D30B490E9ED2FD41CB7F1ADE"><enum>(A)</enum><text display-inline="yes-display-inline">in the matter preceding clause (i),
			 by—</text>
								<clause commented="no" display-inline="no-display-inline" id="H760E2FE4116B49E492F1E85E9C8572D5"><enum>(i)</enum><text display-inline="yes-display-inline">inserting <quote>the excess of</quote>
			 before <quote>the taxpayer’s household income</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HC9C4ABA614D24E0F887C82CD0BD6C742"><enum>(ii)</enum><text display-inline="yes-display-inline">inserting <quote>for the taxable year over
			 the amount of gross income specified in section 6012(a)(1) with respect to the
			 taxpayer</quote> before <quote>for the taxable year</quote>;</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF6AE4D2997CD41358E22881F16E7A21A"><enum>(B)</enum><text display-inline="yes-display-inline">in clause (i), by striking
			 <quote>0.5</quote> and inserting <quote>1.0</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HA7F4BC1254BB4F49964D1228B65F4A56"><enum>(C)</enum><text display-inline="yes-display-inline">in clause (ii), by striking
			 <quote>1.0</quote> and inserting <quote>2.0</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5428C97C069D4CFDBF50C83BA95FBF45"><enum>(D)</enum><text display-inline="yes-display-inline">in clause (iii), by striking
			 <quote>2.0</quote> and inserting <quote>2.5</quote>; and</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H8F4CCFB4DE6249F4B00F5366BA26FAE2"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (3)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H0DCF79D011964F31A1BF2B15B49D6235"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (A), by striking
			 <quote>$750</quote> and inserting <quote>$695</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD4A05790B9BA48BD89140C09DB1591AA"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking
			 <quote>$495</quote> and inserting <quote>$325</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5EB522D6E8EE422587417C8A3D424CCD"><enum>(C)</enum><text display-inline="yes-display-inline">in subparagraph (D)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H34D8A755701C46C3843782FFC3521CBD"><enum>(i)</enum><text display-inline="yes-display-inline">in the matter preceding clause (i), by
			 striking <quote>$750</quote> and inserting <quote>$695</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H7CA03AF89A0D45D39832611E16CF5467"><enum>(ii)</enum><text display-inline="yes-display-inline">in clause (i), by striking
			 <quote>$750</quote> and inserting <quote>$695</quote>.</text>
								</clause></subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H5719FA728F6C4D4489B48BD16244A22B"><enum>(b)</enum><header display-inline="yes-display-inline">Threshold</header><text display-inline="yes-display-inline">Section 5000A of such Code, as so added and
			 amended, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HC6774351B92749CCA71C28911692EE36"><enum>(1)</enum><text display-inline="yes-display-inline">by striking subsection (c)(4)(D);
			 and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0909692C0A5C4B22A6133EC5227DCC26"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (e)(2)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H34988D4D8EB34998B869E9D5C5FB3AAA"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote><header-in-text level="paragraph" style="OLC">under 100 percent of poverty
			 line</header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">below filing threshold</header-in-text></quote>;
			 and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H498322AF260B4A8694DDFB392F8F75B5"><enum>(B)</enum><text display-inline="yes-display-inline">by striking all that follows <quote>less
			 than</quote> and inserting <quote>the amount of gross income specified in
			 section 6012(a)(1) with respect to the taxpayer.</quote>.</text>
							</subparagraph></paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H498AEF6D118142BD91460926ACDBC156" section-type="subsequent-section"><enum>1003.</enum><header display-inline="yes-display-inline">Employer responsibility</header>
					<subsection commented="no" display-inline="no-display-inline" id="HDD8F987A63254450926A704A6E0C6652"><enum>(a)</enum><header display-inline="yes-display-inline">Payment calculation</header><text display-inline="yes-display-inline">Subparagraph (D) of subsection (d)(2) of
			 section 4980H of the Internal Revenue Code of 1986, as added by section 1513 of
			 the Patient Protection and Affordable Care Act and amended by section 10106 of
			 such Act, is amended to read as follows:</text>
						<quoted-block display-inline="no-display-inline" id="HB8C685E5ACD2411D93CFCF257D524765" style="OLC">
							<subparagraph commented="no" display-inline="no-display-inline" id="HDCB677007E464FB7B21BDA0B75E1AEE1"><enum>(D)</enum><header display-inline="yes-display-inline">Application of employer size to assessable
				penalties</header>
								<clause commented="no" display-inline="no-display-inline" id="H630DF61F93034CC1908976B983024BD4"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The number of individuals employed by an
				applicable large employer as full-time employees during any month shall be
				reduced by 30 solely for purposes of calculating—</text>
									<subclause commented="no" display-inline="no-display-inline" id="H2154E75164AF4248BF5C5AB747CAC812"><enum>(I)</enum><text display-inline="yes-display-inline">the assessable payment under subsection
				(a), or</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HC02DFB3D59D9497599BEC7DE3B9B8987"><enum>(II)</enum><text display-inline="yes-display-inline">the overall limitation under subsection
				(b)(2).</text>
									</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HB3E34B7906C044D7A366B8D5A7661100"><enum>(ii)</enum><header display-inline="yes-display-inline">Aggregation</header><text display-inline="yes-display-inline">In the case of persons treated as 1
				employer under subparagraph (C)(i), only 1 reduction under subclause (I) or
				(II) shall be allowed with respect to such persons and such reduction shall be
				allocated among such persons ratably on the basis of the number of full-time
				employees employed by each such
				person.</text>
								</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H66489B668E1A42D9ACAC55EA6BC3F15F"><enum>(b)</enum><header display-inline="yes-display-inline">Applicable payment amount</header><text display-inline="yes-display-inline">Section 4980H of such Code, as so added and
			 amended, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HADD26C3AB4244A52AAE0C7D600C9ECE8"><enum>(1)</enum><text display-inline="yes-display-inline">in the flush text following subsection
			 (c)(1)(B), by striking <quote>400 percent of the applicable payment
			 amount</quote> and inserting <quote>an amount equal to
			 <fraction>1/12</fraction> of $3,000</quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD5484664C6074C25BBA362FE7547A2B2"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (d)(1), by striking
			 <quote>$750</quote> and inserting <quote>$2,000</quote>; and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDA8224E63614458484980243E282D220"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (d)(5)(A), in the matter
			 preceding clause (i), by striking <quote>subsection (b)(2) and (d)(1)</quote>
			 and inserting <quote>subsection (b) and paragraph (1)</quote>.</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H2AA85F99683D43A4859ECCF6DC28DDDC"><enum>(c)</enum><header display-inline="yes-display-inline">Counting part-time workers in setting the
			 threshold for employer responsibility</header><text display-inline="yes-display-inline">Section 4980H(d)(2) of such Code, as so
			 added and amended and as amended by subsection (a), is amended by adding at the
			 end the following new subparagraph:</text>
						<quoted-block display-inline="no-display-inline" id="H258B1C75308A4ADEB540E6816AE0C133" style="OLC">
							<subparagraph commented="no" display-inline="no-display-inline" id="HDD0F1142E388441C8AECF257D9C792A0"><enum>(E)</enum><header display-inline="yes-display-inline">Full-time equivalents treated as full-time
				employees</header><text display-inline="yes-display-inline">Solely for purposes
				of determining whether an employer is an applicable large employer under this
				paragraph, an employer shall, in addition to the number of full-time employees
				for any month otherwise determined, include for such month a number of
				full-time employees determined by dividing the aggregate number of hours of
				service of employees who are not full-time employees for the month by
				120.</text>
							</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H401F57EE018E4C5FAA9BD03A44E48187"><enum>(d)</enum><header display-inline="yes-display-inline">Eliminating waiting period
			 assessment</header><text display-inline="yes-display-inline">Section 4980H of
			 such Code, as so added and amended and as amended by the preceding subsections,
			 is amended by striking subsection (b) and redesignating subsections (c), (d),
			 and (e) as subsections (b), (c), and (d), respectively.</text>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="HE7A2F90629AA4E31890BA06CAF415154" section-type="subsequent-section"><enum>1004.</enum><header display-inline="yes-display-inline">Income definitions</header>
					<subsection commented="no" display-inline="no-display-inline" id="HC72E5E7BDD2A42E383297E9740C25A90"><enum>(a)</enum><header display-inline="yes-display-inline">Modified adjusted gross income</header>
						<paragraph commented="no" display-inline="no-display-inline" id="H131F3E5BBA0D4D628FD51C49AEC625B8"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The following provisions of the Internal
			 Revenue Code of 1986 are each amended by striking <quote>modified gross</quote>
			 each place it appears and inserting <quote>modified adjusted
			 gross</quote>:</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H38E85E6BDF63479A95B0314E37068709"><enum>(A)</enum><text display-inline="yes-display-inline">Clauses (i) and (ii) of section
			 36B(d)(2)(A), as added by section 1401 of the Patient Protection and Affordable
			 Care Act.</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3D1B0A1F9C8546088C6FF566F265FF17"><enum>(B)</enum><text display-inline="yes-display-inline">Section 6103(l)(21)(A)(iv), as added by
			 section 1414 of such Act.</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HDF3614B781634E5A8D8616FE61DBEABF"><enum>(C)</enum><text display-inline="yes-display-inline">Clauses (i) and (ii) of section
			 5000A(c)(4), as added by section 1501(b) of such Act.</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H954A2A5A3E6E46F492EBEDD321E8DE20"><enum>(2)</enum><header display-inline="yes-display-inline">Definition</header>
							<subparagraph commented="no" display-inline="no-display-inline" id="H8FC7D652000846C6976B8ED56D58791A"><enum>(A)</enum><text display-inline="yes-display-inline">Section 36B(d)(2)(B) of such Code, as so
			 added, is amended to read as follows:</text>
								<quoted-block display-inline="no-display-inline" id="H7F10C483FD1A47AE8049535DD9410F86" style="OLC">
									<subparagraph commented="no" display-inline="no-display-inline" id="HECE0DE3CE4A04D02B5AF8808377FC308"><enum>(B)</enum><header display-inline="yes-display-inline">Modified adjusted gross
				income</header><text display-inline="yes-display-inline">The term
				<term>modified adjusted gross income</term> means adjusted gross income
				increased by—</text>
										<clause commented="no" display-inline="no-display-inline" id="H6EE5D4D9F6EF4C6A98FAF8F2FAE22D56"><enum>(i)</enum><text display-inline="yes-display-inline">any amount excluded from gross income under
				section 911, and</text>
										</clause><clause commented="no" display-inline="no-display-inline" id="HFAB5E0C340764784A16B8D744FFED3D1"><enum>(ii)</enum><text display-inline="yes-display-inline">any amount of interest received or accrued
				by the taxpayer during the taxable year which is exempt from
				tax.</text>
										</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD4817463231A4197A5026F6409FCE22D"><enum>(B)</enum><text display-inline="yes-display-inline">Section 5000A(c)(4)(C) of such Code, as so
			 added, is amended to read as follows:</text>
								<quoted-block display-inline="no-display-inline" id="H7DA3017F408F468BB721F4C32FDC4FBC" style="OLC">
									<subparagraph commented="no" display-inline="no-display-inline" id="H16389F1CC1BE4344A7D2A4DE513DE8F4"><enum>(C)</enum><header display-inline="yes-display-inline">Modified adjusted gross
				income</header><text display-inline="yes-display-inline">The term
				<term>modified adjusted gross income</term> means adjusted gross income
				increased by—</text>
										<clause commented="no" display-inline="no-display-inline" id="HE60A6FA35DE04BC9BFB5208B2E467ED6"><enum>(i)</enum><text display-inline="yes-display-inline">any amount excluded from gross income under
				section 911, and</text>
										</clause><clause commented="no" display-inline="no-display-inline" id="HA895803CA7FB4542B6FBB8EC934D7A34"><enum>(ii)</enum><text display-inline="yes-display-inline">any amount of interest received or accrued
				by the taxpayer during the taxable year which is exempt from
				tax.</text>
										</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HC14613B599BA48FC98F5D676EA08285C"><enum>(b)</enum><header display-inline="yes-display-inline">Modified adjusted gross income
			 definition</header>
						<paragraph commented="no" display-inline="no-display-inline" id="HEB6ADF5C91E24073B4CE10FB8A78FC2D"><enum>(1)</enum><header display-inline="yes-display-inline">Medicaid</header><text display-inline="yes-display-inline">Section 1902 of the Social Security Act (42
			 U.S.C. 1396a) is amended by striking <quote>modified gross income</quote> each
			 place it appears in the text and headings of the following provisions and
			 inserting <quote>modified adjusted gross income</quote>:</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HE4F0F187BB5844A68CD6D1D95E3FB752"><enum>(A)</enum><text display-inline="yes-display-inline">Paragraph (14) of subsection (e), as added
			 by section 2002(a) of the Patient Protection and Affordable Care Act.</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE14F9C9F581E4679BCDB76E310F2002C"><enum>(B)</enum><text display-inline="yes-display-inline">Subsection (gg)(4)(A), as added by section
			 2001(b) of such Act.</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H9326D2412DEC4DF29D396ABBB690D6E3"><enum>(2)</enum><header display-inline="yes-display-inline">Chip</header>
							<subparagraph commented="no" display-inline="no-display-inline" id="H0C14DE244BE9411883F4B79C2926D8A3"><enum>(A)</enum><header display-inline="yes-display-inline">State plan requirements</header><text display-inline="yes-display-inline">Section 2102(b)(1)(B)(v) of the Social
			 Security Act (42 U.S.C. 1397bb(b)(1)(B)(v)), as added by section 2101(d)(1) of
			 the Patient Protection and Affordable Care Act, is amended by striking
			 <quote>modified gross income</quote> and inserting <quote>modified adjusted
			 gross income</quote>.</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H800CBFD0E93F45229C1C64A53DD909CB"><enum>(B)</enum><header display-inline="yes-display-inline">Plan administration</header><text display-inline="yes-display-inline">Section 2107(e)(1)(E) of the Social
			 Security Act (42 U.S.C. 1397gg(e)(1)(E)), as added by section 2101(d)(2) of the
			 Patient Protection and Affordable Care Act, is amended by striking
			 <quote>modified gross income</quote> and inserting <quote>modified adjusted
			 gross income</quote>.</text>
							</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HA0BAB999BFB149F0979D9DED4D32A19C"><enum>(c)</enum><header display-inline="yes-display-inline">No excess payments</header><text display-inline="yes-display-inline">Section 36B(f) of the Internal Revenue Code
			 of 1986, as added by section 1401(a) of the Patient Protection and Affordable
			 Care Act, is amended by adding at the end the following new paragraph:</text>
						<quoted-block display-inline="no-display-inline" id="H22D18A31C8E9418F864A7E767E58C7E2" style="OLC">
							<paragraph commented="no" display-inline="no-display-inline" id="H4654AB968E2E4C6DA97A0244A9D4F638"><enum>(3)</enum><header display-inline="yes-display-inline">Information requirement</header><text display-inline="yes-display-inline">Each Exchange (or any person carrying out 1
				or more responsibilities of an Exchange under section 1311(f)(3) or 1321(c) of
				the Patient Protection and Affordable Care Act) shall provide the following
				information to the Secretary and to the taxpayer with respect to any health
				plan provided through the Exchange:</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H384B436F0D3E468BB6A2DB134A1478EF"><enum>(A)</enum><text display-inline="yes-display-inline">The level of coverage described in section
				1302(d) of the Patient Protection and Affordable Care Act and the period such
				coverage was in effect.</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H1C258AF0510B48D59D88D186A79EBAE9"><enum>(B)</enum><text display-inline="yes-display-inline">The total premium for the coverage without
				regard to the credit under this section or cost-sharing reductions under
				section 1402 of such Act.</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5C4EA3F1BB4742918C540635BB38A1DB"><enum>(C)</enum><text display-inline="yes-display-inline">The aggregate amount of any advance payment
				of such credit or reductions under section 1412 of such Act.</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HB672201235AF4336823553AA51CBAEFE"><enum>(D)</enum><text display-inline="yes-display-inline">The name, address, and TIN of the primary
				insured and the name and TIN of each other individual obtaining coverage under
				the policy.</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD5144FA3F39E4F28A5D632D516F43C80"><enum>(E)</enum><text display-inline="yes-display-inline">Any information provided to the Exchange,
				including any change of circumstances, necessary to determine eligibility for,
				and the amount of, such credit.</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF7D164911E584153A9D3E6C38FC980B4"><enum>(F)</enum><text display-inline="yes-display-inline">Information necessary to determine whether
				a taxpayer has received excess advance
				payments.</text>
								</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H40E6F3E07CC441F48908748126E100F4"><enum>(d)</enum><header display-inline="yes-display-inline">Adult dependents</header>
						<paragraph commented="no" display-inline="no-display-inline" id="HAF59065CC7DE4646A2C3180406BE84D3"><enum>(1)</enum><header display-inline="yes-display-inline">Exclusion of amounts expended for medical
			 care</header><text display-inline="yes-display-inline">The first sentence of
			 section 105(b) of the Internal Revenue Code of 1986 (relating to amounts
			 expended for medical care) is amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HB45DF59160C04B5CB8778F1AAB1147CC"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>and his
			 dependents</quote> and inserting <quote>his dependents</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H32D6BBE54A124704BA270A2662C2B304"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting before the period the
			 following: <quote>, and any child (as defined in section 152(f)(1)) of the
			 taxpayer who as of the end of the taxable year has not attained age
			 27</quote>.</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE0D57CDCDC26410C91E94B3BCE3632E9"><enum>(2)</enum><header display-inline="yes-display-inline">Self-employed health insurance
			 deduction</header><text display-inline="yes-display-inline">Section 162(l)(1)
			 of such Code is amended to read as follows:</text>
							<quoted-block display-inline="no-display-inline" id="H009320016F99405DB4CA82A340533E66" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="H4697FECC6CF640A7BF4997BD75E8D334"><enum>(1)</enum><header display-inline="yes-display-inline">Allowance of deduction</header><text display-inline="yes-display-inline">In the case of a taxpayer who is an
				employee within the meaning of section 401(c)(1), there shall be allowed as a
				deduction under this section an amount equal to the amount paid during the
				taxable year for insurance which constitutes medical care for—</text>
									<subparagraph commented="no" display-inline="no-display-inline" id="H49D690B57F8045B18EA6089AC0AF8841"><enum>(A)</enum><text display-inline="yes-display-inline">the taxpayer,</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H56125C489EEB4ED29771C193D386CDA2"><enum>(B)</enum><text display-inline="yes-display-inline">the taxpayer’s spouse,</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H022F3E3B27B94B08887E5DF4127C2815"><enum>(C)</enum><text display-inline="yes-display-inline">the taxpayer’s dependents, and</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF9D3BD7A7CE64C4CA5B464CEA1D20108"><enum>(D)</enum><text display-inline="yes-display-inline">any child (as defined in section 152(f)(1))
				of the taxpayer who as of the end of the taxable year has not attained age
				27.</text>
									</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H4215E519A5784E47B77645C6ED815F5B"><enum>(3)</enum><header display-inline="yes-display-inline">Coverage under self-employed
			 deduction</header><text display-inline="yes-display-inline">Section
			 162(l)(2)(B) of such Code is amended by inserting <quote>, or any dependent, or
			 individual described in subparagraph (D) of paragraph (1) with respect
			 to,</quote> after <quote>spouse of</quote>.</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H02359C36342C4016957A05541CDFB809"><enum>(4)</enum><header display-inline="yes-display-inline">Sick and accident benefits provided to
			 members of a voluntary employees’ beneficiary association and their
			 dependents</header><text display-inline="yes-display-inline">Section 501(c)(9)
			 of such Code is amended by adding at the end the following new sentence:
			 <quote>For purposes of providing for the payment of sick and accident benefits
			 to members of such an association and their dependents, the term
			 <term>dependent</term> shall include any individual who is a child (as defined
			 in section 152(f)(1)) of a member who as of the end of the calendar year has
			 not attained age 27.</quote>.</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H26A334173FE6454EABD658E50303C474"><enum>(5)</enum><header display-inline="yes-display-inline">Medical and other benefits for retired
			 employees</header><text display-inline="yes-display-inline">Section 401(h) of
			 such Code is amended by adding at the end the following: <quote>For purposes of
			 this subsection, the term <term>dependent</term> shall include any individual
			 who is a child (as defined in section 152(f)(1)) of a retired employee who as
			 of the end of the calendar year has not attained age 27.</quote>.</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H7254F814123847D5AA42ED852B2BBD55"><enum>(e)</enum><header display-inline="yes-display-inline">Five percent income disregard for certain
			 individuals</header><text display-inline="yes-display-inline">Section
			 1902(e)(14) of the Social Security Act (42 U.S.C. 1396a(e)(14)), as amended by
			 subsection (b)(1), is further amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HFFB718FCAC484F43B8AE0DB4EE5B2DC3"><enum>(1)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking <quote>No
			 type</quote> and inserting <quote>Subject to subparagraph (I), no type</quote>;
			 and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H465DE39C81BD477CB0D57C0D8F5183EB"><enum>(2)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subparagraph:</text>
							<quoted-block display-inline="no-display-inline" id="H90DC825FE4EE470EAC51B37DE0035F4C" style="OLC">
								<subparagraph commented="no" display-inline="no-display-inline" id="HB263F418CD664F6DA752458DAD7C4DA0"><enum>(I)</enum><header display-inline="yes-display-inline">Treatment of portion of modified adjusted
				gross income</header><text display-inline="yes-display-inline">For purposes of
				determining the income eligibility of an individual for medical assistance
				whose eligibility is determined based on the application of modified adjusted
				gross income under subparagraph (A), the State shall—</text>
									<clause commented="no" display-inline="no-display-inline" id="H8135897B144C4B66AE11A169DF222640"><enum>(i)</enum><text display-inline="yes-display-inline">determine the dollar equivalent of the
				difference between the upper income limit on eligibility for such an individual
				(expressed as a percentage of the poverty line) and such upper income limit
				increased by 5 percentage points; and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="H77785E882B0141349810A09A8BE5EB5C"><enum>(ii)</enum><text display-inline="yes-display-inline">notwithstanding the requirement in
				subparagraph (A) with respect to use of modified adjusted gross income, utilize
				as the applicable income of such individual, in determining such income
				eligibility, an amount equal to the modified adjusted gross income applicable
				to such individual reduced by such dollar equivalent
				amount.</text>
									</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="HE7A2FB33B161477285904A3A1FA2B293" section-type="subsequent-section"><enum>1005.</enum><header display-inline="yes-display-inline">Implementation funding</header>
					<subsection commented="no" display-inline="no-display-inline" id="HE9130DA99C364E3B83D8B565F55FA33E"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">There is hereby established a Health
			 Insurance Reform Implementation Fund (referred to in this section as the
			 <quote>Fund</quote>) within the Department of Health and Human Services to
			 carry out the Patient Protection and Affordable Care Act and this Act (and the
			 amendments made by such Acts).</text>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="HC6B2FE0B1F03431980E6AD4494176F14"><enum>(b)</enum><header display-inline="yes-display-inline">Funding</header><text display-inline="yes-display-inline">There is appropriated to the Fund, out of
			 any funds in the Treasury not otherwise appropriated, $1,000,000,000 for
			 Federal administrative expenses to carry out such Act (and the amendments made
			 by such Acts).</text>
					</subsection></section></subtitle><subtitle commented="no" id="HF2A588FCEC544A4C8C588D8B0B845D34" level-type="subsequent"><enum>B</enum><header display-inline="yes-display-inline">Medicare</header>
				<section commented="no" display-inline="no-display-inline" id="H5CC80C1997A345EF917E051BB947B376" section-type="subsequent-section"><enum>1101.</enum><header display-inline="yes-display-inline">Closing the medicare prescription drug
			 <quote>donut hole</quote></header>
					<subsection commented="no" display-inline="no-display-inline" id="HE88838838824482BA6C731886EB6BC44"><enum>(a)</enum><header display-inline="yes-display-inline">Coverage gap rebate for 2010</header>
						<paragraph commented="no" display-inline="no-display-inline" id="HF106E24E2BDB4A8292ADEF14448DEB20"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1860D–42 of the Social Security Act
			 (42 U.S.C. 1395w–152) is amended by adding at the end the following new
			 subsection:</text>
							<quoted-block display-inline="no-display-inline" id="H048FAF69D6304B6EAD8F61D5BA50FED4" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="HB32BD8557CC749ABA3332DA2B73419FA"><enum>(c)</enum><header display-inline="yes-display-inline">Coverage gap rebate for 2010</header>
									<paragraph commented="no" display-inline="no-display-inline" id="H2BC8E907FB9B4B8FACE710243AE2930E"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">In the case of an individual described in
				subparagraphs (A) through (D) of section 1860D–14A(g)(1) who as of the last day
				of a calendar quarter in 2010 has incurred costs for covered part D drugs so
				that the individual has exceeded the initial coverage limit under section
				1860D–2(b)(3) for 2010, the Secretary shall provide for payment from the
				Medicare Prescription Drug Account of $250 to the individual by not later than
				the 15th day of the third month following the end of such quarter.</text>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H35EBE724DC814077BD690A1D6B20F8F6"><enum>(2)</enum><header display-inline="yes-display-inline">Limitation</header><text display-inline="yes-display-inline">The Secretary shall provide only 1 payment
				under this subsection with respect to any
				individual.</text>
									</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5C93F832C1EA4307A43722699E530363"><enum>(2)</enum><header display-inline="yes-display-inline">Repeal of provision</header><text display-inline="yes-display-inline">Section 3315 of the Patient Protection and
			 Affordable Care Act (including the amendments made by such section) is
			 repealed, and any provision of law amended or repealed by such sections is
			 hereby restored or revived as if such section had not been enacted into
			 law.</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HBB382FB85F1A44F8AB5026D110AC3AC1"><enum>(b)</enum><header display-inline="yes-display-inline">Closing the donut hole</header><text display-inline="yes-display-inline">Part D of title XVIII of the Social
			 Security Act (42 U.S.C. 1395w–101 et seq.), as amended by section 3301 of the
			 Patient Protection and Affordable Care Act, is further amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HEFA5DB03614D40BBAFDDEC39EE50FCCF"><enum>(1)</enum><text display-inline="yes-display-inline">in section 1860D–43—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HF8C561844D7140A88E8C19EC02C2DD99"><enum>(A)</enum><text display-inline="yes-display-inline">in subsection (b), by striking <quote>July
			 1, 2010</quote> and inserting <quote>January 1, 2011</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3B20BAB44D16421EA384D45DE64D3C13"><enum>(B)</enum><text display-inline="yes-display-inline">in subsection (c)(2), by striking
			 <quote>July 1, 2010, and ending on December 31, 2010,</quote> and inserting
			 <quote>January 1, 2011, and December 31, 2011,</quote>;</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB6F5CA63C8B748A8B3FBBBBA87139E75"><enum>(2)</enum><text display-inline="yes-display-inline">in section 1860D–14A—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H1E2E2BD2A58344CAB8A70EC115246C98"><enum>(A)</enum><text display-inline="yes-display-inline">in subsection (a)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H2DF3F80EA0C1426C830349B23589D68D"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>July 1, 2010</quote> and
			 inserting <quote>January 1, 2011</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H32819DF25E0D48DF94F3A38B7E9A2298"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>April 1, 2010</quote>
			 and inserting <quote>180 days after the date of the enactment of this
			 section</quote>;</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HC1C6DD6B9D7444BC805096F5108FAD07"><enum>(B)</enum><text display-inline="yes-display-inline">in subsection (b)(1)(C)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H02B547E799B54B45A8C738BAA34DBF6C"><enum>(i)</enum><text display-inline="yes-display-inline">in the heading, by striking
			 <quote><header-in-text level="clause" style="OLC">2010
			 and</header-in-text></quote>;</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HE8E04725F2FC47FA822C667D3F9D8F72"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>July 1, 2010</quote> and
			 inserting <quote>January 1, 2011</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HCC9E5D3D49F544B88D1FFAB57599ADE2"><enum>(iii)</enum><text display-inline="yes-display-inline">by striking <quote>May 1, 2010</quote> and
			 inserting <quote>not later than 30 days after the date of the establishment of
			 a model agreement under subsection (a)</quote>;</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HEBD08B396B1F440985E23FA02CA9A20F"><enum>(C)</enum><text display-inline="yes-display-inline">in subsection (c)—</text>
								<clause commented="no" display-inline="no-display-inline" id="HDC96E476E8C246EDA3D4C65E199EFC75"><enum>(i)</enum><text display-inline="yes-display-inline">in paragraph (1)(A)(iii), by striking
			 <quote>July 1, 2010, and ending on December 31, 2011</quote> and inserting
			 <quote>January 1, 2011, and ending on December 31, 2011</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H614ED67B6D4E42C0959D8A11C84C7E0D"><enum>(ii)</enum><text display-inline="yes-display-inline">in paragraph (2), by striking
			 <quote>2010</quote> and inserting <quote>2011</quote>;</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5A0C49CF2E814803B99E02513D9E7C3C"><enum>(D)</enum><text display-inline="yes-display-inline">in subsection (d)(2)(B), by striking
			 <quote>July 1, 2010, and ending on December 31, 2010</quote> and inserting
			 <quote>January 1, 2011, and ending on December 31, 2011</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H232B7CD61D024E96B550ED543FF29CFD"><enum>(E)</enum><text display-inline="yes-display-inline">in subsection (g)(1)—</text>
								<clause commented="no" display-inline="no-display-inline" id="HEA0B032BBF9D419C93B0C7FE2FF83B91"><enum>(i)</enum><text display-inline="yes-display-inline">in the matter before subparagraph (A), by
			 striking <quote>an applicable drug</quote> and inserting <quote>a covered part
			 D drug</quote>;</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HA1C7F7C496B84741975BE391B4051D80"><enum>(ii)</enum><text display-inline="yes-display-inline">by adding <quote>and</quote> at the end of
			 subparagraph (C);</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H852A18F7903142BB9475347A2C198C09"><enum>(iii)</enum><text display-inline="yes-display-inline">by striking subparagraph (D); and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H72A920D0AA2548EC97B6DC13EE61B6B6"><enum>(iv)</enum><text display-inline="yes-display-inline">by redesignating subparagraph (E) as
			 subparagraph (D); and</text>
								</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5C96B3DF86134B0F80758B9EF79B0C2C"><enum>(3)</enum><text display-inline="yes-display-inline">in section 1860D–2(b)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HDAF32E8F45924AD3AFE6B48363D74849"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (2)(A), by striking <quote>The
			 coverage</quote> and inserting <quote>Subject to subparagraphs (C) and (D), the
			 coverage</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5907DD2919654DB2BD1C5CC565A2611C"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (2)(B), by striking
			 <quote>subparagraph (A)(ii)</quote> and inserting <quote>subparagraphs (A)(ii),
			 (C), and (D)</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HC807BCD2048B465FBD12AD44E10696EE"><enum>(C)</enum><text display-inline="yes-display-inline">by adding at the end of paragraph (2) the
			 following new subparagraphs:</text>
								<quoted-block display-inline="no-display-inline" id="HB10E2D814F734FC185919C75777A51A6" style="OLC">
									<subparagraph commented="no" display-inline="no-display-inline" id="H7AEBA3044DBC4A5FB4D5D32C6D25B37B"><enum>(C)</enum><header display-inline="yes-display-inline">Coverage for generic drugs in coverage
				gap</header>
										<clause commented="no" display-inline="no-display-inline" id="HCE60AC2EACA545CBB55D603B611BE058"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Except as provided in paragraph (4), the
				coverage for an applicable beneficiary (as defined in section 1860D–14A(g)(1))
				has coinsurance (for costs above the initial coverage limit under paragraph (3)
				and below the out-of-pocket threshold) for covered part D drugs that are not
				applicable drugs under section 1860D–14A(g)(2) that is—</text>
											<subclause commented="no" display-inline="no-display-inline" id="H0C5094E37B7943D68E2D60BC7E15E8BC"><enum>(I)</enum><text display-inline="yes-display-inline">equal to the generic-gap coinsurance
				percentage (specified in clause (ii)) for the year; or</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H36624D6750C84E399503AA8D81B6B4D0"><enum>(II)</enum><text display-inline="yes-display-inline">actuarially equivalent (using processes and
				methods established under section 1860D–11(c)) to an average expected payment
				of such percentage of such costs for covered part D drugs that are not
				applicable drugs under section 1860D–14A(g)(2).</text>
											</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HD2F5EFC00E9C4F2D83B56E558452C1CB"><enum>(ii)</enum><header display-inline="yes-display-inline">Generic-gap coinsurance
				percentage</header><text display-inline="yes-display-inline">The generic-gap
				coinsurance percentage specified in this clause for—</text>
											<subclause commented="no" display-inline="no-display-inline" id="HA2A17FC69E7D48FFB4421EB3E3347B82"><enum>(I)</enum><text display-inline="yes-display-inline">2011 is 93 percent;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H4320F7E5EF34491E9F9DE7DD648162AB"><enum>(II)</enum><text display-inline="yes-display-inline">2012 and each succeeding year before 2020
				is the generic-gap coinsurance percentage under this clause for the previous
				year decreased by 7 percentage points; and</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H7703706C946F4DCC84B2C838DED9A865"><enum>(III)</enum><text display-inline="yes-display-inline">2020 and each subsequent year is 25
				percent.</text>
											</subclause></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H596605A16915463AB50C5EF30D72747D"><enum>(D)</enum><header display-inline="yes-display-inline">Coverage for applicable drugs in coverage
				gap</header>
										<clause commented="no" display-inline="no-display-inline" id="HBB1948485D854C6DA99D2C5C9EB61F9F"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Except as provided in paragraph (4), the
				coverage for an applicable beneficiary (as defined in section 1860D–14A(g)(1))
				has coinsurance (for costs above the initial coverage limit under paragraph (3)
				and below the out-of-pocket threshold) for the negotiated price (as defined in
