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Code · STATUTES-AT-LARGE · Vol. 79 STAT. · July 30, 1965 · Public Law 89–97

Public Law 89–97.

75,193 words·~342 min read·/statutes-at-large/vol-79/public-law-89-97

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

79 Stat. 286 Public Law 89–97 AN ACT To provide a hospital insurance program for the aged under the Social Security Act with a supplementary medical benefits program and an expanded program of medical assistance, to Increase benefits under the Old-Age, Survivors, and Disability Insurance System, to improve the Federal-State public assistance programs, and for other purposes. July 30, 1965[[H. R. 6675](/us/bill/89/hr/6675)] *Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled*, Social Security Amendments of 1965.
That this Act, with the following table of contents, may be cited as the “Social Security Amendments of 1965”. TABLE OF CONTENTS Title I— Health Insurance for the Aged and Medical Assistance Sec. 100. Short title. part i— health insurance benefits for the aged Sec. 101. Entitlement to hospital insurance benefits. Sec. 102. Hospital insurance benefits and supplementary medical insurance benefits. Title XVIII— Health Insurance for the Aged Sec. 1801. Prohibition against any Federal interference.
Sec. 1802. Free choice by patient guaranteed. Sec. 1803. Option to individuals to obtain other health insurance protection. part a— hospital insurance benefits fob the aged Sec. 1811. Description of program. Sec. 1812. Scope of benefits. Sec. 1813. Deductibles and coinsurance. Sec. 1814. Conditions of and limitations on payment for services.
(a)Requirement of requests and certifications.
(b)Reasonable cost of services.
(e)No payments to Federal providers of services.
(d)Payments for emergency hospital services.
(e)Payment for inpatient hospital services prior to notification of non-eligibility.
(f)Payment for certain emergency hospital services furnished outside the United States. Sec. 1815. Payment to providers of services Sec. 1818. Use of public agencies or private organizations to facilitate payment to providers of services. Sec. 1817. Federal hospital insurance trust fund. part b— supplementary medical insurance benefits fob the aged Sec. 1831. Establishment of supplementary medical insurance program for the aged. Sec. 1832. Scope of benefits. Sec. 1833. Payment of benefits. Sec. 1834. Limitation on home health services. Sec. 1835. Procedure for payment of claims of providers of services Sec. 1838. Eligible individuals. Sec. 1837. Enrollment periods. Sec. 1838. Coverage period. Sec. 1830. Amounts of premiums. Sec. 1840. Payment of premiums. Sec. 1841. Federal supplementary medical insurance trust fund. Sec. 1842. Use of carriers for administration of benefits. Sec. 1843. State agreements for coverage of eligible Individuals who are receiving money payments under public assistance programs. Sec. 1844. Appropriations to cover Government contributions and contingency reserve. 79 Stat. 287 TABLE OF CONTENTS—Continued Title XVIII— Health Insurance for the Aged—Continued part c— miscellaneous provisions Sec. 1861. Definitions of services, institutions, etc.
(a)Spell of Illness.
(b)Inpatient hospital services.
(c)Inpatient psychiatric hospital services.
(d)Inpatient tuberculosis hospital services.
(e)Hospital.
(f)Psychiatric hospital.
(g)Tuberculosis hospital.
(h)Extended care services.
(i)Post-hospital extended care services.
(j)Extended care facility.
(k)Utilization review.
(l)Agreements for transfer between extended care facilities and hospitals.
(m)Home health services.
(n)Post-hospital home health services.
(o)Home health agency.
(p)Outpatient hospital diagnostic services.
(q)Physicians’ services.
(r)Physician.
(s)Medical and other health services.
(t)Drugs and biologicals.
(u)Provider of services.
(v)Reasonable cost.
(w)Arrangements for certain services.
(x)State and United States.
