Page:United States Statutes at Large Volume 102 Part 1.djvu/835

 PUBLIC LAW 100-360—JULY 1, 1988

102 STAT. 797

(J) Section 9414(b)(3) of the Omnibus Budget Reconciliation Act of 1986, as amended by section 4118(o)(l)(C) of OBRA, is amended by striking "nonfarm". (K) Section 4118(o)(2)(A) of OBRA is amended by inserting "each place it appears" before "and inserting". (L) Section 4118(p)(9) of OBRA is amended by striking "1925(a)" and "(4111(a))" and inserting "1923(a)" and "4211(a)", respectively. (M) Section 4118(p) of OBRA is amended by adding at the end the following new paragraph: "(11) Paragraph (5) of section 9432(c) of the Omnibus Budget Reconciliation Act of 1986 is amended to read as follows: " *(5) The Secretary shall submit an interim report on the results of the study, including an analysis of the geographic variations under paragraph (2), to the Congress not later than January 1, 1990, and shall report the final results of the study to the Congress not later than January 1, 1992.'.". (11) OMITTED SECTION.—(A) Part 2 of subtitle B of title IV of OBRA is amended by adding at the end the following new section:

100 Stat. 2064 101 Stat. 1330158.

42 USC i396s

42 USC 1396a note. Reports.

"SEC. 4119. STUDY OF MEANS OF RECOVERING COSTS OF NURSING FACILITY SERVICES FROM ESTATES OF BENEFICIARIES.

"The Secretary of Health and Human Services shall study the means of recovering amounts from estates of deceased medicaid beneficiaries (or the estates of the spouses of such deceased beneficiaries) to pay for the medical assistance for skilled nursing facility or intermediate care facility services furnished, under title XIX of the Social Security Act, to such medicaid beneficiaries. The Sec- Reports, retary shall report to Congress, not later than December 31, 1988, on such means, and include appropriate recommendations for changes in legislation.", (B) The table of contents of title IV of OBRA is amended by inserting after the item relating to section 4118 the following new item: "Sec. 4119. Study of means of recovering costs of nursing facility services from estates of beneficiaries.". (12)

MEDICAID CONFORMING AMENDMENT TO SECTION 40 1 4 OF

OBRA.—(A) Paragraph (5) of section 1903(m) of the Social Security Act (42 U.S.C. 1396b(m)) is amended to read as follows: "(5)(A) If the Secretary determines that an entity with a contract Contracts. under this subsection— "(i) fails substantially to provide medically necessary items and services that are required (under law or under the contract) to be provided to an individual covered under the contract, if the failure has adversely affected (or has substantial likelihood of adversely affecting) the individual; "(ii) imposes premiums on individuals enrolled under this subsection in excess of the premiums permitted under this title; "(iii) acts to discriminate among individuals in violation of the provision of paragraph (2)(A)(v), including expulsion or refusal to re-enroll an individual or engaging in any practice that would reasonably be expected to have the effect of denying or discouraging enrollment (except as permitted by this subsection) by eligible individuals with the organization whose medical condi-

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