Sec. 44133. Revising the payment limit for certain State directed payments
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/bill/119/hr/1/rh/section-44133A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Subject to subsection (b), the Secretary of Health and Human Services shall revise section 438.6(c)(2)(iii) of title 42, Code of Federal Regulations (or a successor regulation) such that, with respect to a payment described in such section made for a service furnished during a rating period beginning on or after the date of the enactment of this Act, the total payment rate for such service is limited to 100 percent of the specified total published Medicare payment rate. In the case of a payment described in section 438.6(c)(2)(iii) of title 42, Code of Federal Regulations (or a successor regulation) for which written prior approval was made before the date of the enactment of this Act for the rating period occurring as of such date of enactment, or a payment so described for such rating period for which a preprint was submitted to the Secretary of Health and Human Services prior to such date of enactment, the revisions described in subsection
(a)shall not apply to such payment for such rating period and for any subsequent rating period if the amount of such payment does not exceed the amount of such payment so approved. In this section: The term rating period has the meaning given such term in section 438.2 of title 42, Code of Federal Regulations (or a successor regulation). The term total published Medicare payment rate means amounts calculated as payment for specific services that have been developed under part A or part B of title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ). The term written prior approval has the meaning given such term in section 438.6(c)(2)(i) of title 42, Code of Federal Regulations (or a successor regulation). There are appropriated out of any monies in the Treasury not otherwise appropriated $7,000,000 for each of fiscal years 2026 through 2033 for purposes of carrying out this section.
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Sec. 44133
Revising the payment limit for certain State directed payments
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