Page:United States Statutes at Large Volume 86.djvu/1449

 86

STAT.]

1407

PUBLIC LAW 92-603-OCT. 30, 1972

"(1) such hospital has an agreement with the Secretary under section 1866, and "(2) the Secretary has received written assurances that such payment will be used by such fund solely for the improvement of care to patients in such hospital or for educational or charitable purposes and (B) the individuals who were furnished such services or any other persons will not be charged for such services (or if charged provision will be made for return for any moneys incorrectly collected)/' (8) Section 1842(a) of such Act is amended by inserting after "which involve payments for physicians' services" the following: "on a reasonable charge basis". (f) Section 1861(q) of such Act is amended by striking out the parenthetical phrase "(but not including services described in the last sentence of subsection (b)) " and inserting in lieu thereof "(but not including services described in subsection (b)(6)) ". (g) The amendments made by this section shall apply with respect to accounting periods beginning after June 30, 1978. ADVAXCE APPROVAL OF EXTENDED CARE A X D H O M E H E A L T H U N D E R MEDICARE

42 USC 1395CC.

42 USC 1395u.

42 USC 1395x.

Ante,

p. 1404.

Effective date.

COVERAGE

SEC. 228. (a) Section 1814 of the Social Security Act (as amended by section 227(b)(2) of this Act) is amended by adding at the end thereof the following new subsections:

Ante,

p. 1405.

Post,

p. 1425.

"Payment for Posthospital Extended Care Services " (h)(1) An individual shall be presumed to require the care specified in subsection (a)(2) ((.) of this section for purposes of making payment to an extended care facility (subject to the provisions of section 1812) for posthospital extended care services which are furnished by such facility to such individual if— " (A) the certification referred to in subsection (a)(2)(C) of this section is submitted prior to or at the time of admission of such individual to such extended care facility, " (B) such certification states that the medical condition of the individual is a condition designated in regulations, " (C) such certification is accompanied by a plan of treatment for providing such services, and " (D) there is compliance with such other requirements and procedures as may be specified in regulations, but only for services furnished during such limited periods of time with respect to such conditions of the individual as may be prescribed in regulations by the Secretary, taking into account the medical severity of such conditions, the degree of incapacity, and the minimum length of stay in an institution generally needed for such conditions, and such other factors affecting the type of care to be provided as the Secretary deems pertinent. "(2) If the Secretary determines with respect to a physician that such physician is submitting with some frequency (A) erroneous certifications that individuals have conditions designated in regulations as provided in ^this subsection or (B) plans for providing services which are inappropriate, the provisions of paragraph (1) shall not apply, after the effective date of such determination, in any case in which such physician submits a certification or plan referred to in subparagraph (A), (B), o r (C) of paragraph (1).

42 USC 139Sd.

Erroneous certification, nonapplicability.

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