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1 ‘‘(E) by any organization described in sec-
2 tion 501(c)(6), or
3 ‘‘(F) in the case of a plan not described in
4 the preceding subparagraphs, by a multiple em-
5 ployer welfare arrangement (as defined in sec-
6 tion 3(40) of Employee Retirement Income Se-
7 curity Act of 1974), a rural electric cooperative
8 (as defined in section 3(40)(B)(iv) of such Act),
9 or a rural telephone cooperative association (as
10 defined in section 3(40)(B)(v) of such Act).
11 ‘‘SEC. 4377. DEFINITIONS AND SPECIAL RULES.

12 ‘‘(a) DEFINITIONS.—For purposes of this sub-

13 chapter—
14 ‘‘(1) ACCIDENT AND HEALTH COVERAGE.—The

15 term ‘accident and health coverage’ means any cov-

16 erage which, if provided by an insurance policy,
17 would cause such policy to be a specified health in-
18 surance policy (as defined in section 4375(c)).
19 ‘‘(2) INSURANCE POLICY.—The term ‘insurance
20 policy’ means any policy or other instrument where-
21 by a contract of insurance is issued, renewed, or ex-
22 tended.
23 ‘‘(3) UNITED STATES.—The term ‘United
24 States’ includes any possession of the United States.
25 ‘‘(b) TREATMENT OF GOVERNMENTAL ENTITIES.—

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1 ‘‘(1) IN GENERAL.—For purposes of this sub-
2 chapter—
3 ‘‘(A) the term ‘person’ includes any gov-
4 ernmental entity, and
5 ‘‘(B) notwithstanding any other law or rule
6 of law, governmental entities shall not be ex-
7 empt from the fees imposed by this subchapter
8 except as provided in paragraph (2).
9 ‘‘(2) TREATMENT OF EXEMPT GOVERNMENTAL

10 PROGRAMS.—In the case of an exempt governmental

11 program, no fee shall be imposed under section 4375
12 or section 4376 on any covered life under such pro-
13 gram.
14 ‘‘(3) EXEMPT GOVERNMENTAL PROGRAM DE-

15 FINED.—For purposes of this subchapter, the term

16 ‘exempt governmental program’ means—
17 ‘‘(A) any insurance program established
18 under title XVIII of the Social Security Act,
19 ‘‘(B) the medical assistance program es-
20 tablished by title XIX or XXI of the Social Se-
21 curity Act,
22 ‘‘(C) any program established by Federal
23 law for providing medical care (other than
24 through insurance policies) to individuals (or

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1 the spouses and dependents thereof) by reason
2 of such individuals being—
3 ‘‘(i) members of the Armed Forces of
4 the United States, or
5 ‘‘(ii) veterans, and
6 ‘‘(D) any program established by Federal
7 law for providing medical care (other than
8 through insurance policies) to members of In-
9 dian tribes (as defined in section 4(d) of the In-
10 dian Health Care Improvement Act).
11 ‘‘(c) TREATMENT AS TAX.—For purposes of subtitle
12 F, the fees imposed by this subchapter shall be treated
13 as if they were taxes.
14 ‘‘(d) NO COVER OVER TO POSSESSIONS.—Notwith-
15 standing any other provision of law, no amount collected
16 under this subchapter shall be covered over to any posses-
17 sion of the United States.’’.
18 (2) CLERICAL AMENDMENTS.—

19 (A) Chapter 34 of such Code is amended

20 by striking the chapter heading and inserting
21 the following:
22 ‘‘CHAPTER 34—TAXES ON CERTAIN
23 INSURANCE POLICIES
‘‘SUBCHAPTER A. POLICIES ISSUED BY FOREIGN INSURERS

‘‘SUBCHAPTER B. INSURED AND SELF-INSURED HEALTH PLANS

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1 ‘‘Subchapter A—Policies Issued By Foreign
2 Insurers’’.
3 (B) The table of chapters for subtitle D of
4 such Code is amended by striking the item re-
5 lating to chapter 34 and inserting the following
6 new item:
‘‘CHAPTER 34—TAXES ON CERTAIN INSURANCE POLICIES’’.

7 (3) EFFECTIVE DATE.—The amendments made

8 by this subsection shall apply with respect to policies
9 and plans for portions of policy or plan years begin-
10 ning on or after October 1, 2012.
11 TITLE IX—MISCELLANEOUS
12 PROVISIONS
13 SEC. 1901. REPEAL OF TRIGGER PROVISION.

14 Subtitle A of title VIII of the Medicare Prescription

15 Drug, Improvement, and Modernization Act of 2003 (Pub-
16 lic Law 108–173) is repealed and the provisions of law
17 amended by such subtitle are restored as if such subtitle
18 had never been enacted.
19 SEC. 1902. REPEAL OF COMPARATIVE COST ADJUSTMENT

20 (CCA) PROGRAM.