(y)Post-hospital extended care in Christian Science extended care facilities. Sec. 1862. Exclusions from coverage. Sec. 1863. Consultation with State agencies and other organizations to develop conditions of participation for providers of services. Sec. 1864. Use of State agencies to determine compliance by providers of services with conditions of participation. Sec. 1865. Effect of accreditation. Sec. 1866. Agreements with providers of services. Sec. 1867. Health insurance benefits advisory council. Sec. 1868. National medical review committee. Sec. 1869. Determinations; appeals. Sec. 1870. Overpayments on behalf of individuals. Sec. 1871. Regulations. Sec. 1872. Application of certain provisions of title II. Sec. 1873. Designation of organization or publication by name. Sec. 1874. Administration. Sec. 1875. Studies and recommendations. Sec. 103. Transitional provision on eligibility of presently uninsured individuals for hospital insurance benefits. Sec. 104. Suspension in case of aliens; persons convicted of subversive activities. Sec. 105. Railroad retirement amendments. Sec. 106. Medical expense deduction. Sec. 107. Receipts for employees must show taxes separately. Sec. 108. Technical and administrative amendments relating to trust funds. Sec. 109. Advisory council on social security. Sec. 110. Meaning of term “Secretary”, Sec. 111. Role of the Railroad Retirement Board in the administration of hospital insurance for the aged. 79 Stat. 288 TABLE OF CONTENTS—Continued Title XVIII— Health Insurance for the Aged—Continued part 2— grants to states for medical assistance programs Sec. 121. Establishment of programs. Title XIX— Grants to States for Medical Assistance Programs Sec. 1901. Appropriation. Sec. 1902. State plans for medical assistance. Sec. 1903. Payment to States. Sec. 1904. Operation of State plans. Sec. 1905. Definitions. Sec. 122. Payment by States of premiums for supplementary medical insurance. Title II— Other Amendments Relating to Health Care part 1— maternal and child health and crippled children’s services Sec. 201. Increase in maternal and child health services. Sec. 202. Increase in crippled children’s services. Sec. 203. Training of professional personnel for the care of crippled children. Sec. 204. Payment for inpatient hospital services. Sec. 205. Special project grants for health of school and preschool children. Sec. 206. Evaluation and report. Sec. 207. Increase in child welfare services. Sec. 208. Day care services. part 2— implementation of mental retardation planning Sec. 211. Authorization of appropriations. part 3— public assistance amendments relating to health care Sec. 221. Removal of limitations on Federal participation in assistance to individuals with tuberculosis or mental disease. Sec. 222. Amendment to definition of medical assistance for the aged. part 4— miscellaneous amendments relating to health care Sec. 231. Health study of resources relating to children’s emotional Illness. Title III— Social Security Amendments Sec. 300. Short title. Sec. 301. Increase in old-age, survivors, and disability insurance benefits. Sec. 302. Computation and recomputation of benefits. Sec. 303. Disability insurance benefits. Sec. 304. Payment of disability insurance benefits after entitlement to other monthly insurance benefits. Sec. 305. Disability insurance trust fund. Sec. 306. Payment of child’s insurance benefits after attainment of age 18 in case of child attending school. Sec. 307. Reduced benefits for widows at age 60. Sec. 308. Wife’s and widow’s benefits for divorced women. Sec. 309. Transitional insured status. Sec. 310. Increase in amount an Individual is permitted to earn without suffering full deductions from benefits. Sec. 311. Coverage for doctors of medicine. Sec. 312. Gross Income of farmers. Sec. 318. Coverage of tips. Sec. 314. Inclusion of Alaska among States permitted to divide their retirement systems. 79 Stat. 289 TABLE OF CONTENTS—Continued Title III— Social Security Amendments—Continued Sec. 315. Additional period for electing coverage under divided retirement system. Sec. 316. Employees of nonprofit organizations. Sec. 317. Coverage of temporary employees of the District of Columbia. Sec. 318. Coverage for certain additional hospital employees in California. Sec. 319. Tax exemption for religious groups opposed to insurance. Sec. 320. Increase of earnings counted for benefit and tax purposes. Sec. 321. Changes in tax schedules. Sec. 322. Reimbursement of trust funds for cost of noncontributory military service credits. Sec. 323. Adoption of child by retired worker. Sec. 324. Extension of period for filing proof of support and applications for lump-sum death payment. Sec. 325. Treatment of certain royalties for retirement test purposes. Sec. 326. Amendments preserving relationship between railroad retirement and old-age, survivors, and disability insurance systems. Sec. 327. Technical amendment relating to meetings of board of trustees of the old-age, survivors, and disability insurance trust funds. Sec. 328. Applications for benefits. Sec. 329. Underpayments. Sec. 330. Payments to two or more individuals of the same family. Sec. 331. Validating certificates filed by ministers. Sec. 332. Determination of attorneys’ fees in court