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42 U.S.C. § 1395iii — Medicare Improvement Fund

submitted 91 years ago by Pub. L. 110-252 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 300 words · no verdicts yet

in plain englishAI-generated · not legal advice

This section establishes a Medicare Improvement Fund for improvements to the original Medicare fee-for-service program under Parts A and B, including payment adjustments. It provides funding, limits obligations to available funds, and prevents an adjustment from changing later-year payment-rate calculations.

(a) Establishment. The Secretary must establish under this subchapter a Medicare Improvement Fund. The Secretary may use it to make improvements under the original Medicare fee-for-service program under Parts A and B for people entitled to or enrolled for Part A benefits or enrolled under Part B. This includes adjusting payments for items and services furnished by providers and suppliers under that program. This section does not define "original Medicare fee-for-service program."

(b) Funding. (1) The Fund has $2,062,000,000 available for spending on services furnished during and after fiscal year 2027. (2) As Fund spending occurs, the money must come from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund in proportions the Secretary considers appropriate. (3) The Fund may be used before an appropriation is made, but total obligations may not exceed the amount available under paragraph (1). The Secretary may obligate money only after determining, and the CMS Chief Actuary and appropriate budget officer certifying, that enough money is available to cover all obligations consistent with that limit. (4) If Fund spending is applied to or otherwise affects an item's or service's payment rate for one year, the rate for a later year must be calculated as if that spending had never been applied or had no effect.

the actual law source: uscode.house.gov ↗public domain
(a) Establishment

The Secretary shall establish under this subchapter a Medicare Improvement Fund (in this section referred to as the “Fund”) which shall be available to the Secretary to make improvements under the original Medicare fee-for-service program under parts A and B for individuals entitled to, or enrolled for, benefits under part 1 or enrolled under part B including adjustments to payments for items and services furnished by providers of services and suppliers under such original Medicare fee-for-service program.

(b) Funding
(1) In general

There shall be available to the Fund, for expenditures from the Fund for services furnished during and after fiscal year 2027, $2,062,000,000.

(2) Payment from Trust Funds

The amount specified under paragraph (1) shall be available to the Fund, as expenditures are made from the Fund, from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund in such proportion as the Secretary determines appropriate.

(3) Funding limitation

Amounts in the Fund shall be available in advance of appropriations but only if the total amount obligated from the Fund does not exceed the amount available to the Fund under paragraph (1). The Secretary may obligate funds from the Fund only if the Secretary determines (and the Chief Actuary of the Centers for Medicare & Medicaid Services and the appropriate budget officer certify) that there are available in the Fund sufficient amounts to cover all such obligations incurred consistent with the previous sentence.

(4) No effect on payments in subsequent years

In the case that expenditures from the Fund are applied to, or otherwise affect, a payment rate for an item or service under this subchapter for a year, the payment rate for such item or service shall be computed for a subsequent year as if such application or effect had never occurred.

Source credit: (Aug. 14, 1935, ch. 531, title XVIII, § 1898, as added Pub. L. 110–252, title VII, § 7002(a), June 30, 2008, 122 Stat. 2394; amended Pub. L. 110–275, title I, § 188(a)(2)(B), July 15, 2008, 122 Stat. 2589; Pub. L. 110–379, § 6, Oct. 8, 2008, 122 Stat. 4079; Pub. L. 111–5, div. B, title IV, § 4103(b), Feb. 17, 2009, 123 Stat. 487; Pub. L. 111–118, div. B, § 1011(b), Dec. 19, 2009, 123 Stat. 3474; Pub. L. 111–148, title III, § 3112, Mar. 23, 2010, 124 Stat. 421; Pub. L. 111–309, title II, § 207, Dec. 15, 2010, 124 Stat. 3291; Pub. L. 112–240, title VI, § 640, Jan. 2, 2013, 126 Stat. 2357; Pub. L. 113–82, § 3, Feb. 15, 2014, 128 Stat. 1009; Pub. L. 113–93, title II, § 219, Apr. 1, 2014, 128 Stat. 1070; Pub. L. 113–185, § 3(e), Oct. 6, 2014, 128 Stat. 1969; Pub. L. 114–10, title V, § 518, Apr. 16, 2015, 129 Stat. 175; Pub. L. 114–60, § 2(c), Oct. 7, 2015, 129 Stat. 544; Pub. L. 114–113, div. O, title V, § 501, Dec. 18, 2015, 129 Stat. 3018; Pub. L. 114–115, § 5, Dec. 28, 2015, 129 Stat. 3133; Pub. L. 114–198, title VII, § 704(h), July 22, 2016, 130 Stat. 752; Pub. L. 114–255, div. A, title V, § 5001, Dec. 13, 2016, 130 Stat. 1188; Pub. L. 115–63, title III, § 303, Sept. 29, 2017, 131 Stat. 1172; Pub. L. 115–123, div. E, title XII, § 53115, Feb. 9, 2018, 132 Stat. 306; Pub. L. 116–260, div. CC, title IV, § 408, Dec. 27, 2020, 134 Stat. 3008; Pub. L. 117–43, div. D, title I, § 3106, Sept. 30, 2021, 135 Stat. 380; Pub. L. 117–70, div. C, title I, § 2104(b), Dec. 3, 2021, 135 Stat. 1504; Pub. L. 117–71, § 6, Dec. 10, 2021, 135 Stat. 1508; Pub. L. 117–86, div. B, title I, § 1104(b), Feb. 18, 2022, 136 Stat. 17; Pub. L. 117–103, div. P, title II, § 313, Mar. 15, 2022, 136 Stat. 809; Pub. L. 117–159, div. A, title III, § 13201, June 25, 2022, 136 Stat. 1333; Pub. L. 117–180, div. D, title I, § 104, Sept. 30, 2022, 136 Stat. 2135; Pub. L. 117–229, div. C, title I, § 104, Dec. 16, 2022, 136 Stat. 2311; Pub. L. 117–328, div. FF, title IV, § 4161, Dec. 29, 2022, 136 Stat. 5931; Pub. L. 118–22, div. B, title II, § 503, Nov. 17, 2023, 137 Stat. 123; Pub. L. 118–31, div. A, title XVIII, § 1853, Dec. 22, 2023, 137 Stat. 709; Pub. L. 118–35, div. B, title I, § 132, Jan. 19, 2024, 138 Stat. 6; Pub. L. 118–42, div. G, title I, § 309, Mar. 9, 2024, 138 Stat. 417; Pub. L. 118–83, div. B, title II, § 222, Sept. 26, 2024, 138 Stat. 1539; Pub. L. 118–158, div. C, title II, § 3210, Dec. 21, 2024, 138 Stat. 1766; Pub. L. 119–4, div. B, title II, § 2210, Mar. 15, 2025, 139 Stat. 44; Pub. L. 119–37, div. F, title II, § 6212, Nov. 12, 2025, 139 Stat. 634; Pub. L. 119–75, div. J, title II, § 6228, Feb. 3, 2026, 140 Stat. 685.)