				section 1860D–14A(g)(6)) of covered part D drugs that are applicable drugs
				under section 1860D–14A(g)(2) that is—</text>
											<subclause commented="no" display-inline="no-display-inline" id="HDA338DE52EA84845842F01B9F66F8AAA"><enum>(I)</enum><text display-inline="yes-display-inline">equal to the difference between the
				applicable gap percentage (specified in clause (ii) for the year) and the
				discount percentage specified in section 1860D–14A(g)(4)(A) for such applicable
				drugs; or</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="HD4B913CBD5FE4961A931E8DD9F507A14"><enum>(II)</enum><text display-inline="yes-display-inline">actuarially equivalent (using processes and
				methods established under section 1860D–11(c)) to an average expected payment
				of such percentage of such costs, for covered part D drugs that are applicable
				drugs under section 1860D–14A(g)(2).</text>
											</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HDE5873EC6DFD457BAEFB30C046CA2AEE"><enum>(ii)</enum><header display-inline="yes-display-inline">Applicable gap percentage</header><text display-inline="yes-display-inline">The applicable gap percentage specified in
				this clause for—</text>
											<subclause commented="no" display-inline="no-display-inline" id="H3BA4A62A596345758982A2C93764DA73"><enum>(I)</enum><text display-inline="yes-display-inline">2013 and 2014 is 97.5 percent;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="HE3B328DC3EE34154A3DB7113B22715C0"><enum>(II)</enum><text display-inline="yes-display-inline">2015 and 2016 is 95 percent;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H08717690A0AB4B09BF9329BAAE81A722"><enum>(III)</enum><text display-inline="yes-display-inline">2017 is 90 percent;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="HC299D50979E3459A9EBAFC34EC6A5417"><enum>(IV)</enum><text display-inline="yes-display-inline">2018 is 85 percent;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H2EFE77E9A32C4EB4BFDBB398C4DF77F4"><enum>(V)</enum><text display-inline="yes-display-inline">2019 is 80 percent; and</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H354152AA3D6A47E49BBCF903106F35F2"><enum>(VI)</enum><text display-inline="yes-display-inline">2020 and each subsequent year is 75
				percent.</text>
											</subclause></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8C359EC2CD2A4B1B91F22DD0D95A6BA3"><enum>(D)</enum><text display-inline="yes-display-inline">in paragraph (3)(A), as restored under
			 subsection (a)(2), by striking <quote>paragraph (4)</quote> and inserting
			 <quote>paragraphs (2)(C), (2)(D), and (4)</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD9522AFE9759463EABFDD2F01AF55F26"><enum>(E)</enum><text display-inline="yes-display-inline">in paragraph (4)(E), by inserting before
			 the period at the end the following: <quote>, except that incurred costs shall
			 not include the portion of the negotiated price that represents the reduction
			 in coinsurance resulting from the application of paragraph (2)(D)</quote>;
			 and</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0F77E651B9854F788401300B3FC2451E"><enum>(4)</enum><text display-inline="yes-display-inline">in section 1860D–22(a)(2)(A), by inserting
			 before the period at the end the following: <quote>, not taking into account
			 the value of any discount or coverage provided during the gap in prescription
			 drug coverage that occurs between the initial coverage limit under section
			 1860D–2(b)(3) during the year and the out-of-pocket threshold specified in
			 section 1860D–2(b)(4)(B)</quote>.</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HDE7DA4DA0EEF4DB5A337A241317C282F"><enum>(c)</enum><header display-inline="yes-display-inline">Conforming amendment to AMP under
			 Medicaid</header><text display-inline="yes-display-inline">Section
			 1927(k)(1)(B)(i) of the Social Security Act (42 U.S.C. 1396r–8(k)(1)(B)(i)), as
			 amended by section 2503(a)(2)(B) of the Patient Protection and Affordable Care
			 Act, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H330461AC41DA4CCFA5A176D8E100E880"><enum>(1)</enum><text display-inline="yes-display-inline">by striking <quote>and</quote> at the end
			 of subclause (III);</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H1921DFF712AD4225A1B16D4900729C55"><enum>(2)</enum><text display-inline="yes-display-inline">by striking the period at the end of
			 subclause (IV); and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H195367AD26434E7E98AC4AC838E959FB"><enum>(3)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subclause:</text>
							<quoted-block display-inline="no-display-inline" id="H7FACF655F54942759431202DAD90C43E" style="OLC">
								<subclause commented="no" display-inline="no-display-inline" id="HC69E0FF573994013845C18DEB884EAC6"><enum>(V)</enum><text display-inline="yes-display-inline">discounts provided by manufacturers under
				section
				1860D–14A.</text>
								</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HFA40F46F2B304232BB7B910F1E2BDF57"><enum>(d)</enum><header display-inline="yes-display-inline">Reducing growth rate of out-of-pocket cost
			 threshold</header><text display-inline="yes-display-inline">Section 1860D–2(b)
			 of the Social Security Act (42 U.S.C. 1395w–102(b)) is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H51A064095FA04D9A9B9113782E3F8583"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (4)(B)(i)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HE55CBB164DC74CC7BBFADF2855740B82"><enum>(A)</enum><text display-inline="yes-display-inline">in subclause (I), by striking
			 <quote>or</quote> at the end;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H83EB6862521241128637532768427FE6"><enum>(B)</enum><text display-inline="yes-display-inline">by redesignating subclause (II) as
			 subclause (VI); and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H524F9F5558044E0489C03397A76D42C7"><enum>(C)</enum><text display-inline="yes-display-inline">by inserting after subclause (I) the
			 following new subclauses:</text>
								<quoted-block display-inline="no-display-inline" id="HF0B87DE2F96A4467BEEE7B71E9DB6BA6" style="OLC">
									<subclause commented="no" display-inline="no-display-inline" id="H2167D44066154175866A8F2A56D01B41"><enum>(II)</enum><text display-inline="yes-display-inline">for each of years 2007 through 2013, is
				equal to the amount specified in this subparagraph for the previous year,
				increased by the annual percentage increase described in paragraph (6) for the
				year involved;</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="H78AA825B5BEF4123AF432B57BA5A7590"><enum>(III)</enum><text display-inline="yes-display-inline">for 2014 and 2015, is equal to the amount
				specified in this subparagraph for the previous year, increased by the annual
				percentage increase described in paragraph (6) for the year involved, minus
				0.25 percentage point;</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="H0BF6E728D7D44E1E924F0D3A6A72C32F"><enum>(IV)</enum><text display-inline="yes-display-inline">for each of years 2016 through 2019, is
				equal to the amount specified in this subparagraph for the previous year,
				increased by the lesser of—</text>
										<item commented="no" display-inline="no-display-inline" id="H518A1F5004E246EBA39D0368D2993F80"><enum>(aa)</enum><text display-inline="yes-display-inline">the annual percentage increase described in
				paragraph (7) for the year involved, plus 2 percentage points; or</text>
										</item><item commented="no" display-inline="no-display-inline" id="HC22912206A644A669488156E3EC84D3F"><enum>(bb)</enum><text display-inline="yes-display-inline">the annual percentage increase described in
				paragraph (6) for the year;</text>
										</item></subclause><subclause commented="no" display-inline="no-display-inline" id="HE2D1A5A99C3242CDBF6A064E62D0A468"><enum>(V)</enum><text display-inline="yes-display-inline">for 2020, is equal to the amount that would
				have been applied under this subparagraph for 2020 if the amendments made by
				section 1101(d)(1) of the Health Care and Education Reconciliation Act of 2010
				had not been enacted; or</text>
									</subclause><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H92A30FB5F2F54E209600196BADCF811C"><enum>(2)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 paragraph:</text>
							<quoted-block display-inline="no-display-inline" id="HCC2151B160C94973A5397262A61A3AAD" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="H8578A2CBC16B49FAA6E2446669B56EB7"><enum>(7)</enum><header display-inline="yes-display-inline">Additional annual percentage
				increase</header><text display-inline="yes-display-inline">The annual
				percentage increase specified in this paragraph for a year is equal to the
				annual percentage increase in the consumer price index for all urban consumers
				(United States city average) for the 12-month period ending in July of the
				previous
				year.</text>
								</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H867E9366CF774F5E84251D0D28402081" section-type="subsequent-section"><enum>1102.</enum><header display-inline="yes-display-inline">Medicare Advantage payments</header>
					<subsection commented="no" display-inline="no-display-inline" id="H5456F16CDF294BBC9B9E55C5C8425AAE"><enum>(a)</enum><header display-inline="yes-display-inline">Repeal</header><text display-inline="yes-display-inline">Effective as if included in the enactment
			 of the Patient Protection and Affordable Care Act, sections 3201 and 3203 of
			 such Act (and the amendments made by such sections) are repealed.</text>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="HE1D17E75F62B48339CBE5E2B58AF567E"><enum>(b)</enum><header display-inline="yes-display-inline">Phase-in of modified
			 benchmarks</header><text display-inline="yes-display-inline">Section 1853 of
			 the Social Security Act (42 U.S.C. 1395w–23) is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H76844860E16E4203808C48D46FFA3AFD"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (j)(1)(A), by striking
			 <quote>(or, beginning with 2007, <fraction>1/12</fraction> of the applicable
			 amount determined under subsection (k)(1)) for the area for the year</quote>
			 and inserting <quote>for the area for the year (or, for 2007, 2008, 2009, and
			 2010, <fraction>1/12</fraction> of the applicable amount determined under
			 subsection (k)(1) for the area for the year; for 2011,
			 <fraction>1/12</fraction> of the applicable amount determined under subsection
			 (k)(1) for the area for 2010; and, beginning with 2012,
			 <fraction>1⁄12</fraction> of the blended benchmark amount determined under
			 subsection (n)(1) for the area for the year)</quote>; and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDECE9770B3A64038AA3B2C52B3DB7D24"><enum>(2)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subsection:</text>
							<quoted-block display-inline="no-display-inline" id="H7A273FB2EBD241AD93FB17BAB164E4CF" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="H1A494D4C09C3427E9A81AEE34E8B93FE"><enum>(n)</enum><header display-inline="yes-display-inline">Determination of blended benchmark
				amount</header>
									<paragraph commented="no" display-inline="no-display-inline" id="HA6EC4604F6EE4439AB6BB740903B7A27"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">For purposes of subsection (j), subject to
				paragraphs (3), (4), and (5), the term <quote>blended benchmark amount</quote>
				means for an area—</text>
										<subparagraph commented="no" display-inline="no-display-inline" id="HC7B00790B5F449A08DB1DFD6680455C1"><enum>(A)</enum><text display-inline="yes-display-inline">for 2012 the sum of—</text>
											<clause commented="no" display-inline="no-display-inline" id="HD824EE42A8324280A05395766D86F471"><enum>(i)</enum><text display-inline="yes-display-inline">½ of the applicable amount for the area and
				year; and</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H86A1C0E82DEE4216B2D4A7149E7BA1BE"><enum>(ii)</enum><text display-inline="yes-display-inline"><fraction>½</fraction> of the amount
				specified in paragraph (2)(A) for the area and year; and</text>
											</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H93FE441D5153425A8DDDDEA5ED06D230"><enum>(B)</enum><text display-inline="yes-display-inline">for a subsequent year the amount specified
				in paragraph (2)(A) for the area and year.</text>
										</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0D34F668D0544ED98C494B1C1263EF0C"><enum>(2)</enum><header display-inline="yes-display-inline">Specified amount</header>
										<subparagraph commented="no" display-inline="no-display-inline" id="H50CCF276B6A54212AC8367EFE50303D3"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The amount specified in this subparagraph
				for an area and year is the product of—</text>
											<clause commented="no" display-inline="no-display-inline" id="H406094FE8D024B079B016C7008ECD87E"><enum>(i)</enum><text display-inline="yes-display-inline">the base payment amount specified in
				subparagraph (E) for the area and year adjusted to take into account the
				phase-out in the indirect costs of medical education from capitation rates
				described in subsection (k)(4); and</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H5A7BB81E7BE648B58D630BB45A754A2A"><enum>(ii)</enum><text display-inline="yes-display-inline">the applicable percentage for the area for
				the year specified under subparagraph (B).</text>
											</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H622C9B3394D34627871F457D02BA0B68"><enum>(B)</enum><header display-inline="yes-display-inline">Applicable percentage</header><text display-inline="yes-display-inline">Subject to subparagraph (D), the applicable
				percentage specified in this subparagraph for an area for a year in the case of
				an area that is ranked—</text>
											<clause commented="no" display-inline="no-display-inline" id="H6F20C4317F414443816368B435AFCAA8"><enum>(i)</enum><text display-inline="yes-display-inline">in the highest quartile under subparagraph
				(C) for the previous year is 95 percent;</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H6E155F205C874563AA5FD9720BFA9E1E"><enum>(ii)</enum><text display-inline="yes-display-inline">in the second highest quartile under such
				subparagraph for the previous year is 100 percent;</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H9C258107EC444170A09B3D2F56EEB8FB"><enum>(iii)</enum><text display-inline="yes-display-inline">in the third highest quartile under such
				subparagraph for the previous year is 107.5 percent; or</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H5D156AA7619F43A58B63A7AD5C2C02F8"><enum>(iv)</enum><text display-inline="yes-display-inline">in the lowest quartile under such
				subparagraph for the previous year is 115 percent.</text>
											</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H9EB5820FBADD4D00917B3B1D191E3F24"><enum>(C)</enum><header display-inline="yes-display-inline">Periodic ranking</header><text display-inline="yes-display-inline">For purposes of this paragraph in the case
				of an area located—</text>
											<clause commented="no" display-inline="no-display-inline" id="H6D5DE27A5579431AA82D2D4C89B434B1"><enum>(i)</enum><text display-inline="yes-display-inline">in 1 of the 50 States or the District of
				Columbia, the Secretary shall rank such area in each year specified under
				subsection (c)(1)(D)(ii) based upon the level of the amount specified in
				subparagraph (A)(i) for such areas; or</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H52D987E6812A4CE78725D988677BAEEC"><enum>(ii)</enum><text display-inline="yes-display-inline">in a territory, the Secretary shall rank
				such areas in each such year based upon the level of the amount specified in
				subparagraph (A)(i) for such area relative to quartile rankings computed under
				clause (i).</text>
											</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HED4638AC861B4691824C4AC5FA3CDE48"><enum>(D)</enum><header display-inline="yes-display-inline">1-year transition for changes in applicable
				percentage</header><text display-inline="yes-display-inline">If, for a year
				after 2012, there is a change in the quartile in which an area is ranked
				compared to the previous year, the applicable percentage for the area in the
				year shall be the average of—</text>
											<clause commented="no" display-inline="no-display-inline" id="H34EB0508D1534AA2A01C32C4D5B73477"><enum>(i)</enum><text display-inline="yes-display-inline">the applicable percentage for the area for
				the previous year; and</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="HC9A28EED2DE94558888656ADDDDFE48F"><enum>(ii)</enum><text display-inline="yes-display-inline">the applicable percentage that would
				otherwise apply for the area for the year.</text>
											</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF41710C6850B4B4C9FF803D1A97922F2"><enum>(E)</enum><header display-inline="yes-display-inline">Base payment amount</header><text display-inline="yes-display-inline">Subject to subparagraph (F), the base
				payment amount specified in this subparagraph—</text>
											<clause commented="no" display-inline="no-display-inline" id="H3E03B0D9D8264B89B4F4BFD84D114BB2"><enum>(i)</enum><text display-inline="yes-display-inline">for 2012 is the amount specified in
				subsection (c)(1)(D) for the area for the year; or</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="HC687DC3C75B540F0B51C617B302B0486"><enum>(ii)</enum><text display-inline="yes-display-inline">for a subsequent year that—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H7CF36770C3804D0E9BE6DDECC7099258"><enum>(I)</enum><text display-inline="yes-display-inline">is not specified under subsection
				(c)(1)(D)(ii), is the base amount specified in this subparagraph for the area
				for the previous year, increased by the national per capita MA growth
				percentage, described in subsection (c)(6) for that succeeding year, but not
				taking into account any adjustment under subparagraph (C) of such subsection
				for a year before 2004; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="H1AC25997D18E4CBB8405793B34F7D89E"><enum>(II)</enum><text display-inline="yes-display-inline">is specified under subsection
				(c)(1)(D)(ii), is the amount specified in subsection (c)(1)(D) for the area for
				the year.</text>
												</subclause></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H1251B9F4D8FA4FA6B34118366A6AC1EE"><enum>(F)</enum><header display-inline="yes-display-inline">Application of indirect medical education
				phase-out</header><text display-inline="yes-display-inline">The base payment
				amount specified in subparagraph (E) for a year shall be adjusted in the same
				manner under paragraph (4) of subsection (k) as the applicable amount is
				adjusted under such subsection.</text>
										</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD4A397E8FD6046678C2CDB0A7265F256"><enum>(3)</enum><header display-inline="yes-display-inline">Alternative phase-ins</header>
										<subparagraph commented="no" display-inline="no-display-inline" id="HFCC05CFF3EE64E28AD83F94F135190FF"><enum>(A)</enum><header display-inline="yes-display-inline">4-year phase-in for certain
				areas</header><text display-inline="yes-display-inline">If the difference
				between the applicable amount (as defined in subsection (k)) for an area for
				2010 and the projected 2010 benchmark amount (as defined in subparagraph (C))
				for the area is at least $30 but less than $50, the blended benchmark amount
				for the area is—</text>
											<clause commented="no" display-inline="no-display-inline" id="HB799F748DCFB47B5A9127CA6ABD3A054"><enum>(i)</enum><text display-inline="yes-display-inline">for 2012 the sum of—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H90AF275D4A704A40BFAF109BF2517329"><enum>(I)</enum><text display-inline="yes-display-inline"><fraction>3/4</fraction> of the applicable
				amount for the area and year; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="H268A26D1D9A24DCC981E6EA6B16272B6"><enum>(II)</enum><text display-inline="yes-display-inline"><fraction>¼</fraction> of the amount
				specified in paragraph (2)(A) for the area and year;</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HBE421A7E93DE4938AA8C9727B695ACA3"><enum>(ii)</enum><text display-inline="yes-display-inline">for 2013 the sum of—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H6A870417E7764BC4BFCFD47A78D5ECAB"><enum>(I)</enum><text display-inline="yes-display-inline"><fraction>½</fraction> of the applicable
				amount for the area and year; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="HDCBFC0B1A5DB41CCB528B62F788E03C7"><enum>(II)</enum><text display-inline="yes-display-inline"><fraction>½</fraction> of the amount
				specified in paragraph (2)(A) for the area and year;</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H8DBC28C3D51A4223BDA0E41FD5D3E580"><enum>(iii)</enum><text display-inline="yes-display-inline">for 2014 the sum of—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H07ACC63C5AA245B6B5676428E22A9963"><enum>(I)</enum><text display-inline="yes-display-inline"><fraction>1/4</fraction> of the applicable
				amount for the area and year; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="HDF35911238C94A7ABD4827E1562628E3"><enum>(II)</enum><text display-inline="yes-display-inline"><fraction>¾</fraction> of the amount
				specified in paragraph (2)(A) for the area and year; and</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HC908A3C2171742CFAE45D68E72CD7DEF"><enum>(iv)</enum><text display-inline="yes-display-inline">for a subsequent year the amount specified
				in paragraph (2)(A) for the area and year.</text>
											</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF6F7BDFFB3B64C4BA5A8C6EEA681BBD4"><enum>(B)</enum><header display-inline="yes-display-inline">6-year phase-in for certain
				areas</header><text display-inline="yes-display-inline">If the difference
				between the applicable amount (as defined in subsection (k)) for an area for
				2010 and the projected 2010 benchmark amount (as defined in subparagraph (C))
				for the area is at least $50, the blended benchmark amount for the area
				is—</text>
											<clause commented="no" display-inline="no-display-inline" id="HE81E5ADC0F9E439E8AED2747A536A834"><enum>(i)</enum><text display-inline="yes-display-inline">for 2012 the sum of—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H37C633FA6F3945E89C9208218F2B4594"><enum>(I)</enum><text display-inline="yes-display-inline"><fraction>5/6</fraction> of the applicable
				amount for the area and year; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="H5045AC00BD0A45C190708501F40B3DAB"><enum>(II)</enum><text display-inline="yes-display-inline"><fraction>1/6</fraction> of the amount
				specified in paragraph (2)(A) for the area and year;</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HE4CCBA57813441AAB25A35921996B3AA"><enum>(ii)</enum><text display-inline="yes-display-inline">for 2013 the sum of—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H5295F5C806154A168ED3AB67F1541FB4"><enum>(I)</enum><text display-inline="yes-display-inline"><fraction>2/3</fraction> of the applicable
				amount for the area and year; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="H9E34E1726E144EF6AA72E1A9E032032F"><enum>(II)</enum><text display-inline="yes-display-inline"><fraction>1/3</fraction> of the amount
				specified in paragraph (2)(A) for the area and year;</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HE465A657476443CC91360F23E3FC8A53"><enum>(iii)</enum><text display-inline="yes-display-inline">for 2014 the sum of—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H78230BBC5F06440F9EFB9C4A68CCEC81"><enum>(I)</enum><text display-inline="yes-display-inline"><fraction>½</fraction> of the applicable
				amount for the area and year; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="H3E6796663E3A4DB4947DB41E4F35F044"><enum>(II)</enum><text display-inline="yes-display-inline"><fraction>½</fraction> of the amount
				specified in paragraph (2)(A) for the area and year;</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HD8547A04F4824DAF96FF044F4783DF93"><enum>(iv)</enum><text display-inline="yes-display-inline">for 2015 the sum of—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H8BEAE44562CC4A5AA7E6144833FC6078"><enum>(I)</enum><text display-inline="yes-display-inline"><fraction>1/3</fraction> of the applicable
				amount for the area and year; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="HE34D463F16D14D2799F6DC28294DE6F9"><enum>(II)</enum><text display-inline="yes-display-inline"><fraction>2/3</fraction> of the amount
				specified in paragraph (2)(A) for the area and year; and</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H40DAAF6B2C8C46D89031B76CA23B1923"><enum>(v)</enum><text display-inline="yes-display-inline">for 2016 the sum of—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H78D8278FFB4E4823A808B41C3ABA4391"><enum>(I)</enum><text display-inline="yes-display-inline"><fraction>1/6</fraction> of the applicable
				amount for the area and year; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="H446C5339EB654FAA9CF60E6D8755FEC2"><enum>(II)</enum><text display-inline="yes-display-inline"><fraction>5/6</fraction> of the amount
				specified in paragraph (2)(A) for the area and year; and</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H996CAAA5B956461A9E55DCE7E626C84A"><enum>(vi)</enum><text display-inline="yes-display-inline">for a subsequent year the amount specified
				in paragraph (2)(A) for the area and year.</text>
											</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HDDCE27ABD2B64F599F218E38DA28F51A"><enum>(C)</enum><header display-inline="yes-display-inline">Projected 2010 benchmark
				amount</header><text display-inline="yes-display-inline">The projected 2010
				benchmark amount described in this subparagraph for an area is equal to the sum
				of—</text>
											<clause commented="no" display-inline="no-display-inline" id="HCF85B2CCF68B4301A403D8769258CE4A"><enum>(i)</enum><text display-inline="yes-display-inline"><fraction>½</fraction> of the applicable
				amount (as defined in subsection (k)) for the area for 2010; and</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H844597E817B04F7BA9778AFADC8E4C84"><enum>(ii)</enum><text display-inline="yes-display-inline"><fraction>½</fraction> of the amount
				specified in paragraph (2)(A) for the area for 2010 but determined as if there
				were substituted for the applicable percentage specified in clause (ii) of such
				paragraph the sum of—</text>
												<subclause commented="no" display-inline="no-display-inline" id="HFB73487A618B44C09BDF7E4A27CE3504"><enum>(I)</enum><text display-inline="yes-display-inline">the applicable percent that would be
				specified under subparagraph (B) of paragraph (2) (determined without regard to
				subparagraph (D) of such paragraph) for the area for 2010 if any reference in
				such paragraph to <quote>the previous year</quote> were deemed a reference to
				2010; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="H31272AB3D127466C86213FB030EC9C9E"><enum>(II)</enum><text display-inline="yes-display-inline">the applicable percentage increase that
				would apply to a qualifying plan in the area under subsection (o) as if any
				reference in such subsection to 2012 were deemed a reference to 2010 and as if
				the determination of a qualifying county under paragraph (3)(B) of such
				subsection were made for 2010.</text>
												</subclause></clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H349E3F834AF0443582D7B8A5F0AA99DC"><enum>(4)</enum><header display-inline="yes-display-inline">Cap on benchmark amount</header><text display-inline="yes-display-inline">In no case shall the blended benchmark
				amount for an area for a year (determined taking into account subsection (o))
				be greater than the applicable amount that would (but for the application of
				this subsection) be determined under subsection (k)(1) for the area for the
				year.</text>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA59BA8904EFD42078B981239AA45A2A8"><enum>(5)</enum><header display-inline="yes-display-inline">Non-application to pace plans</header><text display-inline="yes-display-inline">This subsection shall not apply to payments
				to a PACE program under section
				1894.</text>
									</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H6C3F3B97CFD547B48473D7592C6202A0"><enum>(c)</enum><header display-inline="yes-display-inline">Applicable percentage quality
			 increases</header><text display-inline="yes-display-inline">Section 1853 of
			 such Act (42 U.S.C. 1395w–23), as amended by subsection (b), is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HCCB479CF2F724CF48078FAF661D40058"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (j), by inserting
			 <quote>subject to subsection (o),</quote> after <quote>For purposes of this
			 part,</quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H151BF4586C684B33BCA33CDD2BE5BB2A"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (n)(2)(B), as added by
			 subsection (b), by inserting <quote>, subject to subsection (o)</quote> after
			 <quote>as follows</quote>; and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3F999F203DA4461D8152979551023708"><enum>(3)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subsection:</text>
							<quoted-block display-inline="no-display-inline" id="HA86CA8728FE64F57968DAD9DFA169A81" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="HDC4F948AB4334E6AB6ED171A16146771"><enum>(o)</enum><header display-inline="yes-display-inline">Applicable percentage quality
				increases</header>
									<paragraph commented="no" display-inline="no-display-inline" id="HC3226FECAAC348E6A56CFFB866B99269"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subject to the succeeding paragraphs, in
				the case of a qualifying plan with respect to a year beginning with 2012, the
				applicable percentage under subsection (n)(2)(B) shall be increased on a plan
				or contract level, as determined by the Secretary—</text>
										<subparagraph commented="no" display-inline="no-display-inline" id="H02F1328B000643B9BF0E74F8568FB42F"><enum>(A)</enum><text display-inline="yes-display-inline">for 2012, by 1.5 percentage points;</text>
										</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H4E9D6F30A4CE4B5A9C68BF14850F7D5D"><enum>(B)</enum><text display-inline="yes-display-inline">for 2013, by 3.0 percentage points;
				and</text>
										</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H1198F23AC62E4043815CB1737D54FE85"><enum>(C)</enum><text display-inline="yes-display-inline">for 2014 or a subsequent year, by 5.0
				percentage points.</text>
										</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE5BBD19C73124A62A99662D9F615B897"><enum>(2)</enum><header display-inline="yes-display-inline">Increase for qualifying plans in qualifying
				counties</header><text display-inline="yes-display-inline">The increase applied
				under paragraph (1) for a qualifying plan located in a qualifying county for a
				year shall be doubled.</text>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA5C8A8767CDF447AB6302EBE221BC22E"><enum>(3)</enum><header display-inline="yes-display-inline">Qualifying plans and qualifying county
				defined; application of increases to low enrollment and new plans</header><text display-inline="yes-display-inline">For purposes of this subsection:</text>
										<subparagraph commented="no" display-inline="no-display-inline" id="HF514A39A21C34DCC98E51449ADE009B3"><enum>(A)</enum><header display-inline="yes-display-inline">Qualifying plan</header>
											<clause commented="no" display-inline="no-display-inline" id="H36032AA51AEA48E68FDC6647FF219712"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The term <quote>qualifying plan</quote>
				means, for a year and subject to paragraph (4), a plan that had a quality
				rating under paragraph (4) of 4 stars or higher based on the most recent data
				available for such year.</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="HFABB043A7B6B44478F271627E6FE84F3"><enum>(ii)</enum><header display-inline="yes-display-inline">Application of increases to low enrollment
				plans</header>
												<subclause commented="no" display-inline="no-display-inline" id="H80FC94B82D204DCBADFC694B95F44A52"><enum>(I)</enum><header display-inline="yes-display-inline">2012</header><text display-inline="yes-display-inline">For 2012, the term <quote>qualifying
				plan</quote> includes an MA plan that the Secretary determines is not able to
				have a quality rating under paragraph (4) because of low enrollment.</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="HFAA91503ED4F4EBABB851AA11B88B751"><enum>(II)</enum><header display-inline="yes-display-inline">2013 and subsequent years</header><text display-inline="yes-display-inline">For 2013 and subsequent years, for purposes
				of determining whether an MA plan with low enrollment (as defined by the
				Secretary) is included as a qualifying plan, the Secretary shall establish a
				method to apply to MA plans with low enrollment (as defined by the Secretary)
				the computation of quality rating and the rating system under paragraph
				(4).</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H6C0B4C0F888F4C04B3D85DDBCD1102B9"><enum>(iii)</enum><header display-inline="yes-display-inline">Application of increases to new
				plans</header>
												<subclause commented="no" display-inline="no-display-inline" id="H15509F83F1BC45619EE301074AFD9DDE"><enum>(I)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">A new MA plan that meets criteria specified
				by the Secretary shall be treated as a qualifying plan, except that in applying
				paragraph (1), the applicable percentage under subsection (n)(2)(B) shall be
				increased—</text>
													<item commented="no" display-inline="no-display-inline" id="HD8762833FF264D5B86541A999BB8701F"><enum>(aa)</enum><text display-inline="yes-display-inline">for 2012, by 1.5 percentage points;</text>
													</item><item commented="no" display-inline="no-display-inline" id="HFD34E475A1DE4FE1BBA34AD7D557EA75"><enum>(bb)</enum><text display-inline="yes-display-inline">for 2013, by 2.5 percentage points;
				and</text>
													</item><item commented="no" display-inline="no-display-inline" id="H33AFA967E23945C7AA6F8CE8CDD9A4A4"><enum>(cc)</enum><text display-inline="yes-display-inline">for 2014 or a subsequent year, by 3.5
				percentage points.</text>
													</item></subclause><subclause commented="no" display-inline="no-display-inline" id="H0FCF3728A02C423192C7629680084412"><enum>(II)</enum><header display-inline="yes-display-inline">New ma plan defined</header><text display-inline="yes-display-inline">The term <quote>new MA plan</quote> means,
				with respect to a year, a plan offered by an organization or sponsor that has
				not had a contract as a Medicare Advantage organization in the preceding 3-year
				period.</text>
												</subclause></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8458C1A923ED4D7488C7045B49D3C02D"><enum>(B)</enum><header display-inline="yes-display-inline">Qualifying county</header><text display-inline="yes-display-inline">The term <quote>qualifying county</quote>
				means, for a year, a county—</text>
											<clause commented="no" display-inline="no-display-inline" id="H6F41988862EF421AB54F5C7032C37B8E"><enum>(i)</enum><text display-inline="yes-display-inline">that has an MA capitation rate that, in
				2004, was based on the amount specified in subsection (c)(1)(B) for a
				Metropolitan Statistical Area with a population of more than 250,000;</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H0ACD2F77D0424CA9ADA4C7BCA8528BB7"><enum>(ii)</enum><text display-inline="yes-display-inline">for which, as of December 2009, of the
				Medicare Advantage eligible individuals residing in the county at least 25
				percent of such individuals were enrolled in Medicare Advantage plans;
				and</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H7DCB02B25EFF45B9B52EA318F8D288F1"><enum>(iii)</enum><text display-inline="yes-display-inline">that has per capita fee-for-service
				spending that is lower than the national monthly per capita cost for
				expenditures for individuals enrolled under the original medicare
				fee-for-service program for the year.</text>
											</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA3EDEDA953004865B849C2A3006AB563"><enum>(4)</enum><header display-inline="yes-display-inline">Quality determinations for application of
				increase</header>
										<subparagraph commented="no" display-inline="no-display-inline" id="H2EE406E532874C7ABA59E062ECC7ACDD"><enum>(A)</enum><header display-inline="yes-display-inline">Quality determination</header><text display-inline="yes-display-inline">The quality rating for a plan shall be
				determined according to a 5-star rating system (based on the data collected
				under section 1852(e)).</text>
										</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF378100A29AA4BD7863E95B711FDD331"><enum>(B)</enum><header display-inline="yes-display-inline">Plans that failed to report</header><text display-inline="yes-display-inline">An MA plan which does not report data that
				enables the Secretary to rate the plan for purposes of this paragraph shall be
				counted as having a rating of fewer than 3.5 stars.</text>
										</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H135A92C3BBA047A9AC37E55DC9682F33"><enum>(5)</enum><header display-inline="yes-display-inline">Exception for pace plans</header><text display-inline="yes-display-inline">This subsection shall not apply to payments
				to a PACE program under section 1894.</text>
									</paragraph></subsection><after-quoted-block>.
				</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H2FE436FCB13A48E59D646E4D1E030168"><enum>(4)</enum><header display-inline="yes-display-inline">Determination of Medicare part D low-income
			 benchmark premium</header><text display-inline="yes-display-inline">Section
			 1860D–14(b)(2)(B)(iii) of the Social Security Act (42 U.S.C.
