[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5042 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 5042

To amend title XVIII of the Social Security Act to protect the right of 
 a Medicare beneficiary enrolled in a Medicare+Choice plan to receive 
  services at a skilled nursing facility selected by that individual.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 27, 2000

Mr. Hobson (for himself and Ms. Pryce of Ohio) 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 protect the right of 
 a Medicare beneficiary enrolled in a Medicare+Choice plan to receive 
  services at a skilled nursing facility selected by that individual.

    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 ``Seniors Healing at Home Act of 
2000''.

SEC. 2. PROVIDING CHOICE FOR SKILLED NURSING FACILITY SERVICES UNDER 
              THE MEDICARE+CHOICE PROGRAM.

    (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) Return to Home Skilled Nursing Facilities for Covered Post-
Hospital Extended Care Services.--
            ``(1) Ensuring return to home snf.--
                    ``(A) In general.--A Medicare+Choice organization 
                offering a Medicare+Choice plan that provides for 
                coverage of post-hospital extended care services shall 
                provide for such coverage through a home skilled 
                nursing facility if the following conditions are met:
                            ``(i) Enrollee election.--The enrollee 
                        elects to receive such coverage through such 
                        facility.
                            ``(ii) SNF agreement.--The facility has a 
                        contract with the Medicare+Choice organization 
                        for the provision of such services, or the 
                        facility 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.
                    ``(B) Manner of payment to home snf.--The 
                organization shall provide payment to the home skilled 
                nursing facility consistent with the contract or the 
                agreement described in subparagraph (A)(ii), as the 
                case may be.
            ``(2) No less favorable coverage.--The coverage provided 
        under paragraph (1) (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.
            ``(3) Rule of construction.--Nothing in this subsection 
        shall be construed to do the following:
                    ``(A) To require 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.
                    ``(B) To prevent 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.
            ``(4) Definitions.--In this subsection:
                    ``(A) Home skilled nursing facility.--The term 
                `home skilled nursing facility' means, with respect to 
                an enrollee who is entitled to receive post-hospital 
                extended care services under a Medicare+Choice plan, 
                any of the following skilled nursing facilities:
                            ``(i) 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.
                            ``(ii) SNF in continuing care retirement 
                        community.--A skilled nursing facility that is 
                        providing such services through a continuing 
                        care retirement community (as defined in 
                        subparagraph (B)) which provided residence to 
                        the enrollee at the time of such admission.
                            ``(iii) 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.
                    ``(B) Continuing care retirement community 
                defined.--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 amendment made by subsection (a) applies 
with respect to contracts entered into or renewed on or after the date 
of enactment of this Act.
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