Page:United States Statutes at Large Volume 104 Part 2.djvu/451

 PUBLIC LAW 101-508—NOV. 5, 1990 104 STAT. 1388-43 included in the enactment of the Omnibus Budget Reconciliation Act of 1989. SEC. 4006. HOSPICE BENEFIT EXTENSION. (a) IN GENERAL.— Section 1812 (42 U.S.C. 1395d) is amended— (1) in subsection (a)(4), by striking "90 days each" and all that follows through "with respect to" and inserting the following: "90 days each, a subsequent period of 30 days, and a subsequent extension period with respect to"; and (2) in subsection (d)— (A) in paragraph (1), by striking "90 days each" and all that follows through "lifetime" and inserting the following: "90 days each, a subsequent period of 30 days, and a subsequent extension period during the individual's lifetime", and (B) in paragraph (2)(B), by striking "a 90- or 30-day period," and inserting "a 90- or 30-day period or a subsequent extension period,". (b) CONFORMING AMENDMENT.— Section 1814(a)(7)(A) (42 U.S.C. 1395f(a)(7)(A)) is amended— (1) in clause (i), by striking "and" at the end; (2) in clause (ii), by striking the semicolon at the end and inserting ", and"; and (3) by adding at the end the following new clause: "(iii) in a subsequent extension period, the medical director or physician described in clause (i)(II) recertifies at the beginning of the period that the individual is terminally ill;". (c) EFFECTIVE DATE.— The amendments made by this section shall apply with respect to care and services furnished on or after January 1, 1990. SEC. 4007. FREEZE IN PAYMENTS UNDER PART A THROUGH DECEMBER 31. (a) IN GENERAL. — Notwithstanding any other provision of law, for purposes of determining the amount of payment for items or services under part A of title XVIII of the Social Security Act (including payments under section 1886 of such Act attributable to or allocated under such part) during the period described in subsection (b): (1) The market basket percentage increase (described in section 1886(b)(3)(B)(iii) of the Social Security Act) shall be deemed to be 0 for discharges occurring during such period. (2) The percentage increase or decrease in the medical care expenditure category of the consumer price index applicable under section 1814(i)(2)(B) of such Act shall be deemed to be 0. (3) The area wage index applicable to a subsection (d) hospital under section 1886(d)(3)(E) of such Act shall be deemed to be the area wage index applicable to such hospital as of September 30, 1990. (4) The percentage change in the consumer price index applicable under section 1886(h)(2)(D) of such Act shall be deemed tobe0. (b) DESCRIPTION OF PERIOD. —The period referred to in subsection (a) is the period beginning on October 21, 1990, and ending on December 31, 1990. 42 USC 1395d note. 42 USC 1395WW note.

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