Sec. 223. Hospice payments for dual eligible individuals residing in long-term care facilities
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/bill/113/s/3009/is/section-223A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1888 of the Social Security Act ( 42 U.S.C. 1395yy ) is amended by adding at the end the following new subsection: For cost reporting periods beginning on or after January 1, 2016, the Secretary, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall establish procedures under which payments for room and board under the State Medicaid plan with respect to an applicable individual are made directly to the long-term care facility (as defined by the Secretary for purposes of title XIX) the individual is a resident of.
For purposes of the preceding sentence, the term applicable individual means an individual who is entitled to or enrolled for benefits under part A or enrolled for benefits under part B and is eligible for medical assistance for hospice care under a State plan under title XIX. . Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is amended— in paragraph (74), by striking and at the end; in paragraph (80), by striking and at the end; in paragraph (81), by striking the period at the end and inserting ; and ; and by inserting after paragraph
(81)the following new paragraph: provide that the State will make payments for room and board with respect to applicable individuals in accordance with section 1888(i). . Except as provided in subparagraph (B), the amendments made by paragraph
(1)take effect on January 1, 2016. In the case of a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) which the Secretary determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by paragraph (1), 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 these additional requirements 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 enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature.
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Sec. 223
Hospice payments for dual eligible individuals residing in long-term care facilities
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