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 A
MENDMENT IN THE
N
 ATURE OF
S
UBSTITUTE
 
TO
H.R. 4872,
 AS
R
EPORTED
 
Strike all after the enacting clause and insert thefollowing:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
1
(a) S
HORT
T
ITLE
.—This Act may be cited as the
2
‘‘Health Care and Education Affordability Reconciliation
3
 Act of 2010’’.
4
(b) T
 ABLE OF
C
ONTENTS
.—The table of contents of 
5
this Act is as follows:
6
Sec.1.Short title; table of contents.TITLE I—COVERAGE, MEDICARE, MEDICAID, AND REVENUESSubtitle A—CoverageSec.1001.Affordability.Sec.1002.Individual responsibility.Sec.1003.Employer responsibility.Sec.1004.Income definitions.Sec.1005.Implementation funding.Subtitle B—MedicareSec.1101.Closing the medicare prescription drug ‘‘donut hole’’.Sec.1102.Medicare Advantage payments.Sec.1103.Savings from limits on MA plan administrative costs.Sec.1104.Disproportionate share hospital (DSH) payments.Sec.1105.Market basket updates.Sec.1106.Physician ownership-referral.Sec.1107.Payment for imaging services.Subtitle C—MedicaidSec.1201.Federal funding for States.Sec.1202.Payments to primary care physicians.Sec.1203.Disproportionate share hospital payments.Sec.1204.Funding for the territories.
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2
Sec.1205.Delay in Community First Choice option.Sec.1206.Drug rebates for new formulations of existing drugs.Subtitle D—Reducing Fraud, Waste, and AbuseSec.1301.Community mental health centers.Sec.1302.Medicare prepayment medical review limitations .Sec.1303.CMS–IRS data match to identify fraudulent providers.Sec.1304.Funding to fight fraud, waste, and abuse.Sec.1305.90-day period of enhanced oversight for initial claims of DME sup-pliers.Subtitle E—Provisions Relating to RevenueSec.1401.High-cost plan excise tax.Sec.1402.Medicare tax.Sec.1403.Delay of limitation on health flexible spending arrangements undercafeteria plans.Sec.1404.Brand name pharmaceuticals.Sec.1405.Excise tax on medical device manufacturers.Sec.1406.Health insurance providers.Sec.1407.Delay of elimination of deduction for expenses allocable to medicarepart D subsidy.Sec.1408.Elimination of unintended application of cellulosic biofuel producercredit.Sec.1409.Codification of economic substance doctrine and penalties.Sec.1410.Time for payment of corporate estimated taxes.Sec.1411.No impact on Social Security trust funds.Subtitle F—Other ProvisionsSec.1501.Community college and career training grant program.TITLE II—EDUCATION AND HEALTHSubtitle A—EducationSec.2001.Short title; references.P
 ART
I—I
NVESTING IN
S
TUDENTS AND
F
 AMILIES
 Sec.2101.Federal Pell Grants.Sec.2102.Student financial assistance.Sec.2103.College access challenge grant program.Sec.2104.Investment in historically black colleges and universities and minor-ity-serving institutions.P
 ART
II—S
TUDENT
L
OAN
R
EFORM
 Sec.2201.Termination of Federal Family Education Loan appropriations.Sec.2202.Termination of Federal loan insurance program.Sec.2203.Termination of applicable interest rates.Sec.2204.Termination of Federal payments to reduce student interest costs.Sec.2205.Termination of FFEL PLUS Loans.Sec.2206.Federal Consolidation Loans.Sec.2207.Termination of Unsubsidized Stafford Loans for middle-income bor-rowers.Sec.2208.Termination of special allowances.
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3
Sec.2209.Origination of Direct Loans at institutions outside the UnitedStates.Sec.2210.Conforming amendments.Sec.2211.Terms and conditions of loans.Sec.2212.Contracts; mandatory funds.Sec.2213.Agreements with State-owned banks.Sec.2214.Income-based repayment.Subtitle B—HealthSec.2301.Insurance reforms.Sec.2302.Drugs purchased by covered entities.Sec.2303.Community health centers.
TITLE I—COVERAGE, MEDICARE,
1
MEDICAID, AND REVENUES
2
Subtitle A—Coverage
3
SEC. 1001. AFFORDABILITY.
4
(a) P
REMIUM
T
 AX 
C
REDITS
.—Section 36B of the In-
5
ternal Revenue Code of 1986, as added by section 1401
6
of the Patient Protection and Affordable Care Act and
7
amended by section 10105 of such Act, is amended—
8
(1) in subsection (b)(3)(A)—
9
(A) in clause (i), by striking ‘‘with respect
10
to any taxpayer’’ and all that follows up to the
11
end period and inserting ‘‘for any taxable year
12
shall be the percentage such that the applicable
13
percentage for any taxpayer whose household
14
income is within an income tier specified in the
15
following table shall increase, on a sliding scale
16
in a linear manner, from the initial premium
17
percentage to the final premium percentage
18
specified in such table for such income tier:
19
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