42 U.S.C. § 1395i — Federal Hospital Insurance Trust Fund

Page 2966 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i amendments to agreements under section 1816 [42 U.S.C. 1395h] and contracts under section 1842 of the So- cial Security Act [42 U.S.C. 1395u], and regulations, to such extent as may be necessary to implement the amendments made by subsections (a) and (b) [amending this section] on a timely basis.’’ REPLACEMENT OF AGENCY, ORGANIZATION, OR CARRIER PROCESSING MEDICARE CLAIMS; NUMBER OF AGREE- MENTS AND CONTRACTS AUTHORIZED FOR FISCAL YEARS 1985 THROUGH 1993 Pub. L. 98–369, div. B, title III, § 2326(a), July 18, 1984, 98 Stat. 1087, as amended by Pub. L. 98–617, § 3(a)(2), Nov. 8, 1984, 98 Stat. 3295; Pub. L. 99–509, title IX, § 9321(b), Oct. 21, 1986, 100 Stat. 2016; Pub. L. 101–239, title VI, § 6215(a), Dec. 19, 1989, 103 Stat. 2252; Pub. L. 103–432, title I, § 159(a), Oct. 31, 1994, 108 Stat. 4443, pro- vided that: ‘‘During each fiscal year (beginning with fiscal year 1985 and ending with fiscal year 1993), the Secretary of Health and Human Services may enter into not more than two agreements under section 1816 of the Social Security Act [42 U.S.C. 1395h], and not more than two contracts under section 1842 of such Act [42 U.S.C. 1395u], on the basis of competitive bidding, without regard to the nominating process under section 1816(a) of such Act or cost reimbursement provisions under sections 1816(c) or 1842(c) of such Act during the term of the agreement. Such procedure may be used only for the purpose of replacing an agency or organiza- tion or carrier which over a 2-year period of time has been in the lowest 20th percentile of agencies and orga- nizations or carriers having agreements or contracts under the respective section, as measured by the Sec- retary’s cost and performance criteria. In addition, be- ginning with fiscal year 1990 and any subsequent fiscal year the Secretary may enter into such additional agreements and contracts without regard to such cost reimbursement provisions if the fiscal intermediary or carrier involved and the Secretary agree to waive such provisions, but the Secretary may not take any action that has the effect of requiring that the intermediary or carrier agree to waive such provisions, including re- quiring such a waiver as a condition for entering into or renewing such an agreement or contract. Any agen- cy or organization or carrier selected on the basis of competitive bidding must perform all of the duties list- ed in section 1816(a) of such Act, or the duties listed in paragraphs (1) through (4) of section 1842(a) of such Act, as the case may be, and must be a health insuring orga- nization (as determined by the Secretary).’’ [Pub. L. 103–432, title I, § 159(b), Oct. 31, 1994, 108 Stat. 4443, provided that: ‘‘The amendment made by sub- section (a) [amending section 2326(a) of Pub. L. 98–369, set out above] shall apply beginning with fiscal year 1994.’’] [Pub. L. 101–239, title VI, § 6215(b), Dec. 19, 1989, 103 Stat. 2252, provided that: ‘‘The amendments made by subsection (a) [amending section 2326(a) of Pub. L. 98–369, set out above] shall apply beginning with fiscal year 1990.’’] AUDIT AND MEDICAL CLAIMS REVIEW Pub. L. 97–248, title I, § 118, Sept. 3, 1982, 96 Stat. 355, as amended by Pub. L. 99–272, title IX, § 9216(a), Apr. 7, 1986, 100 Stat. 180, provided that, in addition to any funds otherwise provided for payments to inter- mediaries and carriers under agreements entered into under this section and section 1395u of this title, there were transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical In- surance Fund an additional $45,000,000 for each of fiscal years 1983, 1984, and 1985, and $105,000,000 for each of fis- cal years 1986, 1987, and 1988 for payments to such inter- mediaries and carriers under such agreements to be used exclusively for purposes of carrying out provider cost audits, of reviewing medical necessity, and of re- covering third-party liability payments. DEVELOPMENTAL DATE FOR STANDARDS, CRITERIA, AND PROCEDURES PURSUANT TO SUBSEC. (f) OF THIS SEC- TION Pub. L. 95–142, § 14(b), Oct. 15, 1977, 91 Stat. 1200, di- rected the Secretary of Health, Education, and Welfare to develop the standards, criteria, and procedures de- scribed in subsection (f) of section 1816 of the Social Se- curity Act [42 U.S.C. 1395h(f)] (as added by subsection (a)(5)) not later than Oct. 1, 1978. § 1395i. Federal Hospital Insurance Trust Fund (a) Creation; deposits; transfers from Treasury There is hereby created on the books of the Treasury of the United States a trust fund to be known as the ‘‘Federal Hospital Insurance Trust Fund’’ (hereinafter in this section referred to as the ‘‘Trust Fund’’). The Trust Fund shall consist of such gifts and bequests as may be made as provided in section 401(i)(1) of this title, and such amounts as may be deposited in, or appro- priated to, such fund as provided in this part. There are hereby appropriated to the Trust Fund for the fiscal year ending June 30, 1966, and for each fiscal year thereafter, out of any mon- eys in the Treasury not otherwise appropriated, amounts equivalent to 100 per centum of— (1) the taxes imposed by sections 3101(b) and 3111(b) of the Internal Revenue Code of 1986 with respect to wages reported to the Sec- retary of the Treasury or his delegate pursu- ant to subtitle F of such Code after December 31, 1965, as determined by the Secretary of the Treasury by applying the applicable rates of tax under such sections to such wages, which wages shall be certified by the Commissioner of Social Security on the basis of records of wages established and maintained by the Com- missioner of Social Security in accordance with such reports; and (2) the taxes imposed by section 1401(b) of the Internal Revenue Code of 1986 with respect to self-employment income reported to the Secretary of the Treasury or his delegate on tax returns under subtitle F of such Code, as determined by the Secretary of the Treasury by applying the applicable rate of tax under such section to such self-employment income, which self-employment income shall be cer- tified by the Commissioner of Social Security on the basis of records of self-employment es- tablished and maintained by the Commis- sioner of Social Security in accordance with such returns. The amounts appropriated by the preceding sen- tence shall be transferred from time to time from the general fund in the Treasury to the Trust Fund, such amounts to be determined on the basis of estimates by the Secretary of the Treasury of the taxes, specified in the preceding sentence, paid to or deposited into the Treasury; and proper adjustments shall be made in amounts subsequently transferred to the extent prior estimates were in excess of or were less than the taxes specified in such sentence. (b) Board of Trustees; composition; meetings; du- ties With respect to the Trust Fund, there is here- by created a body to be known as the Board of Page 2967 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i 1 So in original. See 2003 Amendment note below. Trustees of the Trust Fund (hereinafter in this section referred to as the ‘‘Board of Trustees’’) composed of the Commissioner of Social Secu- rity, the Secretary of the Treasury, the Sec- retary of Labor, and the Secretary of Health and Human Services, all ex officio, and of two mem- bers of the public (both of whom may not be from the same political party), who shall be nominated by the President for a term of four years and subject to confirmation by the Sen- ate. A member of the Board of Trustees serving as a member of the public and nominated and confirmed to fill a vacancy occurring during a term shall be nominated and confirmed only for the remainder of such term. An individual nomi- nated and confirmed as a member of the public may serve in such position after the expiration of such member’s term until the earlier of the time at which the member’s successor takes of- fice or the time at which a report of the Board is first issued under paragraph (2) after the expi- ration of the member’s term. The Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees (hereinafter in this sec- tion referred to as the ‘‘Managing Trustee’’). The Administrator of the Centers for Medicare & Medicaid Services shall serve as the Secretary of the Board of Trustees. The Board of Trustees shall meet not less frequently than once each calendar year. It shall be the duty of the Board of Trustees to— (1) Hold the Trust Fund; (2) Report to the Congress not later than the first day of April of each year on the operation and status of the Trust Fund during the pre- ceding fiscal year and on its expected oper- ation and status during the current fiscal year and the next 2 fiscal years; Each report pro- vided under paragraph (2) beginning with the report in 2005 shall include the information specified in section 801(a) of the Medicare Pre- scription Drug, Improvement, and Moderniza- tion