			 1395w–114(b)(2)(B)(iii)) as amended by section 3302 of the Patient Protection
			 and Affordable Care Act, is amended by striking <quote>, determined without
			 regard to any reduction in such premium as a result of any beneficiary rebate
			 under section 1854(b)(1)(C) or bonus payment under section 1853(n)</quote> and
			 inserting the following: <quote>and determined before the application of the
			 monthly rebate computed under section 1854(b)(1)(C)(i) for that plan and year
			 involved and, in the case of a qualifying plan, before the application of the
			 increase under section 1853(o) for that plan and year involved</quote>.</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HA53840DB08CA4C48B4EF7C55EDF4FF27"><enum>(d)</enum><header display-inline="yes-display-inline">Beneficiary rebates</header><text display-inline="yes-display-inline">Section 1854(b)(1)(C) of such Act (42
			 U.S.C. 1395w–24(b)(1)(C)), as amended by section 3202(b) of the Patient
			 Protection and Affordable Care Act, is further amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HACCCAE51C7CB4397824C3D2A05E6C181"><enum>(1)</enum><text display-inline="yes-display-inline">in clause (i), by inserting <quote>(or the
			 applicable rebate percentage specified in clause (iii) in the case of plan
			 years beginning on or after January 1, 2012)</quote> after <quote>75
			 percent</quote>; and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HEDF3ECA6F485452D9CB30DB8081CF740"><enum>(2)</enum><text display-inline="yes-display-inline">by striking clause (iii), by redesignating
			 clauses (iv) and (v) as clauses (vii) and (viii), respectively, and by
			 inserting after clause (ii) the following new clauses:</text>
							<quoted-block display-inline="no-display-inline" id="HFF147743682B483484F73F48781ECE63" style="OLC">
								<clause commented="no" display-inline="no-display-inline" id="H6840397A6223411B89A4414108D16B1B"><enum>(iii)</enum><header display-inline="yes-display-inline">Applicable rebate percentage</header><text display-inline="yes-display-inline">The applicable rebate percentage specified
				in this clause for a plan for a year, based on the system under section
				1853(o)(4)(A), is the sum of—</text>
									<subclause commented="no" display-inline="no-display-inline" id="HB9C55B2C3A204EA9AEA217DA9F33BF68"><enum>(I)</enum><text display-inline="yes-display-inline">the product of the old phase-in proportion
				for the year under clause (iv) and 75 percent; and</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HE135FC418D5944809994872477E530DC"><enum>(II)</enum><text display-inline="yes-display-inline">the product of the new phase-in proportion
				for the year under clause (iv) and the final applicable rebate percentage under
				clause (v).</text>
									</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HAF5284260F6D406CA4EE4D033E53304E"><enum>(iv)</enum><header display-inline="yes-display-inline">Old and new phase-in
				proportions</header><text display-inline="yes-display-inline">For purposes of
				clause (iv)—</text>
									<subclause commented="no" display-inline="no-display-inline" id="H95865AE82F4B4293AF3F8C4C92B40FB4"><enum>(I)</enum><text display-inline="yes-display-inline">for 2012, the old phase-in proportion is
				<fraction>2⁄3</fraction> and the new phase-in proportion is
				<fraction>1⁄3</fraction>;</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HD2CBBBA443434E3DAEFB7905E0359878"><enum>(II)</enum><text display-inline="yes-display-inline">for 2013, the old phase-in proportion is
				<fraction>1⁄3</fraction> and the new phase-in proportion is
				<fraction>2⁄3</fraction>; and</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HB9E04F27FDFD43E2BDAAF7EE99067513"><enum>(III)</enum><text display-inline="yes-display-inline">for 2014 and any subsequent year, the old
				phase-in proportion is 0 and the new phase-in proportion is 1.</text>
									</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H0A17EA55FFFD4B6398C9D7E6CACF53A7"><enum>(v)</enum><header display-inline="yes-display-inline">Final applicable rebate
				percentage</header><text display-inline="yes-display-inline">Subject to clause
				(vi), the final applicable rebate percentage under this clause is—</text>
									<subclause commented="no" display-inline="no-display-inline" id="H2C1BC4432D56445D8D5A9F4B62281789"><enum>(I)</enum><text display-inline="yes-display-inline">in the case of a plan with a quality rating
				under such system of at least 4.5 stars, 70 percent;</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HC2A59E0818E14DBDBC65CC761A67E06D"><enum>(II)</enum><text display-inline="yes-display-inline">in the case of a plan with a quality rating
				under such system of at least 3.5 stars and less than 4.5 stars, 65 percent;
				and</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HC54CC57FF72F42FBAFF45CB54585350D"><enum>(III)</enum><text display-inline="yes-display-inline">in the case of a plan with a quality rating
				under such system of less than 3.5 stars, 50 percent.</text>
									</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HC1D336834FBF4E9B99D319D8D7E0B2FA"><enum>(vi)</enum><header display-inline="yes-display-inline">Treatment of low enrollment and new
				plans</header><text display-inline="yes-display-inline">For purposes of clause
				(v)—</text>
									<subclause commented="no" display-inline="no-display-inline" id="HFC642045DE9344A381DFAA9FD1097AF8"><enum>(I)</enum><text display-inline="yes-display-inline">for 2012, in the case of a plan described
				in subclause (I) of subsection (o)(3)(A)(ii), the plan shall be treated as
				having a rating of 4.5 stars; and</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="H376B9B9ADFAA4D799C9D6B11ED2AF999"><enum>(II)</enum><text display-inline="yes-display-inline">for 2012 or a subsequent year, in the case
				of a new MA plan (as defined under subclause (III) of subsection
				(o)(3)(A)(iii)) that is treated as a qualifying plan pursuant to subclause (I)
				of such subsection, the plan shall be treated as having a rating of 3.5
				stars.</text>
									</subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HAAF79311BB884F8DB09DB02215D67D93"><enum>(e)</enum><header display-inline="yes-display-inline">Coding intensity adjustment</header><text display-inline="yes-display-inline">Section 1853(a)(1)(C)(ii) of such Act (42
			 U.S.C. 1395w–23(a)(1)(C)(ii)) is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H182483EC6B3D4E93928D764A2A6F33F9"><enum>(1)</enum><text display-inline="yes-display-inline">in the heading, by striking
			 <quote><header-in-text level="clause" style="OLC">during phaseout of budget
			 neutrality factor</header-in-text></quote> and inserting <quote><header-in-text level="clause" style="OLC">of coding
			 adjustment</header-in-text></quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB31AEE6A11554A31B958B5FBA93D696C"><enum>(2)</enum><text display-inline="yes-display-inline">in the matter before subclause (I), by
			 striking <quote>through 2010</quote> and inserting <quote>and each subsequent
			 year</quote>; and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB57A590ABA3940ABA145131F98666A7E"><enum>(3)</enum><text display-inline="yes-display-inline">in subclause (II)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HEE7D0DE3B1544456AAD4CAB2D954B869"><enum>(A)</enum><text display-inline="yes-display-inline">in the first sentence, by inserting
			 <quote>annually</quote> before <quote>conduct an analysis</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HA0F3FA4C81CB4CA6985FF8EDEA736447"><enum>(B)</enum><text display-inline="yes-display-inline">in the second sentence—</text>
								<clause commented="no" display-inline="no-display-inline" id="HB9926B3E560D47169A8AD16CEBEF1358"><enum>(i)</enum><text display-inline="yes-display-inline">by inserting <quote>on a timely
			 basis</quote> after <quote>are incorporated</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H028335B068B24A38841F0FBB1BCC659B"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>only for 2008, 2009, and
			 2010</quote> and inserting <quote>for 2008 and subsequent years</quote>;</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HA5ABD35DAD6E466A9B6B5B999236832F"><enum>(C)</enum><text display-inline="yes-display-inline">in the third sentence, by inserting
			 <quote>and updated as appropriate</quote> before the period at the end;
			 and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HBCBB41B58A39471181D4AB3A80CEF114"><enum>(D)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subclauses:</text>
								<quoted-block display-inline="no-display-inline" id="H5F5156F56DCE49B3AC8E7950B39BC017" style="OLC">
									<subclause commented="no" display-inline="no-display-inline" id="H758FBA9CC56C41B9987D86EA80500E3E"><enum>(III)</enum><text display-inline="yes-display-inline">In calculating each year’s adjustment, the
				adjustment factor shall be for 2014, not less than the adjustment factor
				applied for 2010, plus 1.3 percentage points; for each of years 2015 through
				2018, not less than the adjustment factor applied for the previous year, plus
				0.25 percentage point; and for 2019 and each subsequent year, not less than 5.7
				percent.</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HCD7CA7F01CE74F99BD365A35A3B818BB"><enum>(IV)</enum><text display-inline="yes-display-inline">Such adjustment shall be applied to risk
				scores until the Secretary implements risk adjustment using Medicare Advantage
				diagnostic, cost, and use
				data.</text>
									</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H3B5D1E9A8DBD41ABBC69CAC385A04456"><enum>(f)</enum><header display-inline="yes-display-inline">Repeal of comparative cost adjustment
			 program</header><text display-inline="yes-display-inline">Section 1860C–1 of
			 the Social Security Act (42 U.S.C. 1395w–29), as added by section 241(a) of the
			 Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public
			 Law 108–173), is repealed.</text>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="HD859A75DF66C45FBAEFE49E0C2051E39" section-type="subsequent-section"><enum>1103.</enum><header display-inline="yes-display-inline">Savings from limits on MA plan
			 administrative costs</header><text display-inline="no-display-inline">Section
			 1857(e) of the Social Security Act (42 U.S.C. 1395w–27(e)) is amended by adding
			 at the end the following new paragraph:</text>
					<quoted-block display-inline="no-display-inline" id="H044DFC14CF00464A81282082303FBBA5" style="OLC">
						<paragraph commented="no" display-inline="no-display-inline" id="H18237F40465D46A7A241EBDB51408FB1"><enum>(4)</enum><header display-inline="yes-display-inline">Requirement for minimum medical loss
				ratio</header><text display-inline="yes-display-inline">If the Secretary
				determines for a contract year (beginning with 2014) that an MA plan has failed
				to have a medical loss ratio of at least .85—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HCE6AD1325CFC4ACEBAD2E1C092EEE69F"><enum>(A)</enum><text display-inline="yes-display-inline">the MA plan shall remit to the Secretary an
				amount equal to the product of—</text>
								<clause commented="no" display-inline="no-display-inline" id="H43EB26943825489B90C9DDB08E86361D"><enum>(i)</enum><text display-inline="yes-display-inline">the total revenue of the MA plan under this
				part for the contract year; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HEA207DAB3574460DBD144B6FC3CCDC1A"><enum>(ii)</enum><text display-inline="yes-display-inline">the difference between .85 and the medical
				loss ratio;</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HFBB488E94A9A4A6A837F33751A8482CC"><enum>(B)</enum><text display-inline="yes-display-inline">for 3 consecutive contract years, the
				Secretary shall not permit the enrollment of new enrollees under the plan for
				coverage during the second succeeding contract year; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H383F92394CC04D488D7671DDBD70C087"><enum>(C)</enum><text display-inline="yes-display-inline">the Secretary shall terminate the plan
				contract if the plan fails to have such a medical loss ratio for 5 consecutive
				contract
				years.</text>
							</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
				</section><section commented="no" display-inline="no-display-inline" id="H0E6A0E57EB8C408F9300E7A95C393C1A" section-type="subsequent-section"><enum>1104.</enum><header display-inline="yes-display-inline">Disproportionate share hospital (DSH)
			 payments</header><text display-inline="no-display-inline">Section 1886(r) of
			 the Social Security Act (42 U.S.C. 1395ww(r)), as added by section 3133 of the
			 Patient Protection and Affordable Care Act and as amended by section 10316 of
			 such Act, is amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="H782A73D7008746BD97B9A98BA109424B"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1), by striking
			 <quote>2015</quote> and inserting <quote>2014</quote>; and</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H4DBE0EE924474675A68C5FF4D6D14E90"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (2)—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="H991040ACD05E42BC9DEEBCC7E7B5C0D2"><enum>(A)</enum><text display-inline="yes-display-inline">in the matter preceding subparagraph (A),
			 by striking <quote>2015</quote> and inserting <quote>2014</quote>;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE09B6B33AC7F4EE381BB81C884C78FA5"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (B)(i)—</text>
							<clause commented="no" display-inline="no-display-inline" id="H8CE8C3DBA823463880A2603E07345379"><enum>(i)</enum><text display-inline="yes-display-inline">in the heading, by inserting
			 <quote><header-in-text level="clause" style="OLC">2014,</header-in-text></quote> after <quote><header-in-text level="clause" style="OLC">years</header-in-text></quote>;</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="H27EF67153B6F49CABAE2C0FB2582F539"><enum>(ii)</enum><text display-inline="yes-display-inline">in the matter preceding subclause (I), by
			 inserting <quote>2014,</quote> after <quote>each of fiscal
			 years</quote>;</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="H8BAFB586314B442FB6C6988201EE6757"><enum>(iii)</enum><text display-inline="yes-display-inline">in subclause (I), by striking <quote>on
			 such Act</quote> and inserting <quote>on the <short-title>Health Care and Education Reconciliation Act of
			 2010</short-title></quote>; and</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="H1A05A6EF6F6C4A2E84D8BA42F56AE409"><enum>(iv)</enum><text display-inline="yes-display-inline">in the matter following subclause (II), by
			 striking <quote>minus 1.5 percentage points</quote> and inserting <quote>minus
			 0.1 percentage points for fiscal year 2014 and minus 0.2 percentage points for
			 each of fiscal years 2015, 2016, and 2017</quote>; and</text>
							</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H26280B51DFB54DA8A7B3F94D42E7D595"><enum>(C)</enum><text display-inline="yes-display-inline">in subparagraph (B)(ii), in the matter
			 following subclause (II), by striking <quote>and, for each of 2018 and 2019,
			 minus 1.5 percentage points</quote> and inserting <quote>minus 0.2 percentage
			 points for each of fiscal years 2018 and 2019</quote>.</text>
						</subparagraph></paragraph></section><section commented="no" display-inline="no-display-inline" id="HAE951CE953114D5EAADD23F096E3BDF3" section-type="subsequent-section"><enum>1105.</enum><header display-inline="yes-display-inline">Market basket updates</header>
					<subsection commented="no" display-inline="no-display-inline" id="H8C40592B9B0C481B9B929B28A0F26431"><enum>(a)</enum><header display-inline="yes-display-inline">IPPS</header><text display-inline="yes-display-inline">Section 1886(b)(3)(B) of the Social
			 Security Act (42 U.S.C. 1395ww(b)(3)(B)), as amended by sections 3401(a)(4) and
			 10319(a) of the Patient Protection and Affordable Care Act, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H1D170F41101D4450A7642B60ED77ABBC"><enum>(1)</enum><text display-inline="yes-display-inline">in clause (xii)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H8DE4DE1FEC9846F494F4BB7676638527"><enum>(A)</enum><text display-inline="yes-display-inline">by placing the subclause (II) (inserted by
			 section 10319(a)(3) of the Patient Protection and Affordable Care Act)
			 immediately after subclause (I) and, in such subclause (II), by striking
			 <quote>and</quote> at the end; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H4AB362E99B6A4F969AAF7ACAD200735B"><enum>(B)</enum><text display-inline="yes-display-inline">by striking subclause (III) and inserting
			 the following:</text>
								<quoted-block display-inline="no-display-inline" id="H9F1FB6893D974B9EA042BB5548E99975" style="OLC">
									<subclause commented="no" display-inline="no-display-inline" id="HA2D653D3D9E04310BD9EE6743B42DF9E" indent="up3"><enum>(III)</enum><text display-inline="yes-display-inline">for fiscal year 2014, by 0.3 percentage
				point;</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="H6210A3293B4B460DBA44402B16E1C1D1" indent="up3"><enum>(IV)</enum><text display-inline="yes-display-inline">for each of fiscal years 2015 and 2016, by
				0.2 percentage point; and</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HF60868EA2A464B639E5BDB137C93A7D9" indent="up3"><enum>(V)</enum><text display-inline="yes-display-inline">for each of fiscal years 2017, 2018, and
				2019, by 0.75 percentage point.</text>
									</subclause><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA37B8301C7434B44B6EAE172184ABAAB"><enum>(2)</enum><text display-inline="yes-display-inline">by striking clause (xiii).</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HC7841691874E4808BAF86B1541A12F94"><enum>(b)</enum><header display-inline="yes-display-inline">Long-term care hospitals</header><text display-inline="yes-display-inline">Section 1886(m)(4) of the Social Security
			 Act (42 U.S.C. 1395ww(m)(4)), as added by section 3401(c) of the Patient
			 Protection and Affordable Care Act and amended by section 10319(b) of such Act,
			 is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H7783D2A83C754560A590ACA10093935B"><enum>(1)</enum><text display-inline="yes-display-inline">in subparagraph (A)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HCFE75CC7688049E7BE9EED2B38D77BAF"><enum>(A)</enum><text display-inline="yes-display-inline">in clause (iii), by striking
			 <quote>and</quote> at the end; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H4DFFA4D22BFC402EA43DF5AB64CC36E4"><enum>(B)</enum><text display-inline="yes-display-inline">by striking clause (iv) and inserting the
			 following:</text>
								<quoted-block display-inline="no-display-inline" id="H25EC6B64C6574507A9E3DA4DC5804628" style="OLC">
									<clause commented="no" display-inline="no-display-inline" id="H9CA42B5DCD734C77A4894A70FAF8D4C4"><enum>(iv)</enum><text display-inline="yes-display-inline">for rate year 2014, 0.3 percentage
				point;</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="HD61291B07E2A45D19B638700AAF7A351"><enum>(v)</enum><text display-inline="yes-display-inline">for each of rate years 2015 and 2016, 0.2
				percentage point; and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="HD5F23CEA9BCD46F995BE7E3FD3921D14"><enum>(vi)</enum><text display-inline="yes-display-inline">for each of rate years 2017, 2018, and
				2019, 0.75 percentage point.</text>
									</clause><after-quoted-block>;
				</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDA7014BE70004D9FBE0BA6CD532379DE"><enum>(2)</enum><text display-inline="yes-display-inline">by striking subparagraph (B); and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA263457F5211459B97A4D42F80442099"><enum>(3)</enum><text display-inline="yes-display-inline">by striking <quote>(4)
			 <header-in-text level="paragraph" style="OLC">Other
			 adjustment.—</header-in-text></quote> and all that follows through <quote>For
			 purposes</quote> and inserting <quote>(4)
			 <header-in-text level="paragraph" style="OLC">Other
			 adjustment</header-in-text>.—For purposes</quote> (and redesignating clauses
			 (i) through (vi) as subparagraphs (A) through (F), respectively, with
			 appropriate indentation).</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H131712F966B94892BE798A967ADBE23C"><enum>(c)</enum><header display-inline="yes-display-inline">Inpatient rehabilitation
			 facilities</header><text display-inline="yes-display-inline">Section
			 1886(j)(3)(D) of the Social Security Act (42 U.S.C. 1395ww(j)(3)(D)), as added
			 by section 3401(d)(2) of the Patient Protection and Affordable Care Act and
			 amended by section 10319(c) of such Act, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H3600703F758A4920B5D2F9F23710F3DB"><enum>(1)</enum><text display-inline="yes-display-inline">in clause (i)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H666FAED7A415496E958768EAD2FE4DEF"><enum>(A)</enum><text display-inline="yes-display-inline">by placing the subclause (II) (inserted by
			 section 10319(c)(3) of the Patient Protection and Affordable Care Act)
			 immediately after subclause (I) and, in such subclause (II), by striking
			 <quote>and</quote> at the end; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HB74E27B39A7840D7A3CEA1FD798DBE00"><enum>(B)</enum><text display-inline="yes-display-inline">by striking subclause (III) and inserting
			 the following:</text>
								<quoted-block display-inline="no-display-inline" id="H4B554C3759FA480598A53021FB71A4E5" style="OLC">
									<subclause commented="no" display-inline="no-display-inline" id="H2FB713792DF34880AFEA4FD89F8076A5"><enum>(III)</enum><text display-inline="yes-display-inline">for fiscal year 2014, 0.3 percentage
				point;</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HDBF9C4F55B924C4F9315EB4AB8B6C7C6"><enum>(IV)</enum><text display-inline="yes-display-inline">for each of fiscal years 2015 and 2016, 0.2
				percentage point; and</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="H76ABA60536154F1DB964065233251279"><enum>(V)</enum><text display-inline="yes-display-inline">for each of fiscal years 2017, 2018, and
				2019, 0.75 percentage point.</text>
									</subclause><after-quoted-block>;
				</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3AB071B160D6448CB88AE40089BEA71A"><enum>(2)</enum><text display-inline="yes-display-inline">by striking clause (ii); and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H8BF506BC5CE34465993E5452D35556EE"><enum>(3)</enum><text display-inline="yes-display-inline">by striking <quote>(D)
			 <header-in-text level="paragraph" style="OLC">Other
			 adjustment.—</header-in-text></quote> and all that follows through <quote>For
			 purposes</quote> and inserting <quote>(D)
			 <header-in-text level="paragraph" style="OLC">Other
			 adjustment</header-in-text>.—For purposes</quote> (and redesignating subclauses
			 (I) through (V) as clauses (i) through (v), respectively, with appropriate
			 indentation).</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H6FC0FE3E260943B79A915E27218D9C50"><enum>(d)</enum><header display-inline="yes-display-inline">Psychiatric hospitals</header><text display-inline="yes-display-inline">Section 1886(s)(3) of the Social Security
			 Act, as added by section 3401(f) of the Patient Protection and Affordable Care
			 Act and amended by section 10319(e) of such Act, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HD0A65D56B9024A4D99F74120DED742DF"><enum>(1)</enum><text display-inline="yes-display-inline">in subparagraph (A)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H3A090BF010AD435BB2A81A79044E57DE"><enum>(A)</enum><text display-inline="yes-display-inline">by placing the clause (ii) (inserted by
			 section 10319(e)(3) of the Patient Protection and Affordable Care Act)
			 immediately after clause (i) and, in such clause (ii), by striking
			 <quote>and</quote> at the end; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3F55CD91F1294EF8A1D6CD078900C028"><enum>(B)</enum><text display-inline="yes-display-inline">by striking clause (iii) and inserting the
			 following:</text>
								<quoted-block display-inline="no-display-inline" id="H3FF63B0C2D5940D58506F0BBBF291440" style="OLC">
									<clause commented="no" display-inline="no-display-inline" id="H26FE1DD7AEA44F39B2B40D6B03637145"><enum>(iii)</enum><text display-inline="yes-display-inline">for the rate year beginning in 2014, 0.3
				percentage point;</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="H44967EDEE62C4E8B978EC54F6B44DC32"><enum>(iv)</enum><text display-inline="yes-display-inline">for each of the rate years beginning in
				2015 and 2016, 0.2 percentage point; and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="H5566520B52C74C32825957A74D2BECA0"><enum>(v)</enum><text display-inline="yes-display-inline">for each of the rate years beginning in
				2017, 2018, and 2019, 0.75 percentage
				point.</text>
									</clause><after-quoted-block>;
				</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H56D5406862874219AF7EB69F19EB00BF"><enum>(2)</enum><text display-inline="yes-display-inline">by striking subparagraph (B); and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H835FE520091F4753952433361AE9EC3D"><enum>(3)</enum><text display-inline="yes-display-inline">by striking <quote>(3)
			 <header-in-text level="paragraph" style="OLC">Other
			 adjustment.—</header-in-text></quote> and all that follows through <quote>For
			 purposes</quote> and inserting <quote>(3)
			 <header-in-text level="paragraph" style="OLC">Other
			 adjustment</header-in-text>.—For purposes</quote> (and redesignating clauses
			 (i) through (v) as subparagraphs (A) through (E), respectively, with
			 appropriate indentation).</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HE1BA33C3A2A540EAA67941BB4A72BCBF"><enum>(e)</enum><header display-inline="yes-display-inline">Outpatient hospitals</header><text display-inline="yes-display-inline">Section 1833(t)(3)(G) of the Social
			 Security Act (42 U.S.C. 1395l(t)(3)(G)), as added by section 3401(i)(2) of the
			 Patient Protection and Affordable Care Act and amended by section 10319(g) of
			 such Act, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H5DBE46271520455D8620AD3D1EF41749"><enum>(1)</enum><text display-inline="yes-display-inline">in clause (i)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H58E9A7F222954B9DA016372A3D99A99A"><enum>(A)</enum><text display-inline="yes-display-inline">by placing the subclause (II) (inserted by
			 section 10319(g)(3) of the Patient Protection and Affordable Care Act)
			 immediately after subclause (I) and, in such subclause (II), by striking
			 <quote>and</quote> at the end; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H57D05CA9F30B484898BECD32A838C711"><enum>(B)</enum><text display-inline="yes-display-inline">by striking subclause (III) and inserting
			 the following:</text>
								<quoted-block display-inline="no-display-inline" id="H545525CAF3FB46F3901F8B3C3EFEAA1F" style="OLC">
									<subclause commented="no" display-inline="no-display-inline" id="H4DF978C6857B4DB4BD7C52D67AAFA2E8"><enum>(III)</enum><text display-inline="yes-display-inline">for 2014, 0.3 percentage point;</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="HDAF0664C66A84395A005C38B6402307D"><enum>(IV)</enum><text display-inline="yes-display-inline">for each of 2015 and 2016, 0.2 percentage
				point; and</text>
									</subclause><subclause commented="no" display-inline="no-display-inline" id="H5FB6F0AFE5BC482F98EC766A0E4D75B1"><enum>(V)</enum><text display-inline="yes-display-inline">for each of 2017, 2018, and 2019, 0.75
				percentage point.</text>
									</subclause><after-quoted-block>;
				</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB832EB44A6DE4077890BAD3F8E002EB4"><enum>(2)</enum><text display-inline="yes-display-inline">by striking clause (ii); and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H997BF59D11F74CBD92D28FEBA357EBAE"><enum>(3)</enum><text display-inline="yes-display-inline">by striking <quote>(G)
			 <header-in-text level="paragraph" style="OLC">Other
			 adjustment.—</header-in-text></quote> and all that follows through <quote>For
			 purposes</quote> and inserting <quote>(G)
			 <header-in-text level="subparagraph" style="OLC">Other
			 adjustment</header-in-text>.—For purposes</quote> (and redesignating subclauses
			 (I) through (V) as clauses (i) through (v), respectively, with appropriate
			 indentation).</text>
						</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H266AA572EC7F46C1B72E5FED53D1A1BE" section-type="subsequent-section"><enum>1106.</enum><header display-inline="yes-display-inline">Physician ownership-referral</header><text display-inline="no-display-inline">Section 1877(i) of the Social Security Act
			 (42 U.S.C. 1395nn(i)), as added by section 6001(a)(3) of the Patient Protection
			 and Affordable Care Act and as amended by section 10601(a) of such Act, is
			 amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="HDFB9193C0CAD4CD1B6D20A5529D9F0C2"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1)(A)(i), by striking
			 <quote>August 1, 2010</quote> and inserting <quote>December 31, 2010</quote>;
			 and</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H22383B9A1FA245708E809FF8621BE5C9"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (3)—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="H2DC899D7CBB54DFCB51F33FCBF73A707"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (A)(i), by striking
			 <quote>an applicable hospital (as defined in subparagraph (E))</quote> and
			 inserting <quote>a hospital that is an applicable hospital (as defined in
			 subparagraph (E)) or is a high Medicaid facility described in subparagraph
			 (F)</quote>;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H9DC9FCE4E8204BCFB98FEF6255B0A435"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (C)(iii), by inserting
			 after <quote>date of enactment of this subsection</quote> the following:
			 <quote>(or, in the case of a hospital that did not have a provider agreement in
			 effect as of such date but does have such an agreement in effect on December
			 31, 2010, the effective date of such provider agreement)</quote>;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H831915BF24874FE3BB46DB1E3F90031E"><enum>(C)</enum><text display-inline="yes-display-inline">by redesignating subparagraphs (F) through
			 (H) as subparagraphs (G) through (I), respectively; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5A9830591B434C498E1507A9BD2D3A72"><enum>(D)</enum><text display-inline="yes-display-inline">by inserting after subparagraph (E) the
			 following new subparagraph:</text>
							<quoted-block display-inline="no-display-inline" id="H98C4EC86D176437BA2461BAAFDF462C6" style="OLC">
								<subparagraph commented="no" display-inline="no-display-inline" id="H1CED365A751C45FD94114F938B58E745"><enum>(F)</enum><header display-inline="yes-display-inline">High Medicaid facility
				described</header><text display-inline="yes-display-inline">A high Medicaid
				facility described in this subparagraph is a hospital that—</text>
									<clause commented="no" display-inline="no-display-inline" id="H4D6ACE5FC2C646E39B2C8A12EC088425"><enum>(i)</enum><text display-inline="yes-display-inline">is not the sole hospital in a
				county;</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="HDDA2C0FB9AF849588174A64E7636E88E"><enum>(ii)</enum><text display-inline="yes-display-inline">with respect to each of the 3 most recent
				years for which data are available, has an annual percent of total inpatient
				admissions that represent inpatient admissions under title XIX that is
				estimated to be greater than such percent with respect to such admissions for
				any other hospital located in the county in which the hospital is located;
				and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="H8B28BCAF1B2042F5BF94A2E29DC5A0FA"><enum>(iii)</enum><text display-inline="yes-display-inline">meets the conditions described in
				subparagraph
				(E)(iii).</text>
									</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</subparagraph></paragraph></section><section commented="no" display-inline="no-display-inline" id="H21FB198F9681470F9CA0743546ACE849" section-type="subsequent-section"><enum>1107.</enum><header display-inline="yes-display-inline">Payment for imaging services</header><text display-inline="no-display-inline">Section 1848 of the Social Security Act (42
			 U.S.C. 1395w–4), as amended by section 3135(a) of the Patient Protection and
			 Affordable Care Act, is amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="H28100AD8D72C4BB3844FF5D892686D20"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (b)(4)—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HC669F22A94314B0BA681668C4A88284D"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking “this
			 paragraph” and inserting “subparagraph (A)”; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8B13603481B14F219F5CE51E2EEB19DA"><enum>(B)</enum><text display-inline="yes-display-inline">by amending subparagraph (C) to read as
			 follows:</text>
							<quoted-block display-inline="no-display-inline" id="H78BD2DC3F0C44668B188EFA7E388170A" style="OLC">
								<subparagraph commented="no" display-inline="no-display-inline" id="H979FA8C2B3F54AE397EAFD1EC1BABF9A"><enum>(C)</enum><header display-inline="yes-display-inline">Adjustment in imaging utilization
				rate</header><text display-inline="yes-display-inline">With respect to fee
				schedules established for 2011 and subsequent years, in the methodology for
				determining practice expense relative value units for expensive diagnostic
				imaging equipment under the final rule published by the Secretary in the
				Federal Register on November 25, 2009 (42 CFR 410 et al.), the Secretary shall
				use a 75 percent assumption instead of the utilization rates otherwise
				established in such final rule.</text>
								</subparagraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA698D3CC0BC84E279825A031811A4F43"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (c)(2)(B)(v), by striking
			 subclauses (III), (IV), and (V) and inserting the following new
			 subclause:</text>
						<quoted-block display-inline="no-display-inline" id="H5D4214597A84496BABF33AA19F8A76EF" style="OLC">
							<subclause commented="no" display-inline="no-display-inline" id="H700CE0B116804D3A9377C51FB4430BBF"><enum>(III)</enum><header display-inline="yes-display-inline">Change in utilization rate for certain
				imaging services</header><text display-inline="yes-display-inline">Effective
				for fee schedules established beginning with 2011, reduced expenditures
				attributable to the change in the utilization rate applicable to 2011, as
				described in subsection
				(b)(4)(C).</text>
							</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></section><section commented="no" display-inline="no-display-inline" id="H07605BE1D8254E1A871CFD8C06B8CD09" section-type="subsequent-section"><enum>1108.</enum><header display-inline="yes-display-inline">PE GPCI adjustment for 2010</header><text display-inline="no-display-inline">Effective as if included in the enactment of
			 the Patient Protection and Affordable Care Act, section 1848(e)(1)(H)(i) of the
			 Social Security Act (42 U.S.C. 1395w–4(e)(1)(H)(i)), as added by section
			 3102(b)(2) of the Patient Protection and Affordable Care Act, is amended by
			 striking <quote><fraction>3/4</fraction></quote> and inserting
			 <quote><fraction>½</fraction></quote>.</text>
				</section><section commented="no" display-inline="no-display-inline" id="H9D5FDAA1A8B648D38BB3133375A9115F" section-type="subsequent-section"><enum>1109.</enum><header display-inline="yes-display-inline">Payment for qualifying hospitals</header>
					<subsection commented="no" display-inline="no-display-inline" id="HD34F34EFF97145C790246093B1DC92CE"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">From the amount available under subsection
			 (b), the Secretary of Health and Human Services shall provide for a payment to
			 qualifying hospitals (as defined in subsection (d)) for fiscal years 2011 and
			 2012 of the amount determined under subsection (c).</text>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H609323AD883B4A0987C7F412DF8D02E2"><enum>(b)</enum><header display-inline="yes-display-inline">Amounts available</header><text display-inline="yes-display-inline">There shall be available from the Federal
			 Hospital Insurance Trust Fund $400,000,000 for payments under this section for
			 fiscal years 2011 and 2012.</text>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="HD1CB13611BB44FC8975A882FCC5E0EF6"><enum>(c)</enum><header display-inline="yes-display-inline">Payment
			 amount</header><text display-inline="yes-display-inline">The amount of payment
			 under this section for a qualifying hospital shall be determined, in a manner
			 consistent with the amount available under subsection (b), in proportion to the
			 portion of the amount of the aggregate payments under section 1886(d) of the
			 Social Security Act to the hospital for fiscal year 2009 bears to the sum of
			 all such payments to all qualifying hospitals for such fiscal year.</text>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H9F306FDF4F9E4F398386B51D6E8A3F91"><enum>(d)</enum><header display-inline="yes-display-inline">Qualifying hospital defined</header><text display-inline="yes-display-inline">In this section, the term <quote>qualifying
			 hospital</quote> means a subsection (d) hospital (as defined for purposes of
			 section 1886(d) of the Social Security Act) that is located in a county that
			 ranks, based upon its ranking in age, sex, and race adjusted spending for
			 benefits under parts A and B under title XVIII of such Act per enrollee, within
			 the lowest quartile of such counties in the United States.</text>
					</subsection></section></subtitle><subtitle commented="no" id="H861CFCE88B1F4CB5B8C8CA1EABE66B36" level-type="subsequent"><enum>C</enum><header display-inline="yes-display-inline">Medicaid</header>
				<section commented="no" display-inline="no-display-inline" id="H72E8FB605D70401F904A6B00645F5241" section-type="subsequent-section"><enum>1201.</enum><header display-inline="yes-display-inline">Federal funding for States</header><text display-inline="no-display-inline">Section 1905 of the Social Security Act (42
			 U.S.C. 1396d), as amended by sections 2001(a)(3) and 10201(c) of the Patient
			 Protection and Affordable Care Act, is amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="HF83D584EE5E543C5AA05F034665DC05F"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (y)—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HA240E2BF72EB4C768DCB1AD0D91BC8DD"><enum>(A)</enum><text display-inline="yes-display-inline">by redesignating subclause (II) of
			 paragraph (1)(B)(ii) as paragraph (5) of subsection (z) and realigning the left
			 margins accordingly; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HA5F3A9BC0CE34C52A8854AF5E56731C5"><enum>(B)</enum><text display-inline="yes-display-inline">by striking paragraph (1) and inserting the
			 following:</text>
							<quoted-block display-inline="no-display-inline" id="H63F7DD89EA55429FB9E4775B1D8C2C30" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="HFEB8E3949D724CBCA0319A69B732E93A"><enum>(1)</enum><header display-inline="yes-display-inline">Amount of increase</header><text display-inline="yes-display-inline">Notwithstanding subsection (b), the Federal
				medical assistance percentage for a State that is one of the 50 States or the
				District of Columbia, with respect to amounts expended by such State for
				medical assistance for newly eligible individuals described in subclause (VIII)
				of section 1902(a)(10)(A)(i), shall be equal to—</text>
									<subparagraph commented="no" display-inline="no-display-inline" id="H149D23E4135C4F1BB594C16A96F1819D"><enum>(A)</enum><text display-inline="yes-display-inline">100 percent for calendar quarters in 2014,
				2015, and 2016;</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H94B6C4D2EA0B4B43A598B7CCE83E0BFE"><enum>(B)</enum><text display-inline="yes-display-inline">95 percent for calendar quarters in