history & why it existsrecord from the source credit
  • 1935Enacted · Pub. L. 110-252 · 122 Stat. 2394
  • 2008Amended · Pub. L. 110-275 · 122 Stat. 2589
  • 2008Amended · Pub. L. 110-379 · 122 Stat. 4079
  • 2009Amended · Pub. L. 111-5 · 123 Stat. 487
  • 2009Amended · Pub. L. 111-118 · 123 Stat. 3474
  • 2010Amended · Pub. L. 111-148 · 124 Stat. 421
  • 2010Amended · Pub. L. 111-309 · 124 Stat. 3291
  • 2013Amended · Pub. L. 112-240 · 126 Stat. 2357
  • 2014Amended · Pub. L. 113-82 · 128 Stat. 1009
  • 2014Amended · Pub. L. 113-93 · 128 Stat. 1070
  • 2014Amended · Pub. L. 113-185 · 128 Stat. 1969
  • 2015Amended · Pub. L. 114-10 · 129 Stat. 175
  • 2015Amended · Pub. L. 114-60 · 129 Stat. 544
  • 2015Amended · Pub. L. 114-113 · 129 Stat. 3018
  • 2015Amended · Pub. L. 114-115 · 129 Stat. 3133
  • 2016Amended · Pub. L. 114-198 · 130 Stat. 752
  • 2016Amended · Pub. L. 114-255 · 130 Stat. 1188
  • 2017Amended · Pub. L. 115-63 · 131 Stat. 1172
  • 2018Amended · Pub. L. 115-123 · 132 Stat. 306
  • 2020Amended · Pub. L. 116-260 · 134 Stat. 3008
  • 2021Amended · Pub. L. 117-43 · 135 Stat. 380
  • 2021Amended · Pub. L. 117-70 · 135 Stat. 1504
  • 2021Amended · Pub. L. 117-71 · 135 Stat. 1508
  • 2022Amended · Pub. L. 117-86 · 136 Stat. 17
  • 2022Amended · Pub. L. 117-103 · 136 Stat. 809
  • 2022Amended · Pub. L. 117-159 · 136 Stat. 1333
  • 2022Amended · Pub. L. 117-180 · 136 Stat. 2135
  • 2022Amended · Pub. L. 117-229 · 136 Stat. 2311
  • 2022Amended · Pub. L. 117-328 · 136 Stat. 5931
  • 2023Amended · Pub. L. 118-22 · 137 Stat. 123
  • 2023Amended · Pub. L. 118-31 · 137 Stat. 709
  • 2024Amended · Pub. L. 118-35 · 138 Stat. 6
  • 2024Amended · Pub. L. 118-42 · 138 Stat. 417
  • 2024Amended · Pub. L. 118-83 · 138 Stat. 1539
  • 2024Amended · Pub. L. 118-158 · 138 Stat. 1766
  • 2025Amended · Pub. L. 119-4 · 139 Stat. 44
  • 2025Amended · Pub. L. 119-37 · 139 Stat. 634
  • 2026Amended · Pub. L. 119-75 · 140 Stat. 685

A history note hasn’t been published yet. The record shows enactment by Pub. L. 110-252 on 1935-08-14.

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