Page:United States Statutes at Large Volume 98 Part 1.djvu/1157

 PUBLIC LAW 98-369—JULY 18, 1984

98 STAT. 1109

(b) Section 1912(a) of such Act is amended by striking out "State 42 USC 1396k plan for medical assistance may" and inserting in lieu thereof "State plan for medical assistance shall". (c)(1) Except as provided in paragraph (2), the amendments made Effective date. 42 USC 1396a by this section shall become effective on October 1, 1984. (2) In the case of a State plan for medical assistance under title note. XIX of the Social Security Act which the Secretary of Health and 42 USC 1396 Human Services determines requires State legislation in order for the plan to meet the additional requirement imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet this additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. REQUIREMENTS FOR MEDICAL REVIEW AND INDEPENDENT PROFESSIONAL REVIEW UNDER MEDICAID

SEC. 2368. (a) Section 1902(a)(31) of the Social Security Act is 42 USC I396a. amended to read as follows: "(31) with respect to skilled nursing facility services (and with respect to intermediate care facility services, where the State plan includes medical assistance for such services) provide— "(A) with respect to each patient receiving such services, for a written plan of care, prior to admission to or authorization of benefits in such facility, in accordance with regulations of the Secretary, and for a regular program of independent professional review (including medical evaluation) which shall periodically review his need for such services; "(B) with respect to each skilled nursing or intermediate care facility within the State, for periodic onsite inspections of the care being provided to each person receiving medical assistance, by one or more independent professional review teams (composed of a physician or registered nurse and other appropriate health and social service personnel), including with respect to each such person (i) the adequacy of the services available to meet his current health needs and promote his maximum physical well-being, (ii) the necessity and desirability of his continued placement in the facility, and (iii) the feasibility of meeting his health care needs through alternative institutional or noninstitutional services; and pj J"(C) for full reports to the State agency by each independent professional review team of the findings of each inspection under subparagraph (B), together with any recommendations;". (b) Section 1902(a)(26) of such Act is amended to read as follows: "(26) if the State plan includes medical assistance for inpatient mental hospital services, provide— "(A) with respect to each patient receiving such services, for a regular program of medical review (including medical evaluation) of his need for such services, and for a written plan of care; "(Bj for periodic inspections to be made in all mental institutions within the State by one or more medical review

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