Page:United States Statutes at Large Volume 103 Part 3.djvu/177

 PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2245 area, eligible organizations with risk-sharing contracts under this section and enrolling individuals residing in that part of the service area are required to have an open enrollment period for individuals residing in the part of the service area who were enrolled under the contract as of the date of notice of such discontinued coverage. "(II) The open enrollment periods required under subclause (I) shall be for 30 days and shall begin 30 days sifter the date that the Secretary provides notice of such requirement. "(Ill) Enrollment under this clause shall be effective 30 days after the end of the open enrollment period, or, if the Secretary deter- mines that such date is not feasible, such other date as the Secretary specifies.". (2) EFFECTIVE DATE.— The amendments made by paragraph (1) shall take effect 60 days after the date of the enactment of this Act. SEC. 6207. EXTENSION OF EXPIRING AUTHORITIES. (a) DELAY IN EFFECTIVE DATE IN PHYSICIAN INCENTIVE RULES.— Section 9313(c)(2)(B) of the Omnibus Budget Reconciliation Act of 1986, as amended by section 4016 of the Omnibus Budget Reconcili- ation Act of 1987, is amended by striking "April 1, 1990" and inserting "April 1, 1991". (b) EXTENSION OF PROHIBITION ON COST SAVINGS POLICIES. BEFORE BEGINNING OF FISCAL YEAR.— Section 4039(d) of the Omnibus Budget Reconciliation Act of 1987, as amended by section 426(e) of the Medicare Catastrophic Coverage Act of 1988, is amended— (1) by striking "October 15, 1989" and inserting "October 15, 1990", and (2) by inserting "or in fiscal year 1991" after "fiscal year 1990". Subpart B—Technical and Miscellaneous Provisions SEC. 6211. MEDICARE HOSPITAL PATIENT PROTECTION AMENDMENTS. (a) SCOPE OF HOSPITAL RESPONSIBILITY FOR SCREENING.— Subsec- tion (a) of section 1867 of the Social Security Act (42 U.S.C. 1395dd) is amended by striking "department" the third place it appears and inserting the following: "department, including ancillary services routinely available to the emergency department,". (b) INFORMED REFUSALS OF TREATMENT OR TRANSFERS. —Subsection (b) of such section is amended— (1) in paragraph (2)— (A) by inserting "and informs the individual (or a person acting on the individual's behalf) of the risks and benefits to the individual of such examination and treatment," after "in that paragraph", (B) by striking "or treatment" and inserting "and treat- ment", and (C) by adding at the end the following new sentence: "The hospital shall take all reasonable steps to secure the individual's (or person's) written informed consent to refuse such examination and treatment."; and (2) in paragraph (3)— (A) by inserting "and informs the individual (or a person acting on the individual's behalf) of the risks and benefits to the individual of such transfer," after "with subsection (c)", and 42 USC 1395mm note. 42 USC 1320a-7a note. 42 USC 1395WW note.

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