Page:United States Statutes at Large Volume 111 Part 1.djvu/495

 PUBLIC LAW 105-33 —AUG. 5, 1997 111 STAT. 471 "(G) with respect to items and services described in section 1861(s)(10)(A), the lesser of— "(i) the reasonable cost of such services, as determined under section 186 l(v), or "(ii) the customary charges with respect to such services, or, if such services are furnished by a public provider of services, or by another provider which demonstrates to the satisfaction of the Secretary that a significant portion of its patients are low-income (and requests that payment be made under this provision), free of charge or at nominal charges to the public, the amount determined in accordance with section 1814(b)(2);". (B) REQUIRING PAYME^^^ FOR ALL ITEMS AND SERVICES TO BE MADE TO AGENCY.— (i) IN GENERAL. —The first sentence of section 1842(b)(6) (42 U.S.C. 1395u(b)(6)) (as amended by section 4432(b)(2)) is amended— (I) by striking "and (E)" and inserting "(E)"; and (II) by striking the period at the end and inserting the following: ", and (F) in the case of home health services furnished to an individual who (at the time the item or service is furnished) is under a plan of care of a home heeilth agency, payment shall be made to the agency (without regard to whether or not the item or service was furnished by the agency, by others under arrangement with them made by the agency, or when any other contracting or consulting arrangement, or otherwise).". (ii) CONFORMING AMENDMENT.—Section 1832(a)(1) (42 U.S.C. 1395k(a)(l)) (as amended by section 4432(b)(5)(B)) is amended by striking "section 1842(b)(6)(E);" and inserting "subparagraphs (E) and (F) of section 1842(b)(6);". (C) EXCLUSIONS FROM COVERAGE.— Section 1862(a) (42 U.S.C. 1395y(a)) (as amended by sections 4319(b), 4432(b), 4507(a)(2)(B) and 4541(b)) is amended— (i) by striking "or" at the end of paragraph (19); (ii) by striking the period at the end of paragraph (20) and inserting "; or"; and (iii) by inserting after paragraph (20) the following: "(21) where such expenses are for home health services furnished to an individual who is under a plan of care of the home hegJth agency if the claim for payment for such services is not submitted by the agency.". (d) EFFECTIVE DATE.— Except as otherwise provided, the amendments made by this section shall apply to cost reporting periods beginning on or after October 1, 1999. (e) CONTINGENCY.— I f the Secretary of Health and Human Services for any reason does not establish and implement the prospective payment system for home health services described in section 1895(b) of the Social Security Act (as added by subsection (a)) for cost reporting periods described in subsection (d), for such cost reporting periods the Secretary shall provide for a reduction by 15 percent in the cost limits and per beneficiary limits described 42 USC 1395fff note. 42 USC 1395fff note.

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