[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4028 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 4028

     To amend title XVIII of the Social Security Act to expand the 
definition of homebound for purposes of receiving home health services 
 under the medicare program to allow medicare beneficiaries to attend 
adult day care programs for treatment of Alzheimer's disease and other 
                              conditions.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 16, 2000

  Mr. Smith of New Jersey (for himself and Mr. Markey) 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 expand the 
definition of homebound for purposes of receiving home health services 
 under the medicare program to allow medicare beneficiaries to attend 
adult day care programs for treatment of Alzheimer's disease and other 
                              conditions.

    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 ``Alzheimer's Disease Medicare Home 
Health Care Benefit Clarification Act of 2000''.

SEC. 2. FINDINGS.

    (a) Findings.--Congress finds the following:
            (1) Home health services are a vital component of the 
        benefits that are furnished to beneficiaries under the medicare 
        program under title XVIII of the Social Security Act.
            (2) Home health services under the medicare program enable 
        homebound individuals who are at great risk for costly 
        institutionalized care to stay in their own homes and 
        communities.
            (3) Existing medicare regulations and practices 
        inadvertently penalize medicare beneficiaries (including those 
        with Alzheimer's disease, a related dementia, or both) who 
        participate in an adult day care program. Under those 
        regulations, if a medicare beneficiary attends a privately 
        funded adult day care program as part of their Alzheimer's 
        treatment regime, including an Alzheimer's treatment regime, 
        they may lose eligibility for the medicare home health benefit 
        because the absences of the individual from home are not 
        infrequent and short duration.
            (4) Adult day care programs can be a valuable and medically 
        beneficial part of a treatment regime for a person with 
        Alzheimer's disease or a related dementia. These programs can 
        provide structured activities and health monitoring to maintain 
        function, manage behavioral symptoms, and prevent health care 
        crises and premature institutionalization.
            (5) The Health Care Financing Administration and its 
        various medicare contractors and fiscal intermediaries have 
        misinterpreted the intent of Congress with respect to 
        eligibility for home health services. Participation by medicare 
        beneficiaries in privately funded adult day care programs is 
        not intended to preclude eligiblity for home health services 
        for those medicare beneficiaries under the medicare program.

SEC. 3. CLARIFICATION OF THE DEFINITION OF HOMEBOUND.

    (a) In General.--The last sentence of sections 1814(a) and 1835(a) 
of the Social Security Act (42 U.S.C. 1395f(a); 1395n(a)) are each 
amended by striking the period and inserting ``including participating 
in an adult day care program licensed by a State to furnish adult day 
care services in the State, for the purpose of therapeutic treatment 
for Alzheimer's disease or a related dementia, or for medical treatment 
furnished in an adult day care program.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to items and services provided on or after the date of enactment 
of this Act.
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