Act of 2003.1 (3) Report immediately to the Congress whenever the Board is of the opinion that the amount of the Trust Fund is unduly small; and (4) Review the general policies followed in managing the Trust Fund, and recommend changes in such policies, including necessary changes in the provisions of law which govern the way in which the Trust Fund is to be man- aged. The report provided for in paragraph (2) shall in- clude a statement of the assets of, and the dis- bursements made from, the Trust Fund during the preceding fiscal year, an estimate of the ex- pected income to, and disbursements to be made from, the Trust Fund during the current fiscal year and each of the next 2 fiscal years, and a statement of the actuarial status of the Trust Fund. Such report shall also include an actu- arial opinion by the Chief Actuary of the Cen- ters for Medicare & Medicaid Services certifying that the techniques and methodologies used are generally accepted within the actuarial profes- sion and that the assumptions and cost esti- mates used are reasonable. Such report shall be printed as a House document of the session of the Congress to which the report is made. A per- son serving on the Board of Trustees shall not be considered to be a fiduciary and shall not be per- sonally liable for actions taken in such capacity with respect to the Trust Fund. (c) Investment of Trust Fund by Managing Trustee It shall be the duty of the Managing Trustee to invest such portion of the Trust Fund as is not, in his judgment, required to meet current withdrawals. Such investments may be made only in interest-bearing obligations of the United States or in obligations guaranteed as to both principal and interest by the United States. For such purpose such obligations may be ac- quired (1) on original issue at the issue price, or (2) by purchase of outstanding obligations at the market price. The purposes for which obliga- tions of the United States may be issued under chapter 31 of title 31 are hereby extended to au- thorize the issuance at par of public-debt obliga- tions for purchase by the Trust Fund. Such obli- gations issued for purchase by the Trust Fund shall have maturities fixed with due regard for the needs of the Trust Fund and shall bear inter- est at a rate equal to the average market yield (computed by the Managing Trustee on the basis of market quotations as of the end of the cal- endar month next preceding the date of such issue) on all marketable interest-bearing obliga- tions of the United States then forming a part of the public debt which are not due or callable until after the expiration of 4 years from the end of such calendar month; except that where such average market yield is not a multiple of one- eighth of 1 per centum, the rate of interest on such obligations shall be the multiple of one- eighth of 1 per centum nearest such market yield. The Managing Trustee may purchase other interest-bearing obligations of the United States or obligations guaranteed as to both principal and interest by the United States, on original issue or at the market price, only where he determines that the purchase of such other obligations is in the public interest. (d) Authority of Managing Trustee to sell obliga- tions Any obligations acquired by the Trust Fund (except public-debt obligations issued exclu- sively to the Trust Fund) may be sold by the Managing Trustee at the market price, and such public-debt obligations may be redeemed at par plus accrued interest. (e) Interest on and proceeds from sale or re- demption of obligations The interest on, and the proceeds from the sale or redemption of, any obligations held in the Trust Fund shall be credited to and form a part of the Trust Fund. (f) Payment of estimated taxes (1) The Managing Trustee is directed to pay from time to time from the Trust Fund into the Treasury the amount estimated by him as taxes imposed under section 3101(b) which are subject to refund under section 6413(c) of the Internal Revenue Code of 1986 with respect to wages paid after December 31, 1965. Such taxes shall be de- termined on the basis of the records of wages es- Page 2968 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i tablished and maintained by the Commissioner of Social Security in accordance with the wages reported to the Secretary of the Treasury or his delegate pursuant to subtitle F of the Internal Revenue Code of 1986, and the Commissioner of Social Security shall furnish the Managing Trustee such information as may be required by the Managing Trustee for such purpose. The payments by the Managing Trustee shall be cov- ered into the Treasury as repayments to the ac- count for refunding internal revenue collections. (2) Repayments made under paragraph (1) shall not be available for expenditures but shall be carried to the surplus fund of the Treasury. If it subsequently appears that the estimates under such paragraph in any particular period were too high or too low, appropriate adjustments shall be made by the Managing Trustee in future payments. (g) Transfers from other Funds There shall be transferred periodically (but not less often than once each fiscal year) to the Trust Fund from the Federal Old-Age and Sur- vivors Insurance Trust Fund and from the Fed- eral Disability Insurance Trust Fund amounts equivalent to the amounts not previously so transferred which the Secretary of Health and Human Services shall have certified as overpay- ments (other than amounts so certified to the Railroad Retirement Board) pursuant to section 1395gg(b) of this title. There shall be transferred periodically (but not less often than once each fiscal year) to the Trust Fund from the Railroad Retirement Account amounts equivalent to the amounts not previously so transferred which the Secretary of Health and Human Services shall have certified as overpayments to the Railroad Retirement Board pursuant to section 1395gg(b) of this title. (h) Payments from Trust Fund amounts certified by Secretary The Managing Trustee shall also pay from time to time from the Trust Fund such amounts as the Secretary of Health and Human Services certifies are necessary to make the payments provided for by this part, and the payments with respect to administrative expenses in accord- ance with section 401(g)(1) of this title. (i) Payment of travel expenses for travel within United States; reconsideration interviews and proceedings before administrative law judges There are authorized to be made available for expenditure out of the Trust Fund such amounts as are required to pay travel expenses, either on an actual cost or commuted basis, to parties, their representatives, and all reasonably nec- essary witnesses for travel within the United States (as defined in section 410(i) of this title) to attend reconsideration interviews and pro- ceedings before administrative law judges with respect to any determination under this sub- chapter. The amount available under the pre- ceding sentence for payment for air travel by any person shall not exceed the coach fare for air travel between the points involved unless the use of first-class accommodations is required (as determined under regulations of the Secretary) because of such person’s health condition or the unavailability of alternative accommodations; and the amount available for payment for other travel by any person shall not exceed the cost of travel (between the points involved) by the most economical and expeditious means of transpor- tation appropriate to such person’s health con- dition, as specified in such regulations. The amount available for payment under this sub- section for travel by a representative to attend an administrative proceeding before an adminis- trative law judge or other adjudicator shall not exceed the maximum amount allowable under this subsection for such travel originating with- in the geographic area of the office having juris- diction over such proceeding. (j) Loans from other Funds; interest; repayment; report to Congress (1) If at any time prior to January 1988 the Managing Trustee determines that borrowing authorized under this subsection is appropriate in order to best meet the need for financing the benefit payments from the Federal Hospital In- surance Trust Fund, the Managing Trustee may, subject to paragraph (5), borrow such amounts as he determines to be appropriate from either the Federal Old-Age and Survivors Insurance Trust Fund or the Federal Disability Insurance Trust Fund for transfer to and deposit in the Federal Hospital Insurance Trust Fund. (2) In any case where a loan has been made to the Federal Hospital Insurance Trust Fund under paragraph (1), there shall be transferred on the last day of each month after such loan is made, from such Trust Fund to the lending Trust Fund, the total interest accrued to such day with respect to the unrepaid balance of such loan at a rate equal to the rate which the lend- ing Trust Fund would earn on the amount in- volved if the