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United States · Law · HR

H.R. 4302 (113th)

Protecting Access to Medicare Act of 2014

enactedUnited States· United States Congress· EN

Introduced

26 March 2014

Last action

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Status

Became Public Law No: 113-93.

Sponsors

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Subjects

Discovery layer

Source updated

7 April 2025

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Summary

Protecting Access to Medicare Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act (SSA) with respect to physician payment update to: (1) extend the update currently scheduled for January through March of 2014 to the entire calendar year of 2014, (2) freeze the update to the single conversion factor at 0.00% for January 1, 2015, through March 31, 2015, and (3) require that the conversion factor for April 1, 2015, through December 31, 2015, and for 2016 and subsequent years be computed as if such freeze had never applied. Extends: (1) the geographic practice cost index (GPCI) floor through April 1, 2015; (2) the therapy cap exceptions process through March 15, 2015; (3) add-on payments for ground ambulance and super rural ground ambulance services through April 1, 2015; (4) the increased inpatient hospital payment adjustment for certain low-volume hospitals starting on April 1, 2015, for FY2016, and subsequent fiscal years; (5) the Medicare-Dependent Hospital (MDH) program through March 31, 2015; (6) specialized MedicareAdvantage (MA) plans for special needs individuals through December 31, 2016; (7) through December 31, 2016, authority to renew a reasonable cost reimbursement contract with a health maintenance organization and competitive medical plan; and (8) through March 31, 2015, the funding for any contract with a consensus-based entity regarding performance measurement as well as multi-stakeholder group input into selection of quality and efficiency measures (endorsement, input, and selection). Amends the Medicare Improvements for Patients and Providers Act of 2008, as amended by the Patient Protection and Affordable Care Act (PPACA), the American Taxpayer Relief Act, and the Pathway for SGR Reform Act of 2013 to extend through March 31, 2015 the funding of various programs, including area agencies on aging and the contract with the National Center for Benefits and Outreach Enrollment. Authorizes the Secretary of Health and Human Services (HHS) to continue through June 2015, and with a specified limitation, certain medical review activities related to the two-midnight rule. (The two-midnight rule allows Medicare coverage of only hospital stays for which a physician admits to a hospital a beneficiary expected to require care that crosses two midnights, but generally denies coverage of care expected to require less than a two-midnight stay.) Amends SSA title XVIII and the Medicare. Medicaid, and SCHIP Extension Act of 2007 with respect to Medicare long-term care hospital (LTCH) requirements. Amends SSA title XIX (Medicaid) to extend: (1) through March 31, 2015, the qualifying individual (QI) and transitional medical assistance (TMA) programs, and (2) through September 30, 2015, express lane program eligibility under both Medicaid and SSA title XXI (Children's Health Insurance Program) (CHIP). Amends the Public Health Service Act (PHSA) to extend special diabetes programs for Type I diabetes and for Indians through FY2015. Amends SSA title V (Maternal and Child Health Services Block Grant) to extend: (1) the abstinence education grant and personal responsibility education programs through FY2015, and (2) the family-to-family health information centers through March 31, 2015. Amends SSA title XX (Block Grants to States for Social Services) to extend the health workforce demonstration project for low-income individuals through FY2015. Extends the maternal, infant, and early childhood home visiting programs under SSA title V through March 31, 2015. Amends SSA title XI to earmark funding for pediatric quality measures for improving the quality of children's health care. Requires the aggregate amount awarded by the Secretary for grants and contracts for the development, testing, and validation of emerging and innovative evidence-based measures under such program to equal the aggregate amount awarded by the Secretary for grants as part of the program to advance pediatric quality measures. Delays the effective date for Medicaid amendments in the Bipartisan Budget Act of 2013 relating to beneficiary liability settlements. Delays until October 1, 2015, the transition from International Statistical Classification of Diseases (ICD)-9 to ICD-10. Amends PPACA to repeal the limitation on cost-sharing (deductibles) for employer-sponsored health plans. Directs the Comptroller General (GAO) to evaluate the children's hospital graduate medical education (GME) program. Directs the Secretary to specify a skilled nursing facility all-cause all-condition hospital readmission measure (or any successor) by October 1, 2015. Amends SSA title XVIII to prescribe requirements for establishment of Medicare payment rates for clinical diagnostic laboratory tests. Revises requirements for the Medicare end state renal disease (ESRD) prospective payment system. Prescribes quality incentives, including penalties, for certain computed tomography services. Eliminates FY2014-FY2015 funding for the Medicare Improvement Fund. Authorizes the Secretary to collect and use certain information on physicians' services in the determination of relative values in the formulae for setting physicians' fees. Amends SSA title XIX to increase the amounts of reductions to Medicaid disproportionate share hospital (DSH) allotments for FY2017-FY2024. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to adjust the 2% maximum reduction for specified Medicare programs for FY2024 under any presidential sequestration order to make it 4% for the first 6 months of FY2024 and 0% for the last 6 months. Requires the Secretary to: (1) publish criteria for a state-certified community behavioral health clinic to participate in a certain mental health services demonstration program, and (2) establish a 4-year pilot program to award up to 50 grants each year to eligible entities for assisted outpatient treatment programs for individuals with serious mental illness.

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