Medicare Payment Adjustment To Community Health Centers (PATCH) Act of 2005

Medicare Payment Adjustment To Community Health Centers (PATCH) Act of 2005 - Amends part E (Miscellaneous) of title XVIII (Medicare) of the Social Security Act to revise the definition of Federally qualified health center (FQHC) services to include certain services furnished by an FQHC for which payment may otherwise be made under Medicare if they were furnished by a health care provider or health care professional other than an FQHC.

Repeals the limitation of such services to outpatients of an FQHC, extending them to all patients of an FQHC. Repeals the declaration that any reference to a rural health clinic is deemed a reference to an FQHC.

Ensures FQHC reimbursement for patients of hospitals and critical access hospitals under the hospital prospective payment system.

[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1819 Introduced in House (IH)]






109th CONGRESS
  1st Session
                                H. R. 1819

 To amend title XVIII of the Social Security Act to enhance the access 
 of Medicare beneficiaries who live in medically underserved areas to 
   critical primary and preventive health care benefits at Federally 
                       qualified health centers.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 26, 2005

  Mr. Weller introduced the following bill; which was referred to the 
Committee on Ways and Means, and in addition to the Committee on Energy 
    and Commerce, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to enhance the access 
 of Medicare beneficiaries who live in medically underserved areas to 
   critical primary and preventive health care benefits at Federally 
                       qualified health centers.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Payment Adjustment To 
Community Health Centers (PATCH) Act of 2005''.

SEC. 2. DELIVERY OF MEDICARE-COVERED PRIMARY AND PREVENTIVE SERVICES AT 
              FEDERALLY QUALIFIED HEALTH CENTERS.

    (a) Coverage of Medicare-Covered Ambulatory Services by FQHCs.--
Section 1861(aa)(3) of the Social Security Act (42 U.S.C. 1395x(aa)(3)) 
is amended to read as follows:
    ``(3) The term `Federally qualified health center services' means--
            ``(A) services of the type described in subparagraphs (A) 
        through (C) of paragraph (1), and such other services furnished 
        by a Federally qualified health center for which payment may 
        otherwise be made under this title if such services were 
        furnished by a health care provider or health care professional 
        other than a Federally qualified health center; and
            ``(B) preventive primary health services that a center is 
        required to provide under section 330 of the Public Health 
        Service Act,
when furnished to an individual as a patient of a Federally qualified 
health center and such services when provided by a health care provider 
or health care professional employed by or under contract with a 
Federally qualified health center shall be treated as billable visits 
for purposes of payment to the Federally qualified health center.''.
    (b) Ensuring FQHC Reimbursement for Patients of Hospitals and 
Critical Access Hospitals Under the Hospital Prospective Payment 
System.--Section 1862(a)(14) of the Social Security Act (42 U.S.C. 
1395y(a)) is amended by inserting ``Federally qualified health center 
services,'' after ``qualified psychologist services,''.
    (c) Technical Corrections.--Clauses (i) and (ii)(II) of section 
1861(aa)(4)(A) of the Social Security Act (42 U.S.C. 1395x(aa)(4)(A)) 
are each amended by striking ``(other than subsection (h))''.
    (d) Effective Dates.--The amendments made--
            (1) by subsections (a) and (b) shall apply to services 
        furnished on or after January 1, 2006; and
            (2) by subsection (c) shall take effect as if included in 
        the enactment of the Health Centers Consolidation Act of 1996 
        (Public Law 104-299).
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