loan were an investment under sub- section (c) (even if such an investment would earn interest at a rate different than the rate earned by investments redeemed by the lending fund in order to make the loan). (3)(A) If in any month after a loan has been made to the Federal Hospital Insurance Trust Fund under paragraph (1), the Managing Trustee determines that the assets of such Trust Fund are sufficient to permit repayment of all or part of any loans made to such Fund under paragraph (1), he shall make such repayments as he deter- mines to be appropriate. (B)(i) If on the last day of any year after a loan has been made under paragraph (1) by the Federal Old-Age and Survivors Insurance Trust Fund or the Federal Disability Insurance Trust Fund to the Federal Hospital Insurance Trust Fund, the Managing Trustee determines that the Hospital Insurance Trust Fund ratio exceeds 15 percent, he shall transfer from such Trust Fund to the lending trust fund an amount that— (I) together with any amounts transferred to another lending trust fund under this para- graph for such year, will reduce the Hospital Insurance Trust Fund ratio to 15 percent; and (II) does not exceed the outstanding balance of such loan. (ii) Amounts required to be transferred under clause (i) shall be transferred on the last day of the first month of the year succeeding the year in which the determination described in clause (i) is made. Page 2969 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i (iii) For purposes of this subparagraph, the term ‘‘Hospital Insurance Trust Fund ratio’’ means, with respect to any calendar year, the ratio of— (I) the balance in the Federal Hospital Insur- ance Trust Fund, as of the last day of such cal- endar year; to (II) the amount estimated by the Secretary to be the total amount to be paid from the Federal Hospital Insurance Trust Fund during the calendar year following such calendar year (other than payments of interest on, and re- payments of, loans from the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund under paragraph (1)), and reducing the amount of any transfer to the Railroad Retirement Ac- count by the amount of any transfers into such Trust Fund from the Railroad Retire- ment Account. (C)(i) The full amount of all loans made under paragraph (1) (whether made before or after Jan- uary 1, 1983) shall be repaid at the earliest fea- sible date and in any event no later than Decem- ber 31, 1989. (ii) For the period after December 31, 1987 and before January 1, 1990, the Managing Trustee shall transfer each month from the Federal Hos- pital Insurance Trust Fund to any Trust Fund that is owed any amount by the Federal Hos- pital Insurance Trust Fund on a loan made under paragraph (1), an amount not less than an amount equal to (I) the amount owed to such Trust Fund by the Federal Hospital Insurance Trust Fund at the beginning of such month (plus the interest accrued on the outstanding balance of such loan during such month), divided by (II) the number of months elapsing after the pre- ceding month and before January 1990. The Man- aging Trustee may, during this period, transfer larger amounts than prescribed by the preceding sentence. (4) The Board of Trustees shall make a timely report to the Congress of any amounts trans- ferred (including interest payments) under this subsection. (5)(A) No amounts may be loaned by the Fed- eral Old-Age and Survivors Insurance Trust Fund or the Federal Disability Insurance Trust Fund under paragraph (1) during any month if the OASDI trust fund ratio for such month is less than 10 percent. (B) For purposes of this paragraph, the term ‘‘OASDI trust fund ratio’’ means, with respect to any month, the ratio of— (i) the combined balance in the Federal Old- Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund, reduced by the outstanding amount of any loan (including interest thereon) theretofore made to either such Trust Fund from the Fed- eral Hospital Insurance Trust Fund under sec- tion 401(l) of this title, as of the last day of the second month preceding such month, to (ii) the amount obtained by multiplying by twelve the total amount which (as estimated by the Secretary) will be paid from the Fed- eral Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund during the month for which such ratio is to be determined for all purposes au- thorized by section 401 of this title (other than payments of interest on, or repayments of, loans from the Federal Hospital Insurance Trust Fund under section 401(l) of this title), but excluding any transfer payments between such trust funds and reducing the amount of any transfers to the Railroad Retirement Ac- count by the amount of any transfers into ei- ther such trust fund from that Account. (k) Health Care Fraud and Abuse Control Ac- count (1) Establishment There is hereby established in the Trust Fund an expenditure account to be known as the ‘‘Health Care Fraud and Abuse Control Ac- count’’ (in this subsection referred to as the ‘‘Account’’). (2) Appropriated amounts to Trust Fund (A) In general There are hereby appropriated to the Trust Fund— (i) such gifts and bequests as may be made as provided in subparagraph (B); (ii) such amounts as may be deposited in the Trust Fund as provided in sections 242(b) and 249(c) of the Health Insurance Portability and Accountability Act of 1996, and subchapter XI; and (iii) such amounts as are transferred to the Trust Fund under subparagraph (C). (B) Authorization to accept gifts The Trust Fund is authorized to accept on behalf of the United States money gifts and bequests made unconditionally to the Trust Fund, for the benefit of the Account or any activity financed through the Account. (C) Transfer of amounts The Managing Trustee shall transfer to the Trust Fund, under rules similar to the rules in section 9601 of the Internal Revenue Code of 1986, an amount equal to the sum of the following: (i) Criminal fines recovered in cases in- volving a Federal health care offense (as defined in section 24(a) of title 18). (ii) Civil monetary penalties and assess- ments imposed in health care cases, in- cluding amounts recovered under this sub- chapter and subchapters XI and XIX, and chapter 38 of title 31 (except as otherwise provided by law). (iii) Amounts resulting from the for- feiture of property by reason of a Federal health care offense. (iv) Penalties and damages obtained and otherwise creditable to miscellaneous re- ceipts of the general fund of the Treasury obtained under sections 3729 through 3733 of title 31 (known as the False Claims Act), in cases involving claims related to the provision of health care items and services (other than funds awarded to a re- lator, for restitution or otherwise author- ized by law). (D) Application Nothing in subparagraph (C)(iii) shall be construed to limit the availability of recov- Page 2970 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i eries and forfeitures obtained under title I of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1001 et seq.] for the pur- pose of providing equitable or remedial relief for employee welfare benefit plans, and for participants and beneficiaries under such plans, as authorized under such title. (3) Appropriated amounts to Account for fraud and abuse control program, etc. (A) Departments of Health and Human Serv- ices and Justice (i) In general There are hereby appropriated to the Ac- count from the Trust Fund such sums as the Secretary and the Attorney General certify are necessary to carry out the pur- poses described in subparagraph (C), to be available without further appropriation until expended, in an amount not to ex- ceed— (I) for fiscal year 1997, $104,000,000; (II) for each of the fiscal years 1998 through 2003, the limit for the preceding fiscal year, increased by 15 percent; (III) for each of fiscal years 2004, 2005, and 2006, the limit for fiscal year 2003; and (IV) for each fiscal year after fiscal year 2006, the limit under this clause for the preceding fiscal year, increased by the percentage increase in the consumer price index for all urban consumers (all items; United States city average) over the previous year. (ii) Medicare and medicaid activities For each fiscal year, of the amount ap- propriated in clause (i), the following amounts shall be available only for the purposes of the activities of the Office of the Inspector General of the Department of Health and Human Services with respect to the programs under this subchapter and subchapter XIX— (I) for fiscal year 1997, not less than $60,000,000 and not more than $70,000,000; (II) for fiscal year 1998, not less than $80,000,000 and not more than $90,000,000; (III) for fiscal year 1999, not less than $90,000,000 and not more than $100,000,000; (IV) for fiscal year 2000, not less than $110,000,000 and not more than $120,000,000; (V) for fiscal year 2001, not less than $120,000,000 and not more than $130,000,000; (VI) for fiscal year 2002, not less than $140,000,000 and not