,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #dfgf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #ai1 #bjad ,mr4  
,mc,dermott introduc$ ! foll[+ bill2 :i*
 0 ref]r$ to ! ,committee on ,en]gy &   
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d titles     
,,xviii & ,,xix ( ! ,social ,security   
,act to apply ! ,m$ic>e re/riction on   
self-ref]ral to ,/ate plan requirem5ts  
"u ,m$icaid1 & = o!r purposes4  #a4     
,%ort title ,?is ,act may be cit$ z !   
,m$icaid ,physician ,self-,ref]ral ,act 
( #bjad4  #b4 ,adju/m5ts to re/riction  
on self-ref]ral "u ,m$icaid  7a7 ,repeal
 ( re/riction on receipt ( ,f$]al funds 
9 ! case ( self-,ref]ral ,subsection 7s7
 ( section #aijc ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #acif;b7s77 is      
repeal$4  7b7 ,requirem5t ( re/riction  
on self-,ref]ral 9 ,/ate plan           

requirem5ts ,section #aijb ( su* ,act   
7#db ,u4,s4,c4 #acif;a7 is am5d$--  7#a7
 9 subsection 7a7--  7,a7 9 p>agraph    
7#hj7 by /rik+ & at ! end2  7,b7 9      
p>agraph 7#ha7 by /rik+ ! p]iod at ! end
 & ins]t+ 2 &2  7,c7 by ins]t+ aft]     
p>agraph 7#ha7 ! foll[+3  7#hb7 provide 
t no paym5t may be made "u ! ,/ate plan 
= a ,m$icaid designat$ heal? s]vice     
furni%$ to an individual on ! basis ( a 
ref]ral by a physician if ! physician   
7or an imm$iate family memb] ( !        
physician7 has an own]%ip or inve/m5t   
int]e/ or a comp5sation arrangem5t 7z   
def9$ 9 section #ahgg7 ) ! entity       
furni%+ ! ,m$icaid designat$ heal?      
s]vice t w\ld n comply ) section #ahgg  
if ! ref]ral 7 = an item or s]vice      
o!rwise payable "u title ,,xviii4  2 &  
7,d7 by ins]t+ aft] ! matt] imm$iately  
foll[+ p>agraph 7#hb7 ! foll[+3  ,=     
purposes ( p>agraph 7#hb71 subsections  
7f7 & 7g7 ( section #ahgg %all apply to 
a provid] ( a ,m$icaid designat$ heal?  
s]vice 9 a simil> mann] z su*           

subsections apply to a provid] ( an item
 or s]vice = :i* paym5t may be made "u  
title ,,xviii4 2 &  7#b7 by add+ at !   
end ! foll[+ new subsection3  7ll7      
,def9ition ( ,m$icaid designat$ heal?   
s]vice ,= purposes ( subsection 7a7 !   
t]m ,m$icaid designat$ heal? s]vice     
means an item or s]vice li/$ 9          
subsection 7h77#f7 ( section #ahgg z    
cov]$ by a ,/ate plan & any o!r s]vice a
 ,/ate may *oose to add = purposes (    
subsection 7a77#hb74  4  7c7            
,application ( ,false ,claims ,act to   
violations ( self-,ref]ral ,section     
#ahgg7;g7 ( su* ,act 7#db ,u4,s4,c4     
#acienn7g77 is am5d$ by add+ at ! end ! 
foll[+3  7#g7 ,false ,claims ,act ,a    
claim t includes an item or s]vice      
result+ f a violation ( ?is section     
con/itutes a false or fraudul5t claim = 
purposes ( sections #cgbi-cgcc ( title  
#ca1 ,unit$ ,/ates ,code4  4  7d7       
,exceptions = violations ( self-,ref]ral
 limit$ to ,m$icaid ,section #ahgg7;h7 (
 su* ,act 7#db ,u4,s4,c4 #acienn7h77 is 

am5d$ by add+ at ! end ! foll[+3  7#h7  
,m$icaid self-,ref]ral limitations ,any 
au?ority ( ! ,secret>y to issue         
regulations "u ?is section %all include 
! au?ority to issue regulations limit$  
to ! application ( self-ref]ral         
limitations to ,/ate plan requirem5ts1 z
 describ$ "u section #aijb7;a77#hb7 (   
?is ,act 7#db ,u4,s4,c4                 
#acif;a7a77#hb774  4  7e7 ,m$icaid      
self-,ref]ral disclosure protocol ,!    
,secret>y ( ,heal? & ,human ,s]vices    
%all e/abli% a protocol consi/5t ) !    
requirem5ts ( ! ,m$ic>e self-ref]ral    
disclosure protocol requir$ "u section  
#fdji ( ! ,pati5t ,protection &         
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#acienn note7 t enables heal? c>e       
provid]s to disclose an actual or       
pot5tial violation ( section #ahgg ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acienn7 z appli$ to title ,,xix ( su*  
,act1 pursuant to section #aijb7;a77#hb7
 ( su* ,act 7#db ,u4,s4,c4              
#acif;a7a77#hb774  #c4 ,effective date  

7#a7 ,9 g5]al ,subject to p>agraph 7#b71
 ! am5dm5ts made by ?is ,act %all apply 
to items & s]vices furni%$ aft] ! fir/  
day ( ! fir/ cal5d> ye> t beg9s aft]    
date ( enactm5t ( ?is ,act4  7#b7       
,exception = ,/ate legislation ,9 ! case
 ( a ,/ate plan "u title ,,xix ( !      
,social ,security ,act t ! ,secret>y (  
,heal? & ,human ,s]vices det]m9es       
requires ,/ate legislation 9 ord] = !   
respective plan to meet any requirem5t  
impos$ by am5dm5ts made by ?is ,act1 !  
respective plan %all n be reg>d$ z fail+
 to comply ) ! requirem5ts ( su* title  
solely on ! basis ( its failure to meet 
su* an additional requirem5t be=e ! fir/
 day ( ! fir/ cal5d> qu>t] beg9n+ aft] !
 close ( ! fir/ regul> session ( ! ,/ate
 legislature t beg9s aft] ! date (      
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 ! session %all be consid]$ to be a     
sep>ate regul> session ( ! ,/ate        
legislature4