[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4736 Introduced in House (IH)]







105th CONGRESS
  2d Session
                                H. R. 4736

 To amend title XVIII of the Social Security Act to ensure the proper 
 payment of approved nursing and paramedical education programs under 
                         the Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 8, 1998

   Mr. Bentsen (for himself, Mr. Crane, Mr. Ganske, Mr. Cardin, Mr. 
 Rangel, Mr. Stark, and Mr. Jefferson) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addition 
     to the Committee on Commerce, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to ensure the proper 
 payment of approved nursing and paramedical education programs under 
                         the Medicare Program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Nursing and Paramedical 
Education Act of 1998''.

SEC. 2. EXCLUSION OF NURSING AND PARAMEDICAL EDUCATION COSTS IN 
              CALCULATING MEDICARE+CHOICE PAYMENT RATE.

    (a) Excluding Costs in Calculating Payment Rate.--
            (1) In general.--Section 1853(c)(3)(C)(i) of the Social 
        Security Act (42 U.S.C. 1395w-23(c)(3)(C)(i)) is amended--
                    (A) by striking ``and'' at the end of subclause 
                (I);
                    (B) by striking the period at the end of subclause 
                (II) and inserting ``, and''; and
                    (C) by adding at the end the following new 
                subclause:
                                    ``(III) for costs attributable to 
                                approved nursing and paramedical 
                                education programs under section 
                                1861(v).''.
            (2) Effective date.--The amendments made by paragraph (1) 
        apply in determining the annual per capita rate of payment for 
        years beginning with 2000.
    (b) Payment to Hospitals of Nursing and Paramedical Education 
Program Costs for Medicare+Choice Enrollees.--Section 1886(d) of such 
Act (42 U.S.C. 1395ww(d)) is amended by adding at the end the following 
new paragraph:
            ``(12) Additional payment of nursing and paramedical 
        education program costs for managed care enrollees.--
                    ``(A) In general.--For portions of cost reporting 
                periods occurring on or after January 1, 2000, the 
                Secretary shall provide for an additional payment 
                amount to any subsection (d) hospital that has approved 
                nursing and paramedical education programs for each 
                discharge of any individual who is enrolled under a 
                risk-sharing contract with an eligible organization 
                under section 1876 and who is entitled to benefits 
                under part A or any individual who is enrolled with a 
                Medicare+Choice organization under part C.
                    ``(B) Determination of amount.--The amount of the 
                payment under this paragraph with respect to any 
                applicable discharge shall be equal to an amount 
                estimated by the Secretary of the average per discharge 
                amount that would otherwise have been paid to the 
                subsection (d) hospital to reflect the costs to the 
                hospital of approved nursing and paramedical education 
                programs under section 1861(v) if the individuals had 
                not been enrolled as described in subparagraph (A).''.
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