more than $150,000,000; (VII) for each of fiscal years 2003, 2004, 2005, and 2006, not less than $150,000,000 and not more than $160,000,000; (VIII) for fiscal year 2007, not less than $160,000,000, increased by the percentage increase in the consumer price index for all urban consumers (all items; United States city average) over the previous year; and (IX) for each fiscal year after fiscal year 2007, not less than the amount re- quired under this clause for the pre- ceding fiscal year, increased by the per- centage increase in the consumer price index for all urban consumers (all items; United States city average) over the pre- vious year. (B) Federal Bureau of Investigation There are hereby appropriated from the general fund of the United States Treasury and hereby appropriated to the Account for transfer to the Federal Bureau of Investiga- tion to carry out the purposes described in subparagraph (C), to be available without further appropriation until expended— (i) for fiscal year 1997, $47,000,000; (ii) for fiscal year 1998, $56,000,000; (iii) for fiscal year 1999, $66,000,000; (iv) for fiscal year 2000, $76,000,000; (v) for fiscal year 2001, $88,000,000; (vi) for fiscal year 2002, $101,000,000; (vii) for each of fiscal years 2003, 2004, 2005, and 2006, $114,000,000; and (viii) for each fiscal year after fiscal year 2006, the amount to be appropriated under this subparagraph for the preceding fiscal year, increased by the percentage increase in the consumer price index for all urban consumers (all items; United States city average) over the previous year. (C) Use of funds The purposes described in this subpara- graph are to cover the costs (including equipment, salaries and benefits, and travel and training) of the administration and op- eration of the health care fraud and abuse control program established under section 1320a–7c(a) of this title, including the costs of— (i) prosecuting health care matters (through criminal, civil, and administra- tive proceedings); (ii) investigations; (iii) financial and performance audits of health care programs and operations; (iv) inspections and other evaluations; and (v) provider and consumer education re- garding compliance with the provisions of subchapter XI. (4) Appropriated amounts to Account for Medi- care Integrity Program (A) In general There are hereby appropriated to the Ac- count from the Trust Fund for each fiscal year such amounts as are necessary for ac- tivities described in paragraph (3)(C) and to carry out the Medicare Integrity Program under section 1395ddd of this title, subject to subparagraphs (B), (C), and (D) and to be available without further appropriation until expended. (B) Amounts specified Subject to subparagraph (C), the amount appropriated under subparagraph (A) for a fiscal year is as follows: (i) For fiscal year 1997, such amount shall be not less than $430,000,000 and not more than $440,000,000. Page 2971 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i (ii) For fiscal year 1998, such amount shall be not less than $490,000,000 and not more than $500,000,000. (iii) For fiscal year 1999, such amount shall be not less than $550,000,000 and not more than $560,000,000. (iv) For fiscal year 2000, such amount shall be not less than $620,000,000 and not more than $630,000,000. (v) For fiscal year 2001, such amount shall be not less than $670,000,000 and not more than $680,000,000. (vi) For fiscal year 2002, such amount shall be not less than $690,000,000 and not more than $700,000,000. (vii) For each fiscal year after fiscal year 2002, such amount shall be not less than $710,000,000 and not more than $720,000,000. (C) Adjustments The amount appropriated under subpara- graph (A) for a fiscal year is increased as fol- lows: (i) For fiscal year 2006, $100,000,000. (ii) For each fiscal year after 2010, by the percentage increase in the consumer price index for all urban consumers (all items; United States city average) over the pre- vious year. (D) Expansion of the Medicare-Medicaid Data Match Program The amount appropriated under subpara- graph (A) for a fiscal year is further in- creased as follows for purposes of carrying out section 1395ddd(b)(6) of this title for the respective fiscal year: (i) $12,000,000 for fiscal year 2006. (ii) $24,000,000 for fiscal year 2007. (iii) $36,000,000 for fiscal year 2008. (iv) $48,000,000 for fiscal year 2009. (v) $60,000,000 for fiscal year 2010 and each fiscal year thereafter. (5) Annual report Not later than January 1, the Secretary and the Attorney General shall submit jointly a report to Congress which identifies— (A) the amounts appropriated to the Trust Fund for the previous fiscal year under para- graph (2)(A) and the source of such amounts; and (B) the amounts appropriated from the Trust Fund for such year under paragraph (3) and the justification for the expenditure of such amounts. (6) GAO report Not later than June 1, 1998, and January 1 of 2000, 2002, and 2004, the Comptroller General of the United States shall submit a report to Congress which— (A) identifies— (i) the amounts appropriated to the Trust Fund for the previous two fiscal years under paragraph (2)(A) and the source of such amounts; and (ii) the amounts appropriated from the Trust Fund for such fiscal years under paragraph (3) and the justification for the expenditure of such amounts; (B) identifies any expenditures from the Trust Fund with respect to activities not in- volving the program under this subchapter; (C) identifies any savings to the Trust Fund, and any other savings, resulting from expenditures from the Trust Fund; and (D) analyzes such other aspects of the op- eration of the Trust Fund as the Comptroller General of the United States considers ap- propriate. (7) Additional funding In addition to the funds otherwise appro- priated to the Account from the Trust Fund under paragraphs (3) and (4) and for purposes described in paragraphs (3)(C) and (4)(A), there are hereby appropriated an additional $10,000,000 to such Account from such Trust Fund for each of fiscal years 2011 through 2020. The funds appropriated under this paragraph shall be allocated in the same proportion as the total funding appropriated with respect to paragraphs (3)(A) and (4)(A) was allocated with respect to fiscal year 2010, and shall be avail- able without further appropriation until ex- pended. (8) Additional funding (A) In general In addition to the funds otherwise appro- priated to the Account from the Trust Fund under paragraphs (3)(C) and (4)(A) and for purposes described in paragraphs (3)(C) and (4)(A), there are hereby appropriated to such Account from such Trust Fund the following additional amounts: (i) For fiscal year 2011, $95,000,000. (ii) For fiscal year 2012, $55,000,000. (iii) For each of fiscal years 2013 and 2014, $30,000,000. (iv) For each of fiscal years 2015 and 2016, $20,000,000. (B) Allocation The funds appropriated under this para- graph shall be allocated in the same propor- tion as the total funding appropriated with respect to paragraphs (3)(A) and (4)(A) was allocated with respect to fiscal year 2010, and shall be available without further appro- priation until expended. (Aug. 14, 1935, ch. 531, title XVIII, § 1817, as added Pub. L. 89–97, title I, § 102(a), July 30, 1965, 79 Stat. 299; amended Pub. L. 90–248, title I, § 169(a), Jan. 2, 1968, 81 Stat. 875; Pub. L. 92–603, title I, § 132(d), Oct. 30, 1972, 86 Stat. 1361; Pub. L. 95–292, § 5, June 13, 1978, 92 Stat. 315; Pub. L. 96–265, title III, § 310(c), June 9, 1980, 94 Stat. 460; Pub. L. 97–123, § 1(b), Dec. 29, 1981, 95 Stat. 1659; Pub. L. 98–21, title I, §§ 141(b), 142(b)(1), (2)(A), (3), (4), 154(b), title III, § 341(b), Apr. 20, 1983, 97 Stat. 98, 100, 101, 107, 135; Pub. L. 98–369, div. B, title III, §§ 2337(a), 2354(b)(2), title VI, § 2663(j)(2)(F)(i), July 18, 1984, 98 Stat. 1091, 1100, 1170; Pub. L. 99–272, title IX, § 9213(b), Apr. 7, 1986, 100 Stat. 180; Pub. L. 99–514, § 2, Oct. 22, 1986, 100 Stat. 2095; Pub. L. 100–360, title II, § 212(c)(3), July 1, 1988, 102 Stat. 741; Pub. L. 100–647, title VIII, § 8005(a), Nov. 10, 1988, 102 Stat. 3781; Pub. L. 101–234, title II, § 202(a), Dec. 13, 1989, 103 Stat. 1981; Pub. L. 101–508, title V, § 5106(c), Nov. 5, 1990, 104 Stat. 1388–268; Pub. L. 103–296, title I, § 108(c)(1), Aug. 15, 1994, 108 Stat. 1485; Pub. L. 104–191, title II, § 201(b), Aug. 21, 1996, 110 Stat. 1993; Pub. L. Page 2972 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i 105–33, title IV, § 4318, Aug. 5, 1997, 111 Stat. 392; Pub. L. 106–113, div. B, § 1000(a)(6) [title III, § 321(j)(1)], Nov. 29, 1999, 113 Stat. 1536, 1501A–366; Pub. L. 108–173, title VII, § 736(a)(5), (6), title VIII, § 801(d)(1), title IX, § 900(e)(1)(D), Dec. 8, 2003, 117 Stat. 2355, 2359, 2371; Pub. L. 109–171, title V, § 5204, title VI, § 6034(d)(2), Feb. 8, 2006, 120 Stat. 48, 78; Pub. L. 109–432, div. B, title III, § 303, Dec. 20, 2006, 120 Stat. 2992; Pub. L. 111–148, title VI, § 6402(i), Mar. 23, 2010, 124 Stat. 760; Pub. L. 111–152, title I, § 1303(a)(1), Mar. 30, 2010, 124 Stat. 1057.) Editorial Notes REFERENCES IN TEXT The Internal Revenue Code of 1986, referred to in sub- secs. (a)(1), (2), (f)(1), and (k)(2)(C), is classified gen- erally to Title 26, Internal Revenue Code. Subtitle F of such Code appears at section 6001 et seq. of Title 26. Section 801(a) of the Medicare Prescription Drug, Im- provement, and Modernization Act of 2003, referred to in subsec. (b)(2), is section 801(a) of Pub. L. 108–173, which is set out as a note under this section. Sections 242(b) and 249(b) of the Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (k)(2)(A)(ii), are sections 242(b) and 249(b) of Pub. L. 104–191, which are set out as notes under this section. The Employee Retirement Income Security Act of 1974, referred to in subsec. (k)(2)(D), is Pub. L. 93–406, Sept. 2, 1974, 88 Stat. 832. Title I of the Act is classified generally to subchapter I (§ 1001 et seq.) of chapter 18 of Title 29, Labor. