Sec. 202. FISCAL EFFICIENCY AND REVENUE NEUTRALITY
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## SEC. 202 FISCAL EFFICIENCY AND REVENUE NEUTRALITY ###
(a)In General Section 1862(b) of the Social Security Act (42 U.S.C. 1395y(b)) is amended— ####
(1)in paragraph (2)(B)(ii), by striking “A primary plan” and inserting “Subject to paragraph (9), a primary plan”; and ####
(2)by adding at the end the following new paragraph: > > #### “(9) Exception > > > ##### “(A) In general > > Clause
(ii)of paragraph (2)(B) and any reporting required by paragraph
(8)shall not apply with respect to any settlement, judgment, award, or other payment by an applicable plan arising from liability insurance (including self-insurance) and from alleged physical trauma-based incidents (excluding alleged ingestion, implantation, or exposure cases) constituting a total payment obligation to a claimant of not more than the single threshold amount calculated by the Secretary under subparagraph
(B)for the year involved. > > > ##### “(B) Annual computation of threshold > > > ###### “(i) In general > > Not later than November 15 before each year, the Secretary shall calculate and publish a single threshold amount for settlements, judgments, awards, or other payments for obligations arising from liability insurance (including self-insurance) and for alleged physical trauma-based incidents (excluding alleged ingestion, implantation, or exposure cases) subject to this section for that year. The annual single threshold amount for a year shall be set such that the estimated average amount to be credited to the Medicare trust funds of collections of conditional payments from such settlements, judgments, awards, or other payments arising from liability insurance (including self-insurance) and for such alleged incidents subject to this section shall equal the estimated cost of collection incurred by the United States (including payments made to contractors) for a conditional payment arising from liability insurance (including self-insurance) and for such alleged incidents subject to this section for the year. At the time of calculating, but before publishing, the single threshold amount for a year, the Secretary shall inform, and seek review of, the Comptroller General of the United States with regard to such amount. > > > ###### “(ii) Publication > > The Secretary shall include, as part of such publication for a year— > > > ###### “(I) > > the estimated cost of collection incurred by the United States (including payments made to contractors) for a conditional payment arising from liability insurance (including self-insurance) and for such alleged incidents; and > > > ###### “(II) > > a summary of the methodology and data used by the Secretary in computing such threshold amount and such cost of collection. > > > ##### “(C) Exclusion of ongoing expenses > > For purposes of this paragraph and with respect to a settlement, judgment, award, or other payment not otherwise addressed in clause
(ii)of paragraph (2)(B) that includes ongoing responsibility for medical payments (excluding settlements, judgments, awards, or other payments made by a workers’ compensation law or plan or no fault insurance), the amount utilized for calculation of the threshold described in subparagraph
(A)shall include only the cumulative value of the medical payments made under this title. > > > ##### “(D) Report to congress > > Not later than November 15 before each year, the Secretary shall submit to the Congress a report on the single threshold amount for settlements, judgments, awards, or other payments for conditional payment obligations arising from liability insurance (including self-insurance) and alleged incidents described in subparagraph
(A)for that year and on the establishment and application of similar thresholds for such payments for conditional payment obligations arising from worker compensation cases and from no fault insurance cases subject to this section for the year. For each such report, the Secretary shall— > > > ###### “(i) > > calculate the threshold amount by using the methodology applicable to certain liability claims described in subparagraph (B); and > > > ###### “(ii) > > include a summary of the methodology and data used in calculating each threshold amount and the amount of estimated savings under this title achieved by the Secretary implementing each such threshold.” > . ###
(b)Effective Date **[**[42 U.S.C. 1395y note](/us/usc/t42/s1395y)**]** The amendments made by subsection
(a)shall apply to years beginning with 2014.
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Sec. 202
FISCAL EFFICIENCY AND REVENUE NEUTRALITY
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