				2017;</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE024C258746849FAAF2E9E8F7EE97D3E"><enum>(C)</enum><text display-inline="yes-display-inline">94 percent for calendar quarters in
				2018;</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H2F28813EE705441594376106B71609A0"><enum>(D)</enum><text display-inline="yes-display-inline">93 percent for calendar quarters in 2019;
				and</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HAB6ACF2BA9F547B7973927B2A27D7962"><enum>(E)</enum><text display-inline="yes-display-inline">90 percent for calendar quarters in 2020
				and each year thereafter.</text>
									</subparagraph></paragraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE13DDC15E3FA44A497195EB34FE48F26"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (z)—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HEA7DE522FB274A69B96CE5AC6AF66482"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (1), by striking
			 <quote>September 30, 2019</quote> and inserting <quote>December 31,
			 2015</quote> and by striking <quote>subsection (y)(1)(B)(ii)(II)</quote> and
			 inserting <quote>paragraph (3)</quote>;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H4681502834794F64BC6CF0ED80CDCB4F"><enum>(B)</enum><text display-inline="yes-display-inline">by striking paragraphs (2) through (4) and
			 inserting the following:</text>
							<quoted-block display-inline="no-display-inline" id="HE0D082738BBF4080BCC119485EEEE483" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="H864F7C5C71D84A76AF4032A44A60B7BF"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H9021CEF664C342BAAE7AE1415BE7715E"><enum>(A)</enum><text display-inline="yes-display-inline">For calendar quarters in 2014 and each year
				thereafter, the Federal medical assistance percentage otherwise determined
				under subsection (b) for an expansion State described in paragraph (3) with
				respect to medical assistance for individuals described in section
				1902(a)(10)(A)(i)(VIII) who are nonpregnant childless adults with respect to
				whom the State may require enrollment in benchmark coverage under section 1937
				shall be equal to the percent specified in subparagraph (B)(i) for such
				year.</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H4732A984B4E44962BA5F655BF6B65F51" indent="up1"><enum>(B)</enum><clause commented="no" display-inline="yes-display-inline" id="H8468B3171012488FBB10ACAFEC1F234B"><enum>(i)</enum><text display-inline="yes-display-inline">The percent specified in this subparagraph
				for a State for a year is equal to the Federal medical assistance percentage
				(as defined in the first sentence of subsection (b)) for the State increased by
				a number of percentage points equal to the transition percentage (specified in
				clause (ii) for the year) of the number of percentage points by which—</text>
											<subclause commented="no" display-inline="no-display-inline" id="H41F9E283813B45C08127EA67267AD8B5" indent="up1"><enum>(I)</enum><text display-inline="yes-display-inline">such Federal medical assistance percentage
				for the State, is less than</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="HC62F43FE072849B3B42A6964422CD61E" indent="up1"><enum>(II)</enum><text display-inline="yes-display-inline">the percent specified in subsection (y)(1)
				for the year.</text>
											</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HBA025380D7F14D8B83ECA805BB56A178" indent="up1"><enum>(ii)</enum><text display-inline="yes-display-inline">The transition percentage specified in this
				clause for—</text>
											<subclause commented="no" display-inline="no-display-inline" id="HBB99348B1892434EBA353E36DC94BF6F"><enum>(I)</enum><text display-inline="yes-display-inline">2014 is 50 percent;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H26485A4384CA48E0A60D3CB940BA0919"><enum>(II)</enum><text display-inline="yes-display-inline">2015 is 60 percent;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H3FA7D30FAD7045E58678EF0AB2149A55"><enum>(III)</enum><text display-inline="yes-display-inline">2016 is 70 percent;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H038004DD73054064A221D0064E3D833D"><enum>(IV)</enum><text display-inline="yes-display-inline">2017 is 80 percent;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H1B83EF4D9DDC4D239C707ED4BD912066"><enum>(V)</enum><text display-inline="yes-display-inline">2018 is 90 percent; and</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H49101D4D89DC41FE909436A249F93154"><enum>(VI)</enum><text display-inline="yes-display-inline">2019 and each subsequent year is 100
				percent.</text>
											</subclause></clause></subparagraph></paragraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H9E46BE69D5F2488DB8C7B8750762D67F"><enum>(C)</enum><text display-inline="yes-display-inline">by redesignating paragraph (5) (as added by
			 paragraph (1)(A) of this section) as paragraph (3), realigning the left margins
			 to align with paragraph (2), and striking the heading and all that follows
			 through <quote>a State is</quote> and inserting <quote>A State
			 is</quote>.</text>
						</subparagraph></paragraph></section><section commented="no" display-inline="no-display-inline" id="HCB3D713BA019412DA350F5FAB3924B12" section-type="subsequent-section"><enum>1202.</enum><header display-inline="yes-display-inline">Payments to primary care
			 physicians</header>
					<subsection commented="no" display-inline="no-display-inline" id="HE132662A5C3F49D7AA426F3C3E42CC43"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header>
						<paragraph commented="no" display-inline="no-display-inline" id="HDEDDA385FE324629B08E83658E88F46C"><enum>(1)</enum><header display-inline="yes-display-inline">Fee-for-service payments</header><text display-inline="yes-display-inline">Section 1902 of the Social Security Act (42
			 U.S.C. 1396a), as amended by section 2303(a)(2) of the Patient Protection and
			 Affordable Care Act, is amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H795F43EECC4F40278CAAAA9DF8681737"><enum>(A)</enum><text display-inline="yes-display-inline">in subsection (a)(13)—</text>
								<clause commented="no" display-inline="no-display-inline" id="HD751BE04DD23431B883CD88EFA28A466"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>and</quote> at the end
			 of subparagraph (A);</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H62480E0935CF42EE8BD2EB1FDB292B5A"><enum>(ii)</enum><text display-inline="yes-display-inline">by adding <quote>and</quote> at the end of
			 subparagraph (B); and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H4193927268EC488696BB88095D3D7D52"><enum>(iii)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subparagraph:</text>
									<quoted-block display-inline="no-display-inline" id="H35E93531A1504BBDAD7D99571E846DB7" style="OLC">
										<subparagraph commented="no" display-inline="no-display-inline" id="H02415373E90F46D296B038A56F5F6A82"><enum>(C)</enum><text display-inline="yes-display-inline">payment for primary care services (as
				defined in subsection (jj)) furnished in 2013 and 2014 by a physician with a
				primary specialty designation of family medicine, general internal medicine, or
				pediatric medicine at a rate not less than 100 percent of the payment rate that
				applies to such services and physician under part B of title XVIII (or, if
				greater, the payment rate that would be applicable under such part if the
				conversion factor under section 1848(d) for the year involved were the
				conversion factor under such section for
				2009);</text>
										</subparagraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H9FD8E2DB22D14682B4F427A5F32958CA"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subsection:</text>
								<quoted-block display-inline="no-display-inline" id="H7605610164754E13BF8EA13573D9A89C" style="OLC">
									<subsection commented="no" display-inline="no-display-inline" id="HB91346893E3747BA9060A709C3620595"><enum>(jj)</enum><header display-inline="yes-display-inline">Primary care services defined</header><text display-inline="yes-display-inline">For purposes of subsection (a)(13)(C), the
				term <quote>primary care services</quote> means—</text>
										<paragraph commented="no" display-inline="no-display-inline" id="H84A4DC88A6F24566BEDBC7D0B33D1220"><enum>(1)</enum><text display-inline="yes-display-inline">evaluation and management services that are
				procedure codes (for services covered under title XVIII) for services in the
				category designated Evaluation and Management in the Healthcare Common
				Procedure Coding System (established by the Secretary under section 1848(c)(5)
				as of December 31, 2009, and as subsequently modified); and</text>
										</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H30F95CE47A004BFDB9D56C02071FE8E0"><enum>(2)</enum><text display-inline="yes-display-inline">services related to immunization
				administration for vaccines and toxoids for which CPT codes 90465, 90466,
				90467, 90468, 90471, 90472, 90473, or 90474 (as subsequently modified) apply
				under such
				System.</text>
										</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H6ABB757FE0124B0CAC631EB3BD6F2578"><enum>(2)</enum><header display-inline="yes-display-inline">Under Medicaid managed care
			 plans</header><text display-inline="yes-display-inline">Section 1932(f) of such
			 Act (42 U.S.C. 1396u–2(f)) is amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HF5DA48EAC0674D81A75DEBE6713D5C15"><enum>(A)</enum><text display-inline="yes-display-inline">in the heading, by adding at the end the
			 following: <quote><header-in-text level="subsection" style="OLC">; adequacy of
			 payment for primary care services</header-in-text></quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF4E927BDC6E248EDAE8D2C96AD1A42CE"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting before the period at the end
			 the following: “and, in the case of primary care services described in section
			 1902(a)(13)(C), consistent with the minimum payment rates specified in such
			 section (regardless of the manner in which such payments are made, including in
			 the form of capitation or partial capitation)”.</text>
							</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HD91F4AA8E8684B68A15A6C9C39677235"><enum>(b)</enum><header display-inline="yes-display-inline">Increase in payment using increased
			 FMAP</header><text display-inline="yes-display-inline">Section 1905 of the
			 Social Security Act, as amended by section 1004(b) of this Act and section
			 10201(c)(6) of the Patient Protection and Affordable Care Act, is amended by
			 adding at the end the following new subsection:</text>
						<quoted-block display-inline="no-display-inline" id="H15A291E251C340E2A4934E26B228EEAC" style="OLC">
							<subsection commented="no" display-inline="no-display-inline" id="HF8F0E0DA99E54D0C9D3223CD42E5D900"><enum>(dd)</enum><header display-inline="yes-display-inline">Increased FMAP for additional expenditures
				for primary care services</header><text display-inline="yes-display-inline">Notwithstanding subsection (b), with
				respect to the portion of the amounts expended for medical assistance for
				services described in section 1902(a)(13)(C) furnished on or after January 1,
				2013, and before January 1, 2015, that is attributable to the amount by which
				the minimum payment rate required under such section (or, by application,
				section 1932(f)) exceeds the payment rate applicable to such services under the
				State plan as of July 1, 2009, the Federal medical assistance percentage for a
				State that is one of the 50 States or the District of Columbia shall be equal
				to 100 percent. The preceding sentence does not prohibit the payment of Federal
				financial participation based on the Federal medical assistance percentage for
				amounts in excess of those specified in such
				sentence.</text>
							</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="H9E913604AC3B47E588FF98C47B1E6D5A" section-type="subsequent-section"><enum>1203.</enum><header display-inline="yes-display-inline">Disproportionate share hospital
			 payments</header>
					<subsection commented="no" display-inline="no-display-inline" id="H30169CAB1F604141A745966734D3390A"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1923(f) of the Social Security Act
			 (42 U.S.C. 1396r–4(f)), as amended by sections 2551(a)(4) and 10201(e)(1) of
			 the Patient Protection and Affordable Care Act, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H8CF139E8E75F4B97AE538E9FD36794BD"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (6)(B)(iii), in the matter
			 preceding subclause (I), by striking <quote>or paragraph (7)</quote>;
			 and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HCBFAC36062B44274AEF7E2A79982BF5B"><enum>(2)</enum><text display-inline="yes-display-inline">by striking paragraph (7) and inserting the
			 following:</text>
							<quoted-block display-inline="no-display-inline" id="H9A851D0491C047F390564C20C3D22884" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="HEF4D948384AF478EA56881D7FD845634"><enum>(7)</enum><header display-inline="yes-display-inline">Medicaid DSH reductions</header>
									<subparagraph commented="no" display-inline="no-display-inline" id="H3E66CCEA1BB54FA8BE454F5C9AF70851"><enum>(A)</enum><header display-inline="yes-display-inline">Reductions</header>
										<clause commented="no" display-inline="no-display-inline" id="H8CB40253BA1146C79B1741334E7505FE"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">For each of fiscal years 2014 through 2020
				the Secretary shall effect the following reductions:</text>
											<subclause commented="no" display-inline="no-display-inline" id="HA091F7EFFBE442438BC6FF14AF835AE4"><enum>(I)</enum><header display-inline="yes-display-inline">Reduction in DSH allotments</header><text display-inline="yes-display-inline">The Secretary shall reduce DSH allotments
				to States in the amount specified under the DSH health reform methodology under
				subparagraph (B) for the State for the fiscal year.</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H3FB0D8DDF0024ACB9C40DB37AAD29D6D"><enum>(II)</enum><header display-inline="yes-display-inline">Reductions in payments</header><text display-inline="yes-display-inline">The Secretary shall reduce payments to
				States under section 1903(a) for each calendar quarter in the fiscal year, in
				the manner specified in clause (iii), in an amount equal to
				<fraction>1/4</fraction> of the DSH allotment reduction under subclause (I) for
				the State for the fiscal year.</text>
											</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H5E5112DEB30F41FEBFB4ED509F725B3D"><enum>(ii)</enum><header display-inline="yes-display-inline">Aggregate reductions</header><text display-inline="yes-display-inline">The aggregate reductions in DSH allotments
				for all States under clause (i)(I) shall be equal to—</text>
											<subclause commented="no" display-inline="no-display-inline" id="HB3EFAA74273E4DBC8271F62E091F5575"><enum>(I)</enum><text display-inline="yes-display-inline">$500,000,000 for fiscal year 2014;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H800E583EF27C46ED8616BB240F86DDAE"><enum>(II)</enum><text display-inline="yes-display-inline">$600,000,000 for fiscal year 2015;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H260815E393E146A7A77A3944CF387407"><enum>(III)</enum><text display-inline="yes-display-inline">$600,000,000 for fiscal year 2016;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H43DB320E93EB45E8A1D1C86D9F408BBC"><enum>(IV)</enum><text display-inline="yes-display-inline">$1,800,000,000 for fiscal year 2017;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H63EAFD09135645CBB81CC75BFF315997"><enum>(V)</enum><text display-inline="yes-display-inline">$5,000,000,000 for fiscal year 2018;</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H68E1A059F9FD4A80BF6FEEF01ADFD8EA"><enum>(VI)</enum><text display-inline="yes-display-inline">$5,600,000,000 for fiscal year 2019;
				and</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="HC7E2BBFBB62E47B185F5ABFA9CE816D0"><enum>(VII)</enum><text display-inline="yes-display-inline">$4,000,000,000 for fiscal year 2020.</text>
											</subclause><continuation-text commented="no" continuation-text-level="clause">The Secretary shall distribute such
				aggregate reductions among States in accordance with subparagraph (B).</continuation-text></clause><clause commented="no" display-inline="no-display-inline" id="HCFFD5813DC5E43CABA96AF8A7C734EB7"><enum>(iii)</enum><header display-inline="yes-display-inline">Manner of payment reduction</header><text display-inline="yes-display-inline">The amount of the payment reduction under
				clause (i)(II) for a State for a quarter shall be deemed an overpayment to the
				State under this title to be disallowed against the State’s regular quarterly
				draw for all spending under section 1903(d)(2). Such a disallowance is not
				subject to a reconsideration under subsections (d) and (e) of section
				1116.</text>
										</clause><clause commented="no" display-inline="no-display-inline" id="H1540858DC2F144689381006A2858CF0F"><enum>(iv)</enum><header display-inline="yes-display-inline">Definition</header><text display-inline="yes-display-inline">In this paragraph, the term
				<quote>State</quote> means the 50 States and the District of Columbia.</text>
										</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H75A183641ACD4EF484BCBB97BD81FEE1"><enum>(B)</enum><header display-inline="yes-display-inline">DSH Health Reform methodology</header><text display-inline="yes-display-inline">The Secretary shall carry out subparagraph
				(A) through use of a DSH Health Reform methodology that meets the following
				requirements:</text>
										<clause commented="no" display-inline="no-display-inline" id="HD6FD327681714B44960640CA7576DE59"><enum>(i)</enum><text display-inline="yes-display-inline">The methodology imposes the largest
				percentage reductions on the States that—</text>
											<subclause commented="no" display-inline="no-display-inline" id="H03D36780498F4DC880A987AD9793A7F7"><enum>(I)</enum><text display-inline="yes-display-inline">have the lowest percentages of uninsured
				individuals (determined on the basis of data from the Bureau of the Census,
				audited hospital cost reports, and other information likely to yield accurate
				data) during the most recent year for which such data are available; or</text>
											</subclause><subclause commented="no" display-inline="no-display-inline" id="H5D7A9A957B694159BF85FBCC573531FF"><enum>(II)</enum><text display-inline="yes-display-inline">do not target their DSH payments on—</text>
												<item commented="no" display-inline="no-display-inline" id="H84806C62923B4D4E83FC7CB99A28EA27"><enum>(aa)</enum><text display-inline="yes-display-inline">hospitals with high volumes of Medicaid
				inpatients (as defined in subsection (b)(1)(A)); and</text>
												</item><item commented="no" display-inline="no-display-inline" id="H04913A7C0A194488BC92AD8A69F1439A"><enum>(bb)</enum><text display-inline="yes-display-inline">hospitals that have high levels of
				uncompensated care (excluding bad debt).</text>
												</item></subclause></clause><clause commented="no" display-inline="no-display-inline" id="HCD4B6D75CA014140A416E682A1F5BB24"><enum>(ii)</enum><text display-inline="yes-display-inline">The methodology imposes a smaller
				percentage reduction on low DSH States described in paragraph (5)(B).</text>
										</clause><clause commented="no" display-inline="no-display-inline" id="H57A7522DD9F5439091F3B4B6B08EB7A2"><enum>(iii)</enum><text display-inline="yes-display-inline">The methodology takes into account the
				extent to which the DSH allotment for a State was included in the budget
				neutrality calculation for a coverage expansion approved under section 1115 as
				of July 31,
				2009.</text>
										</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H524A86CB1E7348EA8428F2FEDBD254DC"><enum>(b)</enum><header display-inline="yes-display-inline">Extension of DSH allotment</header><text display-inline="yes-display-inline">Section 1923(f)(6)(A) of the Social
			 Security Act (42 U.S.C. 1396r–4(f)(6)(A)) is amended by adding at the end the
			 following:</text>
						<quoted-block display-inline="no-display-inline" id="H8508A6411A524D85877CB4438A7A39F1" style="OLC">
							<clause commented="no" display-inline="no-display-inline" id="H44C66348F694497693ACE9C293D6BE4C"><enum>(v)</enum><header display-inline="yes-display-inline">Allotment for 2d, 3rd, and 4th quarters of
				fiscal year 2012 and for fiscal year 2013</header><text display-inline="yes-display-inline">Notwithstanding the table set forth in
				paragraph (2):</text>
								<subclause commented="no" display-inline="no-display-inline" id="H4FFD5BBCAB8645A19AED37FDFE3DED84"><enum>(I)</enum><header display-inline="yes-display-inline">2d, 3rd, and 4th quarters of fiscal year
				2012</header><text display-inline="yes-display-inline">In the case of a State
				that has a DSH allotment of $0 for the 2d, 3rd, and 4th quarters of fiscal year
				2012, the DSH allotment shall be $47,200,000 for such quarters.</text>
								</subclause><subclause commented="no" display-inline="no-display-inline" id="HE6966DCCFD1E437BA78BF4AB22B50386"><enum>(II)</enum><header display-inline="yes-display-inline">Fiscal year 2013</header><text display-inline="yes-display-inline">In the case of a State that has a DSH
				allotment of $0 for fiscal year 2013, the DSH allotment shall be $53,100,000
				for such fiscal
				year.</text>
								</subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="HC597736792AF4EA09F30F623DA97C642" section-type="subsequent-section"><enum>1204.</enum><header display-inline="yes-display-inline">Funding for the territories</header>
					<subsection commented="no" display-inline="no-display-inline" id="H8DFE33CEB5F544208141875D0436F907"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Part III of subtitle D of title I of the
			 Patient Protection and Affordable Care Act, as amended by section 10104(m) of
			 such Act, is amended by inserting after section 1322 the following
			 section:</text>
						<quoted-block display-inline="no-display-inline" id="HA3E2F8BCDA3944ABB378BEE6EEB49F33" style="OLC">
							<section commented="no" display-inline="no-display-inline" id="HC31D4303937E4503BCD6CF73D3E04451" section-type="subsequent-section"><enum>1323.</enum><header display-inline="yes-display-inline">Funding for the territories</header>
								<subsection commented="no" display-inline="no-display-inline" id="HCF3EB4C05AF84434A9DCEB7E69BCB09F"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">A territory that—</text>
									<paragraph commented="no" display-inline="no-display-inline" id="H2C91CF989EEE4FC1A8B8527AD00BE45C"><enum>(1)</enum><text display-inline="yes-display-inline">elects consistent with subsection (b) to
				establish an Exchange in accordance with part II of this subtitle and
				establishes such an Exchange in accordance with such part shall be treated as a
				State for purposes of such part and shall be entitled to payment from the
				amount allocated to the territory under subsection (c); or</text>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0F6F7BBC60B541068FBE1A8A149BC6A0"><enum>(2)</enum><text display-inline="yes-display-inline">does not make such election shall be
				entitled to an increase in the dollar limitation applicable to the territory
				under subsections (f) and (g) of section 1108 of the Social Security Act (42
				U.S.C. 1308) for such period in such amount for such territory and such
				increase shall not be taken into account in computing any other amount under
				such subsections.</text>
									</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H41B6198D72FC4780826C96671DC9AD64"><enum>(b)</enum><header display-inline="yes-display-inline">Terms and conditions</header><text display-inline="yes-display-inline">An election under subsection (a)(1)
				shall—</text>
									<paragraph commented="no" display-inline="no-display-inline" id="HC04D95D221C64AAC941CA893945A709C"><enum>(1)</enum><text display-inline="yes-display-inline">not be effective unless the election is
				consistent with section 1321 and is received not later than October 1, 2013;
				and</text>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HFFE8AA0A9FB24867A4276EE36010BDC4"><enum>(2)</enum><text display-inline="yes-display-inline">be contingent upon entering into an
				agreement between the territory and the Secretary that requires that—</text>
										<subparagraph commented="no" display-inline="no-display-inline" id="H4B5761AFBD184C49948D5079C1F34787"><enum>(A)</enum><text display-inline="yes-display-inline">funds provided under the agreement shall be
				used only to provide premium and cost-sharing assistance to residents of the
				territory obtaining health insurance coverage through the Exchange; and</text>
										</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H77AD9BCDA6EA43E2803A4993AC47DA87"><enum>(B)</enum><text display-inline="yes-display-inline">the premium and cost-sharing assistance
				provided under such agreement shall be structured in such a manner so as to
				prevent any gap in assistance for individuals between the income level at which
				medical assistance is available through the territory’s Medicaid plan under
				title XIX of the Social Security Act and the income level at which premium and
				cost-sharing assistance is available under the agreement.</text>
										</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H94DF5F454B884EDEAF94E165412512B9"><enum>(c)</enum><header display-inline="yes-display-inline">Appropriation and allocation</header>
									<paragraph commented="no" display-inline="no-display-inline" id="H1970DF2461E9436088B26D9BA35A2BAC"><enum>(1)</enum><header display-inline="yes-display-inline">Appropriation</header><text display-inline="yes-display-inline">Out of any funds in the Treasury not
				otherwise appropriated, there is appropriated for purposes of payment pursuant
				to subsection (a) $1,000,000,000, to be available during the period beginning
				with 2014 and ending with 2019.</text>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H10893A87F6D64D48ABEB9B73327547AF"><enum>(2)</enum><header display-inline="yes-display-inline">Allocation</header><text display-inline="yes-display-inline">The Secretary shall allocate the amount
				appropriated under paragraph (1) among the territories for purposes of carrying
				out this section as follows:</text>
										<subparagraph commented="no" display-inline="no-display-inline" id="H9398DAE2C10748D9AB1392E5F35A2626"><enum>(A)</enum><text display-inline="yes-display-inline">For Puerto Rico, $925,000,000.</text>
										</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0ED14D2E39014AAEBD8657198BD2CBC1"><enum>(B)</enum><text display-inline="yes-display-inline">For another territory, the portion of
				$75,000,000 specified by the
				Secretary.</text>
										</subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="HF91C8D5EE8A64FE8AFDF17B0E00E0224"><enum>(b)</enum><header display-inline="yes-display-inline">Medicaid funding</header>
						<paragraph commented="no" display-inline="no-display-inline" id="H9AB9A672661748518916101D41EC470B"><enum>(1)</enum><header display-inline="yes-display-inline">Increase in funding caps</header><text display-inline="yes-display-inline">Section 1108(g) of the Social Security Act
			 (42 U.S.C. 1308(g)), as amended by section 2005(a) of the Patient Protection
			 and Affordable Care Act, is amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H0AE8E0B5970044D087CED52DC091E9D4"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (2), by inserting <quote>and
			 section 1323(a)(2) of the Patient Protection and Affordable Care Act</quote>
			 after <quote>subject to</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HBB10AC9421D44F71BA3259168B35F6F9"><enum>(B)</enum><text display-inline="yes-display-inline">by striking paragraph (5) and inserting the
			 following:</text>
								<quoted-block display-inline="no-display-inline" id="H5CC412F21B4942B2AFDA6849F33D5F86" style="OLC">
									<paragraph commented="no" display-inline="no-display-inline" id="H870FF9B4F72D44CA9792F7F325A5D715"><enum>(5)</enum><header display-inline="yes-display-inline">Additional increase</header><text display-inline="yes-display-inline">The Secretary shall increase the amounts
				otherwise determined under this subsection for Puerto Rico, the Virgin Islands,
				Guam, the Northern Mariana Islands, and American Samoa (after the application
				of subsection (f) and the preceding paragraphs of this subsection) for the
				period beginning July 1, 2011, and ending on September 30, 2019, by such
				amounts that the total additional payments under title XIX to such territories
				equals $6,300,000,000 for such period. The Secretary shall increase such
				amounts in proportion to the amounts applicable to such territories under this
				subsection and subsection (f) on the date of enactment of this
				paragraph.</text>
									</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD6CD6FCE18F9408497B75302BFF00F29"><enum>(2)</enum><header display-inline="yes-display-inline">Disregard of payments; increased
			 FMAP</header><text display-inline="yes-display-inline">Section 2005 of the
			 Patient Protection and Affordable Care Act is amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HB0872E72FB8F454CB969B0450AAA51E2"><enum>(A)</enum><text display-inline="yes-display-inline">by repealing subsection (b) (and the
			 amendments made by that subsection) and section 1108(g)(4) of the Social
			 Security Act shall be applied as if such amendments had never been enacted;
			 and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HA5030647D71643E7B614C567701F4DA1"><enum>(B)</enum><text display-inline="yes-display-inline">in subsection (c)(2), by striking
			 <quote>January</quote> and inserting <quote>July</quote>.</text>
							</subparagraph></paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H8AF2DB86DFE04B1AA7B06CA95687478C" section-type="subsequent-section"><enum>1205.</enum><header display-inline="yes-display-inline">Delay in Community First Choice
			 option</header><text display-inline="no-display-inline">Section 1915(k)(1) of
			 the Social Security Act (42 U.S.C. 1396n(k)), as added by section 2401 of the
			 Patient Protection and Affordable Care Act, is amended by striking
			 <quote>October 1, 2010</quote> and inserting <quote>October 1,
			 2011</quote>.</text>
				</section><section commented="no" display-inline="no-display-inline" id="HE7415B813A264003A8FAC867D1F4CFED" section-type="subsequent-section"><enum>1206.</enum><header display-inline="yes-display-inline">Drug rebates for new formulations of
			 existing drugs</header>
					<subsection commented="no" display-inline="no-display-inline" id="HBBC79CBF238F4E9BB8D3895A52121938"><enum>(a)</enum><header display-inline="yes-display-inline">Treatment of new formulations</header><text display-inline="yes-display-inline">Subparagraph (C) of section 1927(c)(2) of
			 the Social Security Act (42 U.S.C. 1396r–8(c)(2)), as added by section 2501(d)
			 of the Patient Protection and Affordable Care Act, is amended to read as
			 follows:</text>
						<quoted-block display-inline="no-display-inline" id="H678FBD83AB504BFBB8A35BFE54CA4862" style="OLC">
							<subparagraph commented="no" display-inline="no-display-inline" id="HDE28036295B74B95A675E6A573D43297"><enum>(C)</enum><header display-inline="yes-display-inline">Treatment of new formulations</header><text display-inline="yes-display-inline">In the case of a drug that is a line
				extension of a single source drug or an innovator multiple source drug that is
				an oral solid dosage form, the rebate obligation with respect to such drug
				under this section shall be the amount computed under this section for such new
				drug or, if greater, the product of—</text>
								<clause commented="no" display-inline="no-display-inline" id="H0497903803E14E17871F1D96A41621BE"><enum>(i)</enum><text display-inline="yes-display-inline">the average manufacturer price of the line
				extension of a single source drug or an innovator multiple source drug that is
				an oral solid dosage form;</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H38E537EE701B4F9ABD5D5F79B0F0E195"><enum>(ii)</enum><text display-inline="yes-display-inline">the highest additional rebate (calculated
				as a percentage of average manufacturer price) under this section for any
				strength of the original single source drug or innovator multiple source drug;
				and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H2A431A22BCB44348A5880534AF15D3EC"><enum>(iii)</enum><text display-inline="yes-display-inline">the total number of units of each dosage
				form and strength of the line extension product paid for under the State plan
				in the rebate period (as reported by the State).</text>
								</clause><continuation-text commented="no" continuation-text-level="subparagraph">In this subparagraph, the term
				<quote>line extension</quote> means, with respect to a drug, a new formulation
				of the drug, such as an extended release
				formulation.</continuation-text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H11251C0A2093401EB963EBF038089781"><enum>(b)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendment made by
			 subsection (a) shall take effect as if included in the enactment of the Patient
			 Protection and Affordable Care Act.</text>
					</subsection></section></subtitle><subtitle commented="no" id="H8157382EFD774FA8952F0F1EB6CAFA3B" level-type="subsequent"><enum>D</enum><header display-inline="yes-display-inline">Reducing Fraud, Waste, and Abuse</header>
				<section commented="no" display-inline="no-display-inline" id="HCA982B13280043518BFC021B0938C590" section-type="subsequent-section"><enum>1301.</enum><header display-inline="yes-display-inline">Community mental health centers</header>
					<subsection commented="no" display-inline="no-display-inline" id="H89E4B8D5872A44FAADCCF7786EE9EFD0"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1861(ff)(3)(B) of the Social
			 Security Act (42 U.S.C. 1395x(ff)(3)(B)) is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HD3E318A10DB043EB90B438CFC2F300B1"><enum>(1)</enum><text display-inline="yes-display-inline">in clause (ii), by striking
			 <quote>and</quote> at the end;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H14EEBFE75F524261879357B3AAA138FB"><enum>(2)</enum><text display-inline="yes-display-inline">by redesignating clause (iii) as clause
			 (iv); and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H6BE6FED19FBB4750A0FDE742228C36CB"><enum>(3)</enum><text display-inline="yes-display-inline">by inserting after clause (ii) the
			 following:</text>
							<quoted-block display-inline="no-display-inline" id="H32C1F4B62E0A46B985D86A29FF678A8C" style="OLC">
								<clause commented="no" display-inline="no-display-inline" id="HB3AF5DEDFA464DEEAB6DDF7A1A35A6D1" indent="up2"><enum>(iii)</enum><text display-inline="yes-display-inline">provides at least 40 percent of its
				services to individuals who are not eligible for benefits under this title;
				and</text>
								</clause><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H24C710E4C1474D929B9D4D97CA3ED556"><enum>(b)</enum><header display-inline="yes-display-inline">Restriction</header><text display-inline="yes-display-inline">Section 1861(ff)(3)(A) of such Act (42
			 U.S.C. 1395x(ff)(3)(A)) is amended by inserting <quote>other than in an
			 individual’s home or in an inpatient or residential setting</quote> before the
			 period.</text>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H43C8DAF2B0FE46E096298AD153C59376"><enum>(c)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendments made by
			 this section shall apply to items and services furnished on or after the first
			 day of the first calendar quarter that begins at least 12 months after the date
			 of the enactment of this Act.</text>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="HCBE4E31D48984B8AA52FEE7B209D96A9" section-type="subsequent-section"><enum>1302.</enum><header display-inline="yes-display-inline">Medicare prepayment medical review
			 limitations</header><text display-inline="no-display-inline">Section 1874A(h)
			 of the Social Security Act (42 U.S.C. 1395w–3a(h)) is repealed.</text>
				</section><section commented="no" display-inline="no-display-inline" id="H0E9F5351D77A413D921884A6CDC64B3F" section-type="subsequent-section"><enum>1303.</enum><header display-inline="yes-display-inline">Funding to fight fraud, waste, and
			 abuse</header>
					<subsection commented="no" display-inline="no-display-inline" id="H7159F5F57F6841D08556B04516DE0DC4"><enum>(a)</enum><header display-inline="yes-display-inline">Funding to fight fraud, waste, and
			 abuse</header>
						<paragraph commented="no" display-inline="no-display-inline" id="H838284B8886C40A99AE6BDD69A258EB0"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1817(k) of the Social Security Act
			 (42 U.S.C. 1395i(k)), as amended by section 6402(i) of the Patient Protection
			 and Affordable Care Act, is further amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H4EB3AAF0EE4A4FD6B925668AD2A077C3"><enum>(A)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 paragraph:</text>
								<quoted-block display-inline="no-display-inline" id="HFE1C16581F4B454CB4C3E195B53B2B72" style="OLC">
									<paragraph commented="no" display-inline="no-display-inline" id="HD06BDB40B8D345D2B89ACB61FE9217D1"><enum>(8)</enum><header display-inline="yes-display-inline">Additional funding</header>
										<subparagraph commented="no" display-inline="no-display-inline" id="HF2ADEAFFFDD14C04A079C8A4458E8C8D"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">In addition to the funds otherwise
				appropriated to the Account from the Trust Fund under paragraphs (3)(C) and
				(4)(A) and for purposes described in paragraphs (3)(C) and (4)(A), there are
				hereby appropriated to such Account from such Trust Fund the following
				additional amounts:</text>
											<clause commented="no" display-inline="no-display-inline" id="H8FEFF6FBD1364656815A2C52EBC2C29F"><enum>(i)</enum><text display-inline="yes-display-inline">For fiscal year 2011, $95,000,000.</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H539A908D43C042BF81D78F95BC285236"><enum>(ii)</enum><text display-inline="yes-display-inline">For fiscal year 2012, $55,000,000.</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H587423C713FB4FA5B4CBD2D69B1FAC3D"><enum>(iii)</enum><text display-inline="yes-display-inline">For each of fiscal years 2013 and 2014,
				$30,000,000.</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H942EE684597C408183AF7266BD08B636"><enum>(iv)</enum><text display-inline="yes-display-inline">For each of fiscal years 2015 and 2016,
				$20,000,000.</text>
											</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HAD221494A4B247DCAD31BA5C121CA4C6"><enum>(B)</enum><header display-inline="yes-display-inline">Allocation</header><text display-inline="yes-display-inline">The funds appropriated under this paragraph
				shall be allocated in the same proportion as the total funding appropriated
				with respect to paragraphs (3)(A) and (4)(A) was allocated with respect to
				fiscal year 2010, and shall be available without further appropriation until
				expended.</text>
										</subparagraph></paragraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H73C676D7DA324F41A0E50D14D44E3D62"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (4)(A), by inserting
			 <quote>for activities described in paragraph (3)(C) and</quote> after
			 <quote>necessary</quote>.</text>
							</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HAA5BF9076603401B992865BE2C054AAE"><enum>(b)</enum><header display-inline="yes-display-inline">Medicaid Integrity Program</header><text display-inline="yes-display-inline">Section 1936(e)(1) of such Act (42 U.S.C.
