Page:United States Statutes at Large Volume 100 Part 1.djvu/245

 PUBLIC LAW 99-272—APR. 7, 1986

100 STAT. 209

XVIII, and the making available of such assistance shall not, by 42 USC 1395. reason of this paragraph (10), require the making available of medical assistance for hospice care to other individuals or the making available of medical assistance for services waived by such terminally ill individuals". (2)

HIGHER

INCOME

STANDARD

PERMITTED.—Section

1902(a)(10)(A)(ii) of such Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended— (A) by striking out "or" at the end of subclause (V); (B) by striking out the semicolon at the end of subclause (VI) and inserting in lieu thereof ", or"; and (C) by adding at the end the following new subclause: "(VII) who would be eligible under the State plan under this title if they were in a medical institution, who are terminally ill, and who will receive hospice care pursuant to a voluntary election described in section 1905(o);". 42 USC 1396d. (c) PAYMENT FOR HOSPICE CARE.— (1) U S E OF MEDICARE RATES.—Section

1902(a)(13) of such Act

(42 U.S.C. 1396a(a)(13)) is amended— (A) by striking out "and" at the end of subparagraph (B); (B) by redesignating subparagraph (C) as subparagraph (D); and (C) by inserting after subparagraph (B) the following new subparagraph: "(C) for payment for hospice care in the same amounts, and using the same methodology, as used under part A of title XVIII; except that a separate rate may be paid for 42 USC 1395c. hospice care which is furnished to an individual who is a resident of a skilled nursing facility or intermediate care facility, and who would be eligible under the plan for skilled nursing facility services or intermediate care facility services if he had not elected to receive hospice care, to take into account the room and board furnished by such facility; and". (2) LIMITATION ON COPAYMENTS.—Subsections (a)(2) and (b)(2)

of section 1916 of the Social Security Act (42 U.S.C. 1396o) are each amended— (A) by striking out "or" at the end of subparagraph (C); (B) by striking out "; and" at the end of subparagraph (D) and inserting in lieu thereof ", or"; and (C) by adding at the end the following new subparagraph: "(E) services furnished to an individual who is receiving hospice care (as defined in section 1905(o)); and". (d) CONFORMING AMENDMENTS.—

(1) Section 1902(j) of such Act (42 U.S.C. 1396a(j)) is amended by striking out "(18)" and inserting in lieu thereof "(19)". (2) Section 1902(a)(10)(C)(iv) of such Act (42 U.S.C. 1396a(a)(10)(C)(iv)) is amended by striking out "through (17)" and inserting in lieu thereof "through (18)". (e) EFFECTIVE DATE.—The amendments made by this section shall 42 USC I396a apply to medical assistance provided for hospice care furnished on or "°te. after the date of the enactment of this Act.

