Page:United States Statutes at Large Volume 95.djvu/834

 95 STAT. 808

42 USC 1396a. Effective date. 42 USC 1396a note.

PUBLIC LAW 97-35—AUG. 13, 1981 "(iv) if such medical assistance includes services in institutions for mental diseases or intermediate care facility services for the mentally retarded (or both) for any such group, it also must include for all groups covered at least the care and services listed in paragraphs (1) through (5) and (17) of section 1905(a) or the care and services listed in any 7 of the paragraphs numbered (1) through (17) of such section; and "(D) for the inclusion of home health services for any individual who, under the State plan, is entitled to skilled nursing facility services;". (b) Section 1902(a)(13) of such Act is amended by striking out subparagraphs (A), (B), and (C). (c) The amendments made by this section shall become effective on the date of the enactment of this Act. FLEXIBILITY IN COVERAGE OF INDIVIDUALS AGED 18-20

42 USC I396d.

Effective date. 42 USC 1396a note.

SEC. 2172. (a) Paragraph (2) of section 19020)) of the Social Security Act is amended to read as follows: "(2) any age requirement which excludes any individual who has not attained the age of 19 and is a dependent child under part A of title IV;". (b)(1) Clause (i) of section 1905(a) of such Act is amended to read as follows: "(i) under the age of 21, or, at the option of the State, under the age of 20, 19, or 18 as the State may choose, or any reasonable category of such individuals,". (2) Section 1905(a)(ii) of such Act is amended by striking out ", except for section 406(a)(2),". (c) The amendments made by this section shall become effective on the date of the enactment of this Act. REIMBURSEMENT OF HOSPITALS

42 USC 1396a.

42 USC I395x.

SEC. 2173. (a)(1) Section 1902(a)(13) of the Social Security Act is amended— (A) by striking out subparagraph (D); (B) in subparagraph (E)— (i) by striking out "skilled nursing facility and intermediate care facility" and inserting in lieu thereof "hospital, skilled nursing facility, and intermediate care facility"; (ii) by inserting "and which, in the case of hospitals, take into account the situation of hospitals which serve a disproportionate number of low income patients with special needs and provide, in the case of hospital patients receiving services at an inappropriate level of care (under conditions similar to those described in section 1861(v)(l)(G)), for lower reimbursement rates reflecting the level of care actuallv received (in a manner consistent with section 1861(v)(l)(G))' after "determined in accordance with methods and standards developed by the State"; (iii) by inserting before the first semicolon the following: "and to assure that individuals eligible for medical assistance have reasonable access (taking into account geographic location and reasonable travel time) to inpatient hospital services of adequate quality"; and

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