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1 PART 2—MARKET BASKET UPDATES

2 SEC. 1131. INCORPORATING PRODUCTIVITY IMPROVE-

3 MENTS INTO MARKET BASKET UPDATES

4 THAT DO NOT ALREADY INCORPORATE SUCH

5 IMPROVEMENTS.

6 (a) OUTPATIENT HOSPITALS.—

7 (1) IN GENERAL.—The first sentence of section
8 1833(t)(3)(C)(iv) of the Social Security Act (42
9 U.S.C. 1395l(t)(3)(C)(iv)) is amended—
10 (A) by inserting ‘‘(which is subject to the
11 productivity adjustment described in subclause
12 (II) of such section)’’ after
13 ‘‘1886(b)(3)(B)(iii)’’; and
14 (B) by inserting ‘‘(but not below 0)’’ after
15 ‘‘reduced’’.
16 (2) EFFECTIVE DATE.—The amendments made
17 by paragraph (1) shall apply to increase factors for
18 services furnished in years beginning with 2010.
19 (b) AMBULANCE SERVICES.—Section 1834(l)(3)(B)
20 of such Act (42 U.S.C. 1395m(l)(3)(B))) is amended by
21 inserting before the period at the end the following: ‘‘and,
22 in the case of years beginning with 2010, subject to the
23 productivity adjustment described in section
24 1886(b)(3)(B)(iii)(II)’’.

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1 (c) AMBULATORY SURGICAL CENTER SERVICES.—
2 Section 1833(i)(2)(D) of such Act (42 U.S.C.
3 1395l(i)(2)(D)) is amended—
4 (1) by redesignating clause (v) as clause (vi);
5 and
6 (2) by inserting after clause (iv) the following
7 new clause:
8 ‘‘(v) In implementing the system described in clause
9 (i), for services furnished during 2010 or any subsequent
10 year, to the extent that an annual percentage change fac-
11 tor applies, such factor shall be subject to the productivity
12 adjustment described in section 1886(b)(3)(B)(iii)(II).’’.
13 (d) LABORATORY SERVICES.—Section
14 1833(h)(2)(A)) of such Act (42 U.S.C. 1395l(h)(2)(A)) is
15 amended—
16 (1) in clause (i), by striking ‘‘for each of years
17 2009 through 2013’’ and inserting ‘‘for 2009’’; and
18 (2) clause (ii)—
19 (A) by striking ‘‘and’’ at the end of sub-
20 clause (III);
21 (B) by striking the period at the end of
22 subclause (IV) and inserting ‘‘; and’’; and
23 (C) by adding at the end the following new
24 subclause:

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1 ‘‘(V) the annual adjustment in the fee schedules
2 determined under clause (i) for years beginning with
3 2010 shall be subject to the productivity adjustment
4 described in section 1886(b)(3)(B)(iii)(II).’’.
5 (e) CERTAIN DURABLE MEDICAL EQUIPMENT.—Sec-
6 tion 1834(a)(14) of such Act (42 U.S.C. 1395m(a)(14))
7 is amended—
8 (1) in subparagraph (K), by inserting before
9 the semicolon at the end the following: ‘‘, subject to
10 the productivity adjustment described in section
11 1886(b)(3)(B)(iii)(II)’’;
12 (2) in subparagraph (L)(i), by inserting after
13 ‘‘June 2013,’’ the following: ‘‘subject to the produc-
14 tivity adjustment described in section
15 1886(b)(3)(B)(iii)(II),’’;
16 (3) in subparagraph (L)(ii), by inserting after
17 ‘‘June 2013’’ the following: ‘‘, subject to the produc-
18 tivity adjustment described in section
19 1886(b)(3)(B)(iii)(II)’’; and
20 (4) in subparagraph (M), by inserting before
21 the period at the end the following: ‘‘, subject to the
22 productivity adjustment described in section
23 1886(b)(3)(B)(iii)(II)’’.

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1 PART 3—OTHER PROVISIONS

2 SEC. 1141. RENTAL AND PURCHASE OF POWER-DRIVEN

3 WHEELCHAIRS.

4 (a) IN GENERAL.—Section 1834(a)(7)(A)(iii) of the

5 Social Security Act (42 U.S.C. 1395m(a)(7)(A)(iii)) is
6 amended—
7 (1) in the heading, by inserting ‘‘CERTAIN COM-

8 PLEX REHABILITATIVE’’ after ‘‘OPTION FOR’’; and

9 (2) by striking ‘‘power-driven wheelchair’’ and
10 inserting ‘‘complex rehabilitative power-driven wheel-
11 chair recognized by the Secretary as classified within
12 group 3 or higher’’.
13 (b) EFFECTIVE DATE.—The amendments made by
14 subsection (a) shall take effect on January 1, 2011, and
15 shall apply to power-driven wheelchairs furnished on or
16 after such date. Such amendments shall not apply to con-
17 tracts entered into under section 1847 of the Social Secu-
18 rity Act (42 U.S.C. 1395w–3) pursuant to a bid submitted
19 under such section before October 1, 2010, under sub-
20 section (a)(1)(B)(i)(I) of such section.
21 SEC. 1142. EXTENSION OF PAYMENT RULE FOR