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of Title 29 and Tables. AMENDMENTS 2010—Subsec. (k)(3)(A)(i)(III). Pub. L. 111–148, § 6402(i)(2)(A)(i), inserted ‘‘and’’ at the end. Subsec. (k)(3)(A)(i)(IV). Pub. L. 111–148, § 6402(i)(2)(A)(ii), substituted ‘‘for each fiscal year after fiscal year 2006’’ for ‘‘for each of fiscal years 2007, 2008, 2009, and 2010’’ and a period for ‘‘; and’’. Subsec. (k)(3)(A)(i)(V). Pub. L. 111–148, § 6402(i)(2)(A)(iii), struck out subcl. (V) which read as follows: ‘‘for each fiscal year after fiscal year 2010, the limit under this clause for fiscal year 2010.’’ Subsec. (k)(3)(A)(ii)(VIII). Pub. L. 111–148, § 6402(i)(2)(B)(i), inserted ‘‘and’’ at the end. Subsec. (k)(3)(A)(ii)(IX). Pub. L. 111–148, § 6402(i)(2)(B)(ii), substituted ‘‘for each fiscal year after fiscal year 2007’’ for ‘‘for each of fiscal years 2008, 2009, and 2010’’ and a period for ‘‘; and’’. Subsec. (k)(3)(A)(ii)(X). Pub. L. 111–148, § 6402(i)(2)(B)(iii), struck out subcl. (X) which read as follows: ‘‘for each fiscal year after fiscal year 2010, not less than the amount required under this clause for fis- cal year 2010.’’ Subsec. (k)(3)(B)(vii). Pub. L. 111–148, § 6402(i)(2)(C)(i), inserted ‘‘and’’ at the end. Subsec. (k)(3)(B)(viii). Pub. L. 111–148, § 6402(i)(2)(C)(ii), substituted ‘‘for each fiscal year after fiscal year 2006’’ for ‘‘for each of fiscal years 2007, 2008, 2009, and 2010’’ and a period for ‘‘; and’’. Subsec. (k)(3)(B)(ix). Pub. L. 111–148, § 6402(i)(2)(C)(iii), struck out cl. (ix) which read as follows: ‘‘for each fis- cal year after fiscal year 2010, the amount to be appro- priated under this subparagraph for fiscal year 2010.’’ Subsec. (k)(4)(A). Pub. L. 111–152, § 1303(a)(1)(B), in- serted ‘‘for activities described in paragraph (3)(C) and’’ after ‘‘necessary’’. Pub. L. 111–148, § 6402(i)(1)(B), inserted ‘‘until ex- pended’’ after ‘‘appropriation’’. Subsec. (k)(4)(C)(ii). Pub. L. 111–148, § 6402(i)(2)(D), added cl. (ii). Subsec. (k)(7). Pub. L. 111–148, § 6402(i)(1)(A), added par. (7). Subsec. (k)(8). Pub. L. 111–152, § 1303(a)(1)(A), added par. (8). 2006—Subsec. (k)(3)(A)(i). Pub. L. 109–432, § 303(a)(1), in introductory provisions inserted ‘‘until expended’’ after ‘‘without further appropriation’’, in subcl. (II) struck out ‘‘and’’ at end, in subcl. (III) substituted ‘‘for each of fiscal years 2004, 2005, and 2006’’ for ‘‘for each fiscal year after fiscal year 2003’’ and semicolon for period at end, and added subcls. (IV) and (V). Subsec. (k)(3)(A)(ii)(VI) to (X). Pub. L. 109–432, § 303(a)(2), in subcl. (VI) struck out ‘‘and’’ at end, in subcl. (VII) substituted ‘‘for each of fiscal years 2003, 2004, 2005, and 2006’’ for ‘‘for each fiscal year after fiscal year 2002’’ and semicolon for period at end, and added subcls. (VIII) to (X). Subsec. (k)(3)(B). Pub. L. 109–432, § 303(b), in introduc- tory provisions inserted ‘‘until expended’’ after ‘‘with- out further appropriation’’, in cl. (vi) struck out ‘‘and’’ at end, in cl. (vii) substituted ‘‘for each of fiscal years 2003, 2004, 2005, and 2006’’ for ‘‘for each fiscal year after fiscal year 2002’’ and semicolon for period at end, and added cls. (viii) and (ix). Subsec. (k)(4)(A). Pub. L. 109–171, § 6034(d)(2)(A), sub- stituted ‘‘subparagraphs (B), (C), and (D)’’ for ‘‘subpara- graph (B)’’. Subsec. (k)(4)(B). Pub. L. 109–171, § 5204(1), substituted ‘‘Subject to subparagraph (C), the amount’’ for ‘‘The amount’’ in introductory provisions. Subsec. (k)(4)(C). Pub. L. 109–171, § 5204(2), added sub- par. (C). Subsec. (k)(4)(D). Pub. L. 109–171, § 6034(d)(2)(B), added subpar. (D). 2003—Subsec. (b). Pub. L. 108–173, § 900(e)(1)(D), in fifth sentence of introductory provisions, substituted ‘‘Cen- ters for Medicare & Medicaid Services’’ for ‘‘Health Care Financing Administration’’, and, in second sen- tence of concluding provisions, substituted ‘‘Chief Ac- tuary of the Centers for Medicare & Medicaid Services’’ for ‘‘Chief Actuarial Officer of the Health Care Financ- ing Administration’’. Subsec. (b)(2). Pub. L. 108–173, § 801(d)(1), inserted at end ‘‘Each report provided under paragraph (2) begin- ning with the report in 2005 shall include the informa- tion specified in section 801(a) of the Medicare Prescrip- tion Drug, Improvement, and Modernization Act of 2003.’’ Subsec. (k)(3)(A)(i)(I). Pub. L. 108–173, § 736(a)(5)(A), substituted semicolon for comma at end. Subsec. (k)(3)(A)(ii). Pub. L. 108–173, § 736(a)(5)(B), sub- stituted ‘‘the programs under this subchapter and sub- chapter XIX’’ for ‘‘the Medicare and medicaid pro- grams’’ in introductory provisions. Subsec. (k)(6)(B). Pub. L. 108–173, § 736(a)(6), sub- stituted ‘‘program under this subchapter’’ for ‘‘Medi- care program under this subchapter’’. 1999—Subsec. (k)(2)(C)(i). Pub. L. 106–113 substituted ‘‘section 24(a)’’ for ‘‘section 982(a)(6)(B)’’. 1997—Subsec. (k)(6). Pub. L. 105–33 inserted ‘‘June 1, 1998, and’’ after ‘‘Not later than’’ in introductory provi- sions. 1996—Subsec. (k). Pub. L. 104–191 added subsec. (k). 1994—Subsec. (a). Pub. L. 103–296, § 108(c)(1)(A), sub- stituted ‘‘Commissioner of Social Security’’ for ‘‘Sec- retary of Health and Human Services’’ wherever ap- pearing. Subsec. (b). Pub. L. 103–296, § 108(c)(1)(B), inserted ‘‘the Commissioner of Social Security,’’ after ‘‘com- posed of’’ in introductory provisions. Subsec. (f)(1). Pub. L. 103–296, § 108(c)(1)(C), sub- stituted ‘‘Commissioner of Social Security’’ for ‘‘Sec- retary of Health and Human Services’’ in two places. 1990—Subsec. (i). Pub. L. 101–508 inserted at end ‘‘The amount available for payment under this subsection for travel by a representative to attend an administrative proceeding before an administrative law judge or other adjudicator shall not exceed the maximum amount al- lowable under this subsection for such travel origi- nating within the geographic area of the office having jurisdiction over such proceeding.’’ 1989—Subsec. (b). Pub. L. 101–234 repealed Pub. L. 100–360, § 212(c)(3), and provided that the provisions of Page 2973 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i law amended or repealed by such section are restored or revised as if such section had not been enacted, see 1988 Amendment note below. 1988—Subsec. (b). Pub. L. 100–647 inserted after first sentence ‘‘A member of the Board of Trustees serving as a member of the public and nominated and con- firmed to fill a vacancy occurring during a term shall be nominated and confirmed only for the remainder of such term. An individual nominated and confirmed as a member of the public may serve in such position after the expiration of such member’s term until the earlier of the time at which the member’s successor takes of- fice or the time at which a report of the Board is first issued under paragraph (2) after the expiration of the member’s term.’’ Pub. L. 100–360 inserted after sixth sentence ‘‘Such re- port shall also identify (and treat separately) those outlays from the Trust Fund which are also outlays from the Medicare Catastrophic Coverage Account cre- ated under section 1395t–2 of this title and those out- lays for which there are amounts transferred into the Federal Hospital Insurance Catastrophic Coverage Re- serve Fund.’’ 1986—Subsec. (a)(1), (2). Pub. L. 99–514 substituted ‘‘Internal Revenue Code of 1986’’ for ‘‘Internal Revenue Code of 1954’’. Subsec. (b). Pub. L. 99–272 struck out provision at end of penultimate sentence that certification shall not refer to economic assumptions underlying Trustee’s re- port. Subsec. (f)(1). Pub. L. 99–514 substituted ‘‘Internal Revenue Code of 1986’’ for ‘‘Internal Revenue Code of 1954’’ wherever appearing. 