			 1396–u6(e)(1)) is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HDE96E0BB57C147AF91BDFD334C86A515"><enum>(1)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking at the end
			 <quote>and</quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H821F1F0C78384F949E3BCE376F7298D2"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (C)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H4DA3CD244FFC470693C6EF579D637DD9"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>for each fiscal year
			 thereafter</quote> and inserting <quote>for each of fiscal years 2009 and
			 2010</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE873D1683686453CB5DFE2EC6BEA2B51"><enum>(B)</enum><text display-inline="yes-display-inline">by striking the period and inserting
			 <quote>; and</quote>; and</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H76C1EA19326C4E8A9401AA82A07955B0"><enum>(3)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subparagraph:</text>
							<quoted-block display-inline="no-display-inline" id="HD26EE45550BB47E38DDDFB6D91645266" style="OLC">
								<subparagraph commented="no" display-inline="no-display-inline" id="HF424DC4A5AEC4AA688AC99DE2FA8D73C"><enum>(D)</enum><text display-inline="yes-display-inline">for each fiscal year after fiscal year
				2010, the amount appropriated under this paragraph for the previous fiscal
				year, increased by the percentage increase in the consumer price index for all
				urban consumers (all items; United States city average) over the previous
				year.</text>
								</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H9843BCA40AAA493C9F97DA600BEE2CEF" section-type="subsequent-section"><enum>1304.</enum><header display-inline="yes-display-inline">90-day period of enhanced oversight for
			 initial claims of DME suppliers</header><text display-inline="no-display-inline">Section 1866(j), as amended by section 6401
			 of the Patient Protection and Affordable Care Act, is further amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="HDDC4DE96CA2F417784589CA92F29ADFD"><enum>(1)</enum><text display-inline="yes-display-inline">by redesignating paragraphs (4) through (7)
			 as paragraphs (5) through (8), respectively; and</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H616F2D5CE5F84B0FAB22167FEBCBCF09"><enum>(2)</enum><text display-inline="yes-display-inline">by inserting after paragraph (3) the
			 following new paragraph:</text>
						<quoted-block display-inline="no-display-inline" id="H0532EF88E7434DF5B4BB1B2C4C8C7B8E" style="OLC">
							<paragraph commented="no" display-inline="no-display-inline" id="HA719761E0486452BA087E2642A046DD7"><enum>(4)</enum><header display-inline="yes-display-inline">90-day period of enhanced oversight for
				initial claims of DME suppliers</header><text display-inline="yes-display-inline">For periods beginning after January 1,
				2011, if the Secretary determines that there is a significant risk of
				fraudulent activity among suppliers of durable medical equipment, in the case
				of a supplier of durable medical equipment who is within a category or
				geographic area under title XVIII identified pursuant to such determination and
				who is initially enrolling under such title, the Secretary shall,
				notwithstanding sections 1816(c), 1842(c), and 1869(a)(2), withhold payment
				under such title with respect to durable medical equipment furnished by such
				supplier during the 90-day period beginning on the date of the first submission
				of a claim under such title for durable medical equipment furnished by such
				supplier.</text>
							</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></section></subtitle><subtitle commented="no" id="H120E9C1B37E94BA3BA6371E564B405C7" level-type="subsequent"><enum>E</enum><header display-inline="yes-display-inline">Provisions relating to revenue</header>
				<section commented="no" display-inline="no-display-inline" id="H18C1CBBE9E7248EB89C54EA1716B1BC7" section-type="subsequent-section"><enum>1401.</enum><header display-inline="yes-display-inline">High-cost plan excise tax</header>
					<subsection commented="no" display-inline="no-display-inline" id="H648C69AFCC014375B61886A3E73CB983"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 4980I of the Internal Revenue Code
			 of 1986, as added by section 9001 of the Patient Protection and Affordable Care
			 Act and amended by section 10901 of such Act, is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H389B620FB2A2451A9A6EC5CFBB5C5785"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (b)(3)(B)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H55713BCF29874D298EB05B3288AC9745"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>The annual</quote> and
			 inserting the following:</text>
								<quoted-block display-inline="no-display-inline" id="HEA96C12530224253934897972B0D3132" style="OLC">
									<clause commented="no" display-inline="no-display-inline" id="H20CF992755C0410B8E42115E2563284C"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Except as provided in clause (ii), the
				annual</text>
									</clause><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H7E867FEDC9C94F1F946960FFAA19BBEF"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 clause:</text>
								<quoted-block display-inline="no-display-inline" id="HEB82947D50214E6BAFE40E211602A587" style="OLC">
									<clause commented="no" display-inline="no-display-inline" id="HFCCF5E64D675427A8DD01BC517C51843"><enum>(ii)</enum><header display-inline="yes-display-inline">Multiemployer plan coverage</header><text display-inline="yes-display-inline">Any coverage provided under a multiemployer
				plan (as defined in section 414(f)) shall be treated as coverage other than
				self-only
				coverage.</text>
									</clause><after-quoted-block>;</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H00A66CFADD414EA994348E352D3003A1"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)(3)(C)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HB79B57FC6B1843D4B289AC7C850B15FB"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>Except as provided in
			 subparagraph (D)—</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3B60CC6FC45D4A8CB340138ED1775332"><enum>(B)</enum><text display-inline="yes-display-inline">in clause (i)—</text>
								<clause commented="no" display-inline="no-display-inline" id="HD7E407EC6B9C454BB02AC0AD0282A72A"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>2013</quote> each place
			 it appears in the heading and the text and inserting
			 <quote>2018</quote>;</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H591B2DC869E14F888DEA6C7EBA12A41F"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>$8,500</quote> in
			 subclause (I) and inserting <quote>$10,200 multiplied by the health cost
			 adjustment percentage (determined by only taking into account self-only
			 coverage)</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HA90935DDAEDC47AC83C5CD953EBB36A4"><enum>(iii)</enum><text display-inline="yes-display-inline">by striking <quote>$23,000</quote> in
			 subclause (II) and inserting <quote>$27,500 multiplied by the health cost
			 adjustment percentage (determined by only taking into account coverage other
			 than self-only coverage)</quote>;</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HF9C00659559B4636A5A9182AAF50D3EF"><enum>(C)</enum><text display-inline="yes-display-inline">by redesignating clauses (ii) and (iii) as
			 clauses (iv) and (v), respectively, and by inserting after clause (i) the
			 following new clauses:</text>
								<quoted-block display-inline="no-display-inline" id="HC21071A0A24641799011CC37E95D5DF1" style="OLC">
									<clause commented="no" display-inline="no-display-inline" id="H380066FF094847A7BBC797736631415D"><enum>(ii)</enum><header display-inline="yes-display-inline">Health cost adjustment
				percentage</header><text display-inline="yes-display-inline">For purposes of
				clause (i), the health cost adjustment percentage is equal to 100 percent plus
				the excess (if any) of—</text>
										<subclause commented="no" display-inline="no-display-inline" id="HE151A3FE0985490F939D9D9DA014574C"><enum>(I)</enum><text display-inline="yes-display-inline">the percentage by which the per employee
				cost for providing coverage under the Blue Cross/Blue Shield standard benefit
				option under the Federal Employees Health Benefits Plan for plan year 2018
				(determined by using the benefit package for such coverage in 2010) exceeds
				such cost for plan year 2010, over</text>
										</subclause><subclause commented="no" display-inline="no-display-inline" id="HECB861CF42AF437791EB1B0D72F9E346"><enum>(II)</enum><text display-inline="yes-display-inline">55 percent.</text>
										</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H60978B110A4C4FC2B7544F0C0EA1B303"><enum>(iii)</enum><header display-inline="yes-display-inline">Age and gender adjustment</header>
										<subclause commented="no" display-inline="no-display-inline" id="H37FAAC2A652A4535A2E084F85747BB7A"><enum>(I)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The amount determined under subclause (I)
				or (II) of clause (i), whichever is applicable, for any taxable period shall be
				increased by the amount determined under subclause (II).</text>
										</subclause><subclause commented="no" display-inline="no-display-inline" id="H13893A7B60234C3DA4E91A8ECF1EEC44"><enum>(II)</enum><header display-inline="yes-display-inline">Amount determined</header><text display-inline="yes-display-inline">The amount determined under this subclause
				is an amount equal to the excess (if any) of—</text>
											<item commented="no" display-inline="no-display-inline" id="H14D2CF41EEF84D37850FA34041F2A037"><enum>(aa)</enum><text display-inline="yes-display-inline">the premium cost of the Blue Cross/Blue
				Shield standard benefit option under the Federal Employees Health Benefits Plan
				for the type of coverage provided such individual in such taxable period if
				priced for the age and gender characteristics of all employees of the
				individual’s employer, over</text>
											</item><item commented="no" display-inline="no-display-inline" id="H6E4FB198CE794C808072C5372F5F81EE"><enum>(bb)</enum><text display-inline="yes-display-inline">that premium cost for the provision of such
				coverage under such option in such taxable period if priced for the age and
				gender characteristics of the national
				workforce.</text>
											</item></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H547EBFB5BE8C49B0A2A31CAD204570DC"><enum>(D)</enum><text display-inline="yes-display-inline">in clause (iv), as redesignated by
			 subparagraph (C)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H1197DAE09F584D1BBF5610F9F2ADE567"><enum>(i)</enum><text display-inline="yes-display-inline">by inserting <quote>covered by the
			 plan</quote> after <quote>whose employees</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H9410813288DB4EC184F26A9780E8E2CE"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking subclauses (I) and (II) and
			 inserting the following:</text>
									<quoted-block display-inline="no-display-inline" id="H6BD180D8ED83435BBB90956DFDB95A0A" style="OLC">
										<subclause commented="no" display-inline="no-display-inline" id="HF0E4377B92644A4D8F9A79F97058683B"><enum>(I)</enum><text display-inline="yes-display-inline">the dollar amount in clause (i)(I) shall be
				increased by $1,650, and</text>
										</subclause><subclause commented="no" display-inline="no-display-inline" id="H8668B031DCB1400887F3A7B1EA7CB7BB"><enum>(II)</enum><text display-inline="yes-display-inline">the dollar amount in clause (i)(II) shall
				be increased by $3,450,</text>
										</subclause><after-quoted-block>,
				and</after-quoted-block></quoted-block>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD223F0E866554F3F80B3CD67D81BE0B1"><enum>(E)</enum><text display-inline="yes-display-inline">in clause (v), as redesignated by
			 subparagraph (C)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H8853FFCE94E44454BB774A3020C3A3A8"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>2013</quote> and
			 inserting <quote>2018</quote>;</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H02067040EC814244857547BEAFB087DA"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>clauses (i) and
			 (ii)</quote> and inserting <quote>clauses (i) (after the application of clause
			 (ii)) and (iv)</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H6D53CE4AE9544E208CB54FB4F0FB360E"><enum>(iii)</enum><text display-inline="yes-display-inline">by inserting <quote>in the case of
			 determinations for calendar years beginning before 2020</quote> after <quote>1
			 percentage point</quote> in subclause (II) thereof;</text>
								</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H6AABD746091B477885F39DDAE516F01E"><enum>(3)</enum><text display-inline="yes-display-inline">by striking subparagraph (D) of subsection
			 (b)(3);</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF59F3200A1FD4D5F95224CDEEDC60EC4"><enum>(4)</enum><text display-inline="yes-display-inline">in subsection (d)(1)(B), by redesignating
			 clause (ii) as clause (iii) and by inserting after clause (i) the following new
			 clause:</text>
							<quoted-block display-inline="no-display-inline" id="HC262E30D133F4E3188BE5252A18AFF7C" style="OLC">
								<clause commented="no" display-inline="no-display-inline" id="H3173121529AC456390925C59F23C7F78"><enum>(ii)</enum><text display-inline="yes-display-inline">any coverage under a separate policy,
				certificate, or contract of insurance which provides benefits substantially all
				of which are for treatment of the mouth (including any organ or structure
				within the mouth) or for treatment of the eye,
				or</text>
								</clause><after-quoted-block>; and</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H2399D2FB8E914CFD8B608065659DA393"><enum>(5)</enum><text display-inline="yes-display-inline">in subsection (d), by adding at the end the
			 following new paragraph:</text>
							<quoted-block display-inline="no-display-inline" id="HAB68EF9AC49342D1A5008F4F1AFB5BD8" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="H0740D78E56674373A1511CE694C9FDDD"><enum>(3)</enum><header display-inline="yes-display-inline">Employee</header><text display-inline="yes-display-inline">The term <term>employee</term> includes any
				former employee, surviving spouse, or other primary insured
				individual.</text>
								</paragraph><after-quoted-block>.
				</after-quoted-block></quoted-block>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H1E09322B3ABE4ED5B23373AFE3F28F70"><enum>(b)</enum><header display-inline="yes-display-inline">Effective dates</header>
						<paragraph commented="no" display-inline="no-display-inline" id="HB0905D13019B4564B08D1DAFB6A37FA1"><enum>(1)</enum><text display-inline="yes-display-inline">Section 9001(c) of the Patient Protection
			 and Affordable Care Act is amended by striking <quote>2012</quote> and
			 inserting <quote>2017</quote>.</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H4F44E21FE3224B078F3821DF4490FFBA"><enum>(2)</enum><text display-inline="yes-display-inline">Section 10901(c) of the Patient Protection
			 and Affordable Care Act is amended by striking <quote>2012</quote> and
			 inserting <quote>2017</quote>.</text>
						</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H99AAA07D706A44C291A35F69E188850E" section-type="subsequent-section"><enum>1402.</enum><header display-inline="yes-display-inline">Unearned income Medicare
			 contribution</header>
					<subsection commented="no" display-inline="no-display-inline" id="H05687B9485694C228976D067F549D466"><enum>(a)</enum><header display-inline="yes-display-inline">Investment income</header>
						<paragraph commented="no" display-inline="no-display-inline" id="HB8B0998407B946D6BB5857CA16B2D478"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subtitle A of the Internal Revenue Code of
			 1986 is amended by inserting after chapter 2 the following new chapter:</text>
							<quoted-block display-inline="no-display-inline" id="H18E56C27B60A4844AE365A41F0C98C08" style="OLC">
								<chapter commented="no" id="H15EDF9173986416A994B2B72EDCE5B3C" level-type="subsequent" style="OLC"><enum>2A</enum><header display-inline="yes-display-inline">Unearned income Medicare
				contribution</header>
									<toc>
										<toc-entry bold="off" level="section">Sec. 1411. Imposition of
				  tax.</toc-entry>
									</toc>
									<section commented="no" display-inline="no-display-inline" id="HDDC1E034DA3F47DA83AA80CF9C178608" section-type="subsequent-section"><enum>1411.</enum><header display-inline="yes-display-inline">Imposition of tax</header>
										<subsection commented="no" display-inline="no-display-inline" id="H7C14DAD551FC45688DDD2C1321DE4A00"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Except as provided in subsection
				(e)—</text>
											<paragraph commented="no" display-inline="no-display-inline" id="HF64A8BA3F069403F8878E8B2B15DBB1D"><enum>(1)</enum><header display-inline="yes-display-inline">Application to individuals</header><text display-inline="yes-display-inline">In the case of an individual, there is
				hereby imposed (in addition to any other tax imposed by this subtitle) for each
				taxable year a tax equal to 3.8 percent of the lesser of—</text>
												<subparagraph commented="no" display-inline="no-display-inline" id="H0FCA8C2535C943BAAA505F9A7BBAEF74"><enum>(A)</enum><text display-inline="yes-display-inline">net investment income for such taxable
				year, or</text>
												</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H7D9E1BA81FC04CFABBF4A10291D0B315"><enum>(B)</enum><text display-inline="yes-display-inline">the excess (if any) of—</text>
													<clause commented="no" display-inline="no-display-inline" id="H01657B63184E40DC9B7DBD318A5AA229"><enum>(i)</enum><text display-inline="yes-display-inline">the modified adjusted gross income for such
				taxable year, over</text>
													</clause><clause commented="no" display-inline="no-display-inline" id="HCF18F51505EB4351B658C614296F6EBA"><enum>(ii)</enum><text display-inline="yes-display-inline">the threshold amount.</text>
													</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF33C6A73CD9E4F64B0FE77719112611F"><enum>(2)</enum><header display-inline="yes-display-inline">Application to estates and
				trusts</header><text display-inline="yes-display-inline">In the case of an
				estate or trust, there is hereby imposed (in addition to any other tax imposed
				by this subtitle) for each taxable year a tax of 3.8 percent of the lesser
				of—</text>
												<subparagraph commented="no" display-inline="no-display-inline" id="HF6B86060931848C9BF2CC4BADF431638"><enum>(A)</enum><text display-inline="yes-display-inline">the undistributed net investment income for
				such taxable year, or</text>
												</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HB01161DE6B854FA78CBE6B197593341A"><enum>(B)</enum><text display-inline="yes-display-inline">the excess (if any) of—</text>
													<clause commented="no" display-inline="no-display-inline" id="H6DF694B7C0784AAC9F8ECAF0410775BF"><enum>(i)</enum><text display-inline="yes-display-inline">the adjusted gross income (as defined in
				section 67(e)) for such taxable year, over</text>
													</clause><clause commented="no" display-inline="no-display-inline" id="H9C0DC82BC621494A95AF5C472E716923"><enum>(ii)</enum><text display-inline="yes-display-inline">the dollar amount at which the highest tax
				bracket in section 1(e) begins for such taxable year.</text>
													</clause></subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H2AB846DC0A3B4E12B6581F088400D1C8"><enum>(b)</enum><header display-inline="yes-display-inline">Threshold amount</header><text display-inline="yes-display-inline">For purposes of this chapter, the term
				<term>threshold amount</term> means—</text>
											<paragraph commented="no" display-inline="no-display-inline" id="H56BF91D0E62C4D8482A5D43403AB6C97"><enum>(1)</enum><text display-inline="yes-display-inline">in the case of a taxpayer making a joint
				return under section 6013 or a surviving spouse (as defined in section 2(a)),
				$250,000,</text>
											</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5AAD29673E7C47C6A7C54BB3402346DE"><enum>(2)</enum><text display-inline="yes-display-inline">in the case of a married taxpayer (as
				defined in section 7703) filing a separate return, ½ of the dollar amount
				determined under paragraph (1), and</text>
											</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H7025B4B6E7B84E7D91062B9D0D61EABE"><enum>(3)</enum><text display-inline="yes-display-inline">in any other case, $200,000.</text>
											</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H4F4399008C944CF1A36FFC2C9197B3C2"><enum>(c)</enum><header display-inline="yes-display-inline">Net investment income</header><text display-inline="yes-display-inline">For purposes of this chapter—</text>
											<paragraph commented="no" display-inline="no-display-inline" id="HA49218C7A243412392D48AD3F356B15B"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The term <term>net investment income</term>
				means the excess (if any) of—</text>
												<subparagraph commented="no" display-inline="no-display-inline" id="H7BF388CFB65E4EB2902694853ED606E6"><enum>(A)</enum><text display-inline="yes-display-inline">the sum of—</text>
													<clause commented="no" display-inline="no-display-inline" id="H632E596B88FA4163936BD4A42FA7EAA7"><enum>(i)</enum><text display-inline="yes-display-inline">gross income from interest, dividends,
				annuities, royalties, and rents, other than such income which is derived in the
				ordinary course of a trade or business not described in paragraph (2),</text>
													</clause><clause commented="no" display-inline="no-display-inline" id="H99300D035586458CB954B9651374286F"><enum>(ii)</enum><text display-inline="yes-display-inline">other gross income derived from a trade or
				business described in paragraph (2), and</text>
													</clause><clause commented="no" display-inline="no-display-inline" id="H0E9E6E96CB274CF2AB21F3A9134C851F"><enum>(iii)</enum><text display-inline="yes-display-inline">net gain (to the extent taken into account
				in computing taxable income) attributable to the disposition of property other
				than property held in a trade or business not described in paragraph (2),
				over</text>
													</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HDD60355F2B5D46C3A0831C3CD951DDD5"><enum>(B)</enum><text display-inline="yes-display-inline">the deductions allowed by this subtitle
				which are properly allocable to such gross income or net gain.</text>
												</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA564F5A3CE384E5FB95DF5DC2E5F070B"><enum>(2)</enum><header display-inline="yes-display-inline">Trades and businesses to which tax
				applies</header><text display-inline="yes-display-inline">A trade or business
				is described in this paragraph if such trade or business is—</text>
												<subparagraph commented="no" display-inline="no-display-inline" id="H748645FA0A4E47548E099F0860417E60"><enum>(A)</enum><text display-inline="yes-display-inline">a passive activity (within the meaning of
				section 469) with respect to the taxpayer, or</text>
												</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H6545E42340434CA18C98F3EF75C149DE"><enum>(B)</enum><text display-inline="yes-display-inline">a trade or business of trading in financial
				instruments or commodities (as defined in section 475(e)(2)).</text>
												</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB9CD342C28FC403E86AEE361D06BB92F"><enum>(3)</enum><header display-inline="yes-display-inline">Income on investment of working capital
				subject to tax</header><text display-inline="yes-display-inline">A rule similar
				to the rule of section 469(e)(1)(B) shall apply for purposes of this
				subsection.</text>
											</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB9D41AC22CEC412388BFBAB340BFA536"><enum>(4)</enum><header display-inline="yes-display-inline">Exception for certain active interests in
				partnerships and S corporations</header><text display-inline="yes-display-inline">In the case of a disposition of an interest
				in a partnership or S corporation—</text>
												<subparagraph commented="no" display-inline="no-display-inline" id="H94F7511A194E43878F91EE925E040779"><enum>(A)</enum><text display-inline="yes-display-inline">gain from such disposition shall be taken
				into account under clause (iii) of paragraph (1)(A) only to the extent of the
				net gain which would be so taken into account by the transferor if all property
				of the partnership or S corporation were sold for fair market value immediately
				before the disposition of such interest, and</text>
												</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3C93DECE274A4385B8000D4357E383A8"><enum>(B)</enum><text display-inline="yes-display-inline">a rule similar to the rule of subparagraph
				(A) shall apply to a loss from such disposition.</text>
												</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H6BB0D193348D468483F21ECD9A509DA3"><enum>(5)</enum><header display-inline="yes-display-inline">Exception for distributions from qualified
				plans</header><text display-inline="yes-display-inline">The term <term>net
				investment income</term> shall not include any distribution from a plan or
				arrangement described in section 401(a), 403(a), 403(b), 408, 408A, or
				457(b).</text>
											</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H697E8237CCEE4C1BB6748A6C97EAD0DE"><enum>(6)</enum><header display-inline="yes-display-inline">Special rule</header><text display-inline="yes-display-inline">Net investment income shall not include any
				item taken into account in determining self-employment income for such taxable
				year on which a tax is imposed by section 1401(b).</text>
											</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HB2795F6AB71344D8A2F634381D0533C8"><enum>(d)</enum><header display-inline="yes-display-inline">Modified adjusted gross
				income</header><text display-inline="yes-display-inline">For purposes of this
				chapter, the term <term>modified adjusted gross income</term> means adjusted
				gross income increased by the excess of—</text>
											<paragraph commented="no" display-inline="no-display-inline" id="HB2D68F5A9ECB4D7E95B30E60981D9ED7"><enum>(1)</enum><text display-inline="yes-display-inline">the amount excluded from gross income under
				section 911(a)(1), over</text>
											</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H9B8BC0186CA94AFA8F74358BCE875CE7"><enum>(2)</enum><text display-inline="yes-display-inline">the amount of any deductions (taken into
				account in computing adjusted gross income) or exclusions disallowed under
				section 911(d)(6) with respect to the amounts described in paragraph
				(1).</text>
											</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H4B364EB20EAA48E99B20AC59BAA85BAC"><enum>(e)</enum><header display-inline="yes-display-inline">Nonapplication of section</header><text display-inline="yes-display-inline">This section shall not apply to—</text>
											<paragraph commented="no" display-inline="no-display-inline" id="H32ABF10ACE1E4A14807825BACB62DCA2"><enum>(1)</enum><text display-inline="yes-display-inline">a nonresident alien, or</text>
											</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HAD318B8EA7F94479B4CBF5861004D660"><enum>(2)</enum><text display-inline="yes-display-inline">a trust all of the unexpired interests in
				which are devoted to one or more of the purposes described in section
				170(c)(2)(B).</text>
											</paragraph></subsection></section></chapter><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB9A2C0D5566045678A5EC8631F51E14C"><enum>(2)</enum><header display-inline="yes-display-inline">Estimated taxes</header><text display-inline="yes-display-inline">Section 6654 of the Internal Revenue Code
			 of 1986 is amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HF65487A076FA4F5F9F624DBE33925767"><enum>(A)</enum><text display-inline="yes-display-inline">in subsection (a), by striking <quote>and
			 the tax under chapter 2</quote> and inserting <quote>the tax under chapter 2,
			 and the tax under chapter 2A</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H41871241A3224FDDBF5F0ED2BA8104BD"><enum>(B)</enum><text display-inline="yes-display-inline">in subsection (f)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H14CF887464B04C57AAD5A71345B73EEF"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>minus</quote> at the end
			 of paragraph (2) and inserting <quote>plus</quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H4182715CC9A84B16AB2EFE7072F6300C"><enum>(ii)</enum><text display-inline="yes-display-inline">by redesignating paragraph (3) as paragraph
			 (4) and inserting after paragraph (2) the following new paragraph:</text>
									<quoted-block display-inline="no-display-inline" id="H83325C5761034EC0B83C261F8A4A6EA4" style="OLC">
										<paragraph commented="no" display-inline="no-display-inline" id="HEC422D9B490F4376A7B4C58A3B43608B"><enum>(3)</enum><text display-inline="yes-display-inline">the taxes imposed by chapter 2A,
				minus</text>
										</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
								</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5CC14332E496486BBC221A5B49C34C5A"><enum>(3)</enum><header display-inline="yes-display-inline">Clerical amendment</header><text display-inline="yes-display-inline">The table of chapters for subtitle A of
			 chapter 1 of the Internal Revenue Code of 1986 is amended by inserting after
			 the item relating to chapter 2 the following new item:</text>
							<quoted-block display-inline="no-display-inline" id="HAA63F59E6CE14EC09F8C55D6BFAB30E4" style="OLC">
								<toc>
									<toc-entry bold="off" idref="H15EDF9173986416A994B2B72EDCE5B3C" level="chapter">Chapter 2A—Unearned
				income Medicare
				contribution</toc-entry>
								</toc>
								<after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HAF3A03D591AC4A78A9D7857C8A0A51C0"><enum>(4)</enum><header display-inline="yes-display-inline">Effective dates</header><text display-inline="yes-display-inline">The amendments made by this subsection
			 shall apply to taxable years beginning after December 31, 2012.</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HAA374CD8DBA8448BA99E855F5AB78AF3"><enum>(b)</enum><header display-inline="yes-display-inline">Earned income</header>
						<paragraph commented="no" display-inline="no-display-inline" id="H6F19BB6F7DD24DF0972531E54030F6F2"><enum>(1)</enum><header display-inline="yes-display-inline">Threshold</header>
							<subparagraph commented="no" display-inline="no-display-inline" id="H712572E827654278918ABD8FA67CAD8A"><enum>(A)</enum><header display-inline="yes-display-inline">FICA</header><text display-inline="yes-display-inline">Paragraph (2) of section 3101(b) of the
			 Internal Revenue Code of 1986, as added by section 9015 of the Patient
			 Protection and Affordable Care Act and amended by section 10906 of such Act, is
			 amended by striking <quote>and</quote> at the end of subparagraph (A), by
			 redesignating subparagraph (B) as subparagraph (C), and by inserting after
			 subparagraph (A) the following new subparagraph:</text>
								<quoted-block display-inline="no-display-inline" id="HD31A6A12C6E14CEFB0B090876228C4BE" style="OLC">
									<subparagraph commented="no" display-inline="no-display-inline" id="H526BFE6A3F1D482DB19D9E76A7BB0BE5"><enum>(B)</enum><text display-inline="yes-display-inline">in the case of a married taxpayer (as
				defined in section 7703) filing a separate return, ½ of the dollar amount
				determined under subparagraph (A),
				and</text>
									</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HFD19622C1A1E432FB06A5EC079AE6F71"><enum>(B)</enum><header display-inline="yes-display-inline">SECA</header><text display-inline="yes-display-inline">Section 1401(b)(2) of the Internal Revenue
			 Code of 1986, as added by section 9015 of the Patient Protection and Affordable
			 Care Act and amended by section 10906 of such Act, is amended—</text>
								<clause commented="no" display-inline="no-display-inline" id="HD609177C145842C993D9466C6070AD79"><enum>(i)</enum><text display-inline="yes-display-inline">in subparagraph (A), by striking
			 <quote>and</quote> at the end of clause (i), by redesignating clause (ii) as
			 clause (iii), and by inserting after clause (i) the following new
			 clause:</text>
									<quoted-block display-inline="no-display-inline" id="H3BF6AD721A71400290BF2351C4E95BF1" style="OLC">
										<clause commented="no" display-inline="no-display-inline" id="H1002F5742C694A4AA19CCA7119C8046E"><enum>(ii)</enum><text display-inline="yes-display-inline">in the case of a married taxpayer (as
				defined in section 7703) filing a separate return, ½ of the dollar amount
				determined under clause (i), and</text>
										</clause><after-quoted-block>;
				and</after-quoted-block></quoted-block>
								</clause><clause commented="no" display-inline="no-display-inline" id="H11D982E1B71E4548970C02210FD3FB00"><enum>(ii)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking
			 <quote>under clauses (i) and (ii)</quote> and inserting <quote>under clause
			 (i), (ii), or (iii) (whichever is applicable)</quote>.</text>
								</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H72F97636EA02487089F5928161147E75"><enum>(2)</enum><header display-inline="yes-display-inline">Estimated taxes</header><text display-inline="yes-display-inline">Section 6654 of the Internal Revenue Code
			 of 1986 is amended by redesignating subsection (m) as subsection (n) and by
			 inserting after subsection (l) the following new subsection:</text>
							<quoted-block display-inline="no-display-inline" id="HD762CFAAFC964A3D827AC29285A3BE03" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="H4D61D8F91C044B169E8D8038188F60FF"><enum>(m)</enum><header display-inline="yes-display-inline">Special rule for medicare tax</header><text display-inline="yes-display-inline">For purposes of this section, the tax
				imposed under section 3101(b)(2) (to the extent not withheld) shall be treated
				as a tax imposed under chapter
				2.</text>
								</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H66322B537125405C867F2531FD7AD654"><enum>(3)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendments made by
			 this subsection shall apply with respect to remuneration received, and taxable
			 years beginning after, December 31, 2012.</text>
						</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="HFA8AB1958E644BF28EE8E44319FC3106" section-type="subsequent-section"><enum>1403.</enum><header display-inline="yes-display-inline">Delay of limitation on health flexible
			 spending arrangements under cafeteria plans</header>
					<subsection commented="no" display-inline="no-display-inline" id="H2E597978268F418AAC8659966C41458C"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 10902(b) of the Patient Protection
			 and Affordable Care Act is amended by striking <quote>December 31, 2010</quote>
			 and inserting <quote>December 31, 2012</quote>.</text>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H3D13444FFA79431AA7D303E5B204F8E4"><enum>(b)</enum><header display-inline="yes-display-inline">Inflation adjustment</header><text display-inline="yes-display-inline">Paragraph (2) of section 125(i) of the
			 Internal Revenue Code of 1986, as added by section 9005 of the Patient
			 Protection and Affordable Care Act and amended by section 10902 of such Act, is
			 amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H3FB3FE36F4F443A7AC9369E1A170390D"><enum>(1)</enum><text display-inline="yes-display-inline">in the matter preceding subparagraph (A),
			 by striking <quote>December 31, 2011</quote> and inserting <quote>December 31,
			 2013</quote>; and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H730C65CA94014A3A93F1A61CA0FA35B2"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking
			 <quote>2010</quote> and inserting <quote>2012</quote>.</text>
						</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H5514FAD1B4234E13960E1EC9E0C3F508" section-type="subsequent-section"><enum>1404.</enum><header display-inline="yes-display-inline">Brand name pharmaceuticals</header>
					<subsection commented="no" display-inline="no-display-inline" id="H3064F489D67648088E217848A76D9629"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 9008 of the Patient Protection and
			 Affordable Care Act is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H4801D95075A249A9A2F365F75247AB53"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)(1), by striking
			 <quote>2009</quote> and inserting <quote>2010</quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5D4BF6E061B843C185FDEDA3949FB1E1"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H844951C558E44B59BC8A9D2B291D9780"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>$2,300,000,000</quote>
			 in paragraph (1) and inserting <quote>the applicable amount</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HBFB555F0359A4BAF860AA8BB43704155"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 paragraph:</text>
								<quoted-block display-inline="no-display-inline" id="H7668C0A21D874F2C9A0241FBAB6397DC" style="OLC">
									<paragraph commented="no" display-inline="no-display-inline" id="H565C77E792C64494B09D2CB94D5781C7"><enum>(4)</enum><header display-inline="yes-display-inline">Applicable amount</header><text display-inline="yes-display-inline">For purposes of paragraph (1), the
				applicable amount shall be determined in accordance with the following
				table:</text>
										<table align-to-level="section" blank-lines-after="0" blank-lines-before="1" colsep="0" frame="none" line-rules="no-gen" rowsep="0" rule-weights="0.0.0.0.0.0" table-template-name="Entry: 2 text, bold hds" table-type="">
											<tgroup cols="2" grid-typeface="1.1" rowsep="0" thead-tbody-ldg-size="0.10.12"><colspec coldef="txt" colname="column1" colsep="0" colwidth="230pts" min-data-value="190" rowsep="0"></colspec><colspec coldef="txt-no-ldr-no-spread" colname="column2" colsep="0" colwidth="95pts" min-data-value="95" rowsep="0"></colspec>
												<tbody>
													<row><entry colname="column1" leader-modify="clr-ldr" rowsep="0" stub-definition="txt-clr" stub-hierarchy="1"><bold>Calendar year
						</bold></entry><entry colname="column2" leader-modify="clr-ldr"><bold>Applicable amount</bold></entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2011</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$2,500,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2012</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$2,800,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2013</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$2,800,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2014</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$3,000,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2015</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$3,000,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2016</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$3,000,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2017</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$4,000,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2018</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$4,100,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2019 and thereafter</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$2,800,000,000.</entry>
													</row>
												</tbody>
											</tgroup></table>
									</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H347141792C8A43C0BFE2423F12AAD809"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (d), by adding at the end the
			 following new paragraph:</text>
							<quoted-block display-inline="no-display-inline" id="H2BEC2D45825F46EB99625518868B7523" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="HE725504F49CC47DEA55B1E997859F260"><enum>(3)</enum><header display-inline="yes-display-inline">Joint and several liability</header><text display-inline="yes-display-inline">If more than one person is liable for
				payment of the fee under subsection (a) with respect to a single covered entity
				by reason of the application of paragraph (2), all such persons shall be
				jointly and severally liable for payment of such
				fee.</text>
								</paragraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA5242AFA27D34BFE8AF48F5E7D44C509"><enum>(4)</enum><text display-inline="yes-display-inline">by striking subsection (j) and inserting
			 the following new subsection:</text>
							<quoted-block display-inline="no-display-inline" id="H1E080B0685CA43F1A99278D5C0B981BA" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="HCE32364788BD4EA7A230A787DB79B805"><enum>(j)</enum><header display-inline="yes-display-inline">Effective
				date</header><text display-inline="yes-display-inline">This section shall apply
				to calendar years beginning after December 31,
				2010.</text>
								</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H64BFB06F5A6748CA81B719398FC1743F"><enum>(b)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendments made by
			 this section shall take effect as if included in section 9008 of the Patient
			 Protection and Affordable Care Act.</text>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="H7AAC9D1EFEF248CD8E94E9BB35EE0B25" section-type="subsequent-section"><enum>1405.</enum><header display-inline="yes-display-inline">Excise tax on medical device
			 manufacturers</header>
					<subsection commented="no" display-inline="no-display-inline" id="H98ADBCB144C149488F65F58D198177D0"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Chapter 32 of the Internal Revenue Code of
			 1986 is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HB0C5AFAC4CC64707938B7E1864C3D7CF"><enum>(1)</enum><text display-inline="yes-display-inline">by inserting after subchapter D the
			 following new subchapter:</text>
							<quoted-block display-inline="no-display-inline" id="H1B9B887B5BAE4E7E8D0C4412C3362E1A" style="OLC">
								<subchapter commented="no" id="H5E3A703D11FD46C9AAC41B825A54BF43" level-type="subsequent"><enum>E</enum><header display-inline="yes-display-inline">Medical devices </header>
									<toc container-level="subchapter-container" lowest-bolded-level="division-lowest-bolded" lowest-level="section" quoted-block="no-quoted-block" regeneration="yes-regeneration">
										<toc-entry bold="off" level="section">Sec. 4191. Medical
				  devices.</toc-entry>
									</toc>
									<section commented="no" display-inline="no-display-inline" id="HA133CEB87B6945409BD9F9903303D80A" section-type="subsequent-section"><enum>4191.</enum><header display-inline="yes-display-inline">Medical devices</header>
										<subsection commented="no" display-inline="no-display-inline" id="HAD2AEB9F107D49BDA1CA0DD44598470D"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">There is hereby imposed on the sale of any
				taxable medical device by the manufacturer, producer, or importer a tax equal
				to 2.3 percent of the price for which so sold.</text>
										</subsection><subsection commented="no" display-inline="no-display-inline" id="HFB11EA054D464411B74FCCB7301F6C29"><enum>(b)</enum><header display-inline="yes-display-inline">Taxable medical device</header><text display-inline="yes-display-inline">For purposes of this section—</text>
											<paragraph commented="no" display-inline="no-display-inline" id="HC5FA908CE34748DE8E0F22FC38AB4430"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The term <term>taxable medical
				device</term> means any device (as defined in section 201(h) of the Federal
				Food, Drug, and Cosmetic Act) intended for humans.</text>
											</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0E82D3CCCBC244C3A2A8FDE35E685067"><enum>(2)</enum><header display-inline="yes-display-inline">Exemptions</header><text display-inline="yes-display-inline">Such term shall not include—</text>
												<subparagraph commented="no" display-inline="no-display-inline" id="HC18A28920B55418CA7094DA1A9C34ED7"><enum>(A)</enum><text display-inline="yes-display-inline">eyeglasses,</text>
												</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H44135FCB947B4BD8B913337D9AD2EFA8"><enum>(B)</enum><text display-inline="yes-display-inline">contact lenses,</text>
												</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HB7D7B9EA38E645B3AD4FACF1226102C9"><enum>(C)</enum><text display-inline="yes-display-inline">hearing aids, and</text>
												</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5013DAADA01A4D468F5C79F0163D9C83"><enum>(D)</enum><text display-inline="yes-display-inline">any other medical device determined by the
				Secretary to be of a type which is generally purchased by the general public at
				retail for individual use.</text>
												</subparagraph></paragraph></subsection></section></subchapter><after-quoted-block>,
				and</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H11E478A79D594B9F8B089476FD145434"><enum>(2)</enum><text display-inline="yes-display-inline">by inserting after the item relating to
			 subchapter D in the table of subchapters for such chapter the following new
			 item:</text>
							<quoted-block display-inline="no-display-inline" id="HA3B1FEB8993A4BC18C79051EF8F8AF08" style="OLC">
								<toc regeneration="no-regeneration">
									<toc-entry bold="off" level="subchapter">Subchapter E. Medical
				devices</toc-entry>
								</toc>
								<after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HF9C5703BA8CF439BBAEA0F54237522CF"><enum>(b)</enum><header display-inline="yes-display-inline">Certain exemptions not to apply</header>
						<paragraph commented="no" display-inline="no-display-inline" id="H81B83A559FA142528A55895F7B2883E5"><enum>(1)</enum><text display-inline="yes-display-inline">Section 4221(a) of the Internal Revenue
			 Code of 1986 is amended by adding at the end the following new sentence:
			 <quote>In the case of the tax imposed by section 4191, paragraphs (3), (4),
			 (5), and (6) shall not apply.</quote>.</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H000FEF3442E04268BACCA63EA2FDE43F"><enum>(2)</enum><text display-inline="yes-display-inline">Section 6416(b)(2) of such Code is amended
			 by adding at the end the following: <quote>In the case of the tax imposed by
			 section 4191, subparagraphs (B), (C), (D), and (E) shall not
			 apply.</quote>.</text>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H21A4362103834ABE801E368C340C2719"><enum>(c)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendments made by
			 this section shall apply to sales after December 31, 2012.</text>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H03FFF667A8474A5B90AECAD4DE139244"><enum>(d)</enum><header display-inline="yes-display-inline">Repeal of section 9009 of the Patient
			 Protection and Affordable Care Act</header><text display-inline="yes-display-inline">Section 9009 of the Patient Protection and
			 Affordable Care Act, as amended by section 10904 of such Act, is repealed
			 effective as of the date of enactment of that Act.</text>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="H2E4E79138D9745B08DACC30C066F9BE7" section-type="subsequent-section"><enum>1406.</enum><header display-inline="yes-display-inline">Health insurance providers</header>