22 BRACHYTHERAPY.

23 Section 1833(t)(16)(C) of the Social Security Act (42

24 U.S.C. 1395l(t)(16)(C)), as amended by section 142 of the
25 Medicare Improvements for Patients and Providers Act of
26 2008 (Public Law 110–275), is amended by striking, the
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1 first place it appears, ‘‘January 1, 2010’’ and inserting
2 ‘‘January 1, 2012’’.
3 SEC. 1143. HOME INFUSION THERAPY REPORT TO CON-

4 GRESS.

5 Not later than 12 months after the date of enactment

6 of this Act, the Medicare Payment Advisory Commission
7 shall submit to Congress a report on the following:
8 (1) The scope of coverage for home infusion
9 therapy in the fee-for-service Medicare program
10 under title XVIII of the Social Security Act, Medi-
11 care Advantage under part C of such title, the vet-
12 eran’s health care program under chapter 17 of title
13 38, United States Code, and among private payers,
14 including an analysis of the scope of services pro-
15 vided by home infusion therapy providers to their
16 patients in such programs.
17 (2) The benefits and costs of providing such
18 coverage under the Medicare program, including a
19 calculation of the potential savings achieved through
20 avoided or shortened hospital and nursing home
21 stays as a result of Medicare coverage of home infu-
22 sion therapy.
23 (3) An assessment of sources of data on the
24 costs of home infusion therapy that might be used

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1 to construct payment mechanisms in the Medicare
2 program.
3 (4) Recommendations, if any, on the structure
4 of a payment system under the Medicare program
5 for home infusion therapy, including an analysis of
6 the payment methodologies used under Medicare Ad-
7 vantage plans and private health plans for the provi-
8 sion of home infusion therapy and their applicability
9 to the Medicare program.
10 SEC. 1144. REQUIRE AMBULATORY SURGICAL CENTERS

11 (ASCS) TO SUBMIT COST DATA AND OTHER

12 DATA.

13 (a) COST REPORTING.—

14 (1) IN GENERAL.—Section 1833(i) of the Social
15 Security Act (42 U.S.C. 1395l(i)) is amended by
16 adding at the end the following new paragraph:
17 ‘‘(8) The Secretary shall require, as a condition of
18 the agreement described in section 1832(a)(2)(F)(i), the
19 submission of such cost report as the Secretary may speci-
20 fy, taking into account the requirements for such reports
21 under section 1815 in the case of a hospital.’’.
22 (2) DEVELOPMENT OF COST REPORT.—Not

23 later than 3 years after the date of the enactment

24 of this Act, the Secretary of Health and Human
25 Services shall develop a cost report form for use

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1 under section 1833(i)(8) of the Social Security Act,
2 as added by paragraph (1).
3 (3) AUDIT REQUIREMENT.—The Secretary shall
4 provide for periodic auditing of cost reports sub-
5 mitted under section 1833(i)(8) of the Social Secu-
6 rity Act, as added by paragraph (1).
7 (4) EFFECTIVE DATE.—The amendment made
8 by paragraph (1) shall apply to agreements applica-
9 ble to cost reporting periods beginning 18 months
10 after the date the Secretary develops the cost report
11 form under paragraph (2).
12 (b) ADDITIONAL DATA ON QUALITY.—
13 (1) IN GENERAL.—Section 1833(i)(7) of such
14 Act (42 U.S.C. 1395l(i)(7)) is amended—
15 (A) in subparagraph (B), by inserting
16 ‘‘subject to subparagraph (C),’’ after ‘‘may oth-
17 erwise provide,’’; and
18 (B) by adding at the end the following new
19 subparagraph:
20 ‘‘(C) Under subparagraph (B) the Secretary shall re-
21 quire the reporting of such additional data relating to
22 quality of services furnished in an ambulatory surgical fa-
23 cility, including data on health care associated infections,
24 as the Secretary may specify.’’.

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1 (2) EFFECTIVE DATE.—The amendment made
2 by paragraph (1) shall to reporting for years begin-
3 ning with 2012.
4 SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS.

5 Section 1833(t) of the Social Security Act (42 U.S.C.

6 1395l(t)) is amended by adding at the end the following
7 new paragraph:
8 ‘‘(18) AUTHORIZATION OF ADJUSTMENT FOR

9 CANCER HOSPITALS.—

10 ‘‘(A) STUDY.—The Secretary shall conduct

11 a study to determine if, under the system under
12 this subsection, costs incurred by hospitals de-
13 scribed in section 1886(d)(1)(B)(v) with respect
14 to ambulatory payment classification groups ex-
15 ceed those costs incurred by other hospitals fur-
16 nishing services under this subsection (as deter-
17 mined appropriate by the Secretary).
18 ‘‘(B) AUTHORIZATION OF ADJUSTMENT.—

19 Insofar as the Secretary determines under sub-

20 paragraph (A) that costs incurred by hospitals
21 described in section 1886(d)(1)(B)(v) exceed
22 those costs incurred by other hospitals fur-
23 nishing services under this subsection, the Sec-
24 retary shall provide for an appropriate adjust-
25 ment under paragraph (2)(E) to reflect those

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