Page:United States Statutes at Large Volume 102 Part 1.djvu/725

 PUBLIC LAW 100-360—JULY 1, 1988

102 STAT. 687

"(3)(A) The amount payable for extended care services furnished an individual in any calendar year shall be reduced by the coinsurance amount (promulgated under subparagraph (Q for that year) for each day (before the 9th day) on which he is furnished such services during the year. "(B) Before September 1 of each year (beginning with 1988), the Secretary shall estimate the national average per diem reasonable cost recognized under this title for extended care services which will be furnished in the succeeding calendar year. "(C) The Secretary shall, in September of each year (b^;inning with 1988) promulgate the coinsurance amount which shall apply to extended care services furnished in the succeeding year. Such amount shall be equal to 20 percent of the national average per diem cost estimated under subparagraph (B) in that year. If the coinsurance amount determined under the preceding sentence is not a multiple of 50 cents, it shall be rounded to the nearest multiple of 50 cents (or, if it is a multiple of 25 cents but not a multiple of 50 cents, to the next higher multiple of 50 cents)."; and (2) by striking paragraph (3) of subsection (b). SEC. 103. PART A PREMIUM FOR MEDICARE BUY-INS. Subsection (d) of section 1818 (42 U.S.C. 13951) is amended to read 42 USC i395i-2. as follows: "(d)(1) The Secretary shall, during September of each year (beginning with 1988), estimate the monthly actuarial rate for months in the succeeding year. Such actuarial rate shall be one-twelfth of the amount which the Secretary estimates (on an average, per capita basis) is equal to 100 percent of the benefits and administrative costs which will be payable from the Federal Hospital Insurance Trust Fund for services performed and related administrative costs incurred in the succeeding year with respect to individuals age 65 and over who will be entitled to benefits under this part during that entire year. "(2) The Secretary shall, during September of each year determine and promulgate the dollar amount which shall be applicable for premiums for months occurring in the following year. Such amount shall be equal to the monthly actuarial rate determined under paragraph (1) for that following year. Any amount determined under the preceding sentence which is not a multiple of $1 shall be rounded to the nearest multiple of $1 (or, if it is a multiple of 50 cents but not a multiple of $1, to the next higher multiple of $1). "(3) Whenever the Secretary promulgates the dollar amount Public which shall be applicable as the montibly premium under this information. section, he shall, at the time such promulgation is announced, issue a public statement setting forth the actuarial assumptions and bases employed by him in arriving at the amount of an adequate actuarial rate for individuals 65 and older as provided in paragraph (1).". SEC 104. EFFECTIVE DATES, TRANSITION, AND CONFORMING AMENDBIENTS. (a) EJFPECTIVE DATE.—

42 USC i395d

(1) IN GENERAL.—Except as provided in paragraphs (2) and (3), note. the amendments made by this subtitle shall take effect on January 1, 1989, and shall apply— (A) to the inpatient hospital deductible for 1989 and succeeding years.

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