Page:United States Statutes at Large Volume 102 Part 1.djvu/768

 102 STAT. 730

PUBLIC LAW 100-360—JULY 1, 1988 (b) IN-HOME CARE FOR CHRONICALLY DEPENDENT INDIVIDUAL DE-

PINED.—Section 1861 (42 U.S.C. 1395x), as amended by section 204(a)(2) of this Act, is amended by adding at the end the following new subsection: "In-Home Care; Chronically Dependent Individual "(IIXD The term 'in-home care' means the following items and services furnished, under the supervision of a roistered professional nurse, to a chronically dependent individual (as detined in paragraph (2)) during the period described in paragraph (4) by a home health agency or by others under arrangements with them made by such agency in a place of residence used as such individual's home: "(A) Services of a homemaker/home health aide (who has successfully completed a training program approved by the Secretary). "(B) Personal care services. "(C) Nursing care provided by a licensed professional nurse. "(2) The term 'chronically dependent individual' means an individual who— "(A) is dependent on a daily basis on a primary caregiver who is living with the individual and is assisting the individual without monetary compensation in the performance of at least 2 of the activities of daily living (described in paragraph (3)), and "(B) without such assistance could not perform such activities of daily living. "(3) The 'activities of daily living*, referred to in paragraph (2), are as follows: "(i) Eating, "(u) Bathing, "(iii) Dressing, "(iv) Toileting. "(v) Transferring in and out of a bed or in and out of a chair. "(4) The 12-month period described in this paragraph is the 1-year period beginning on the date that the Secretary determines that a chronically dependent individual either— "(A) has become entitled to benefits under section 1833(c) (relating to having incurred out-of-pocket part B cost sharing equal to the part B catastrophic limit), or "OB) has become entitled to have payments made for covered outpatient drugs under section 1834(c). In the case of an individual who qualifies under subparagraph (A) or (B) within 12 months after previously qualifying, the sul^equent qualification shall b ^ i n a new 12-month period under this paragraph. In the case of an individual enrolled in a buy-out plan (as defmed in section 1833(c)(5)(D)) or a drug buy-out plan (as defined in section 1834(c)(6)(D)), the Secretary shall establish such procedures as may be appropriate to identify individuals who are deemed to be described in subparagraph (A) or (B), respectively, for purposes of the provision of in-home care under the plan.". (c) PAYMENT.—Section 1833(a) (42 U.S.C. 13951(a)) is amended— (1) in paragraph (2), by inserting "(A)(ii)," after "subparagraphs" the first place it appears, (2) in paragraph (3), by striking "(D)" and inserting "(A)(ii), (D),",and (3) by adding at the end the following:

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