proceedings under title 11. Sec. 333. Continuation of widow’s and widower’s insurance benefits after remarriage. Sec. 334. Changes in definitions of wife, widow, husband, and widower. Sec. 335. Reduction of benefits on receipt of workmen’s compensation. Sec. 336. Payment of costs of rehabilitation services from the trust funds. Sec. 337. Teachers in the State of Maine. Sec. 338. Modification of agreement with North Dakota and Iowa with respect to certain students. Sec. 339. Qualification of children not qualified under State law. Sec. 340. Disclosure, under certain circumstances, to courts and interested welfare agencies of whereabouts of individuals. Sec. 341. Additional period for filing of ministers certificates. Sec. 342. Rectifying error in interpreting law with respect to certain school employees in Alaska. Sec. 343. Continuation of child’s insurance benefits after adoption by brother or sister. Sec. 344. Disability insurance benefits for the blind: special provisions. Title IV— Public Assistance Amendments Sec. 401. Increased Federal payments under public assistance titles of the Social Security Act Sec. 402. Protective payments. Sec. 403. Disregarding certain earnings in determining need under assistance programs for the aged, blind, and disabled. Sec. 404. Administrative and judicial review of public assistance determinations. Sec. 405. Maintenance of State public assistance expenditures. Sec. 406. Disregarding OASDI benefit increase, and child’s insurance benefit payments beyond age 18, to the extent attributable to retroactive effective date. Sec. 407. Extension of grace period for disregarding certain income for States where legislature has not met in regular session. Sec. 408. Technical amendments relating to public assistance programs. Sec. 409. Eligibility of children over age 18 attending school. Sec. 410. Disregarding certain earnings in determining need of certain dependent children. Sec. 411. Federal share of public assistance expenditures. 79 Stat. 290 TITLE I— HEALTH INSURANCE FOR THE AGED AND MEDICAL ASSISTANCE short title Sec. 100. Health Insurance for the Aged Act. This title may be cited as the “Health Insurance for the Aged Act”. Part 1— Health Insurance Benefits for the Aged entitlement to hospital insurance benefits Sec. 101. [53 Stat. 1362](/us/stat/53/1362).[42 USC 401–425](/us/usc/t42/s401–425). Title II of the Social Security Act is amended by adding at the end thereof the following new section: " “entitlement to hospital insurance benefits “Sec. 226.
(a)Every individual who— “(1) has attained the age of 65, and “(2) is entitled to monthly insurance benefits under section [42 USC 402](/us/usc/t42/s402).202 or is a qualified railroad retirement beneficiary, shall be entitled to hospital insurance benefits under part A of title *Post*, p. 291.XVIII for each month for which he meets the condition specified in paragraph (2), beginning with the first month after June 1966 for which he meets the conditions specified in paragraphs
(1)and (2). “(b) For purposes of subsection (a)— “(1) entitlement of an individual to hospital insurance benefits for a month shall consist of entitlement to have payment made under, and subject to the limitations in, part A of title XVIII on his behalf for inpatient hospital services, post-hospital extended care services, post-hospital home health services, and outpatient hospital diagnostic services (as such terms are defined in part C of title XVIII) furnished him in the United States (or outside the United States in the case of inpatient hospital services furnished under the conditions described in section 1814(f)) during such month; except that
(A)no such payment may be made for post-hospital extended care services furnished before January 1967, and
(B)no such payment may be made for post-hospital extended care services or post-hospital home health services unless the discharge from the hospital required to qualify such services for payment under part A of title XVIII occurred after June 30, 1966, or on or after the first day of the month in which he attains age 65, whichever is later; and “(2) an individual shall be deemed entitled to monthly insurance benefits under section 202, or to be a qualified railroad retirement beneficiary, for the month in which he died if he would have been entitled to such benefits, or would have been a qualified railroad retirement beneficiary, for such month had he died in the next month. “(c) For purposes of this section, the term ‘qualified railroad retirement beneficiary’ means an individual whose name has been certified to the Secretary by the Railroad Retirement Board under *Post*, pp. 335, 340.section 21 of the Railroad Retirement Act of 1937. An individual shall cease to be a qualified railroad retirement beneficiary at the close of the month preceding the month which is certified by the 79 Stat. 291Railroad Retirement Board as the month in which he ceased to meet the requirements of section 21 of the Railroad Retirement Act of 1937.*Post*, pp. 335, 340. “(d) For entitlement to hospital insurance benefits in the case of certain uninsured individuals, see section 103 of the Social Security Amendments of 1965.” " hospital insurance benefits and supplementary medical insurance benefits Sec. 102.
