Page:United States Statutes at Large Volume 117.djvu/2290

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2271

is amended by inserting ‘‘(which for purposes of this subparagraph does not include a nurse practitioner)’’ after ‘‘attending physician (as defined in section 1861(dd)(3)(B))’’. SEC. 409. RURAL HOSPICE DEMONSTRATION PROJECT.

(a) IN GENERAL.—The Secretary shall conduct a demonstration project for the delivery of hospice care to medicare beneficiaries in rural areas. Under the project medicare beneficiaries who are unable to receive hospice care in the facility for lack of an appropriate caregiver are provided such care in a facility of 20 or fewer beds which offers, within its walls, the full range of services provided by hospice programs under section 1861(dd) of the Social Security Act (42 U.S.C. 1395x(dd)). (b) SCOPE OF PROJECT.—The Secretary shall conduct the project under this section with respect to no more than 3 hospice programs over a period of not longer than 5 years each. (c) COMPLIANCE WITH CONDITIONS.—Under the demonstration project— (1) the hospice program shall comply with otherwise applicable requirements, except that it shall not be required to offer services outside of the home or to meet the requirements of section 1861(dd)(2)(A)(iii) of the Social Security Act; and (2) payments for hospice care shall be made at the rates otherwise applicable to such care under title XVIII of such Act. The Secretary may require the program to comply with such additional quality assurance standards for its provision of services in its facility as the Secretary deems appropriate. (d) REPORT.—Upon completion of the project, the Secretary shall submit a report to Congress on the project and shall include in the report recommendations regarding extension of such project to hospice programs serving rural areas.

42 USC 1395d note.

SEC. 410. EXCLUSION OF CERTAIN RURAL HEALTH CLINIC AND FEDERALLY QUALIFIED HEALTH CENTER SERVICES FROM THE PROSPECTIVE PAYMENT SYSTEM FOR SKILLED NURSING FACILITIES.

(a) IN GENERAL.—Section 1888(e)(2)(A) (42 U.S.C. 1395yy(e)(2)(A)) is amended— (1) in clause (i)(II), by striking ‘‘clauses (ii) and (iii)’’ and inserting ‘‘clauses (ii), (iii), and (iv)’’; and (2) by adding at the end the following new clause: ‘‘(iv) EXCLUSION OF CERTAIN RURAL HEALTH CLINIC AND FEDERALLY QUALIFIED HEALTH CENTER SERVICES.— Services described in this clause are— ‘‘(I) rural health clinic services (as defined in paragraph (1) of section 1861(aa)); and ‘‘(II) federally qualified health center services (as defined in paragraph (3) of such section); that would be described in clause (ii) if such services were furnished by an individual not affiliated with a rural health clinic or a federally qualified health center.’’. (b) EFFECTIVE DATE.—The amendments made by subsection (a) shall apply to services furnished on or after January 1, 2005.

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42 USC 1395yy note.

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