					<subsection commented="no" display-inline="no-display-inline" id="H755F601B67BD47E5B41D871974097D31"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 9010 of the Patient Protection and
			 Affordable Care Act, as amended by section 10905 of such Act, is
			 amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="HBE74197A013449B29E0C07530A52B9A9"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)(1), by striking
			 <quote>2010</quote> and inserting <quote>2013</quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H00FDCC8881C14481AFB01478A4CB59C5"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)(2)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HCB055D9A8EB94E3DA44214DDF269F853"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>For purposes of
			 paragraph (1), the net premiums</quote> and
			 inserting</text>
								<quoted-block display-inline="yes-display-inline" id="HC80B466F63974462967C3286CB3C9CC6" style="OLC">
									<text>For purposes of paragraph
			 (1)—</text><subparagraph commented="no" display-inline="no-display-inline" id="HEE695DC73EC44C0FAFBE764B8D8EC9C0"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The net
				premiums</text>
									</subparagraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8001E99FE8AE42A89E0AE8F4BEA2E63E"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following
			 subparagraph:</text>
								<quoted-block display-inline="no-display-inline" id="HA4EF1B24C218436C8D3FA70B481DF422" style="OLC">
									<subparagraph commented="no" display-inline="no-display-inline" id="H6D313C86E3C24A64A0DF5FDA65502796"><enum>(B)</enum><header display-inline="yes-display-inline">Partial exclusion for certain exempt
				activities</header><text display-inline="yes-display-inline">After the
				application of subparagraph (A), only 50 percent of the remaining net premiums
				written with respect to health insurance for any United States health risk that
				are attributable to the activities (other than activities of an unrelated trade
				or business as defined in section 513 of the Internal Revenue Code of 1986) of
				any covered entity qualifying under paragraph (3), (4), (26), or (29) of
				section 501(c) of such Code and exempt from tax under section 501(a) of such
				Code shall be taken into account.</text>
									</subparagraph><after-quoted-block>;
				</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H1B3BCF72349649CE9479A5123678334D"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (c)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HFB7945E36D8041F8B7721ED75618A7FB"><enum>(A)</enum><text display-inline="yes-display-inline">by inserting <quote>during the calendar
			 year in which the fee under this section is due</quote> in paragraph (1) after
			 <quote>risk</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H074A16849BC643C1AEFFA76C1B5B97F5"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (2), by striking subparagraphs
			 (C), (D), and (E) and inserting the following new subparagraphs:</text>
								<quoted-block display-inline="no-display-inline" id="H7DCA3ADDEED140C09DF8A0DB0E99285A" style="OLC">
									<subparagraph commented="no" display-inline="no-display-inline" id="H2CD87BFC6BFE4616A847E4986D3C68EB"><enum>(C)</enum><text display-inline="yes-display-inline">any entity—</text>
										<clause commented="no" display-inline="no-display-inline" id="H7AA617917B6F4F87B0B787D038D4DFFC"><enum>(i)</enum><text display-inline="yes-display-inline">which is incorporated as a nonprofit
				corporation under a State law,</text>
										</clause><clause commented="no" display-inline="no-display-inline" id="HA14186A40C574186BE50F2E1B75EB1AB"><enum>(ii)</enum><text display-inline="yes-display-inline">no part of the net earnings of which inures
				to the benefit of any private shareholder or individual, no substantial part of
				the activities of which is carrying on propaganda, or otherwise attempting, to
				influence legislation (except as otherwise provided in section 501(h) of the
				Internal Revenue Code of 1986), and which does not participate in, or intervene
				in (including the publishing or distributing of statements), any political
				campaign on behalf of (or in opposition to) any candidate for public office,
				and</text>
										</clause><clause commented="no" display-inline="no-display-inline" id="HB6F39CE0EA924CBCAC0D5D40EE0107B1"><enum>(iii)</enum><text display-inline="yes-display-inline">more than 80 percent of the gross revenues
				of which is received from government programs that target low-income, elderly,
				or disabled populations under titles XVIII, XIX, and XXI of the Social Security
				Act, and</text>
										</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0842C08291324D4BA2124A9980016A45"><enum>(D)</enum><text display-inline="yes-display-inline">any entity which is described in section
				501(c)(9) of such Code and which is established by an entity (other than by an
				employer or employers) for purposes of providing health care
				benefits.</text>
									</subparagraph><after-quoted-block>;
				</after-quoted-block></quoted-block>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8A4318516D754F6389718ACC22294F27"><enum>(C)</enum><text display-inline="yes-display-inline">in paragraph (3)(A), by striking
			 <quote>subparagraph (C)(i)(I), (D)(i)(I), or (E)(i)</quote> and inserting
			 <quote>subparagraph (C) or (D)</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H992805A642D049DF9159E52EAD53AD1D"><enum>(D)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 paragraph:</text>
								<quoted-block display-inline="no-display-inline" id="H0A60A9300A34413EA8B2D66D6B3980EF" style="OLC">
									<paragraph commented="no" display-inline="no-display-inline" id="HC9AADFD9E17246D2902B9F4035A3020F"><enum>(4)</enum><header display-inline="yes-display-inline">Joint and several liability</header><text display-inline="yes-display-inline">If more than one person is liable for
				payment of the fee under subsection (a) with respect to a single covered entity
				by reason of the application of paragraph (3), all such persons shall be
				jointly and severally liable for payment of such
				fee.</text>
									</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H98F20F8B447A474A9929BD0905131C34"><enum>(4)</enum><text display-inline="yes-display-inline">by striking subsection (e) and inserting
			 the following:</text>
							<quoted-block display-inline="no-display-inline" id="HC02E6102F079445ABB022A52421027EA" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="HE2959E3B2CDC4B46811266B92675A08A"><enum>(e)</enum><header display-inline="yes-display-inline">Applicable amount</header><text display-inline="yes-display-inline">For purposes of subsection (b)(1)—</text>
									<paragraph commented="no" display-inline="no-display-inline" id="H4D72A8FFCB0F42098DD381A4055FC72B"><enum>(1)</enum><header display-inline="yes-display-inline">Years before 2019</header><text display-inline="yes-display-inline">In the case of calendar years beginning
				before 2019, the applicable amount shall be determined in accordance with the
				following table:</text>
										<table align-to-level="section" blank-lines-after="0" blank-lines-before="1" colsep="0" frame="none" line-rules="no-gen" rowsep="0" rule-weights="0.0.0.0.0.0" table-template-name="Entry: 2 text, bold hds" table-type="">
											<tgroup cols="2" grid-typeface="1.1" rowsep="0" thead-tbody-ldg-size="0.10.12"><colspec coldef="txt" colname="column1" colsep="0" colwidth="230pts" min-data-value="190" rowsep="0"></colspec><colspec coldef="txt-no-ldr-no-spread" colname="column2" colsep="0" colwidth="95pts" min-data-value="95" rowsep="0"></colspec>
												<tbody>
													<row><entry colname="column1" leader-modify="clr-ldr" rowsep="0" stub-definition="txt-clr" stub-hierarchy="1"><bold>Calendar year
						</bold></entry><entry colname="column2" leader-modify="clr-ldr"><bold>Applicable amount</bold></entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2014</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$8,000,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2015</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$11,300,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2016</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$11,300,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2017</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$13,900,000,000</entry>
													</row>
													<row><entry colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="2">2018</entry><entry colname="column2" leader-modify="clr-ldr" rowsep="0">$14,300,000,000.</entry>
													</row>
												</tbody>
											</tgroup>
										</table>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H9F872D6A63C544088A323ADC474CD835"><enum>(2)</enum><header display-inline="yes-display-inline">Years after 2018</header><text display-inline="yes-display-inline">In the case of any calendar year beginning
				after 2018, the applicable amount shall be the applicable amount for the
				preceding calendar year increased by the rate of premium growth (within the
				meaning of section 36B(b)(3)(A)(ii) of the Internal Revenue Code of 1986) for
				such preceding calendar year.</text>
									</paragraph></subsection><after-quoted-block>;
				</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H344FFF115305416083A6FF807D109E65"><enum>(5)</enum><text display-inline="yes-display-inline">in subsection (g), by adding at the end the
			 following new paragraphs:</text>
							<quoted-block display-inline="no-display-inline" id="HE9F8E9042C12432789342090C4C5DAC4" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="HB1F5FDA6781D42BEAA74FE4E6CD1C554"><enum>(3)</enum><header display-inline="yes-display-inline">Accuracy-related penalty</header>
									<subparagraph commented="no" display-inline="no-display-inline" id="H08E03EE1CA64479AB6916B129D620DDE"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">In the case of any understatement of a
				covered entity’s net premiums written with respect to health insurance for any
				United States health risk for any calendar year, there shall be paid by the
				covered entity making such understatement, an amount equal to the excess
				of—</text>
										<clause commented="no" display-inline="no-display-inline" id="H3B1B9035F67249EF82710518F91E9429"><enum>(i)</enum><text display-inline="yes-display-inline">the amount of the covered entity’s fee
				under this section for the calendar year the Secretary determines should have
				been paid in the absence of any such understatement, over</text>
										</clause><clause commented="no" display-inline="no-display-inline" id="H40A3419A24904B67A73F9E036AD0E60C"><enum>(ii)</enum><text display-inline="yes-display-inline">the amount of such fee the Secretary
				determined based on such understatement.</text>
										</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HEA09EB1E65EE48A3B32EB56D49A4406A"><enum>(B)</enum><header display-inline="yes-display-inline">Understatement</header><text display-inline="yes-display-inline">For purposes of this paragraph, an
				understatement of a covered entity’s net premiums written with respect to
				health insurance for any United States health risk for any calendar year is the
				difference between the amount of such net premiums written as reported on the
				return filed by the covered entity under paragraph (1) and the amount of such
				net premiums written that should have been reported on such return.</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H4976542B49114D9D9A25F80F28870844"><enum>(C)</enum><header display-inline="yes-display-inline">Treatment of penalty</header><text display-inline="yes-display-inline">The penalty imposed under subparagraph (A)
				shall be subject to the provisions of subtitle F of the Internal Revenue Code
				of 1986 that apply to assessable penalties imposed under chapter 68 of such
				Code.</text>
									</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H72B00590CFDB4FCC9D4670B315DA1BAA"><enum>(4)</enum><header display-inline="yes-display-inline">Treatment of information</header><text display-inline="yes-display-inline">Section 6103 of the Internal Revenue Code
				of 1986 shall not apply to any information reported under this
				subsection.</text>
								</paragraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H1A230AE8144A4EB58F4F2F8A46441AA9"><enum>(6)</enum><text display-inline="yes-display-inline">by striking subsection (j) and inserting
			 the following new subsection:</text>
							<quoted-block display-inline="no-display-inline" id="H44EB04B50A484CBE9E490F56A64F875A" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="H9D619B64E60349FC92006ACF8D7E76D3"><enum>(j)</enum><header display-inline="yes-display-inline">Effective
				date</header><text display-inline="yes-display-inline">This section shall apply
				to calendar years beginning after December 31,
				2013.</text>
								</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H371BC7126799412FA74CC5F414F3A67C"><enum>(b)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendments made by
			 this section shall take effect as if included in section 9010 of the Patient
			 Protection and Affordable Care Act.</text>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="H12BC44B84A874CF586ECE8197F31DBE4" section-type="subsequent-section"><enum>1407.</enum><header display-inline="yes-display-inline">Delay of elimination of deduction for
			 expenses allocable to medicare part D subsidy</header><text display-inline="no-display-inline">Section 9012(b) of the Patient Protection
			 and Affordable Care Act is amended by striking <quote>2010</quote> and
			 inserting <quote>2012</quote>.</text>
				</section><section commented="no" display-inline="no-display-inline" id="H131850157EFE421985E49F6D5BBE077A" section-type="subsequent-section"><enum>1408.</enum><header display-inline="yes-display-inline">Elimination of unintended application of
			 cellulosic biofuel producer credit</header>
					<subsection commented="no" display-inline="no-display-inline" id="H51612F02BE25467093DC7AA71F302825"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 40(b)(6)(E) of the Internal Revenue
			 Code of 1986 is amended by adding at the end the following new clause:</text>
						<quoted-block display-inline="no-display-inline" id="HD49E179D52E6429D98AA684B828DEE1D" style="OLC">
							<clause commented="no" display-inline="no-display-inline" id="H5AA7C9590FD04D21B02CDF225DB54560"><enum>(iii)</enum><header display-inline="yes-display-inline">Exclusion of unprocessed
				fuels</header><text display-inline="yes-display-inline">The term
				<term>cellulosic biofuel</term> shall not include any fuel if—</text>
								<subclause commented="no" display-inline="no-display-inline" id="H901FBC0FB04A455CB0272BEAA3DD2970"><enum>(I)</enum><text display-inline="yes-display-inline">more than 4 percent of such fuel
				(determined by weight) is any combination of water and sediment, or</text>
								</subclause><subclause commented="no" display-inline="no-display-inline" id="H9B2AC666DC97444E96405AA7682367AB"><enum>(II)</enum><text display-inline="yes-display-inline">the ash content of such fuel is more than 1
				percent (determined by
				weight).</text>
								</subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H6841EF645B754910B71D46D10FF2B13F"><enum>(b)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendment made by
			 this section shall apply to fuels sold or used on or after January 1,
			 2010.</text>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="H91F73F70D87546C599B8E15DDE90D449" section-type="subsequent-section"><enum>1409.</enum><header display-inline="yes-display-inline">Codification of economic substance doctrine
			 and penalties</header>
					<subsection commented="no" display-inline="no-display-inline" id="H1A02BA184DD24E17A74E629AE429398F"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 7701 of the Internal Revenue Code
			 of 1986 is amended by redesignating subsection (o) as subsection (p) and by
			 inserting after subsection (n) the following new subsection:</text>
						<quoted-block display-inline="no-display-inline" id="H337960B1E38E49518862CECED218A91C" style="OLC">
							<subsection commented="no" display-inline="no-display-inline" id="H579F4ACF354F4DBBB604D44B4A4AA3E0"><enum>(o)</enum><header display-inline="yes-display-inline">Clarification of economic substance
				doctrine</header>
								<paragraph commented="no" display-inline="no-display-inline" id="H5D4EF5B081A04E87B239755C472CB3DF"><enum>(1)</enum><header display-inline="yes-display-inline">Application of doctrine</header><text display-inline="yes-display-inline">In the case of any transaction to which the
				economic substance doctrine is relevant, such transaction shall be treated as
				having economic substance only if—</text>
									<subparagraph commented="no" display-inline="no-display-inline" id="H10245D0E63C3403EA6B08935688DD1D1"><enum>(A)</enum><text display-inline="yes-display-inline">the transaction changes in a meaningful way
				(apart from Federal income tax effects) the taxpayer’s economic position,
				and</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE4D63C85E56947C8AFB9552303790904"><enum>(B)</enum><text display-inline="yes-display-inline">the taxpayer has a substantial purpose
				(apart from Federal income tax effects) for entering into such
				transaction.</text>
									</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD037C0CEDBB342048BA09D7D31241E2A"><enum>(2)</enum><header display-inline="yes-display-inline">Special rule where taxpayer relies on
				profit potential</header>
									<subparagraph commented="no" display-inline="no-display-inline" id="H3113504AF4DF4DFAA0D21DD2F74D9C5C"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The potential for profit of a transaction
				shall be taken into account in determining whether the requirements of
				subparagraphs (A) and (B) of paragraph (1) are met with respect to the
				transaction only if the present value of the reasonably expected pre-tax profit
				from the transaction is substantial in relation to the present value of the
				expected net tax benefits that would be allowed if the transaction were
				respected.</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H869F507B46924B0291968A4695637778"><enum>(B)</enum><header display-inline="yes-display-inline">Treatment of fees and foreign
				taxes</header><text display-inline="yes-display-inline">Fees and other
				transaction expenses shall be taken into account as expenses in determining
				pre-tax profit under subparagraph (A). The Secretary shall issue regulations
				requiring foreign taxes to be treated as expenses in determining pre-tax profit
				in appropriate cases.</text>
									</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H79520832C1F34B06A56023DC58944AF9"><enum>(3)</enum><header display-inline="yes-display-inline">State and local tax benefits</header><text display-inline="yes-display-inline">For purposes of paragraph (1), any State or
				local income tax effect which is related to a Federal income tax effect shall
				be treated in the same manner as a Federal income tax effect.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H26048AE0386C418095F41015E086ABA1"><enum>(4)</enum><header display-inline="yes-display-inline">Financial accounting benefits</header><text display-inline="yes-display-inline">For purposes of paragraph (1)(B), achieving
				a financial accounting benefit shall not be taken into account as a purpose for
				entering into a transaction if the origin of such financial accounting benefit
				is a reduction of Federal income tax.</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3E242AD317CB47B2867F9CC6143A0AE8"><enum>(5)</enum><header display-inline="yes-display-inline">Definitions and special rules</header><text display-inline="yes-display-inline">For purposes of this subsection—</text>
									<subparagraph commented="no" display-inline="no-display-inline" id="H1275B080D659412384B363330DF8AA1F"><enum>(A)</enum><header display-inline="yes-display-inline">Economic substance doctrine</header><text display-inline="yes-display-inline">The term <term>economic substance
				doctrine</term> means the common law doctrine under which tax benefits under
				subtitle A with respect to a transaction are not allowable if the transaction
				does not have economic substance or lacks a business purpose.</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8278FF407DE14FEA9AF0D39E6C6D0B58"><enum>(B)</enum><header display-inline="yes-display-inline">Exception for personal transactions of
				individuals</header><text display-inline="yes-display-inline">In the case of an
				individual, paragraph (1) shall apply only to transactions entered into in
				connection with a trade or business or an activity engaged in for the
				production of income.</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H27DB9DCF983E46F49FFFB8E02047FE30"><enum>(C)</enum><header display-inline="yes-display-inline">Determination of application of doctrine
				not affected</header><text display-inline="yes-display-inline">The
				determination of whether the economic substance doctrine is relevant to a
				transaction shall be made in the same manner as if this subsection had never
				been enacted.</text>
									</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HEE281B5CDCE9434EB42D00DD66DBB9CA"><enum>(D)</enum><header display-inline="yes-display-inline">Transaction</header><text display-inline="yes-display-inline">The term <term>transaction</term> includes
				a series of
				transactions.</text>
									</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H4D84538534BE4E1B9E316D7E931870D1"><enum>(b)</enum><header display-inline="yes-display-inline">Penalty for underpayments attributable to
			 transactions lacking economic substance</header>
						<paragraph commented="no" display-inline="no-display-inline" id="H9D4A8EC20450470FA12861007BFA9FF2"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subsection (b) of section 6662 is amended
			 by inserting after paragraph (5) the following new paragraph:</text>
							<quoted-block display-inline="no-display-inline" id="HDAD6BA8195964781BC85D882AD4B4A8A" style="OLC">
								<paragraph commented="no" display-inline="no-display-inline" id="H8E12A2E99592474BA8B350A944D7CF09"><enum>(6)</enum><text display-inline="yes-display-inline">Any disallowance of claimed tax benefits by
				reason of a transaction lacking economic substance (within the meaning of
				section 7701(o)) or failing to meet the requirements of any similar rule of
				law.</text>
								</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HBD3DA37C4F3C415481B406D13D601CA0"><enum>(2)</enum><header display-inline="yes-display-inline">Increased penalty for nondisclosed
			 transactions</header><text display-inline="yes-display-inline">Section 6662 is
			 amended by adding at the end the following new subsection:</text>
							<quoted-block display-inline="no-display-inline" id="H5629044B73FD4FA59EB809E60CD79A63" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="H940B747B699D435585D9407B400AC92B"><enum>(i)</enum><header display-inline="yes-display-inline">Increase in penalty in case of nondisclosed
				noneconomic substance transactions</header>
									<paragraph commented="no" display-inline="no-display-inline" id="HEAA78E78587442B7956932D310E9C0F0"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">In the case of any portion of an
				underpayment which is attributable to one or more nondisclosed noneconomic
				substance transactions, subsection (a) shall be applied with respect to such
				portion by substituting <quote>40 percent</quote> for <quote>20
				percent</quote>.</text>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H828B746FCEBA443EB2E3FD6C0187155D"><enum>(2)</enum><header display-inline="yes-display-inline">Nondisclosed noneconomic substance
				transactions</header><text display-inline="yes-display-inline">For purposes of
				this subsection, the term <term>nondisclosed noneconomic substance
				transaction</term> means any portion of a transaction described in subsection
				(b)(6) with respect to which the relevant facts affecting the tax treatment are
				not adequately disclosed in the return nor in a statement attached to the
				return.</text>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5026043E7E08411E91A042D6720892A3"><enum>(3)</enum><header display-inline="yes-display-inline">Special rule for amended
				returns</header><text display-inline="yes-display-inline">In no event shall any
				amendment or supplement to a return of tax be taken into account for purposes
				of this subsection if the amendment or supplement is filed after the earlier of
				the date the taxpayer is first contacted by the Secretary regarding the
				examination of the return or such other date as is specified by the
				Secretary.</text>
									</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H85B3704065044A5CBB32A7830765DF33"><enum>(3)</enum><header display-inline="yes-display-inline">Conforming amendment</header><text display-inline="yes-display-inline">Subparagraph (B) of section 6662A(e)(2) is
			 amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HA91B58168F7E4533A9814B8012E18D0F"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>section 6662(h)</quote>
			 and inserting <quote>subsections (h) or (i) of section 6662</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H99562984B4E74FC5B2A7725EB1518F61"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote><header-in-text level="subparagraph" style="OLC">gross valuation misstatement
			 penalty</header-in-text></quote> in the heading and inserting
			 <quote><header-in-text level="subparagraph" style="OLC">certain increased
			 underpayment penalties</header-in-text></quote>.</text>
							</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H544D600A4F1647CD9878A57C417F599C"><enum>(c)</enum><header display-inline="yes-display-inline">Reasonable cause exception not applicable
			 to noneconomic substance transactions</header>
						<paragraph commented="no" display-inline="no-display-inline" id="HF52EA1C4E3D14821BF0DFD7F58C50B9C"><enum>(1)</enum><header display-inline="yes-display-inline">Reasonable cause exception for
			 underpayments</header><text display-inline="yes-display-inline">Subsection (c)
			 of section 6664 is amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HFD846980F4954175901B0E477EA5E5C3"><enum>(A)</enum><text display-inline="yes-display-inline">by redesignating paragraphs (2) and (3) as
			 paragraphs (3) and (4), respectively;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HCC61D946B8C8417987A49568FDF53B3E"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote>paragraph (2)</quote> in
			 paragraph (4)(A), as so redesignated, and inserting <quote>paragraph
			 (3)</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H36D9F40A9FED438A9709ACC0AF310093"><enum>(C)</enum><text display-inline="yes-display-inline">by inserting after paragraph (1) the
			 following new paragraph:</text>
								<quoted-block display-inline="no-display-inline" id="H65BE3B23EE994E3F852E394733482DA4" style="OLC">
									<paragraph commented="no" display-inline="no-display-inline" id="HB3AB39C9018845BEADEF96554278737D"><enum>(2)</enum><header display-inline="yes-display-inline">Exception</header><text display-inline="yes-display-inline">Paragraph (1) shall not apply to any
				portion of an underpayment which is attributable to one or more transactions
				described in section
				6662(b)(6).</text>
									</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA37780C91CA5450A890ABB280E848FCF"><enum>(2)</enum><header display-inline="yes-display-inline">Reasonable cause exception for reportable
			 transaction understatements</header><text display-inline="yes-display-inline">Subsection (d) of section 6664 is
			 amended—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H6430C1FC7B5D464A8203E28517347B94"><enum>(A)</enum><text display-inline="yes-display-inline">by redesignating paragraphs (2) and (3) as
			 paragraphs (3) and (4), respectively;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5B48EAE4C44B4A5FBB42A08979721A84"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote>paragraph (2)(C)</quote>
			 in paragraph (4), as so redesignated, and inserting <quote>paragraph
			 (3)(C)</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H7371E93DE3B749CFB0BE82261F29FD96"><enum>(C)</enum><text display-inline="yes-display-inline">by inserting after paragraph (1) the
			 following new paragraph:</text>
								<quoted-block display-inline="no-display-inline" id="HCD6392C53F1D4E209F04F8F40166216F" style="OLC">
									<paragraph commented="no" display-inline="no-display-inline" id="H9AA85FE8C3D94925BF716D3DCBABD3F2"><enum>(2)</enum><header display-inline="yes-display-inline">Exception</header><text display-inline="yes-display-inline">Paragraph (1) shall not apply to any
				portion of a reportable transaction understatement which is attributable to one
				or more transactions described in section
				6662(b)(6).</text>
									</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
							</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H6F4B0331FDDE436EA1487C7DBBD2364A"><enum>(d)</enum><header display-inline="yes-display-inline">Application of penalty for erroneous claim
			 for refund or credit to noneconomic substance transactions</header><text display-inline="yes-display-inline">Section 6676 is amended by redesignating
			 subsection (c) as subsection (d) and inserting after subsection (b) the
			 following new subsection:</text>
						<quoted-block display-inline="no-display-inline" id="HBD2536D5B3EF43F1AFB70E692ECF2F82" style="OLC">
							<subsection commented="no" display-inline="no-display-inline" id="H325C0CDD06614A7196B3E704D3CE0DF0"><enum>(c)</enum><header display-inline="yes-display-inline">Noneconomic substance transactions treated
				as lacking reasonable basis</header><text display-inline="yes-display-inline">For purposes of this section, any excessive
				amount which is attributable to any transaction described in section 6662(b)(6)
				shall not be treated as having a reasonable
				basis.</text>
							</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="H64E394DD4B3041CE9F8AFFFC57A3B2E9"><enum>(e)</enum><header display-inline="yes-display-inline">Effective Date</header>
						<paragraph commented="no" display-inline="no-display-inline" id="H9B9940D47B034B898F0DA8805CD251F9"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Except as otherwise provided in this
			 subsection, the amendments made by this section shall apply to transactions
			 entered into after the date of the enactment of this Act.</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5D6715B1FBD241D5A2FED4F54F94A9FF"><enum>(2)</enum><header display-inline="yes-display-inline">Underpayments</header><text display-inline="yes-display-inline">The amendments made by subsections (b) and
			 (c)(1) shall apply to underpayments attributable to transactions entered into
			 after the date of the enactment of this Act.</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB5F092DD9A3147EAA85151EACAD05F71"><enum>(3)</enum><header display-inline="yes-display-inline">Understatements</header><text display-inline="yes-display-inline">The amendments made by subsection (c)(2)
			 shall apply to understatements attributable to transactions entered into after
			 the date of the enactment of this Act.</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0F41A93889264889B5829BD74C1255E0"><enum>(4)</enum><header display-inline="yes-display-inline">Refunds and credits</header><text display-inline="yes-display-inline">The amendment made by subsection (d) shall
			 apply to refunds and credits attributable to transactions entered into after
			 the date of the enactment of this Act.</text>
						</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H103C3E4CC0D54EFBB9414FF1884A2F03" section-type="subsequent-section"><enum>1410.</enum><header display-inline="yes-display-inline">Time for payment of corporate estimated
			 taxes</header><text display-inline="no-display-inline">The percentage under
			 paragraph (1) of section 202(b) of the Corporate Estimated Tax Shift Act of
			 2009 in effect on the date of the enactment of this Act is increased by 15.75
			 percentage points.</text>
				</section></subtitle><subtitle commented="no" id="H63199770F32A49D0B71AF3269B3041F7" level-type="subsequent"><enum>F</enum><header display-inline="yes-display-inline">Other provisions</header>
				<section commented="no" display-inline="no-display-inline" id="HAD88D9AE10F041F0B99E13FCACC8D561" section-type="subsequent-section"><enum>1501.</enum><header display-inline="yes-display-inline">Community college and career training grant
			 program</header><text display-inline="no-display-inline">Section 279(b) of the
			 Trade Act of 1974 (19 U.S.C. 2372a(b)) is amended by striking
			 <quote><header-in-text level="subsection" style="OLC">Supplement</header-in-text></quote> and all that follows through
			 <quote>Funds</quote> and inserting <quote>There are</quote> and by striking
			 <quote>pursuant</quote> and all that follows and inserting <quote>$500,000,000
			 for each of fiscal years 2011, 2012, 2013, and 2014 to carry out this
			 subchapter, except that the limitations contained in section 278(a)(2) shall
			 not apply to such funds and each State shall receive not less than 0.5 percent
			 of the amount appropriated pursuant to this subsection for each such fiscal
			 year.</quote>.</text>
				</section></subtitle></title><title commented="no" id="H8B185C5A218C4A54BCC6F0E0D91EC4A0" level-type="subsequent"><enum>II</enum><header display-inline="yes-display-inline">Education and Health</header>
			<subtitle commented="no" id="H9E7E928A33B74533AC0292BE93ED1637" level-type="subsequent"><enum>A</enum><header display-inline="yes-display-inline">Education</header>
				<section commented="no" display-inline="no-display-inline" id="H699EA4C12DB64B42BCCE4CC77603CDFF" section-type="subsequent-section"><enum>2001.</enum><header display-inline="yes-display-inline">Short title; references</header>
					<subsection commented="no" display-inline="no-display-inline" id="HB2FAE47725B0468E9548E680D7D9C818"><enum>(a)</enum><header display-inline="yes-display-inline">Short title</header><text display-inline="yes-display-inline">This subtitle may be cited as the
			 <quote><short-title>SAFRA
			 Act</short-title></quote>.</text>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="HDA204FDEE1E146B8B011803D81D3BE2B"><enum>(b)</enum><header display-inline="yes-display-inline">References</header><text display-inline="yes-display-inline">Except as otherwise expressly provided,
			 whenever in this subtitle an amendment or repeal is expressed in terms of an
			 amendment to, or repeal of, a section or other provision, the reference shall
			 be considered to be made to a section or other provision of the Higher
			 Education Act of 1965 (20 U.S.C. 1001 et seq.).</text>
					</subsection></section><part commented="no" id="HFF93992C56514BFD99D8992E0BBEC998" level-type="subsequent"><enum>I</enum><header display-inline="yes-display-inline">Investing in students and families</header>
					<section commented="no" display-inline="no-display-inline" id="H65CEECDFE0CD4778BF2AC634DF0BD2BE" section-type="subsequent-section"><enum>2101.</enum><header display-inline="yes-display-inline">Federal Pell Grants</header>
						<subsection commented="no" display-inline="no-display-inline" id="H534F809247914DF98E68FF02D6C387F3"><enum>(a)</enum><header display-inline="yes-display-inline">Amount of grants</header><text display-inline="yes-display-inline">Section 401(b) (20 U.S.C. 1070a(b)) is
			 amended—</text>
							<paragraph commented="no" display-inline="no-display-inline" id="H662D120080134465A539305198012D21"><enum>(1)</enum><text display-inline="yes-display-inline">by amending paragraph (2)(A) to read as
			 follows:</text>
								<quoted-block display-inline="no-display-inline" id="HCFDBBC009B8947EAA55532A95822D61F" style="OLC">
									<subparagraph commented="no" display-inline="no-display-inline" id="H8488831128124B8DA97BA19EB9720EA5"><enum>(A)</enum><text display-inline="yes-display-inline">The amount of the Federal Pell Grant for a
				student eligible under this part shall be—</text>
										<clause commented="no" display-inline="no-display-inline" id="H4666E157AB9F4235904706ECA02BDDFF"><enum>(i)</enum><text display-inline="yes-display-inline">the maximum Federal Pell Grant, as
				specified in the last enacted appropriation Act applicable to that award year,
				plus</text>
										</clause><clause commented="no" display-inline="no-display-inline" id="HBF3CD739D55E40F6A22543BD96E6EE14"><enum>(ii)</enum><text display-inline="yes-display-inline">the amount of the increase calculated under
				paragraph (8)(B) for that year, less</text>
										</clause><clause commented="no" display-inline="no-display-inline" id="H16A01663538D4D378BF3875485EC55D7"><enum>(iii)</enum><text display-inline="yes-display-inline">an amount equal to the amount determined to
				be the expected family contribution with respect to that student for that
				year.</text>
										</clause></subparagraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3FCBE5E277244B8DAE48C109C091FC2A"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (8)—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H37A84ABBAF96449488D917AC21B3FA8F"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (A)—</text>
									<clause commented="no" display-inline="no-display-inline" id="H3743899ED4C14FB7B1E0F0868080C540"><enum>(i)</enum><text display-inline="yes-display-inline">in the matter preceding clause (i), by
			 striking <quote>, to carry out subparagraph (B) of this paragraph</quote>;
			 and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="HEDB7112EA8E0418AA0F30376F58305B2"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking clauses (iii) through (x) and
			 inserting the following:</text>
										<quoted-block display-inline="no-display-inline" id="H2E48E8691DD2417EB9C1742112C8EF5A" style="OLC">
											<clause commented="no" display-inline="no-display-inline" id="H7EEDA25AB5A94B209C203B0742E288BB"><enum>(iii)</enum><text display-inline="yes-display-inline">to carry out subparagraph (B) of this
				paragraph, such sums as may be necessary for fiscal year 2010 and each
				subsequent fiscal year to provide the amount of increase of the maximum Federal
				Pell Grant required by clauses (ii) and (iii) of subparagraph (B); and</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H9D8CF1D64D5245C2866400D76AB44949"><enum>(iv)</enum><text display-inline="yes-display-inline">to carry out this section, $13,500,000,000
				for fiscal year
				2011.</text>
											</clause><after-quoted-block>;</after-quoted-block></quoted-block>
									</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H6AD3A0254A3F49FDA273E34507705FE9"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (B)—</text>
									<clause commented="no" display-inline="no-display-inline" id="H9D8FA8C260174BEE907BDA317EE30DC5"><enum>(i)</enum><text display-inline="yes-display-inline">in the matter preceding clause (i), by
			 striking <quote>subparagraph (A)</quote> and inserting <quote>clauses (i)
			 through (iii) of subparagraph (A)</quote>;</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="HFE5F444902DE419DAE1C6308CFC2524C"><enum>(ii)</enum><text display-inline="yes-display-inline">in clause (ii), by striking <quote>and
			 2011–2012</quote> and inserting <quote>, 2011–2012, and 2012–2013</quote>;
			 and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="HBCEFC72894A84B61B2607A72934083D0"><enum>(iii)</enum><text display-inline="yes-display-inline">by striking clause (iii) and inserting the
			 following:</text>
										<quoted-block display-inline="no-display-inline" id="HF420141A7745437193C509CF523A17DC" style="OLC">
											<clause commented="no" display-inline="no-display-inline" id="HC67141A3E51B41ADA70C4F05E52E59A7"><enum>(iii)</enum><text display-inline="yes-display-inline">the amount determined under subparagraph
				(C) for each succeeding award
				year.</text>
											</clause><after-quoted-block>;</after-quoted-block></quoted-block>
									</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HC19686436C2546E6AED91E1AA2F96FE4"><enum>(C)</enum><text display-inline="yes-display-inline">by striking subparagraph (C) and inserting
			 the following:</text>
									<quoted-block display-inline="no-display-inline" id="HC63EE0C452CE4979B335D33B0E610B40" style="OLC">
										<subparagraph commented="no" display-inline="no-display-inline" id="H9C53BE5DE3D648B4A9FBBE6BDDD8596B"><enum>(C)</enum><header display-inline="yes-display-inline">Adjustment amounts</header>
											<clause commented="no" display-inline="no-display-inline" id="H542459C06E6947C2A5DE8A43144CF3F8"><enum>(i)</enum><header display-inline="yes-display-inline">Award year 2013–2014</header><text display-inline="yes-display-inline">For award year 2013–2014, the amount
				determined under this subparagraph for purposes of subparagraph (B)(iii) shall
				be equal to—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H1466794710774485A11EF8D90B52AD17"><enum>(I)</enum><text display-inline="yes-display-inline">$5,550 or the total maximum Federal Pell
				Grant for the preceding award year (as determined under clause (v)(II)),
				whichever is greater, increased by a percentage equal to the annual adjustment
				percentage for award year 2013–2014, reduced by</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="HBD867C26EA7D4304AFE0D08E5F7289A8"><enum>(II)</enum><text display-inline="yes-display-inline">$4,860 or the maximum Federal Pell Grant
				for which a student was eligible for the preceding award year, as specified in
				the last enacted appropriation Act applicable to that year, whichever is
				greater; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="H8DA0B9B4D06F4C3ABB4C5FEDADDCFB69"><enum>(III)</enum><text display-inline="yes-display-inline">rounded to the nearest $5.</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H009D307777764EE1A8852126189B6050"><enum>(ii)</enum><header display-inline="yes-display-inline">Award years 2014–2015 through
				2017–2018</header><text display-inline="yes-display-inline">For each of the
				award years 2014–2015 through 2017–2018, the amount determined under this
				subparagraph for purposes of subparagraph (B)(iii) shall be equal to—</text>
												<subclause commented="no" display-inline="no-display-inline" id="H5F859867605645689B2CEA004DD8B79D"><enum>(I)</enum><text display-inline="yes-display-inline">the total maximum Federal Pell Grant for
				the preceding award year (as determined under clause (v)(II)), increased by a
				percentage equal to the annual adjustment percentage for the award year for
				which the amount under this subparagraph is being determined, reduced by</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="H4CE6AE8DC5634661917EE3E202EEC7DF"><enum>(II)</enum><text display-inline="yes-display-inline">$4,860 or the maximum Federal Pell Grant
				for which a student was eligible for the preceding award year, as specified in
				the last enacted appropriation Act applicable to that year, whichever is
				greater; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="HC0D7009061A544258E570D47FD3ED40F"><enum>(III)</enum><text display-inline="yes-display-inline">rounded to the nearest $5.</text>
												</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H6E06A640F1D1430991DE5DC9B5B5B00B"><enum>(iii)</enum><header display-inline="yes-display-inline">Subsequent award years</header><text display-inline="yes-display-inline">For award year 2018–2019 and each
				subsequent award year, the amount determined under this subparagraph for
				purposes of subparagraph (B)(iii) shall be equal to the amount determined under
				clause (ii) for award year 2017–2018.</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H3304964ADD0F447C9AA3BA473A78EDF0"><enum>(iv)</enum><header display-inline="yes-display-inline">Limitation on decreases</header><text display-inline="yes-display-inline">Notwithstanding
				<internal-xref idref="H542459C06E6947C2A5DE8A43144CF3F8" legis-path="(8)(C)(i)">clauses (i)</internal-xref>, (ii), and (iii), if the
				amount determined under clause (i), (ii), or (iii) for a particular award year
				is less than the amount determined under this paragraph for the award year
				preceding that particular award year, then the amount determined under such
				clause for that particular award year shall be the amount determined under this
				paragraph for the preceding award year.</text>
											</clause><clause commented="no" display-inline="no-display-inline" id="H4274D62C244140D39C2EFFC53890A423"><enum>(v)</enum><header display-inline="yes-display-inline">Definitions</header><text display-inline="yes-display-inline">For purposes of this subparagraph—</text>
												<subclause commented="no" display-inline="no-display-inline" id="HC13EE6B23CDD47E6B3DA74525899BDE7"><enum>(I)</enum><text display-inline="yes-display-inline">the term <term>annual adjustment
				percentage</term> as applied to an award year, is equal to the estimated
				percentage change in the Consumer Price Index (as determined by the Secretary,
				using the definition in section 478(f)) for the most recent calendar year
				ending prior to the beginning of that award year; and</text>
												</subclause><subclause commented="no" display-inline="no-display-inline" id="HDC8C65D7992348D1AC734E7F3619A000"><enum>(II)</enum><text display-inline="yes-display-inline">the term <term>total maximum Federal Pell
				Grant</term> as applied to a preceding award year, is equal to the sum
				of—</text>
													<item commented="no" display-inline="no-display-inline" id="H07AA842BD97341259D4F59FA0E178939"><enum>(aa)</enum><text display-inline="yes-display-inline">the maximum Federal Pell Grant for which a
				student is eligible during an award year, as specified in the last enacted
				appropriation Act applicable to that preceding award year; and</text>
													</item><item commented="no" display-inline="no-display-inline" id="H748A2489281542369546EB4A2B1909F4"><enum>(bb)</enum><text display-inline="yes-display-inline">the amount of the increase in the maximum
				Federal Pell Grant required by this paragraph for that preceding award
				year.</text>
													</item></subclause></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H046FD84E717B40E3975FBB6324A5A348"><enum>(D)</enum><text display-inline="yes-display-inline">by striking subparagraph (E); and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HEBD99CCD7D3F445F9C5C628710B03384"><enum>(E)</enum><text display-inline="yes-display-inline">by redesignating subparagraph (F) as
			 subparagraph (E).</text>
								</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HF6F2D95CB0F8461D9BECEE66ED6CD47B"><enum>(b)</enum><header display-inline="yes-display-inline">Conforming amendments</header><text display-inline="yes-display-inline">Title IV (20 U.S.C. 1070 et seq.) is
			 further amended—</text>
							<paragraph commented="no" display-inline="no-display-inline" id="HE234123094304E96BBCCEFA94E1A1FB4"><enum>(1)</enum><text display-inline="yes-display-inline">in section 401(b) (20 U.S.C.
