Page:United States Statutes at Large Volume 101 Part 2.djvu/939

 PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-145

"(ii) The aggregate amount of the State's medical assistance under this title for home and community-based services for individuals who have attained the age of 65 for the base year increased by a percentage which is equal to the lesser of 7 percent times the number of years beginning after the base year and ending before the waiver year involved or the sum of— "(I) the percentage increase (based on an appropriate market-basket index representing the costs of elements of 9ff' such services) between the base year and the waiver year involved, plus ' '"' j, " ^, "(ID the percentage increase between the base year and the waiver year involved in the number of residents in the State who have attained the age of 65, plus "(III) 2 percent for each year beginning after the base year and ending before the waiver year, "(iii) The Secretary shall develop and promulgate by regulation Regulations, (by not later than October 1, 1989)— "(I) a method, based on an index of appropriately weighted indicators of changes in the wages and prices of the mix of goods J«' t >8U:,|\ 9-ifia and services which comprise both skilled nursing facility services and intermediate care facility services (regardless of the source of payment for such services), for projecting the percentage increase for purposes of clause (i)(I); "(II) a method, based on an index of appropriately weighted indicators of changes in the wages and prices of the mix of goods and services which comprise home and community-based services (regardless of the source of payment for such services), for projecting the percentage increase for purposes of clause (iiXD; and "(III) a method for projecting, on a State specific basis, the percentage increase in the number of residents in each State who are over 75 years of age for any period. Effective on and after the date the Secretary promulgates the regulation under clause (iii), any reference in this subparagraph to the 'lesser of 7 percent' shall be deemed to be a reference to the 'greater of 7 percent'. "(C) In this paragraph: "(i) The term 'home and community-based services' includes services described in sections 1905(a)(7) and 1905(a)(8), services described in subsection (c)(4)(B), services described in paragraph (4)(B), personal care services, and services furnished pursuant to a waiver under subsection (c). "(iiXD Subject to subclause (II), the term 'base year' means the most recent year (ending before the date of the enactment of this subsection) for which actual final expenditures under this title have been reported to, and accepted by, the Secretary. "(II) For purposes of subparagraph (C), in the case of a State that does not report expenditures on the basis of the age categories described in such subparagraph for a year ending before the date of the enactment of this subsection, the term 'base year' means fiscal year 1989. "(iii) The term 'intermediate care facility services' does not include services furnished in an institution certified in accordance with section 1905(d). "(6)(A) A determination by the Secretary to deny a request for a waiver (or extension of waiver) under this subsection shall be subject to review to the extent provided under section 1116(b).

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