Page:United States Statutes at Large Volume 100 Part 1.djvu/244

 100 STAT. 208

42 USC 1396a.

PUBLIC LAW 99-272—APR. 7, 1986

additional requirements imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. (3) No penalty may be applied against any State for a violation of section 1902(a)(25) of the Social Security Act occurring prior to the effective date of the amendments made by this section. (4) The amendment made by subsection (c) shall become effective on the date of the enactment of this Act. SEC. 9505. OPTIONAL HOSPICE BENEFITS. (a) COVERAGE OF HOSPICE CARE AS AN OPTIONAL MEDICAID BENE-

42 USC 1395x.

42 USC 1395d.

FIT.—Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended— (1) in subsection (a)— (A) by striking out "and" at the end of paragraph (17); (B) by redesignating paragraph (18) as paragraph (19); and (C) by inserting after paragraph (17) the following new paragraph: "(18) hospice care (as defined in subsection (o)); and"; and (2) by adding at the end thereof the following new subsection: "(o)(l) The term 'hospice care' means the care described in section 1861(dd)(l) furnished by a hospice program (as defined in section 1861(dd)(2)) to a terminally ill individual who has voluntarily elected (in accordance with paragraph (2)) to have payment made for hospice care instead of having payment made for certain benefits described in section 1812(d)(2)(A) and intermediate care facility services under the plan. For purposes of such election, hospice care may be provided to an individual while such individual is a resident of a skilled nursing facility or intermediate care facility, but the only payment made under the State plan shall be for the hospice care. "(2) An individual's voluntary election under this subsection— "(A) shall be made in accordance with procedures that are established by the State and that are consistent with the procedures established under section 1812(d)(2); "(B) shall be for such a period or periods (which need not be the same periods described in section 1812(d)(1)) as the State may establish; and "(C) may be revoked at any time without a showing of cause and may be modified so as to change the hospice program with respect to which a previous election was made.". (b) ELIGIBILITY.— (1) LIMITATION

TO TERMINALLY ILL INDIVIDUALS.—Section

1902(a)(10) of such Act (42 U.S.C. 1396a(a)(10)), as amended by section 9501 of this Act, is further amended, in the matter following subparagraph (D), by striking out "and" before "(V)" and by inserting before the semicolon at the end thereof the following: ", and (VI) with respect to the making available of medical assistance for hospice care to terminally ill individuals who have made a voluntary election described in section 1905(o) to receive hospice care instead of medical assistance for certain other services, such assistance may not be made available in an amount, duration, or scope less than that provided under title

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