(a)The Social Security Act is amended by adding after title XVII the following new title:[42 USC 1305](/us/usc/t42/s1305). " “TITLE XVIII— HEALTH INSURANCE FOR THE AGED “prohibition against any federal interference “Sec. 1801. Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person. “free choice by patient guaranteed “Sec. 1802. Any individual entitled to insurance benefits under this title may obtain health services from any institution, agency, or person qualified to participate under this title if such institution, agency, or person undertakes to provide him such services. “option to individuals to obtain other health insurance protection “Sec. 1803. Nothing contained in this title shall be construed to preclude any State from providing, or any individual from purchasing or oilier wise securing, protection against the cost of any health services. “Part A— Hospital Insurance Benefits for the Aged “description of program “Sec. 1811. The insurance program for which entitlement is established by section 226 provides basic protection against the costs of hospital *Ante*, p. 290.and related post-hospital services in accordance with this part for individuals who are age 65 or over and are entitled to retirement [42 USC 401–425](/us/usc/t42/s401–425).benefits under title II of this Act or under the railroad retirement system. “scope of benefits “Sec. 1812.
(a)The benefits provided to an individual by the insurance program under this part shall consist of entitlement to have payment made on his behalf (subject to the provisions of this part) for— “(1) inpatient hospital services for up to 90 days during any spell of illness; 79 Stat. 292 “(2) post-hospital extended care services for up to 100 days during any spell of illness; “(3) *Post* p. 320. post-hospital home health services for up to 100 visits (during the one-year period described in section 1861(h)) after the beginning of one spell of illness and before the beginning of the next; and “(4) outpatient hospital diagnostic services. “(b) Payment under this part for services furnished an individual during a spell of illness may not (subject to subsection (c)) be made for— “(1) inpatient hospital services furnished to him during such spell after such services have been furnished to him for 90 days (luring such spell; “(2) post-hospital extended care services furnished to him during such spell after such services have been furnished to him for 100 days during such spell; or “(3) inpatient psychiatric hospital services furnished to him after such services have been furnished to him for a total of 190 days during his lifetime. “(c) If an individual is an inpatient of a psychiatric hospital or a tuberculosis hospital on the first day of the first month for which lie is entitled to benefits under this part, the days on which he was an inpatient of such a hospital in the 90-day period immediately before such first day shall be included in determining the 90-day limit under subsection (b)(1)(but not in determining the 190-day limit under subsection (b)(3)). “(d) Payment under this part may be made for post-hospital home health services furnished an individual only during the one-year period described in section 1861
(n)following his most recent hospital discharge which meets the requirements of such section, and only for the first 100 visits in such period. The number of visits to be charged for purposes of the limitation in the preceding sentence, in connection with items or services described in section 1861 (m), shall be determined in accordance with regulations. “(e) For purposes of subsections (b), (c), and (d), inpatient hospital services, inpatient psychiatric hospital services, post-hospital extended care services, and post-hospital home health services shall be taken into account only if payment is or would be, except for this section or the failure to comply with the request and certification requirements of or under section 1814(a), made with respect to such services under this part. “(f) *Post*, p. 313. For definition of ‘spell of illness’, and for definitions of other terms used in this part, see section 1861. “deductibles and coinsurance “Sec. 1813. Inpatient hospital services.