			 1070a(b))—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="HE761FA617B17495BABA95F10349F54BC"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (4)—</text>
									<clause commented="no" display-inline="no-display-inline" id="H7D60F9D02A78485AA80B20ACA42A894C"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>maximum basic grant
			 level specified in the appropriate appropriation Act </quote> and inserting
			 <quote>maximum amount of a Federal Pell Grant award determined under paragraph
			 (2)(A)</quote>; and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="H272714321CBB4691B581C6DD2456016C"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>such level</quote> each
			 place it appears and inserting <quote>such Federal Pell Grant amount</quote> in
			 each such place; and</text>
									</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H6A04EC27C6C9466CBE14A44CE4EF8920"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (6), by striking <quote>the
			 grant level specified in the appropriate Appropriation Act for this subpart for
			 such year</quote> and inserting <quote>the maximum amount of a Federal Pell
			 Grant award determined under paragraph (2)(A), for which a student is eligible
			 during such award year</quote>;</text>
								</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3514B80B41B44951BB27C894F319DE48"><enum>(2)</enum><text display-inline="yes-display-inline">in section 402D(d)(1) (20 U.S.C.
			 1070a–14(d)(1)), by striking <quote>exceed the maximum</quote> and all that
			 follows through <quote>Grant, for</quote> and inserting <quote>exceed the
			 Federal Pell Grant amount, determined under section 401(b)(2)(A), for which a
			 student is eligible, or be less than the minimum Federal Pell Grant amount
			 described in section 401(b)(4), for</quote>;</text>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HEC2852FB6EA1484CB89A47015B2D870B"><enum>(3)</enum><text display-inline="yes-display-inline">in section 435(a)(5)(A)(i)(I) (20 U.S.C.
			 1085(a)(5)(A)(i)(I)), by striking <quote>one-half the maximum Federal Pell
			 Grant award for which a student would be eligible</quote> and inserting
			 <quote>one-half the Federal Pell Grant amount, determined under section
			 401(b)(2)(A), for which a student would be eligible</quote>;</text>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H577B1BFEBDAC4E9AB91EC6CC8D736352"><enum>(4)</enum><text display-inline="yes-display-inline">in section 483(e)(3)(A)(ii) (20 U.S.C.
			 1090(e)(3)(A)(ii)), by striking <quote>based on the maximum Federal Pell Grant
			 award at the time of application</quote> and inserting <quote>based on the
			 Federal Pell Grant amount, determined under section 401(b)(2)(A), for which a
			 student is eligible at the time of application</quote>;</text>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HAD979075E90049369BB6C038A938D91A"><enum>(5)</enum><text display-inline="yes-display-inline">in section 485E(b)(1)(A) (20 U.S.C.
			 1092f(b)(1)(A)), by striking <quote>of such students' potential eligibility for
			 a maximum Federal Pell Grant under subpart 1 of part A</quote> and inserting
			 <quote>of such students' potential eligibility for the Federal Pell Grant
			 amount, determined under section 401(b)(2)(A), for which the student would be
			 eligible</quote>; and</text>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HCB08672341F840758910A6CC63ACA6E7"><enum>(6)</enum><text display-inline="yes-display-inline">in section 894(f)(2)(C)(ii)(I) (20 U.S.C.
			 1161y(f)(2)(C)(ii)(I)), by striking <quote>the maximum Federal Pell Grant for
			 each award year</quote> and inserting <quote>the Federal Pell Grant amount,
			 determined under section 401(b)(2)(A), for which a student may be eligible for
			 each award year</quote>.</text>
							</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H41B920554FDE4872A6EAEB2A247558D8"><enum>(c)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendments made by
			 subsections (a) and (b) shall take effect on July 1, 2010.</text>
						</subsection></section><section commented="no" display-inline="no-display-inline" id="HDEB6F008722D4F53AEC12F7495A225B5" section-type="subsequent-section"><enum>2102.</enum><header display-inline="yes-display-inline">College access challenge grant
			 program</header><text display-inline="no-display-inline">Section 781 (20 U.S.C.
			 1141) is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H9DF170EC2A9248FBADE5AFD9C0BF29DE"><enum>(1)</enum><text display-inline="yes-display-inline">in the first sentence of subsection (a), by
			 striking <quote>$66,000,000</quote> and all that follows through the period and
			 inserting <quote>$150,000,000 for each of the fiscal years 2010 through 2014.
			 The authority to award grants under this section shall expire at the end of
			 fiscal year 2014.</quote>; and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE3F368767179425B8B692BDEE4140FEB"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (c)(2), by striking
			 <quote>0.5 percent</quote> and inserting <quote>1.0 percent</quote>.</text>
						</paragraph></section><section commented="no" display-inline="no-display-inline" id="HA7234D93713D45ABA2E7C32624DE8FEA" section-type="subsequent-section"><enum>2103.</enum><header display-inline="yes-display-inline">Investment in historically black colleges
			 and universities and minority-serving institutions</header><text display-inline="no-display-inline">Section
			 371(b)(1)(A) (20 U.S.C. 1067q(b)(1)(A)) is amended by striking <quote>and
			 2009.</quote> and all that follows and inserting <quote>through 2019. The
			 authority to award grants under this section shall expire at the end of fiscal
			 year 2019.</quote>.</text>
					</section></part><part commented="no" id="H0FEA0ABBAEE745D0926A48AB8386D52D" level-type="subsequent"><enum>II</enum><header display-inline="yes-display-inline">Student loan reform</header>
					<section commented="no" display-inline="no-display-inline" id="HE771A22FD5524099AD1FEFF9782B092C" section-type="subsequent-section"><enum>2201.</enum><header display-inline="yes-display-inline">Termination of Federal Family Education
			 Loan appropriations</header><text display-inline="no-display-inline">Section
			 421 (20 U.S.C. 1071) is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H40DA25E4CFAA4635B40FCE1B437A4895"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (b), in the first sentence of
			 the matter following paragraph (6), by inserting <quote>, except that no sums
			 may be expended after June 30, 2010, with respect to loans under this part for
			 which the first disbursement is after such date</quote> after
			 <quote>expended</quote>; and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3E307F9654A0428FA309A92004BEE427"><enum>(2)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 subsection:</text>
							<quoted-block display-inline="no-display-inline" id="HA26FFBE7F5F6431CB9F226914E7D0F79" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="HD5417BFC413D4FC29DE8E5A8AA7BE2BE"><enum>(d)</enum><header display-inline="yes-display-inline">Termination of authority to make or insure
				new loans</header><text display-inline="yes-display-inline">Notwithstanding
				paragraphs (1) through (6) of subsection (b) or any other provision of
				law—</text>
									<paragraph commented="no" display-inline="no-display-inline" id="H6C62B2579FB7480D919D706E8832831A"><enum>(1)</enum><text display-inline="yes-display-inline">no new loans (including consolidation
				loans) may be made or insured under this part after June 30, 2010; and</text>
									</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5C3639CED2B94CBCAF9DDCD93401867E"><enum>(2)</enum><text display-inline="yes-display-inline">no funds are authorized to be appropriated,
				or may be expended, under this Act or any other Act to make or insure loans
				under this part (including consolidation loans) for which the first
				disbursement is after June 30, 2010,</text>
									</paragraph><continuation-text commented="no" continuation-text-level="subsection">except as expressly authorized by an
				Act of Congress enacted after the date of enactment of the
				<short-title>SAFRA
				Act</short-title>.</continuation-text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</paragraph></section><section commented="no" display-inline="no-display-inline" id="H0C1827DD9AF24832AB748F6D44EF70D0" section-type="subsequent-section"><enum>2202.</enum><header display-inline="yes-display-inline">Termination of Federal loan insurance
			 program</header><text display-inline="no-display-inline">Section 424(a) (20
			 U.S.C. 1074(a)) is amended by striking <quote>September 30, 1976,</quote> and
			 all that follows and inserting <quote>September 30, 1976, for each of the
			 succeeding fiscal years ending prior to October 1, 2009, and for the period
			 from October 1, 2009, to June 30, 2010, for loans first disbursed on or before
			 June 30, 2010.</quote>.</text>
					</section><section commented="no" display-inline="no-display-inline" id="HC0A4169FA7FD4998AE9030C2474BE109" section-type="subsequent-section"><enum>2203.</enum><header display-inline="yes-display-inline">Termination of applicable interest
			 rates</header><text display-inline="no-display-inline">Section 427A(l) (20
			 U.S.C. 1077a(l)) is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H853D1F79EF3D4DDE83886A38F5825C1B"><enum>(1)</enum><text display-inline="yes-display-inline">in the subsection heading, by inserting
			 <quote><header-in-text level="subsection" style="OLC">and before July 1,
			 2010</header-in-text></quote> after <quote><header-in-text level="subsection" style="OLC">2006</header-in-text></quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HC9275151AE594025A57564F0D5089E27"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (1), by inserting <quote>and
			 before July 1, 2010,</quote> after <quote>July 1, 2006,</quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H29B412A074874EA0962AFB6EE59E3B15"><enum>(3)</enum><text display-inline="yes-display-inline">in paragraph (2), by inserting <quote>and
			 before July 1, 2010,</quote> after <quote>July 1, 2006,</quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3D09C37293B1460E8DB6F00B4F979C08"><enum>(4)</enum><text display-inline="yes-display-inline">in paragraph (3), by inserting <quote>and
			 that was disbursed before July 1, 2010,</quote> after <quote>July 1,
			 2006,</quote>; and</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDDA915A9AAE44122AF7629A9E3E39129"><enum>(5)</enum><text display-inline="yes-display-inline">in paragraph (4)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="HD134AFE587A148E584B47595D37D93C0"><enum>(A)</enum><text display-inline="yes-display-inline">in the matter preceding subparagraph (A),
			 by striking <quote>July 1, 2012</quote> and inserting <quote>July 1,
			 2010</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H7620E285C99140179C54B767B5E2009A"><enum>(B)</enum><text display-inline="yes-display-inline">by repealing subparagraphs (D) and
			 (E).</text>
							</subparagraph></paragraph></section><section commented="no" display-inline="no-display-inline" id="H49345F88574140438004DF8A7DD6EA77" section-type="subsequent-section"><enum>2204.</enum><header display-inline="yes-display-inline">Termination of Federal payments to reduce
			 student interest costs</header>
						<subsection commented="no" display-inline="no-display-inline" id="H0AD40445131E4DE89D19121AB4FD7BCD"><enum>(a)</enum><header display-inline="yes-display-inline">Higher Education Act of 1965</header><text display-inline="yes-display-inline">Section 428 (20 U.S.C. 1078) is
			 amended—</text>
							<paragraph commented="no" display-inline="no-display-inline" id="H1A7FD0CAE5154D4A9EF08FAAD75946F2"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="HE14E2EFC51D44E79A2BE8C6830370539"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (1), in the matter preceding
			 subparagraph (A), by inserting <quote>for which the first disbursement is made
			 before July 1, 2010, and</quote> after <quote>eligible institution</quote>;
			 and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HDEF4C62750A74ECABF601AB027DAF8DB"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (5), by striking
			 <quote>September 30, 2014,</quote> and all that follows through the period and
			 inserting <quote>June 30, 2010.</quote>;</text>
								</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H94D7DD81ED7E4131B58DAA7468748A07"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)(1)—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H4A12854AE190447AA91013B3E5ED59CC"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (G)(ii), by inserting
			 <quote>and before July 1, 2010,</quote> after <quote>July 1, 2006,</quote>;
			 and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H422AF562D2C648EA83E0D4DADEA9BEE1"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (H)(ii), by inserting
			 <quote>and that are first disbursed before July 1, 2010,</quote> after
			 <quote>July 1, 2006,</quote>;</text>
								</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H818988919C1547DB8ECA1F02B7CCED7C"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (f)(1)(A)(ii)—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H5762559230F1461C8EDFE7167C76E939"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>during fiscal years
			 beginning</quote>; and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HB8EE51990D304AC4A826B2C574B09F83"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting <quote>and first disbursed
			 before July 1, 2010,</quote> after <quote>October 1, 2003,</quote>; and</text>
								</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H838A48E1900346A7A9A61BA1F40B6B1A"><enum>(4)</enum><text display-inline="yes-display-inline">in subsection (j)(1), by inserting <quote>,
			 before July 1, 2010,</quote> after <quote>section 435(d)(1)(D) of this Act
			 shall</quote>.</text>
							</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HC00BA7EA849C4A6B9FC61A91E1A90EAA"><enum>(b)</enum><header display-inline="yes-display-inline">College Cost Reduction and Access
			 Act</header><text display-inline="yes-display-inline">Section 303 of the
			 College Cost Reduction and Access Act (Public Law 110–84) is repealed.</text>
						</subsection></section><section commented="no" display-inline="no-display-inline" id="HFCABF35A92494E988DCDD4CC427A41C8" section-type="subsequent-section"><enum>2205.</enum><header display-inline="yes-display-inline">Termination of FFEL PLUS
			 Loans</header><text display-inline="no-display-inline">Section 428B(a)(1) (20
			 U.S.C. 1078–2(a)(1)) is amended by striking <quote>A graduate</quote> and
			 inserting <quote>Prior to July 1, 2010, a graduate</quote>.</text>
					</section><section commented="no" display-inline="no-display-inline" id="HCC12509D459D4463BCEF72D756F01BA4" section-type="subsequent-section"><enum>2206.</enum><header display-inline="yes-display-inline">Federal Consolidation Loans</header>
						<subsection commented="no" display-inline="no-display-inline" id="HFF0CC92C6945473B8BEE0DA502FD5EAD"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 428C (20 U.S.C. 1078–3) is
			 amended—</text>
							<paragraph commented="no" display-inline="no-display-inline" id="HF1144362CC324023A2F9DFE95B6C25E4"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)(4)(A), by inserting
			 <quote>, and first disbursed before July 1, 2010</quote> after <quote>under
			 this part</quote>;</text>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H33887B72E0E847ECBE9F62F93BE93F36"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H63CE37964728441EAAE28AC79026FAD9"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (1)(E), by inserting before
			 the semicolon <quote>, and before July 1, 2010</quote>; and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H816FC2EE236742479BA5685BB10F1238"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (5), by striking <quote>In the
			 event that</quote> and inserting <quote>If, before July 1,
			 2010,</quote>;</text>
								</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0506AA6F17AE43F99566AEE3564415FB"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (c)(1)—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="HB9651F73276043EF8FA789BA06F344F6"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (A)(ii), by inserting
			 <quote>and that is disbursed before July 1, 2010,</quote> after
			 <quote>2006,</quote>; and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H69AA408BD9D9440B8013D7F3AF8B5113"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (C), by inserting
			 <quote>and disbursed before July 1, 2010,</quote> after <quote>1994,</quote>;
			 and</text>
								</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE6B7E4E3CADE4FA9BC1418AF45168DAA"><enum>(4)</enum><text display-inline="yes-display-inline">in subsection (e), by striking
			 <quote>September 30, 2014.</quote> and inserting <quote>June 30, 2010. No loan
			 may be made under this section for which the disbursement is on or after July
			 1, 2010.</quote>.</text>
							</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HD913BF3AF8614FA781E4C99BA697267B"><enum>(b)</enum><header display-inline="yes-display-inline">Temporary loan consolidation
			 authority</header><text display-inline="yes-display-inline">Part D of title IV
			 (20 U.S.C. 1087a et seq.) is amended by inserting after section 459A (20 U.S.C.