1984—Subsec. (a). Pub. L. 98–369, § 2337(a), in provi- sions following par. (2) substituted ‘‘from time to time’’ for ‘‘monthly on the first day of each calendar month’’, ‘‘paid to or deposited into the Treasury’’ for ‘‘to be paid to or deposited into the Treasury during such month’’, and struck out provision that all amounts transferred to the Trust Fund under the preceding sentence had to be invested by the Managing Trustee in the same man- ner and to the same extent as the other assets of the Trust Fund, and the Trust Fund had to pay interest to the general fund on the amount so transferred on the first day of any month at a rate (calculated on a daily basis, and applied against the difference between the amount so transferred on such first day and the amount which would have been transferred to the Trust Fund up to that day under the procedures in effect on January 1, 1983) equal to the rate earned by the invest- ments of the Trust Fund in the same month under sub- sec. (c). Subsec. (a)(1), (2). Pub. L. 98–369, § 2663(j)(2)(F)(i), sub- stituted ‘‘Health and Human Services’’ for ‘‘Health, Education, and Welfare’’ wherever appearing. Subsec. (c). Pub. L. 98–369, § 2354(b)(2), substituted ‘‘under chapter 31 of title 31’’ for ‘‘under the Second Liberty Bond Act, as amended’’. Subsecs. (f)(1), (g), (h). Pub. L. 98–369, § 2663(j)(2)(F)(i), substituted ‘‘Health and Human Services’’ for ‘‘Health, Education, and Welfare’’ wherever appearing. 1983—Subsec. (a). Pub. L. 98–21, § 141(b)(1)(A), in provi- sions following par. (2) substituted ‘‘monthly on the first day of each calendar month’’ for ‘‘from time to time’’, substituted ‘‘to be paid to or deposited into the Treasury during such month’’ for ‘‘paid to or deposited into the Treasury’’, and inserted provision that all amounts transferred to the Trust Fund under existing provisions shall be invested by the Managing Trustee in the same manner and to the same extent as the other assets of the Trust Fund; and the Trust Fund shall pay interest to the general fund on the amount so trans- ferred on the first day of any month at a rate (cal- culated on a daily basis, and applied against the dif- ference between the amount so transferred on such first day and the amount which would have been transferred to the Trust Fund up to that day under the procedures in effect on Jan. 1, 1983) equal to the rate earned by the investments of the Trust Fund in the same month under subsection (c). Subsec. (b). Pub. L. 98–21, § 341(b)(1), substituted in provisions preceding par. (1) ‘‘Secretary of Health and Human Services, all ex officio, and of two members of the public (both of whom may not be from the same po- litical party), who shall be nominated by the President for a term of four years and subject to confirmation by the Senate’’ for ‘‘Secretary of Health, Education, and Welfare, all ex officio’’. Pub. L. 98–21, § 154(b), inserted at end provision that the report referred to in par. (2) shall also include an actuarial opinion by the Chief Actuarial Officer of the Health Care Financing Administration certifying that the techniques and methodologies used are generally accepted within the actuarial profession and that the assumptions and cost estimates used are reasonable and provided further that the certification shall not refer to economic assumptions underlying the Trustee’s report. Pub. L. 98–21, § 341(b)(2), inserted at end provision that a person serving on the Board of Trustees shall not be considered to be a fiduciary and shall not be personally liable for actions taken in such capacity with respect to the Trust Fund. Subsec. (j)(1). Pub. L. 98–21, § 142(b)(1), substituted ref- erence to January 1988 for reference to January 1983 and inserted ‘‘, subject to paragraph (5),’’ after ‘‘may’’. Subsec. (j)(2). Pub. L. 98–21, § 142(b)(2)(A), substituted ‘‘on the last day of each month after such loan is made’’ for ‘‘from time to time’’, substituted ‘‘the total interest accrued to such day’’ for ‘‘interest’’, and in- serted ‘‘(even if such an investment would earn interest at a rate different than the rate earned by investments redeemed by the lending fund in order to make the loan)’’. Subsec. (j)(3)(A). Pub. L. 98–21, § 142(b)(3), designated existing provisions as subpar. (A) and added subpars. (B) and (C). Subsec. (j)(5). Pub. L. 98–21, § 142(b)(4), added par. (5). 1981—Subsec. (j). Pub. L. 97–123 added subsec. (j). 1980—Subsec. (i). Pub. L. 96–265 added subsec. (i). 1978—Subsec. (b). Pub. L. 95–292 substituted ‘‘Admin- istrator of the Health Care Financing Administration’’ for ‘‘Commissioner of Social Security’’ in provisions preceding par. (1). 1972—Subsec. (a). Pub. L. 92–603 inserted ‘‘such gifts and bequests as may be made as provided in section 401(i)(1) of this title, and’’ after ‘‘consist of’’ and before ‘‘such amounts’’ in provisions preceding par. (1). 1968—Subsec. (b)(2). Pub. L. 90–248 substituted ‘‘April’’ for ‘‘March’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1999 AMENDMENT Pub. L. 106–113, div. B, § 1000(a)(6) [title III, § 321(j)(2)], Nov. 29, 1999, 113 Stat. 1536, 1501A–366, provided that: ‘‘The amendment made by this subsection [amending this section] shall take effect as if included in the amendment made by section 201 of the Health Insur- ance Portability and Accountability Act of 1996 (Public Law 104–191; 110 Stat. 1992).’’ EFFECTIVE DATE OF 1994 AMENDMENT Amendment by Pub. L. 103–296 effective Mar. 31, 1995, see section 110(a) of Pub. L. 103–296, set out as a note under section 401 of this title. EFFECTIVE DATE OF 1990 AMENDMENT Amendment by Pub. L. 101–508 applicable with re- spect to determinations made on or after July 1, 1991, and to reimbursement for travel expenses incurred on or after Apr. 1, 1991, see section 5106(d) of Pub. L. 101–508, set out as a note under section 401 of this title. EFFECTIVE DATE OF 1989 AMENDMENT Amendment by Pub. L. 101–234 effective Jan. 1, 1990, see section 202(b) of Pub. L. 100–234, set out as a note under section 401 of this title. EFFECTIVE DATE OF 1988 AMENDMENT Amendment by Pub. L. 100–647 applicable to members of Board of Trustees of Federal Hospital Insurance Page 2974 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i Trust Fund serving on such Board as members of the public on or after Nov. 10, 1988, see section 8005(b) of Pub. L. 100–647, set out as a note under section 401 of this title. EFFECTIVE DATE OF 1984 AMENDMENT Pub. L. 98–369, div. B, title III, § 2337(b), July 18, 1984, 98 Stat. 1091, provided that: ‘‘The amendments made by subsection (a) [amending this section] shall become ef- fective on the first day of the month following the month in which this Act is enacted [July 1984].’’ Amendment by section 2354(b)(2) of Pub. L. 98–369 ef- fective July 18, 1984, but not to be construed as chang- ing or affecting any right, liability, status, or interpre- tation which existed (under the provisions of law in- volved) before that date, see section 2354(e)(1) of Pub. L. 98–369, set out as a note under section 1320a–1 of this title. Amendment by section 2663(j)(2)(F)(i) of Pub. L. 98–369 effective July 18, 1984, but not to be construed as chang- ing or affecting any right, liability, status, or interpre- tation which existed (under the provisions of law in- volved) before that date, see section 2664(b) of Pub. L. 98–369, set out as a note under section 401 of this title. EFFECTIVE DATE OF 1983 AMENDMENT Amendment by section 141(b) of Pub. L. 98–21 effec- tive on first day of month following April 1983, see sec- tion 141(c) of Pub. L. 98–21, set out as a note under sec- tion 401 of this title. Pub. L. 98–21, title I, § 142(b)(2)(B), Apr. 20, 1983, 97 Stat. 101, provided that: ‘‘The amendment made by this paragraph [amending this section] shall apply with re- spect to months beginning more than 30 days after the date of enactment of this Act [Apr. 20, 1983].’’ Amendment by sections 154(b) and 341(b) of Pub. L. 98–21 effective Apr. 20, 1983, see sections 154(e) and 341(d) of Pub. L. 98–21, set out as notes under section 401 of this title. EFFECTIVE DATE OF 1981 AMENDMENT Amendment by Pub. L. 97–123 effective Dec. 29, 1981, see section 1(c) of Pub. L. 97–123, set out as a note under section 401 of this title. EFFECTIVE DATE OF 1978 AMENDMENT Amendment by Pub. L. 95–292 effective with respect to services, supplies, and equipment furnished after the third calendar month beginning after June 13, 1978, ex- cept that provisions for the implementation of an in- centive reimbursement system for dialysis services fur- nished in facilities and providers to become effective with respect to a facility’s or provider’s first account- ing period beginning after the last day of the twelfth month following the month of June 1978, and except that provisions for reimbursement rates for home di- alysis to become effective on Apr. 1, 1979, see section 6 of Pub. L. 95–292, set out as a note under section 426 of this title. EFFECTIVE DATE OF 1972 AMENDMENT Amendment by Pub. L. 92–603 applicable with respect to gifts and bequests received after Oct. 30, 1972, see section 132(f) of Pub. L. 92–603, set out as a note under section 401 of this title. RESTORATION OF MEDICARE TRUST FUNDS Pub. L. 108–173, title VII, § 734, Dec. 8, 2003, 117 Stat. 2352, provided that: ‘‘(a) DEFINITIONS.—In this section: ‘‘(1) CLERICAL ERROR.