Page:United States Statutes at Large Volume 100 Part 3.djvu/185

 PUBLIC LAW 99-509—OCT. 21, 1986

100 STAT. 1993

established for the granting of favorable presumptions with respect to such denials. (3) EFFECTIVE DATE.—The amendments made by paragraph (1) 42 USC 1395pp shall apply to coverage denials occurring on or after July 1, note. 1987, and before October 1, 1989. (h) DEVELOPMENT OF UNIFORM NEEDS ASSESSMENT INSTRUMENT.— 42 USC 1395x

(1) DEVELOPMENT.—The Secretary of Health and Human Serv- note. ices shall develop a uniform needs assessment instrument that— (A) evaluates— (i) the functional capacity of an individual, (ii) the nursing and other care requirements of the individual to meet health care needs and to assist with functional incapacities, and (iii) the social and familial resources available to the individual to meet those requirements; and (B) can be used by discharge planners, hospitals, nursing facilities, other health care providers, and fiscal intermediaries in evaluating an individual's need for posthospital extended care services, home health services, and long-term care services of a health-related or supportive nature. The Secretary may develop more than one such instrument for use in different situations. (2) ADVISORY PANEL.—The Secretary shall develop any instrument in consultation with an advisory panel, appointed by the Secretary, that includes experts in the delivery of posthospital extended care services, home health services, and longterm care services and includes representatives of hospitals, of physicians, of skilled nursing facilities, of home health agencies, of long-term care providers, of fiscal intermediaries, and of medicare beneficiaries. (3) REPORT ON INSTRUMENT.—The Secretary shall report to Congress, not later than January 1, 1989, on the instrument or instruments developed under this section. The report shall recommendations for the appropriate use of such instrument or instruments.

(i) INCLUDING IN ANNUAL REPORTS ON PROSPECTIVE PAYMENT SYSTEM INFORMATION ON QUALITY OF POST-HOSPITAL CARE.—

(1) IN GENERAL.—Section 603(a)(2) of the Social Security Amendments of 1983 is amended— (A) by striking "1987" in subparagraph (A) and inserting "1989", and (B) by adding at the end the following new subparagraph: "(E) In each annual report to Congress under subparagraph (A), the Secretary shall include— "(i) an evaluation of the adequacy of the procedures for assuring quality of post-hospital services furnished under title XVIII of the Social Security Act, "(ii) an assessment of problems that have prevented groups of medicare beneficiaries (including those eligible for medical assistance under title XIX of such Act) from receiving appropriate post-hospital services covered under such title, and "(iii) information on reconsiderations and appeals taken under title XVIII of such Act with respect to payment for posthospital services.".

42 USC 1395WW note.

42 USC 1395.

42 USC 1396

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