(1)The amount payable for inpatient hospital services furnished an individual during any spell of illness shall be reduced by a deduction equal to the inpatient hospital deductible or, if less, the charges imposed with respect to such individual for such services, except that, if the customary charges for such services are greater than the charges so imposed, such customary charges shall be considered to be the charges so imposed. Such amount shall be further reduced by a coinsurance amount equal to one-fourth of the 79 Stat. 293inpatient hospital deductible for each day (before the 91st day) on which such individual is furnished such services during such spell of illness after such services have been furnished to him for 60 days during such spell. “(2) The amount payable for outpatient hospital diagnostic Outpatient hospital diagnostic services.services furnished an individual during a diagnostic study shall be reduced by a deduction equal to the sum of
(A)one-half of the inpatient hospital deductible which is applicable to spells of illness beginning in the same calendar year as such diagnostic study and
(B)20 per centum of the remainder of such amount. For purposes of the preceding sentence, a diagnostic study for any individual consists of the outpatient hospital diagnostic services provided by (or under arrangements made by) the same hospital during the 20-day period beginning on the first day (not included in a previous diagnostic study) on which he is entitled to hospital insurance benefits under section 226 and on which outpatient hospital diagnostic services are *Ante*, p. 290.furnished him. “(3) The amount payable to any provider of services under this part, for services furnished an individual during any spell of illness shall be further reduced by an amount equal to the cost of the first three pints of whole blood furnished to him as part of such services during such spell of illness. “(4) The amount payable for post-hospital extended care services furnished an individual during any spell of illness shall lie reduced by a coinsurance amount equal to one-eighth of the inpatient hospital deductible for each day (before the 101st day) on which he is furnished such services after such services have been furnished to him for 20 days during such spell. “(b)
(1)The inpatient hospital deductible which shall be applicableInpatient hospital deductible. for the purposes of subsection
(a)shall be $40 in the case of any spell of illness or diagnostic study beginning before 1969. “(2) The Secretary shall, between July 1 and October 1 of 1968, and of each year thereafter, determine and promulgate the inpatient hospital deductible which shall be applicable for the purposes of subsection
(a)in the case of any spell of illness or diagnostic study beginning during the succeeding calendar year. Such inpatient hospital deductible shall be equal to $40 multiplied by the ratio of
(A)the current average per diem rate for inpatient hospital services for the calendar year preceding the promulgation, to
(B)the current average per diem rate for such services for 1966. Any amount determined under the preceding sentence which is not a multiple of $4 shall be rounded to the nearest multiple of $4 (or, if it is midway between two multiples of $4, to the next, higher multiple of $4). The current average per diem rate for any year shall be determined by the Secretary on the basis of the best information available to him (at the time the determination is made) as to the amounts paid under this part on account of inpatient hospital services furnished during such year, by hospitals which have agreements in effect under section 1866, to individuals who are entitled *Post*, p. 327.to hospital insurance benefits under section 226, plus the amount which would have been so paid but for subsection (a)(1) of this section. 79 Stat. 294 “conditions of and limitations on payment for services “Requirement of Requests and Certifications “Sec. 1814.
(a)Except as provided in subsection (d), payment for services furnished an individual may be made only to providers of services which are eligible therefor under section 1866 and only *Post*, p. 327.if— “(1) written request, signed by such individual except in cases in which the Secretary finds it impracticable for the individual to do so, is filed for such payment in such form, in such manner, within such time, and by such person or persons as the Secretary may by regulation prescribe; “(2) a physician certifies (and recertifies, where such services are furnished over a period of time, in such cases, with such frequency, and accompanied by such supporting material, appropriate to the case involved, as may be provided by regulations, except that the first of such recertifications shall be required in each case of inpatient hospital services not later than the 20th day of such period) that— “(A) in the case of inpatient hospital services (other than inpatient psychiatric hospital services and inpatient tuberculosis hospital services), such services are or were required to be given on an inpatient basis for such individual’s medical treatment, or that inpatient diagnostic study is or was medically required and such services are or were necessary for such purpose; “(B) in the case of inpatient psychiatric hospital services, such services are or were required to be given on an inpatient basis, by or under the supervision of a physician, tor the psychiatric treatment of an individual; and
(i)such treatment can or could reasonably be expected to improve the condition for which such treatment is or was necessary or
(ii)inpatient diagnostic study is or was medically required and such services are or were necessary for such purposes; “(C) in the case of inpatient tuberculosis hospital services, such services are or were required to be given on an inpatient basis, by or under the supervision of a physician, for the treatment of an individual for tuberculosis; and such treatment can or could reasonably be expected to
(i)improve the condition for which such treatment is or was necessary or
(ii)render the condition noncommunicable; “(D) in the case of post-hospital extended care services, such services are or were required to be given on an inpatient basis because the individual needs or needed skilled nursing care on a continuing basis for any of the conditions with respect to which he was receiving inpatient hospital services (or. services which would constitute inpatient hospital services if the institution met the requirements of paragraphs *Post*, p. 314.(6) and