—The term ‘clerical error’ means a failure that occurs on or after April 15, 2001, to have transferred the correct amount from the gen- eral fund of the Treasury to a Trust Fund. ‘‘(2) TRUST FUND.—The term ‘Trust Fund’ means the Federal Hospital Insurance Trust Fund established under section 1817 of the Social Security Act (42 U.S.C. 1395i) and the Federal Supplementary Medical Insurance Trust Fund established under section 1841 of such Act (42 U.S.C. 1395t). ‘‘(b) CORRECTION OF TRUST FUND HOLDINGS.— ‘‘(1) IN GENERAL.—The Secretary of the Treasury shall take the actions described in paragraph (2) with respect to the Trust Fund with the goal being that, after such actions are taken, the holdings of the Trust Fund will replicate, to the extent practicable in the judgment of the Secretary of the Treasury, in consultation with the Secretary [of Health and Human Services], the holdings that would have been held by the Trust Fund if the clerical error involved had not occurred. ‘‘(2) OBLIGATIONS ISSUED AND REDEEMED.—The Sec- retary of the Treasury shall— ‘‘(A) issue to the Trust Fund obligations under chapter 31 of title 31, United States Code, that bear issue dates, interest rates, and maturity dates that are the same as those for the obligations that— ‘‘(i) would have been issued to the Trust Fund if the clerical error involved had not occurred; or ‘‘(ii) were issued to the Trust Fund and were re- deemed by reason of the clerical error involved; and ‘‘(B) redeem from the Trust Fund obligations that would have been redeemed from the Trust Fund if the clerical error involved had not occurred. ‘‘(c) APPROPRIATION.—There is appropriated to the Trust Fund, out of any money in the Treasury not oth- erwise appropriated, an amount determined by the Sec- retary of the Treasury, in consultation with the Sec- retary, to be equal to the interest income lost by the Trust Fund through the date on which the appropria- tion is being made as a result of the clerical error in- volved. ‘‘(d) CONGRESSIONAL NOTICE.—In the case of a clerical error that occurs after April 15, 2001, the Secretary of the Treasury, before taking action to correct the error under this section, shall notify the appropriate com- mittees of Congress concerning such error and the ac- tions to be taken under this section in response to such error. ‘‘(e) DEADLINE.—With respect to the clerical error that occurred on April 15, 2001, not later than 120 days after the date of the enactment of this Act [Dec. 8, 2003]— ‘‘(1) the Secretary of the Treasury shall take the actions under subsection (b)(1); and ‘‘(2) the appropriation under subsection (c) shall be made.’’ INCLUSION IN ANNUAL REPORT OF MEDICARE TRUSTEES OF INFORMATION ON STATUS OF MEDICARE TRUST FUNDS Pub. L. 108–173, title VIII, § 801, Dec. 8, 2003, 117 Stat. 2357, provided that: ‘‘(a) DETERMINATIONS OF EXCESS GENERAL REVENUE MEDICARE FUNDING.— ‘‘(1) IN GENERAL.—The Board of Trustees of each medicare trust fund shall include in the annual re- ports submitted under subsection (b)(2) of sections 1817 and 1841 of the Social Security Act (42 U.S.C. 1395i and 1395t)— ‘‘(A) the information described in subsection (b); and ‘‘(B) a determination as to whether there is pro- jected to be excess general revenue medicare fund- ing (as defined in subsection (c)) for the fiscal year in which the report is submitted or for any of the succeeding 6 fiscal years. ‘‘(2) MEDICARE FUNDING WARNING.—For purposes of section 1105(h) of title 31, United States Code, and this subtitle [subtitle A (§§ 801–804) of title VIII of Pub. L. 108–173, amending this section, section 1395t of this title, and section 1105 of Title 31, Money and Finance, and enacting provisions set out as a note under section 1105 of Title 31], an affirmative deter- mination under paragraph (1)(B) in 2 consecutive an- nual reports shall be treated as a medicare funding warning in the year in which the second such report is made. Page 2975 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i ‘‘(3) 7-FISCAL-YEAR REPORTING PERIOD.—For purposes of this subtitle, the term ‘7-fiscal-year reporting pe- riod’ means, with respect to a year in which an an- nual report described in paragraph (1) is made, the pe- riod of 7 consecutive fiscal years beginning with the fiscal year in which the report is submitted. ‘‘(b) INFORMATION.—The information described in this subsection for an annual report in a year is as follows: ‘‘(1) PROJECTIONS OF GROWTH OF GENERAL REVENUE SPENDING.—A statement of the general revenue medi- care funding as a percentage of the total medicare outlays for each of the following: ‘‘(A) Each fiscal year within the 7-fiscal-year re- porting period. ‘‘(B) Previous fiscal years and as of 10, 50, and 75 years after such year. ‘‘(2) COMPARISON WITH OTHER GROWTH TRENDS.—A comparison of the trend of such percentages with the annual growth rate in the following: ‘‘(A) The gross domestic product. ‘‘(B) Private health costs. ‘‘(C) National health expenditures. ‘‘(D) Other appropriate measures. ‘‘(3) PART D SPENDING.—Expenditures, including trends in expenditures, under part D of title XVIII of the Social Security Act [42 U.S.C. 1395w–101 et seq.], as added by section 101. ‘‘(4) COMBINED MEDICARE TRUST FUND ANALYSIS.—A financial analysis of the combined medicare trust funds if general revenue medicare funding were lim- ited to the percentage specified in subsection (c)(1)(B) of total medicare outlays. ‘‘(c) DEFINITIONS.—For purposes of this section: ‘‘(1) EXCESS GENERAL REVENUE MEDICARE FUNDING.— The term ‘excess general revenue medicare funding’ means, with respect to a fiscal year, that— ‘‘(A) general revenue medicare funding (as defined in paragraph (2)), expressed as a percentage of total medicare outlays (as defined in paragraph (4)) for the fiscal year; exceeds ‘‘(B) 45 percent. ‘‘(2) GENERAL REVENUE MEDICARE FUNDING.—The term ‘general revenue medicare funding’ means for a year— ‘‘(A) the total medicare outlays (as defined in paragraph (4)) for the year; minus ‘‘(B) the dedicated medicare financing sources (as defined in paragraph (3)) for the year. ‘‘(3) DEDICATED MEDICARE FINANCING SOURCES.—The term ‘dedicated medicare financing sources’ means the following: ‘‘(A) HOSPITAL INSURANCE TAX.—Amounts appro- priated to the Hospital Insurance Trust Fund under the third sentence of section 1817(a) of the Social Security Act (42 U.S.C. 1395i(a)) and amounts trans- ferred to such Trust Fund under section 7(c)(2) of the Railroad Retirement Act of 1974 (45 U.S.C. 231f(c)(2)). ‘‘(B) TAXATION OF CERTAIN OASDI BENEFITS.— Amounts appropriated to the Hospital Insurance Trust Fund under section 121(e)(1)(B) of the Social Security Amendments of 1983 (Public Law 98–21) [set out as a note under section 401 of this title], as inserted by section 13215(c) of the Omnibus Budget Reconciliation Act of 1993 (Public Law 103–66). ‘‘(C) STATE TRANSFERS.—The State share of amounts paid to the Federal Government by a State under section 1843 of the Social Security Act (42 U.S.C. 1395v) or pursuant to section 1935(c) of such Act [42 U.S.C. 1396u–5(c)]. ‘‘(D) PREMIUMS.—The following premiums: ‘‘(i) PART A.—Premiums paid by non-Federal sources under sections 1818 and section [sic] 1818A (42 U.S.C. 1395i–2 and 1395i–2a) of such Act. ‘‘(ii) PART B.—Premiums paid by non-Federal sources under section 1839 of such Act (42 U.S.C. 1395r), including any adjustments in premiums under such section. ‘‘(iii) PART D.—Monthly beneficiary premiums paid under part D of title XVIII of such Act [42 U.S.C. 1395w–101 et seq.], as added by section 101, and MA monthly prescription drug beneficiary premiums paid under part C of such title [42 U.S.C. 1395w–21 et seq.] insofar as they are attrib- utable to basic prescription drug coverage. Premiums under clauses (ii) and (iii) shall be deter- mined without regard to any reduction in such pre- miums attributable to a beneficiary rebate under sec- tion 1854(b)(1)(C) of such title [42 U.S.C. 1395w–24(b)(1)(C)], as amended by section 222(b)(1), and premiums under clause (iii) are deemed to include any amounts paid under section 1860D–13(b) of such title [42 U.S.C. 1395w–113(b)], as added by section 101. ‘‘(E) GIFTS.—Amounts received by the medicare trust funds under section 201(i) of the Social Secu- rity Act (42 U.S.C. 401(i)). ‘‘(4) TOTAL MEDICARE OUTLAYS.—The term ‘total medicare outlays’ means total outlays from the medicare trust funds and shall— ‘‘(A) include payments made to plans under part C of title XVIII of the Social Security Act [42 U.S.C. 1395w–21 et seq.] that are attributable to any rebates under section 1854(b)(1)(C) of such Act (42 U.S.C. 1395w–24(b)(1)(C)), as amended by section 222(b)(1); ‘‘(B) include administrative expenditures made in carrying out title XVIII of such Act [42 U.S.C. 1395 et seq.] and Federal outlays under section 1935(b) of such Act [42 U.S.C. 1396u–5(b)], as added by section 103(a)(2); and ‘‘(C) offset outlays by the amount of fraud and abuse collections insofar as they are applied or de- posited into a medicare trust fund. ‘‘(5) MEDICARE TRUST FUND.