21 Section 1860C–1 of the Social Security Act (42

22 U.S.C. 1395w–29), as added by section 241(a) of the
23 Medicare Prescription Drug, Improvement, and Mod-
24 ernization Act of 2003 (Public Law 108–173), is repealed.

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1 SEC. 1903. EXTENSION OF GAINSHARING DEMONSTRATION.

2 (a) IN GENERAL.—Subsection (d)(3) of section 5007

3 of the Deficit Reduction Act of 2005 (Public Law 109–
4 171) is amended by inserting ‘‘(or September 30, 2011,
5 in the case of a demonstration project in operation as of
6 October 1, 2008)’’ after ‘‘December 31, 2009’’.
7 (b) FUNDING.—
8 (1) IN GENERAL.—Subsection (f)(1) of such
9 section is amended by inserting ‘‘and for fiscal year
10 2010, $1,600,000,’’ after ‘‘$6,000,000,’’.
11 (2) AVAILABILITY.—Subsection (f)(2) of such
12 section is amended by striking ‘‘2010’’ and inserting
13 ‘‘2014 or until expended’’.
14 (c) REPORTS.—
15 (1) QUALITY IMPROVEMENT AND SAVINGS.—

16 Subsection (e)(3) of such section is amended by

17 striking ‘‘December 1, 2008’’ and inserting ‘‘March
18 31, 2011’’.
19 (2) FINAL REPORT.—Subsection (e)(4) of such
20 section is amended by striking ‘‘May 1, 2010’’ and
21 inserting ‘‘March 31, 2013’’.

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1 SEC. 1904. GRANTS TO STATES FOR QUALITY HOME VISITA-

2 TION PROGRAMS FOR FAMILIES WITH YOUNG

3 CHILDREN AND FAMILIES EXPECTING CHIL-

4 DREN.

5 Part B of title IV of the Social Security Act (42

6 U.S.C. 621–629i) is amended by adding at the end the
7 following:
8 ‘‘Subpart 3—Support for Quality Home Visitation

9 Programs

10 ‘‘SEC. 440. HOME VISITATION PROGRAMS FOR FAMILIES

11 WITH YOUNG CHILDREN AND FAMILIES EX-

12 PECTING CHILDREN.

13 ‘‘(a) PURPOSE.—The purpose of this section is to im-

14 prove the well-being, health, and development of children
15 by enabling the establishment and expansion of high qual-
16 ity programs providing voluntary home visitation for fami-
17 lies with young children and families expecting children.
18 ‘‘(b) GRANT APPLICATION.—A State that desires to
19 receive a grant under this section shall submit to the Sec-
20 retary for approval, at such time and in such manner as
21 the Secretary may require, an application for the grant
22 that includes the following:
23 ‘‘(1) DESCRIPTION OF HOME VISITATION PRO-

24 GRAMS.—A description of the high quality programs

25 of home visitation for families with young children
26 and families expecting children that will be sup-
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839
1 ported by a grant made to the State under this sec-
2 tion, the outcomes the programs are intended to
3 achieve, and the evidence supporting the effective-
4 ness of the programs.
5 ‘‘(2) RESULTS OF NEEDS ASSESSMENT.—The

6 results of a statewide needs assessment that de-

7 scribes—
8 ‘‘(A) the number, quality, and capacity of
9 home visitation programs for families with
10 young children and families expecting children
11 in the State;
12 ‘‘(B) the number and types of families who
13 are receiving services under the programs;
14 ‘‘(C) the sources and amount of funding
15 provided to the programs;
16 ‘‘(D) the gaps in home visitation in the
17 State, including identification of communities
18 that are in high need of the services; and
19 ‘‘(E) training and technical assistance ac-
20 tivities designed to achieve or support the goals
21 of the programs.
22 ‘‘(3) ASSURANCES.—Assurances from the State
23 that—
24 ‘‘(A) in supporting home visitation pro-
25 grams using funds provided under this section,

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840
1 the State shall identify and prioritize serving
2 communities that are in high need of such serv-
3 ices, especially communities with a high propor-
4 tion of low-income families or a high incidence
5 of child maltreatment;
6 ‘‘(B) the State will reserve 5 percent of the
7 grant funds for training and technical assist-
8 ance to the home visitation programs using
9 such funds;
10 ‘‘(C) in supporting home visitation pro-
11 grams using funds provided under this section,
12 the State will promote coordination and collabo-
13 ration with other home visitation programs (in-
14 cluding programs funded under title XIX) and
15 with other child and family services, health
16 services, income supports, and other related as-
17 sistance;
18 ‘‘(D) home visitation programs supported
19 using such funds will, when appropriate, pro-
20 vide referrals to other programs serving chil-
21 dren and families; and
22 ‘‘(E) the State will comply with subsection
23 (i), and cooperate with any evaluation con-
24 ducted under subsection (j).

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