[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3004 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 3004

 To amend title XVIII of the Social Security Act to permit a Medicare 
  beneficiary enrolled in a Medicare+Choice plan to elect to receive 
   covered skilled nursing facility services at the skilled nursing 
facility in which the beneficiary or spouse resides or which is part of 
   the continuing care retirement community in which the beneficiary 
                                resides.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 4, 1999

 Mr. Brown of Ohio (for himself, Mr. Waxman, Mr. Stark, Mr. Frost, Mr. 
 Frank of Massachusetts, and Mr. Brady of Pennsylvania) 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 permit a Medicare 
  beneficiary enrolled in a Medicare+Choice plan to elect to receive 
   covered skilled nursing facility services at the skilled nursing 
facility in which the beneficiary or spouse resides or which is part of 
   the continuing care retirement community in which the beneficiary 
                                resides.

    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 Return To Home Act of 
1999''.

SEC. 2. PERMITTING MEDICARE+CHOICE BENEFICIARIES TO RETURN TO NURSING 
              HOME FOR RECEIPT OF COVERED SKILLED NURSING FACILITY 
              SERVICES.

    (a) In General.--Section 1852 of the Social Security Act (42 U.S.C. 
1395w-22) is amended by adding at the end the following new subsection:
    ``(l) Permitting Return to Certain Skilled Nursing Facilities for 
the Receipt of Covered Post-Hospital Extended Care Services.--
            ``(1) In general.--Insofar as a Medicare+Choice plan 
        provides for coverage of post-hospital extended care services, 
        the plan shall provide such coverage through a home skilled 
        nursing facility described in paragraph (2) and consistent with 
        paragraph (3) if the enrollee elects to receive such coverage 
        through such facility and the facility--
                    ``(A) has a contract with the Medicare+Choice 
                organization for the provision of such services; or
                    ``(B) agrees to accept substantially similar 
                payment under the same terms and conditions that apply 
                to similarly situated skilled nursing facilities that 
                are under contract with the Medicare+Choice 
                organization for the provision of such services and 
                through which the enrollee would otherwise receive such 
                services.
        The organization shall provide payment to the home skilled 
        nursing facility consistent with the contract described in 
        subparagraph (A) or the agreement described in subparagraph 
        (B), as the case may be.
            ``(2) Home skilled nursing facility.--For purposes of this 
        subsection, a home skilled nursing facility described in this 
        paragraph, with respect to an enrollee who is entitled to 
        receive post-hospital extended care services under a 
        Medicare+Choice plan, is any of the following skilled nursing 
        facilities:
                    ``(A) SNF residence at time of admission.--The 
                skilled nursing facility in which the enrollee resided 
                at the time of admission to the hospital preceding the 
                receipt of such post-hospital extended care services.
                    ``(B) SNF in continuing care retirement 
                community.--A skilled nursing facility that is 
                providing such services through a continuing care 
                retirement community (as defined in paragraph (5)) 
                which provided residence to the enrollee at the time of 
                such admission.
                    ``(C) SNF residence of spouse at time of 
                discharge.--The skilled nursing facility in which the 
                spouse of the enrollee is residing at the time of 
                discharge from such hospital.
            ``(3) No less favorable terms and conditions of coverage.--
        The coverage provided under this subsection (including scope of 
        services, cost-sharing, and other criteria of coverage) shall 
        be no less favorable to the enrollee than the coverage that 
        would be provided to the enrollee with respect to a skilled 
        nursing facility the post-hospital extended care services of 
        which are otherwise covered under the Medicare+Choice plan.
            ``(4) Construction.--Nothing in this subsection shall be 
        construed--
                    ``(A) as requiring coverage through a skilled 
                nursing facility that is not otherwise qualified to 
                provide benefits under part A for medicare 
                beneficiaries not enrolled in a Medicare+Choice plan; 
                and
                    ``(B) as preventing a skilled nursing facility from 
                refusing to accept, or imposing conditions upon the 
                acceptance of, an enrollee for the receipt of post-
                hospital extended care services.
            ``(5) Continuing care retirement community defined.--For 
        purposes of this subsection, the term `continuing care 
        retirement community' means, with respect to an enrollee in a 
        Medicare+Choice plan, an arrangement under which housing and 
        health-related services are provided (or arranged) through an 
        organization for the enrollee under an agreement that is 
        effective for the life of the enrollee or for a specified 
        period.''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to contracts entered into or renewed on or after the 
date of enactment of this Act.
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