—The term ‘medicare trust fund’ means— ‘‘(A) the Federal Hospital Insurance Trust Fund established under section 1817 of the Social Secu- rity Act (42 U.S.C. 1395i); and ‘‘(B) the Federal Supplementary Medical Insur- ance Trust Fund established under section 1841 of such Act (42 U.S.C. 1395t), including the Medicare Prescription Drug Account under such Trust Fund. ‘‘(d) CONFORMING AMENDMENTS.— ‘‘(1) FEDERAL HOSPITAL INSURANCE TRUST FUND [Amended section 1395i of this title]. ‘‘(2) FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND [Amended section 1395t of this title]. ‘‘(e) NOTICE OF MEDICARE FUNDING WARNING.—When- ever any report described in subsection (a) contains a determination that for any fiscal year within the 7-fis- cal-year reporting period there will be excess general revenue medicare funding, Congress and the President should address the matter under existing rules and pro- cedures.’’ CRIMINAL FINES DEPOSITED IN FEDERAL HOSPITAL INSURANCE TRUST FUND Pub. L. 104–191, title II, § 242(b), Aug. 21, 1996, 110 Stat. 2016, provided that: ‘‘The Secretary of the Treasury shall deposit into the Federal Hospital Insurance Trust Fund pursuant to section 1817(k)(2)(C) of the Social Se- curity Act (42 U.S.C. 1395i) an amount equal to the criminal fines imposed under section 1347 of title 18, United States Code (relating to health care fraud).’’ PROPERTY FORFEITED DEPOSITED IN FEDERAL HOSPITAL INSURANCE TRUST FUND Pub. L. 104–191, title II, § 249(c), Aug. 21, 1996, 110 Stat. 2020, provided that: ‘‘(1) IN GENERAL.—After the payment of the costs of asset forfeiture has been made and after all restoration payments (if any) have been made, and notwith- standing any other provision of law, the Secretary of the Treasury shall deposit into the Federal Hospital In- surance Trust Fund pursuant to section 1817(k)(2)(C) of the Social Security Act [42 U.S.C. 1395i(k)(2)(C)], as added by section 301(b), an amount equal to the net amount realized from the forfeiture of property by rea- son of a Federal health care offense pursuant to section 982(a)(6) of title 18, United States Code. Page 2976 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395i–1 1 See References in Text note below. ‘‘(2) COSTS OF ASSET FORFEITURE.—For purposes of paragraph (1), the term ‘payment of the costs of asset forfeiture’ means— ‘‘(A) the payment, at the discretion of the Attorney General, of any expenses necessary to seize, detain, inventory, safeguard, maintain, advertise, sell, or dis- pose of property under seizure, detention, or for- feited, or of any other necessary expenses incident to the seizure, detention, forfeiture, or disposal of such property, including payment for— ‘‘(i) contract services; ‘‘(ii) the employment of outside contractors to operate and manage properties or provide other spe- cialized services necessary to dispose of such prop- erties in an effort to maximize the return from such properties; and ‘‘(iii) reimbursement of any Federal, State, or local agency for any expenditures made to perform the functions described in this subparagraph; ‘‘(B) at the discretion of the Attorney General, the payment of awards for information or assistance leading to a civil or criminal forfeiture involving any Federal agency participating in the Health Care Fraud and Abuse Control Account; ‘‘(C) the compromise and payment of valid liens and mortgages against property that has been forfeited, subject to the discretion of the Attorney General to determine the validity of any such lien or mortgage and the amount of payment to be made, and the em- ployment of attorneys and other personnel skilled in State real estate law as necessary; ‘‘(D) payment authorized in connection with remis- sion or mitigation procedures relating to property forfeited; and ‘‘(E) the payment of State and local property taxes on forfeited real property that accrued between the date of the violation giving rise to the forfeiture and the date of the forfeiture order. ‘‘(3) RESTORATION PAYMENT.—Notwithstanding any other provision of law, if the Federal health care of- fense referred to in paragraph (1) resulted in a loss to an employee welfare benefit plan within the meaning of section 3(1) of the Employee Retirement Income Secu- rity Act of 1974 [29 U.S.C. 1002(1)], the Secretary of the Treasury shall transfer to such employee welfare ben- efit plan, from the amount realized from the forfeiture of property referred to in paragraph (1), an amount equal to such loss. For purposes of paragraph (1), the term ‘restoration payment’ means the amount trans- ferred to an employee welfare benefit plan pursuant to this paragraph.’’ DUE DATE FOR 1983 REPORT ON OPERATION AND STATUS OF TRUST FUND Notwithstanding subsec. (b)(2) of this section, the an- nual report of the Board of Trustees of the Trust Fund required for calendar year 1983 under this section may be filed at any time not later than forty-five days after Apr. 20, 1983, see section 154(d) of Pub. L. 98–21, set out as a note under section 401 of this title. § 1395i–1. Authorization of appropriations There are authorized to be appropriated to the Federal Hospital Insurance Trust Fund (estab- lished by section 1395i of this title) from time to time such sums as the Secretary deems nec- essary for any fiscal year, on account of— (1) payments made or to be made during such fiscal year from such Trust Fund under this part with respect to individuals who are qualified railroad retirement beneficiaries (as defined in section 426(c) 1 of this title) and who are not, and upon filing application for month- ly insurance benefits under section 402 of this title would not be, entitled to such benefits if service as an employee (as defined in the Rail- road Retirement Act of 1937 [45 U.S.C. 228a et seq.]) after December 31, 1936, had been in- cluded in the term ‘‘employment’’ as defined in this chapter, (2) the additional administrative expenses resulting or expected to result therefrom, and (3) any loss of interest to such Trust Fund resulting from the payment of such amounts, in order to place such Trust Fund in the same position at the end of such fiscal year in which it would have been if the individuals described in paragraph (1) had not been entitled to bene- fits under this part. (Pub. L. 89–97, title I, § 111(d), July 30, 1965, 79 Stat. 343.) Editorial Notes REFERENCES IN TEXT Section 426(c) of this title, referred to in par. (1), was redesignated section 426(d) of this title by Pub. L. 92–603, title II, § 201(b)(5), Oct. 30, 1972, 86 Stat. 1372. The Railroad Retirement Act of 1937, referred to in par. (1), is act Aug. 29, 1935, ch. 812, 49 Stat. 867, as amended generally by act June 24, 1937, ch. 382, part I, 50 Stat. 307, and which was classified principally to sub- chapter III (§ 228a et seq.) of chapter 9 of Title 45, Rail- roads. The Railroad Retirement Act of 1937 was amend- ed generally and redesignated the Railroad Retirement Act of 1974 by Pub. L. 93–445, title I, Oct. 16, 1974, 88 Stat. 1305. The Railroad Retirement Act of 1974 is clas- sified generally to subchapter IV (§ 231 et seq.) of chap- ter 9 of title 45. For complete classification of these Acts to the Code, see Tables. CODIFICATION Section was enacted as part of the Social Security Amendments of 1965 and also as part of the Health In- surance for the Aged Act, and not as part of the Social Security Act which comprises this chapter. Statutory Notes and Related Subsidiaries EFFECTIVE DATE Pub. L. 89–97, title I, § 111(e), July 30, 1965, 79 Stat. 343, provided that: ‘‘(1) The amendments made by the preceding provi- sions of this section [enacting this section and section 228s–2 of Title 45, Railroads, and amending section 1395kk of this title and sections 1401, 3101, 3111, 3201, 3211, and 3221 of Title 26, Internal Revenue Code, and section 228e of Title 45] shall apply to the calendar year 1966 or to any subsequent calendar year, but only if the requirement in paragraph (2) has been met with respect to such calendar year. ‘‘(2) The requirement referred to in paragraph (1) shall be deemed to have been met with respect to any calendar year if, as of the October 1 immediately pre- ceding such calendar year, the Railroad Retirement Tax Act [section 3101 et seq. of Title 26] provides that the maximum amount of monthly compensation tax- able under such Act during all months of such calendar year will be an amount equal to one-twelfth of the maximum wages which the Federal Insurance Con- tributions Act [section 3201 et seq. of Title 26] provides may be counted for such calendar year.’’ § 1395i–1a. Repealed. Pub. L. 101–234, title I, § 102(a), Dec. 13, 1989, 103 Stat. 1980 Section, act Aug. 14, 1935, ch. 531, title XVIII, § 1817A, as added July 1, 1988, Pub. L. 100–360, title I, § 112(a), 102 Stat. 698, provided for establishment and operation of Federal Hospital Insurance Catastrophic Coverage Re- serve Fund.