Page:United States Statutes at Large Volume 100 Part 3.djvu/262

 100 STAT. 2070

PUBLIC LAW 99-509—OCT. 21, 1986

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Ante, p. 208. State and local governments.

42 USC 1395c. 42 USC 1395d.

42 USC 1396a. 42 USC 1395e.

42 USC 1396a note. Ante, p. 210. Handicapped persons.

Ante, pp. 208, 210.

Ante, p. 212.

42 USC 1396b note. Ante, p. 2931.

(2) Section 1905(o) of the Social Security Act, as amended by section 9505(a)(2) of the Consolidated Omnibus Budget Reconciliation Act of 1985, is amended by adding at the end the following new paragraph: "(3) In the case of a State which elects not to provide medical ^ assistance for hospice care, but provides medical assistance for skilled nursing or intermediate care facility services with rej spect to an individual— "(A) who is residing in a skilled nursing or intermediate care facility and is receiving medical assistance for services in such facility under the plan, "(B) who is entitled to benefits under part A of title XVIII and has elected, under section 1812(d), to receive hospice care under such part, and "(C) with respect to whom the hospice program under such title and the skilled nursing or intermediate care facility have entered into a written agreement under which y the program takes full responsibility for the professional management of the individual's hospice care and the facility agrees to provide room and board to the individual, ^, instead of any payment otherwise made under the plan with respect to the facility'services, the State shall provide for payment to the hospice program of an amount equal to the amounts allocated under the plan for room and board in the facility, in accordance with the rates established under section 1902(a)(13), and, if the individual is an individual described in section 1902(a)(10)(A), shall provide for payment of any coinsurance amounts imposed under section 1813(a)(4). For purposes of this paragraph and section 1902(a)(13)(D), the term 'room and board' includes performance of personal care services, including assistance in activities of daily living, in socializing activities, administration of medication, maintaining the cleanliness of a resident's room, and supervising and assisting in the use of durable medical equipment and prescribed therapies.". (c) MEDICAID QUALIFYING TRUSTS.—Section 9506 of the Consolidated Omnibus Budget Reconciliation Act of 1985 is amended by adding at the end the following new subsection: "(c) EXCEPTION.—The amendment made by subsection (a) shall not apply to any trust or initial trust decree established prior to April 7, 1986, solely for the benefit of a mentally retarded individual who resides in an intermediate care facility for the mentally retarded.". (1) Sections 9505(e) and 9508(b) of the Consolidated Omnibus Budget Reconciliation Act of 1985 are each amended by insert• ing before the period at the end the following: ", without regard to whether or not regulations to carry out the amendments have been promulgated by that date". (2) Sections 9510(b) and 9511(b) of the Consolidated Omnibus Budget Reconciliation Act of 1985 are each amended by inserting before the period at the end the following: ", without regard to whether or not regulations to carry out the amendment have been promulgated by that date". (e) HEALTH INSURING ORGANIZATIONS.—Section 9517(c)(2) of the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended by section 1895(c)(4) of the Tax Reform Act of 1986, is amended by adding at the end the following new subparagraph:

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