			 1087i) the following:</text>
							<quoted-block display-inline="no-display-inline" id="HB9F438D4BCB245F0B7FB4A5824D3C2E5" style="OLC">
								<section commented="no" display-inline="no-display-inline" id="HE8EA23D278424505AC68C22DAA0AB6A8" section-type="subsequent-section"><enum>459B.</enum><header display-inline="yes-display-inline">Temporary loan consolidation
				authority</header>
									<subsection commented="no" display-inline="no-display-inline" id="H24874C0AE05747BAABA5E702F1A1148E"><enum>(a)</enum><header display-inline="yes-display-inline">Temporary loan consolidation
				authority</header>
										<paragraph commented="no" display-inline="no-display-inline" id="HFA65E6C19E5D412F88EB8FC256680616"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">A borrower who has 1 or more loans in 2 or
				more of the categories described in paragraph (2), and who has not yet entered
				repayment on 1 or more of those loans in any of the categories, may consolidate
				all of the loans of the borrower that are described in paragraph (2) into a
				Federal Direct Consolidation Loan during the period described in paragraph
				(3).</text>
										</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H1B1BCB901C944935B5A637AF617BE1C5"><enum>(2)</enum><header display-inline="yes-display-inline">Categories of loans that may be
				consolidated</header><text display-inline="yes-display-inline">The categories
				of loans that may be consolidated under paragraph (1) are—</text>
											<subparagraph commented="no" display-inline="no-display-inline" id="H1C47E56563D5409DB98B895CD6D6F858"><enum>(A)</enum><text display-inline="yes-display-inline">loans made under this part;</text>
											</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HEB6AE1EA0B524B10895A08D4BF27D695"><enum>(B)</enum><text display-inline="yes-display-inline">loans purchased by the Secretary pursuant
				to section 459A; and</text>
											</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HEE332C93CE6D4ADA804E57A7B7EF78A4"><enum>(C)</enum><text display-inline="yes-display-inline">loans made under part B that are held by an
				eligible lender, as such term is defined in section 435(d).</text>
											</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H4407B61CB4DB4D8682F28E6189BCAF2E"><enum>(3)</enum><header display-inline="yes-display-inline">Time period in which loans may be
				consolidated</header><text display-inline="yes-display-inline">The Secretary
				may make a Federal Direct Consolidation Loan under this section to a borrower
				whose application for such Federal Direct Consolidation Loan is received on or
				after July 1, 2010, and before July 1, 2011.</text>
										</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H51D8682570E84175A3B4B973999C1B15"><enum>(b)</enum><header display-inline="yes-display-inline">Terms
				of loans</header><text display-inline="yes-display-inline">A Federal Direct
				Consolidation Loan made under this section shall have the same terms and
				conditions as a Federal Direct Consolidation Loan made under section 455(g),
				except that—</text>
										<paragraph commented="no" display-inline="no-display-inline" id="H7011739D69CB44D9AD3CC0A85AB6132D"><enum>(1)</enum><text display-inline="yes-display-inline">in determining the applicable rate of
				interest on the Federal Direct Consolidation Loan made under this section
				(other than on a Federal Direct Consolidation Loan described in paragraph (2)),
				section 427A(l)(3) shall be applied without rounding the weighted average of
				the interest rate on the loans consolidated to the nearest higher one-eighth of
				1 percent as described in subparagraph (A) of section 427A(l)(3); and</text>
										</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H04EBB9AA375B49CFB1FA7B6707AF2DD9"><enum>(2)</enum><text display-inline="yes-display-inline">if a Federal Direct Consolidation Loan made
				under this section that repays a loan which is subject to an interest rate
				determined under section 427A(g)(2), (j)(2), or (k)(2), then the interest rate
				for such Federal Direct Consolidation Loan shall be calculated—</text>
											<subparagraph commented="no" display-inline="no-display-inline" id="H5EDC16D601A9496EB844FDA5EFA50206"><enum>(A)</enum><text display-inline="yes-display-inline">by using the applicable rate of interest
				described in section 427A(g)(2), (j)(2), or (k)(2), respectively; and</text>
											</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HBFC787F1814F4A10A803F9438D7D7601"><enum>(B)</enum><text display-inline="yes-display-inline">in accordance with section
				427A(l)(3).</text>
											</subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
						</subsection></section><section commented="no" display-inline="no-display-inline" id="HDA061D0D167340F5863C549C25F06F09" section-type="subsequent-section"><enum>2207.</enum><header display-inline="yes-display-inline">Termination of Unsubsidized Stafford Loans
			 for middle-income borrowers</header><text display-inline="no-display-inline">Section 428H (20 U.S.C. 1078–8) is
			 amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H483C9947ECA34ED3A9095AD0E79B2FF7"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a), by inserting <quote>that
			 are first disbursed before July 1, 2010,</quote> after <quote>under this
			 part</quote>;</text>
						</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5DC5763153CA4531B919EFAE5E5D4077"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H4CF3B378CA7444D88B3882CF50AAD563"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>Any student</quote> and
			 inserting <quote>Prior to July 1, 2010, any student</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H3FA998384CC24A2295220CD957AE6047"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting <quote>for which the first
			 disbursement is made before such date</quote> after <quote>unsubsidized Federal
			 Stafford Loan</quote>; and</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3D24DBD445924DC9AADD810EB87D32A6"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (h), by inserting <quote>and
			 that are first disbursed before July 1, 2010,</quote> after <quote>July 1,
			 2006,</quote>.</text>
						</paragraph></section><section commented="no" display-inline="no-display-inline" id="H41A09FDA848E403384F16F17D2B125FE" section-type="subsequent-section"><enum>2208.</enum><header display-inline="yes-display-inline">Termination of special
			 allowances</header><text display-inline="no-display-inline">Section 438 (20
			 U.S.C. 1087–1) is amended—</text>
						<paragraph commented="no" display-inline="no-display-inline" id="H10903FB8D84443568C1DD562FE6BC4A6"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (b)(2)(I)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H401EFA613291476EA01AAB772FD78A1D"><enum>(A)</enum><text display-inline="yes-display-inline">in the subclause heading, by inserting
			 <quote><header-in-text level="subparagraph" style="OLC">, and before July 1,
			 2010</header-in-text></quote> after <quote><header-in-text level="subparagraph" style="OLC">2000</header-in-text></quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HDC2E3E077DD2417E888A17CE2592AB4F"><enum>(B)</enum><text display-inline="yes-display-inline">in clause (i), by inserting <quote>and
			 before July 1, 2010,</quote> after <quote>2000,</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H41A5484388834089A6B31547B05C2B5A"><enum>(C)</enum><text display-inline="yes-display-inline">in clause (ii)(II), by inserting <quote>and
			 before July 1, 2010,</quote> after <quote>2006,</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HCC7E7664C13E418295420BF7BBA674AA"><enum>(D)</enum><text display-inline="yes-display-inline">in clause (iii), by inserting <quote>and
			 before July 1, 2010,</quote> after <quote>2000,</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8D6C798755F745B797E2085A165A3B05"><enum>(E)</enum><text display-inline="yes-display-inline">in clause (iv), by inserting <quote>and
			 that is disbursed before July 1, 2010,</quote> after
			 <quote>2000,</quote>;</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE1252B0782E7421185E0376E8E92C0A3"><enum>(F)</enum><text display-inline="yes-display-inline">in clause (v)(I), by inserting <quote>and
			 before July 1, 2010,</quote> after <quote>2006,</quote>; and</text>
							</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H571DA0D08D404803A76D4D313187CE06"><enum>(G)</enum><text display-inline="yes-display-inline">in clause (vi)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H030DDF9956FA45288AE849F3FD5DB103"><enum>(i)</enum><text display-inline="yes-display-inline">in the clause heading, by inserting
			 <quote><header-in-text level="clause" style="OLC">, and before July 1,
			 2010</header-in-text></quote> after <quote><header-in-text level="clause" style="OLC">2007</header-in-text></quote>; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H0DA7BC49446449AE895AE92FA5F1AABC"><enum>(ii)</enum><text display-inline="yes-display-inline">in the matter preceding subclause (I), by
			 inserting <quote>and before July 1, 2010,</quote> after
			 <quote>2007,</quote>;</text>
								</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H56B63F4AF29B46CFB077AFC9853A2104"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (c)—</text>
							<subparagraph commented="no" display-inline="no-display-inline" id="H4A3994887FDA47949C5645CBAAEF8CB7"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (2)(B)—</text>
								<clause commented="no" display-inline="no-display-inline" id="H30C56B5DE98F4AC79E853CE445D4E032"><enum>(i)</enum><text display-inline="yes-display-inline">in clause (iii), by inserting
			 <quote>and</quote> after the semicolon;</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="HD1817791E0204B888043B589B093EA67"><enum>(ii)</enum><text display-inline="yes-display-inline">in clause (iv), by striking <quote>;
			 and</quote> and inserting a period; and</text>
								</clause><clause commented="no" display-inline="no-display-inline" id="H51E34D777C8A40C9B344E280C4636894"><enum>(iii)</enum><text display-inline="yes-display-inline">by striking clause (v); and</text>
								</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HDB14A1A57401434EB9A1DBC1B7D78EBE"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (6), by inserting <quote>and
			 first disbursed before July 1, 2010,</quote> after <quote>1992,</quote>;
			 and</text>
							</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0D54AF295C474291BC3CDA1DF19D5B83"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (d)(2)(B), by inserting
			 <quote>, and before July 1, 2010</quote> after <quote>2007</quote>.</text>
						</paragraph></section><section commented="no" display-inline="no-display-inline" id="H0B4F536E12964435ACFFA76482E653B4" section-type="subsequent-section"><enum>2209.</enum><header display-inline="yes-display-inline">Origination of Direct Loans at institutions
			 outside the United States</header>
						<subsection commented="no" display-inline="no-display-inline" id="H679D0F29AAE74E63B3DAA999AF0ACFD7"><enum>(a)</enum><header display-inline="yes-display-inline">Loans for students attending institutions
			 outside the United States</header><text display-inline="yes-display-inline">Section 452 (20 U.S.C. 1087b) is amended by
			 adding at the end the following:</text>
							<quoted-block display-inline="no-display-inline" id="HACD3C057D1D64150BA76FA44BF460DE9" style="OLC">
								<subsection commented="no" display-inline="no-display-inline" id="H7C88FE2A0D5A4347A368F549D2A99C38"><enum>(d)</enum><header display-inline="yes-display-inline">Institutions outside the United
				States</header><text display-inline="yes-display-inline">Loan funds for
				students (and parents of students) attending institutions outside the United
				States shall be disbursed through a financial institution located or operating
				in the United States and designated by the Secretary to serve as the agent of
				such institutions with respect to the receipt of the disbursements of such loan
				funds and the transfer of such funds to such institutions. To be eligible to
				receive funds under this part, an institution outside the United States shall
				make arrangements with the agent designated by the Secretary under this
				subsection to receive funds under this
				part.</text>
								</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
						</subsection><subsection commented="no" display-inline="no-display-inline" id="H5F52656C0CA0460FAA90C5602FF22BFE"><enum>(b)</enum><header display-inline="yes-display-inline">Conforming amendments</header>
							<paragraph commented="no" display-inline="no-display-inline" id="H0DF1D4005BD242C9BE0F2894EB30B61B"><enum>(1)</enum><header display-inline="yes-display-inline">Amendments</header><text display-inline="yes-display-inline">Section 102 (20 U.S.C. 1002), as amended by
			 section 102 of the Higher Education Opportunity Act (Public Law 110–315) and
			 section 101 of Public Law 111–39, is amended—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H8A2C6F8DE1C8411A9F39CF9CB6AA8ECF"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>part B</quote> each
			 place the term appears and inserting <quote>part D</quote>;</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HBA0C163DA71E4802BF54858FF4A5DF54"><enum>(B)</enum><text display-inline="yes-display-inline">in subsection (a)(1)(C), by inserting
			 <quote>, consistent with the requirements of section 452(d)</quote> before the
			 period at the end; and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H92D99DD665234288B63123F9413AB0BF"><enum>(C)</enum><text display-inline="yes-display-inline">in subsection (a)(2)(A)—</text>
									<clause commented="no" display-inline="no-display-inline" id="H35F76C60C832413DBB66B9618E35EF99"><enum>(i)</enum><text display-inline="yes-display-inline">in the second sentence of the matter
			 preceding clause (i), by striking <quote>made, insured, or guaranteed</quote>
			 and inserting <quote>made</quote>; and</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="H31BB36AA0F4C4E48AA1509CC6869D3A2"><enum>(ii)</enum><text display-inline="yes-display-inline">in clause (iii)—</text>
										<subclause commented="no" display-inline="no-display-inline" id="H0E0D80DA1C494152A2FF27A2DC16D59E"><enum>(I)</enum><text display-inline="yes-display-inline">in subclause (III), by striking <quote>only
			 Federal Stafford</quote> and all that follows through <quote>section
			 428B</quote> and inserting <quote>only Federal Direct Stafford Loans under
			 section 455(a)(2)(A), Federal Direct Unsubsidized Stafford Loans under section
			 455(a)(2)(D), or Federal Direct PLUS Loans under section 455(a)(2)(B)</quote>;
			 and</text>
										</subclause><subclause commented="no" display-inline="no-display-inline" id="H461D40133DB643268EC76F48C38F93E9"><enum>(II)</enum><text display-inline="yes-display-inline">in subclause (V), by striking <quote>a
			 Federal Stafford</quote> and all that follows through <quote>section
			 428B</quote> and inserting <quote>a Federal Direct Stafford Loan under section
			 455(a)(2)(A), a Federal Direct Unsubsidized Stafford Loan under section
			 455(a)(2)(D), or a Federal Direct PLUS Loan under section
			 455(a)(2)(B)</quote>.</text>
										</subclause></clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HC7DE2ACF6FD2428E9139DC8F9777A1EF"><enum>(2)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendments made by
			 subparagraph (C) of paragraph (1) shall be effective on July 1, 2010, as if
			 enacted as part of section 102(a)(1) of the Higher Education Opportunity Act
			 (Public Law 110–315) and subject to section 102(e) of such Act as amended by
			 section 101(a)(2) of Public Law 111–39 (20 U.S.C. 1002 note).</text>
							</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H4CBBC6F15E9C4FC9A82D545FC1E6B623" section-type="subsequent-section"><enum>2210.</enum><header display-inline="yes-display-inline">Conforming amendments</header>
						<subsection commented="no" display-inline="no-display-inline" id="H0EE09BDC5669491FB5BCC15BD177B130"><enum>(a)</enum><header display-inline="yes-display-inline">Amendments</header><text display-inline="yes-display-inline">Section 454 (20 U.S.C. 1087d) is
			 amended—</text>
							<paragraph commented="no" display-inline="no-display-inline" id="H2085038498FE4D76A76188E3F78BACF4"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H4D31478133C7450D87937F5E1C350E29"><enum>(A)</enum><text display-inline="yes-display-inline">by striking paragraph (4); and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5E6BC25E1FDC4655B5F2040D4D8C60ED"><enum>(B)</enum><text display-inline="yes-display-inline">by redesignating paragraphs (5) through (7)
			 as paragraphs (4) through (6), respectively; and</text>
								</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H680DF5C00E9B4E2E923BC44EB47B74A8"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)(2), by striking
			 <quote>(5), (6), and (7)</quote> and inserting <quote>(5), and
			 (6)</quote>.</text>
							</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HB521ED195F604884934724AB3182D6E8"><enum>(b)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendments made by
			 subsection (a) shall take effect on July 1, 2010.</text>
						</subsection></section><section commented="no" display-inline="no-display-inline" id="H0F30634A9F554C58B682BBA7FB454D8F" section-type="subsequent-section"><enum>2211.</enum><header display-inline="yes-display-inline">Terms and conditions of loans</header>
						<subsection commented="no" display-inline="no-display-inline" id="H844B51A4C65445099EFCB18336D84709"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 455 (20 U.S.C. 1087e) is
			 amended—</text>
							<paragraph commented="no" display-inline="no-display-inline" id="H34BEBEA3DB834C0F8D36B4BE244E13E4"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)(1), by inserting <quote>,
			 and first disbursed on June 30, 2010,</quote> before <quote>under sections
			 428</quote>; and</text>
							</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H568197143C9C4E46B8E5CA245B7A01FD"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (g)—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H83D835E4F2814F858A3AB3855279CD89"><enum>(A)</enum><text display-inline="yes-display-inline">by inserting <quote>, including any loan
			 made under part B and first disbursed before July 1, 2010</quote> after
			 <quote>section 428C(a)(4)</quote>; and</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H1D4B9B2C653142C68AA075E97FE2AD41"><enum>(B)</enum><text display-inline="yes-display-inline">by striking the third sentence.</text>
								</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H3F125D22B3574B699B086E2FE86102C7"><enum>(b)</enum><header display-inline="yes-display-inline">Effective
			 date</header><text display-inline="yes-display-inline">The amendment made by
			 subsection (a)(1) shall apply with respect to loans first disbursed under part
			 D of title IV of the Higher Education Act of 1965 (20 U.S.C. 1087a et seq.) on
			 or after July 1, 2010.</text>
						</subsection></section><section commented="no" display-inline="no-display-inline" id="HC4E811C3CF6643E9B19D1C70E765CF00" section-type="subsequent-section"><enum>2212.</enum><header display-inline="yes-display-inline">Contracts; mandatory funds</header>
						<subsection commented="no" display-inline="no-display-inline" id="H5E8F64BE42314A16B36268494992D510"><enum>(a)</enum><header display-inline="yes-display-inline">Contracts</header><text display-inline="yes-display-inline">Section 456 (20 U.S.C. 1087f) is
			 amended—</text>
							<paragraph commented="no" display-inline="no-display-inline" id="H254DDEB5395C41589B81DF2735A573A1"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="H9725EBB619E74A4E8E9FD242DFFB83F7"><enum>(A)</enum><text display-inline="yes-display-inline">by inserting after paragraph (3) the
			 following new paragraph:</text>
									<quoted-block display-inline="no-display-inline" id="H636E684C56EE499EB9EDB59D6025FADB" style="OLC">
										<paragraph commented="no" display-inline="no-display-inline" id="H3D3638F9D4B1495EB20A5AE11AAC9C0F"><enum>(4)</enum><header display-inline="yes-display-inline">Servicing by eligible not-for-profit
				servicers</header>
											<subparagraph commented="no" display-inline="no-display-inline" id="HD597BC4A625B47A38B13EBB28EA10938"><enum>(A)</enum><header display-inline="yes-display-inline">Servicing contracts</header>
												<clause commented="no" display-inline="no-display-inline" id="HF90D1721C7934948BE7338E11572E88E"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary shall contract with each
				eligible not-for-profit servicer to service loans originated under this part,
				if the servicer—</text>
													<subclause commented="no" display-inline="no-display-inline" id="H6C10DABEE9FA4F1D94F2CF46D7FEA064"><enum>(I)</enum><text display-inline="yes-display-inline">meets the standards for servicing Federal
				assets that apply to contracts awarded pursuant to paragraph (1); and</text>
													</subclause><subclause commented="no" display-inline="no-display-inline" id="HC7F8143F1EB94A188B37BA2715BB1E27"><enum>(II)</enum><text display-inline="yes-display-inline">has the capacity to service the applicable
				loan volume allocation described in subparagraph (B).</text>
													</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H7B567A5ECD264207B80EB907090DE4F0"><enum>(ii)</enum><header display-inline="yes-display-inline">Competitive market rate determination for
				first 100,000 borrower accounts</header><text display-inline="yes-display-inline">The Secretary shall establish a separate
				pricing tier for each of the first 100,000 borrower loan accounts at a
				competitive market rate.</text>
												</clause><clause commented="no" display-inline="no-display-inline" id="HD0C6DE24947E40DF93FE86EB6B699A7B"><enum>(iii)</enum><header display-inline="yes-display-inline">Ineligibility</header><text display-inline="yes-display-inline">An eligible not-for-profit servicer shall
				no longer be eligible for a contract under this paragraph after July 1, 2014,
				if—</text>
													<subclause commented="no" display-inline="no-display-inline" id="H106F873308694818AEFC19B128E3974D"><enum>(I)</enum><text display-inline="yes-display-inline">the servicer has not been awarded such a
				contract before that date; or</text>
													</subclause><subclause commented="no" display-inline="no-display-inline" id="HF6E9400B8CEE4554A723D6848E1D430E"><enum>(II)</enum><text display-inline="yes-display-inline">the servicer's contract was terminated, and
				the servicer had not reapplied for, and been awarded, a contract under this
				paragraph.</text>
													</subclause></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE8A7CEE8B9A54DF09782D7B2C040D086"><enum>(B)</enum><header display-inline="yes-display-inline">Allocations</header>
												<clause commented="no" display-inline="no-display-inline" id="H85058297B5954E77AE367313CA80D6D9"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary shall (except as provided in
				clause (ii)) allocate to an eligible not-for-profit servicer, subject to the
				contract of such servicer described in subparagraph (A), the servicing rights
				for the loan accounts of 100,000 borrowers (including borrowers who borrowed
				loans in a prior year that were serviced by the servicer).</text>
												</clause><clause commented="no" display-inline="no-display-inline" id="H90155813AAED4D6EA2C9968D6E754913"><enum>(ii)</enum><header display-inline="yes-display-inline">Servicer allocation</header><text display-inline="yes-display-inline">The Secretary may reallocate, increase,
				reduce, or terminate an eligible not-for-profit servicer's allocation of
				servicing rights under clause (i) based on the performance of such servicer, on
				the same terms as loan allocations provided by contracts awarded pursuant to
				paragraph (1).</text>
												</clause></subparagraph></paragraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
								</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5819618ACF9948918F21AD0839167811"><enum>(2)</enum><text display-inline="yes-display-inline">by adding at the end the following:</text>
								<quoted-block display-inline="no-display-inline" id="H462B8EE67C344C54B9E635ACE655095E" style="OLC">
									<subsection commented="no" display-inline="no-display-inline" id="HE53D3A76C55443C0AC73F14686E8F2B2"><enum>(c)</enum><header display-inline="yes-display-inline">Definition of eligible not-for-profit
				servicer</header><text display-inline="yes-display-inline">In this
				section:</text>
										<paragraph commented="no" display-inline="no-display-inline" id="H6AF2B2ED0B6B4640B811266063ABCD8F"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The term <term>eligible not-for-profit
				servicer</term> means an entity—</text>
											<subparagraph commented="no" display-inline="no-display-inline" id="H93A7C657C72B41AE97098587841F3BDE"><enum>(A)</enum><text display-inline="yes-display-inline">that is not owned or controlled in whole or
				in part by—</text>
												<clause commented="no" display-inline="no-display-inline" id="H355E1E7676584F3981B5CC634E89EA93"><enum>(i)</enum><text display-inline="yes-display-inline">a for-profit entity; or</text>
												</clause><clause commented="no" display-inline="no-display-inline" id="H5DF48770641C4FB58510C101FFAD8737"><enum>(ii)</enum><text display-inline="yes-display-inline">a nonprofit entity having its principal
				place of business in another State; and</text>
												</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H33ED1C930EE14500AB7EC6DA7EADAB33"><enum>(B)</enum><text display-inline="yes-display-inline">that—</text>
												<clause commented="no" display-inline="no-display-inline" id="HF6FD41D3267F485B9BC10D781AD24A11"><enum>(i)</enum><text display-inline="yes-display-inline">as of July 1, 2009—</text>
													<subclause commented="no" display-inline="no-display-inline" id="HE8FF4E0AE7BF4CD0A3BDCFD78674A05A"><enum>(I)</enum><text display-inline="yes-display-inline">meets the definition of an eligible
				not-for-profit holder under section 435(p), except that such term does not
				include eligible lenders described in paragraph (1)(D) of such section;
				and</text>
													</subclause><subclause commented="no" display-inline="no-display-inline" id="H01DBAB67D33D4443B2CEDDFA737D07DE"><enum>(II)</enum><text display-inline="yes-display-inline">was performing, or had entered into a
				contract with a third party servicer (as such term is defined in section
				481(c)) who was performing, student loan servicing functions for loans made
				under part B of this title;</text>
													</subclause></clause><clause commented="no" display-inline="no-display-inline" id="HFC3DDA3ED6DF4C7982603834E54F47D8"><enum>(ii)</enum><text display-inline="yes-display-inline">notwithstanding clause (i), as of July 1,
				2009—</text>
													<subclause commented="no" display-inline="no-display-inline" id="H2D884E054036455590CB21CB96797516"><enum>(I)</enum><text display-inline="yes-display-inline">is the sole beneficial owner of a loan for
				which the special allowance rate is calculated under section
				438(b)(2)(I)(vi)(II) because the loan is held by an eligible lender trustee
				that is an eligible not-for-profit holder as defined under section
				435(p)(1)(D); and</text>
													</subclause><subclause commented="no" display-inline="no-display-inline" id="HFC674FF5B57141E4B618DFE868F09494"><enum>(II)</enum><text display-inline="yes-display-inline">was performing, or had entered into a
				contract with a third party servicer (as such term is defined in section
				481(c)) who was performing, student loan servicing functions for loans made
				under part B of this title; or</text>
													</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H128F918BF7E8453F93DDF2CE40E5C300"><enum>(iii)</enum><text display-inline="yes-display-inline">is an affiliated entity of an eligible
				not-for-profit servicer described in clause (i) or (ii) that—</text>
													<subclause commented="no" display-inline="no-display-inline" id="H78F35D71388F43D4A2D9BF4B9FC9A4B2"><enum>(I)</enum><text display-inline="yes-display-inline">directly employs, or will directly employ
				(on or before the date the entity begins servicing loans under a contract
				awarded by the Secretary pursuant to subsection (a)(3)(A)), the majority of
				individuals who perform borrower-specific student loan servicing functions;
				and</text>
													</subclause><subclause commented="no" display-inline="no-display-inline" id="H1B13D4918A374841A01A10BEF4CA0534"><enum>(II)</enum><text display-inline="yes-display-inline">as of July 1, 2009, was performing, or had
				entered into a contract with a third party servicer (as such term is defined in
				section 481(c)) who was performing, student loan servicing functions for loans
				made under part B of this title.</text>
													</subclause></clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB7A12E33D4F1463CB7301533A09A3F8B"><enum>(2)</enum><header display-inline="yes-display-inline">Affiliated entity</header><text display-inline="yes-display-inline">For the purposes of paragraph (1), the term
				<term>affiliated entity</term>—</text>
											<subparagraph commented="no" display-inline="no-display-inline" id="H8DBE6334BE5A404CA87E6994DA847DB5"><enum>(A)</enum><text display-inline="yes-display-inline">means an entity contracted to perform
				services for an eligible not-for-profit servicer that—</text>
												<clause commented="no" display-inline="no-display-inline" id="H5932DF0BCF154504B0ADE58F7C81B898"><enum>(i)</enum><text display-inline="yes-display-inline">is a nonprofit entity or is wholly owned by
				a nonprofit entity; and</text>
												</clause><clause commented="no" display-inline="no-display-inline" id="H4FC4846F34DA4F9D80D382B0CC7E219F"><enum>(ii)</enum><text display-inline="yes-display-inline">is not owned or controlled, in whole or in
				part, by—</text>
													<subclause commented="no" display-inline="no-display-inline" id="HAF86D64AFA0743AFAC338865F18599C7"><enum>(I)</enum><text display-inline="yes-display-inline">a for-profit entity; or</text>
													</subclause><subclause commented="no" display-inline="no-display-inline" id="H8D99FA27E796455189EFC8880E7E3846"><enum>(II)</enum><text display-inline="yes-display-inline">an entity having its principal place of
				business in another State; and</text>
													</subclause></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H6BEE436628BB4EABAAB99AA416733AD3"><enum>(B)</enum><text display-inline="yes-display-inline">may include an affiliated entity that is
				established by an eligible not-for-profit servicer after the date of enactment
				of the <short-title>SAFRA Act</short-title>, if such
				affiliated entity is otherwise described in paragraph (1)(B)(iii)(I) and
				subparagraph (A) of this
				paragraph.</text>
											</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
							</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HB48608140111413D86CE68183164F11B"><enum>(b)</enum><header display-inline="yes-display-inline">Mandatory funds</header>
							<paragraph commented="no" display-inline="no-display-inline" id="H07E162B145794A83AC890D396386253E"><enum>(1)</enum><header display-inline="yes-display-inline">Amendments</header><text display-inline="yes-display-inline">Section 458(a) (20 U.S.C. 1087h(a)) is
			 amended—</text>
								<subparagraph commented="no" display-inline="no-display-inline" id="HCCFDD70A4CB542FC8017C038DED170D2"><enum>(A)</enum><text display-inline="yes-display-inline">by redesignating paragraph (5) as paragraph
			 (8);</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H0BE845C1C94F4DD7B1A3C1FC28F9FF53"><enum>(B)</enum><text display-inline="yes-display-inline">by redesignating paragraphs (2) through (4)
			 as paragraphs (3) through (5), respectively;</text>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H22C8FA61E76D47C5AF5FA1610E32F823"><enum>(C)</enum><text display-inline="yes-display-inline">by inserting after paragraph (1) the
			 following new paragraph:</text>
									<quoted-block display-inline="no-display-inline" id="H78FDF92C87664DFBA7C8A505EBB4DD8C" style="OLC">
										<paragraph commented="no" display-inline="no-display-inline" id="HC9D71A69C2E042EF93E3B210D07D0382"><enum>(2)</enum><header display-inline="yes-display-inline">Mandatory funds for eligible not-for-profit
				servicers</header><text display-inline="yes-display-inline">For fiscal years
				2010 through 2019, there shall be available to the Secretary, in addition to
				any other amounts appropriated to carry out this paragraph and out of any money
				in the Treasury not otherwise appropriated, funds to be obligated for
				administrative costs of servicing contracts with eligible not-for-profit
				servicers as described in section 456.</text>
										</paragraph><after-quoted-block>;
				and</after-quoted-block></quoted-block>
								</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H5ED464A8D9C74A07B91A0C64E36B2F67"><enum>(D)</enum><text display-inline="yes-display-inline">by inserting after paragraph (5), as
			 redesignated by subparagraph (B) of this paragraph, the following:</text>
									<quoted-block display-inline="no-display-inline" id="HE753B85CCC2C46DA8F2AD5E3D64E7423" style="OLC">
										<paragraph commented="no" display-inline="no-display-inline" id="H590F5F5F792D4FF3A3889DD873D5F04B"><enum>(6)</enum><header display-inline="yes-display-inline">Technical assistance to institutions of
				higher education</header>
											<subparagraph commented="no" display-inline="no-display-inline" id="H5A49164E44F241138C3A2CE2CF4CCCD7"><enum>(A)</enum><header display-inline="yes-display-inline">Provision of assistance</header><text display-inline="yes-display-inline">The Secretary shall provide institutions of
				higher education participating, or seeking to participate, in the loan programs
				under this part with technical assistance in establishing and administering
				such programs.</text>
											</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H6E4CC91587DC4852869A44BCC7ABE495"><enum>(B)</enum><header display-inline="yes-display-inline">Funds</header><text display-inline="yes-display-inline">There are authorized to be appropriated,
				and there are appropriated, to carry out this paragraph (in addition to any
				other amounts appropriated to carry out this paragraph and out of any money in
				the Treasury not otherwise appropriated), $50,000,000 for fiscal year
				2010.</text>
											</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H643A315964D240748BBBE6F99430415C"><enum>(C)</enum><header display-inline="yes-display-inline">Definition</header><text display-inline="yes-display-inline">In this paragraph, the term
				<quote>assistance</quote> means the provision of technical support, training,
				materials, technical assistance, and financial assistance.</text>
											</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H899699D45B4F46DFA4A1644B8443D393"><enum>(7)</enum><header display-inline="yes-display-inline">Additional payments</header>
											<subparagraph commented="no" display-inline="no-display-inline" id="H72C155AE13574BFF8E863552914E59B4"><enum>(A)</enum><header display-inline="yes-display-inline">Provision of assistance</header><text display-inline="yes-display-inline">The Secretary shall provide payments to
				loan servicers for retaining jobs at locations in the United States where such
				servicers were operating under part B on January 1, 2010.</text>
											</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H16226225525D40DFB50A08F5C6554AF9"><enum>(B)</enum><header display-inline="yes-display-inline">Funds</header><text display-inline="yes-display-inline">There are authorized to be appropriated,
				and there are appropriated, to carry out this paragraph (in addition to any
				other amounts appropriated to carry out this paragraph and out of any money in
				the Treasury not otherwise appropriated), $25,000,000 for each of the fiscal
				years 2010 and
				2011.</text>
											</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
								</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HC9D593A52B5B4245A26377D0016336D9"><enum>(2)</enum><header display-inline="yes-display-inline">Conforming amendment</header><text display-inline="yes-display-inline">Section 458 (20 U.S.C. 1087h) is further
			 amended by striking <quote>subsection (a)(3)</quote> in subsection (b) and
			 inserting <quote>subsection (a)(4)</quote>.</text>
							</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="HB6B2F0C2E4904EF1B35B6FACF074E5D7" section-type="subsequent-section"><enum>2213.</enum><header display-inline="yes-display-inline">Income-based repayment</header><text display-inline="no-display-inline">Section 493C (20 U.S.C. 1098e) is amended by
			 adding at the end the following new subsection:</text>
						<quoted-block display-inline="no-display-inline" id="H797DC24F309F4792A796C434A4F70129" style="OLC">
							<subsection commented="no" display-inline="no-display-inline" id="H0F80744A5CF14215951D7A9B9D44E08C"><enum>(e)</enum><header display-inline="yes-display-inline">Special terms for new borrowers on and
				after July 1, 2014</header><text display-inline="yes-display-inline">With
				respect to any loan made to a new borrower on or after July 1, 2014—</text>
								<paragraph commented="no" display-inline="no-display-inline" id="H26C7A77EE9874E8799F6FEB122972228"><enum>(1)</enum><text display-inline="yes-display-inline">subsection (a)(3)(B) shall be applied by
				substituting <quote>10 percent</quote> for <quote>15 percent</quote>;
				and</text>
								</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H37FB230B41E24425813A7396E48900B9"><enum>(2)</enum><text display-inline="yes-display-inline">subsection (b)(7)(B) shall be applied by
				substituting <quote>20 years</quote> for <quote>25
				years</quote>.</text>
								</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</section></part></subtitle><subtitle commented="no" id="H8AFEC46BFF59401DAA103FDEF373438B" level-type="subsequent"><enum>B</enum><header display-inline="yes-display-inline">Health</header>
				<section commented="no" display-inline="no-display-inline" id="HC566B488D63343ED887FBD83852A5AFC" section-type="subsequent-section"><enum>2301.</enum><header display-inline="yes-display-inline">Insurance reforms</header>
					<subsection commented="no" display-inline="no-display-inline" id="HCAD74DEF70814C17833444340CC64CFA"><enum>(a)</enum><header display-inline="yes-display-inline">Extending certain insurance reforms to
			 grandfathered plans</header><text display-inline="yes-display-inline">Section
			 1251(a) of the Patient Protection and Affordable Care Act, as added by section
			 10103(d) of such Act, is amended by adding at the end the following:</text>
						<quoted-block display-inline="no-display-inline" id="H28C2CC67EBD7449489380038128F940B" style="OLC">
							<paragraph commented="no" display-inline="no-display-inline" id="H0D183D6E50944659A28D7624778D5DEA"><enum>(4)</enum><header display-inline="yes-display-inline">Application of certain provisions</header>
								<subparagraph commented="no" display-inline="no-display-inline" id="H25C8AC966F2D44D289E6326B83AF3125"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The following provisions of the Public
				Health Service Act (as added by this title) shall apply to grandfathered health
				plans for plan years beginning with the first plan year to which such
				provisions would otherwise apply:</text>
									<clause commented="no" display-inline="no-display-inline" id="H06BBDC3D45DE48FB823499ABC1CCAD3F"><enum>(i)</enum><text display-inline="yes-display-inline">Section 2708 (relating to excessive waiting
				periods).</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="H5AC8A702DC9842F5817E8996D9FDB1FD"><enum>(ii)</enum><text display-inline="yes-display-inline">Those provisions of section 2711 relating
				to lifetime limits.</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="H1EB89D52ABAC46DC964B478CCFBAC8B7"><enum>(iii)</enum><text display-inline="yes-display-inline">Section 2712 (relating to
				rescissions).</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="H60A864E9D6AD4D30B99DF1CB8929BFE9"><enum>(iv)</enum><text display-inline="yes-display-inline">Section 2714 (relating to extension of
				dependent coverage).</text>
									</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H47DC9B602B2C4B15AC8C9BCFAC288C05"><enum>(B)</enum><header display-inline="yes-display-inline">Provisions applicable only to group health
				plans</header><text display-inline="yes-display-inline"></text>
									<clause commented="no" display-inline="no-display-inline" id="HAA993C9CED274B579355F1C5E6DD54AF"><enum>(i)</enum><header display-inline="yes-display-inline">Provisions described</header><text display-inline="yes-display-inline">Those provisions of section 2711 relating
				to annual limits and the provisions of section 2704 (relating to pre-existing
				condition exclusions) of the Public Health Service Act (as added by this
				subtitle) shall apply to grandfathered health plans that are group health plans
				for plan years beginning with the first plan year to which such provisions
				otherwise apply.</text>
									</clause><clause commented="no" display-inline="no-display-inline" id="HBD1945B6F33246FA8F726CA3F7570491"><enum>(ii)</enum><header display-inline="yes-display-inline">Adult child coverage</header><text display-inline="yes-display-inline">For plan years beginning before January 1,
				2014, the provisions of section 2714 of the Public Health Service Act (as added
				by this subtitle) shall apply in the case of an adult child with respect to a
				grandfathered health plan that is a group health plan only if such adult child
				is not eligible to enroll in an eligible employer-sponsored health plan (as
				defined in section 5000A(f)(2) of the Internal Revenue Code of 1986) other than
				such grandfathered health
				plan.</text>
									</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
					</subsection><subsection commented="no" display-inline="no-display-inline" id="HFBD8634A850D4289B2668D6483E7A4CC"><enum>(b)</enum><header display-inline="yes-display-inline">Clarification regarding dependent
			 coverage</header><text display-inline="yes-display-inline">Section 2714(a) of
			 the Public Health Service Act, as added by section 1001(5) of the Patient
			 Protection and Affordable Care Act, is amended by striking <quote>(who is not
			 married)</quote>.</text>
					</subsection></section><section commented="no" display-inline="no-display-inline" id="H48DA459E92F748EBB2469EE6B8D6F83E" section-type="subsequent-section"><enum>2302.</enum><header display-inline="yes-display-inline">Drugs purchased by covered
			 entities</header><text display-inline="no-display-inline">Section 340B of the
			 Public Health Service Act (42 U.S.C. 256b), as amended by sections 7101 and
			 7102 of the Patient Protection and Affordable Care Act, is amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="HF027E9F1E1B948F1B37F802572946A59"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="H064A579685B540A4875971F1DD7F1A8F"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraphs (1), (2), (5), (7), and (9),
			 by striking the terms <quote>covered drug</quote> and <quote>covered
			 drugs</quote> each place either term appears and inserting <quote>covered
			 outpatient drug</quote> or <quote>covered outpatient drugs</quote>,
			 respectively;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H8A63B4DE159F4006BC1395CD04AE37A3"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (4)(L)—</text>
							<clause commented="no" display-inline="no-display-inline" id="HFE3273080F854CC19BD95113593CC660"><enum>(i)</enum><text display-inline="yes-display-inline">in clause (i), by striking
			 <quote>and</quote> at the end;</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="H7A1B46A25A304A58B1002C636BACE573"><enum>(ii)</enum><text display-inline="yes-display-inline">in clause (ii), by striking the period and
			 inserting <quote>; and</quote>; and</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="H6C842D8D4A25469D9E764C17B64EE498"><enum>(iii)</enum><text display-inline="yes-display-inline">by inserting after clause (ii), the
			 following:</text>
								<quoted-block display-inline="no-display-inline" id="H2A64846C49BD4177A47FD16AFCD4A853" style="OLC">
									<clause commented="no" display-inline="no-display-inline" id="H9D4BC4CAF28F42FA873E2302A2750F27"><enum>(iii)</enum><text display-inline="yes-display-inline">does not obtain covered outpatient drugs
				through a group purchasing organization or other group purchasing
				arrangement.</text>
									</clause><after-quoted-block>;
				and</after-quoted-block></quoted-block>
							</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HBBB99DB9899B4CDFBBD4407F71B15BDC"><enum>(C)</enum><text display-inline="yes-display-inline">in paragraph (5)—</text>
							<clause commented="no" display-inline="no-display-inline" id="H975B7E9BAEE24148BE10DFD0EEDFC586"><enum>(i)</enum><text display-inline="yes-display-inline">by striking subparagraph (C);</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="HCABABB1AC5B4470A9105B85AC6A019AA"><enum>(ii)</enum><text display-inline="yes-display-inline">by redesignating subparagraphs (D) and (E)
			 as subparagraphs (C) and (D), respectively; and</text>
							</clause><clause commented="no" display-inline="no-display-inline" id="H0E306CD006024040AB6137745A4D1DEE"><enum>(iii)</enum><text display-inline="yes-display-inline">in subparagraph (D), as so redesignated, by
			 striking <quote>subparagraph (D)</quote> and inserting <quote>subparagraph
			 (C)</quote>;</text>
							</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H017D582B458E4749BBB017D18022D490"><enum>(2)</enum><text display-inline="yes-display-inline">by striking subsection (c);</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HB080A076EF4A4296BC53E0CDD6AD7DB6"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (d)—</text>
						<subparagraph commented="no" display-inline="no-display-inline" id="HC159C9EA59F24C80B3F7900059063455"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>covered drugs</quote>
			 each place it appears and inserting <quote>covered outpatient
			 drugs</quote>;</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H682BBC0F067E4A4C894FAAACFE0AA6BE"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote>(a)(5)(D)</quote> each
			 place it appears and inserting <quote>(a)(5)(C)</quote>; and</text>
						</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H80B4FB0D5F554697818CF54803ECA11D"><enum>(C)</enum><text display-inline="yes-display-inline">by striking <quote>(a)(5)(E)</quote> each
			 place it appears and inserting <quote>(a)(5)(D)</quote>; and</text>
						</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H1E6834F40D1E4E02B383F8F637838A64"><enum>(4)</enum><text display-inline="yes-display-inline">by inserting after subsection (d) the
			 following:</text>
						<quoted-block display-inline="no-display-inline" id="H9783AC81239F4F8CB7CABB1F4C62E866" style="OLC">
							<subsection commented="no" display-inline="no-display-inline" id="H1A8D7DFC335E42D9987DECDFC3DD6FCA"><enum>(e)</enum><header display-inline="yes-display-inline">Exclusion of orphan drugs for certain
				covered entities</header><text display-inline="yes-display-inline">For covered
				entities described in subparagraph (M), (N), or (O) of subsection (a)(4), the
				term <quote>covered outpatient drug</quote> shall not include a drug designated
				by the Secretary under section 526 of the Federal Food, Drug, and Cosmetic Act
				for a rare disease or
				condition.</text>
							</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
					</paragraph></section><section commented="no" display-inline="no-display-inline" id="H7D6F17D438304275B27D8034FC4FD23B" section-type="subsequent-section"><enum>2303.</enum><header display-inline="yes-display-inline">Community health centers</header><text display-inline="no-display-inline">Section 10503(b)(1) of the Patient
			 Protection and Affordable Care Act is amended—</text>
					<paragraph commented="no" display-inline="no-display-inline" id="HD8E0B4C3579E4075AE55F737EDF0FC7B"><enum>(1)</enum><text display-inline="yes-display-inline">in subparagraph (A), by striking
			 <quote>700,000,000</quote> and inserting <quote>1,000,000,000</quote>;</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HD0BFC906B168496B8A885A1FB6D17220"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking
			 <quote>800,000,000</quote> and inserting <quote>1,200,000,000</quote>;</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H4D82C0AD52844CAABCC536FB2B5F7BAF"><enum>(3)</enum><text display-inline="yes-display-inline">in subparagraph (C), by striking
			 <quote>1,000,000,000</quote> and inserting <quote>1,500,000,000</quote>;</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H62329B550D7B4A6BB383549B94B4F1E9"><enum>(4)</enum><text display-inline="yes-display-inline">in subparagraph (D), by striking
			 <quote>1,600,000,000</quote> and inserting <quote>2,200,000,000</quote>;
			 and</text>
					</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H19775CEE36FE4CEE90A5270F6777153C"><enum>(5)</enum><text display-inline="yes-display-inline">in subparagraph (E), by striking
			 <quote>2,900,000,000</quote> and inserting <quote>3,600,000,000</quote>.</text>
					</paragraph></section></subtitle></title></legis-body>
	<attestation>
		<attestation-group>
			<attestation-date chamber="House" date="20100321">Passed the House of
			 Representatives March 21, 2010.</attestation-date>
			<attestor display="no">Lorraine C. Miller,</attestor>
			<role>Clerk.</role>
		</attestation-group>
	</attestation>
	<endorsement display="yes">
	</endorsement>
</bill>
