following unanticipated outcome. Sec. 391. Affidavit of merit. Sec. 392. Notice of intent to commence lawsuit. Sec. 393. Limitation on liability for volunteer health care professionals. Sec. 394. Rules of construction. Sec. 395. Effective date. Title IV—Medicare and Medicaid Reforms Subtitle A—Medicaid Reforms Sec. 401. Medicaid payment reform. Sec. 402. Income limitations for refundable credits for coverage under a qualified health plan. Sec. 403. Medicaid eligibility determinations. Sec. 404. Lowering safe harbor threshold with respect to State taxes on health care providers. Sec. 405. Providing for State approval and implementation of specified waivers under the Medicaid program. Sec. 406. Deduction for qualified charity care. Subtitle B—Medicare Reforms Sec. 411. Off-campus provider-based department Medicare site neutral payment. Sec. 412. Eliminating FEHBP eligibility for annuitants. Sec. 413. Elimination of Medicare eligibility for certain individuals. Sec. 414. Medicare part D tax deduction. Sec. 415. Repeal of net investment income tax. Sec. 416. Medicare coverage of bad debt. Subtitle C—Medicare Choice and Competition Sec. 421. Competitive bidding and premiums under unified Medicare. Sec. 422. New unified eligibility and enrollment rules. Sec. 423. New benefit structure under unified Medicare. Sec. 424. Late enrollment penalty not to apply for months of any health coverage. Sec. 425. Medigap reform. Sec. 426. ACO revision. Sec. 427. Primary care options. Sec. 428. General provisions