Page:United States Statutes at Large Volume 101 Part 2.djvu/909

 PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-115

"(D) drugs and biologicals furnished for therapeutic purposes (which cannot, as determined in accordance with regulations, be self-administered), "(E) individualized activity therapies that are not primarily recreational or diversionary, "(F) family counseling (the primary purpose of which is treatment of the individual's condition), "(G) patient training and education (to the extent that train,y, ing and educational activities are closely and clearly related to 'IT individual's care and treatment), "(H) diagnostic services, and "(I) such other items and services as the Secretary may provide (but in no event to include meals and transportation); that are reasonable and necessary for the diagnosis or active treatment of the individual's condition, reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization, and furnished pursuant to such guidelines relating to frequency and duration of services as the Secretary shall by regulation establish (taking into account accepted norms of medical practice and the reasonable expectation of patient improvement). (3) A program described in this paragraph is a program which is hospital-based or hospital-affiliated (as defined by the Secretary) and which is a distinct and organized intensive ambulatory treatment service offering less than 24-hour-daily care.". (3) Section 1835(a)(2) of such Act (42 U.S.C. 1395n(a)(2)) is amended— (A) by striking "and" at the end of subparagraph (D); (B) by striking the period at the end of subparagraph (E) and inserting "; and"; and (C) by inserting sifter subparagraph (E) the following new subparagraph: "(F) in the case of partial hospitalization services, (i) the individual would require inpatient psychiatric care in the ef absence of such services, (ii) an individualized, written plan for furnishing such services has been established by a physician and is reviewed periodically by a physician, and tifi (iii) such services are or were furnished while the individual is or was under the care of a physician.". &1 (4) Section 1833(c) of such Act, as amended by subsection (a), is further amended at the end thereof by inserting "or partial hospitalization services that are not directly provided by a ph3rsician" before the period. (c) EFFECTIVE DATE; IMPLEMENTATION.—

(1) The amendment made b^ subsection (a)(1) shall apply with respect to calendar years beginning with 1988; except that with respect to 1988, any reference in section 1833(c) of the Social Security Act, as amended by subsection (a), to "$1375.00" is deemed a reference to "$562.50". The amendment made by subsection (a)(2) shall apply to services furnished on or after January 1, 1989. (2)(A) The amendments made by subsection (b) shall become effective on the date of enactment of this Act. (B) The Secretary of Health and Human Services shall implement the amendments made by subsection (b) so as to ensure that there is no additional cost to the medicare program by reason of such amendments.

42 USC 1395/ note.

42 USC 1395x note.

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