(8)of section 1861(e)) prior to transfer to the extended care facility or for a condition requiring such extended care services which arose after such transfer and while he was still in the facility for treatment of the condition or conditions for which he was receiving such inpatient hospital services; 79 Stat. 295 “(E) in the case of post-hospital home health services, such services are or were required because the individual is or was confined to his home (except when receiving items and services referred to in section 1861 (m)(7)) and *Post*, p. 319.needed skilled nursing care on an intermittent basis, or physical or speech therapy, for any of the conditions with respect to which he was receiving inpatient hospital services (or services which would constitute inpatient hospital services if the institution met the requirements of paragraphs
(6)and
(8)of section 1861(e)) or post-hospital extended care services; a plan for furnishing such services to such individual has been established and is periodically reviewed by a physician; and such services are or were furnished while the individual was under the care of a physician; or “(F) in the case of outpatient hospital diagnostic services, such services are or were required for diagnostic study; “(3) in the case of inpatient psychiatric hospital services, the services are those which the records of the hospital indicate were furnished to the individual during periods when he was receiving
(A)intensive treatment services,
(B)admission and related services necessary for a diagnostic study, or
(C)equivalent services; “(4) in the case of inpatient tuberculosis hospital services, the services are those which the records of the hospital indicate were furnished to the individual during periods when he was receiving treatment which could reasonably be expected to
(A)improve his condition or
(B)render it noncommunicable; “(5) with respect to inpatient hospital services furnished such individual after the 20th day of a continuous period of such services and with respect to post-hospital extended care services furnished sifter such day of a continuous period of such services as may be prescribed in or pursuant to regulations, there was not in effect, at the time of admission of such individual to the hospital or extended care facility, as the case may be, a decision under section 1866(d)(based on a finding that utilization *Post*, p. 327.review of long-stay cases is not being made in such hospital or facility); and “(6) with respect to inpatient hospital services or post-hospital extended care services furnished such individual during a continuous period, a finding has not been made (by the physician members of the committee or group, as described in section 1861(h)(4)) pursuant to the system of utilization review that further inpatient hospital services or further post-hospital extended care services, as the case may be, are not medically necessary; except that, if such a finding has been made, payment may be made for such services furnished before the 4th day after the day on which the hospital or extended care facility, as the case may be, received notice of such finding. To the extent provided by regulations, the certification and recertification requirements of paragraph
(2)shall be deemed satisfied where, at a later date, a physician makes certification of the kind provided in subparagraph (A), (B), (C), (D), (E), or
(F)of paragraph
(2)79 Stat. 296(whichever would have applied), but only where such certification is accompanied by such medical and other evidence as may be required by such regulations. “Reasonable Cost of Services “(b) The amount paid to any provider of services with respect to services for which payment may be made under this part shall, subject *Ante*, p. 292.*Post*, p. 322.to the provisions of section 1813, be the reasonable cost of such services, as determined under section 1861 (v). “No Payments to Federal Providers of Services “(c) No payment may be made under this part (except under subsection (d)) to any Federal provider of services, except a provider of services which the Secretary determines is providing services to the public generally as a community institution or agency; and no such payment may be made to any provider of services for any item or service which such provider is obligated by a law of, or a contract with, the United States to render at public expense. “Payments for Emergency Hospital Services “(d) Payments shall also be made to any hospital for inpatient hospital services or outpatient hospital diagnostic services furnished, by the hospital or under arrangements (as defined in section 1861 (w)) with it, to an individual entitled to hospital insurance benefits under *Ante*, p. 290.section 226 even though such hospital does not have an agreement in effect under this title if
(A)such services were emergency services and
(B)the Secretary would be required to make such payment if the hospital had such an agreement in effect and otherwise met the conditions of payment hereunder. Such payments shall be made only in the amounts provided under subsection
(b)and then only if such hospital agrees to comply, with respect to the emergency services provided, *Post*, p. 327.with the provisions of section 1866(a). “Payment for Inpatient Hospital Services Prior to Notification of Noneligibility “(e) Notwithstanding that an individual is not entitled to have payment made under this part for inpatient hospital services furnished by any hospital, payment shall be made to such hospital (unless it elects not to receive such payment or, if payment has already been made by or on behalf of such individual, fails to refund such payment within the time specified by the Secretary) for such services which are furnished to the individual prior to notification to such hospital from the Secretary of his lack of entitlement, if such payments are precluded *Ante*, p. 291.only by reason of section 1812 and if such hospital complies with the requirements of and regulations under this title with respect to such payments, has acted in good faith and without knowledge of such lack of entitlement, and has acted reasonably in assuming entitlement existed. Payment under the preceding sentence may not be made for services furnished an individual pursuant, to any admission after the 6th elapsed day (not including as an elapsed day Saturday, Sunday, or a legal holiday) after the day on which such admission occurred. 79 Stat. 297 “Payment for Certain Emergency Hospital Services Furnished Outside the United States “(f) The authority contained in subsection
(d)shall be applicable to emergency inpatient hospital services furnished an individual by a hospital located outside the United States if— “(1) such individual was physically present in a place within the United States at the time the emergency which necessitated such inpatient hospital services occurred; and “(2) such hospital was closer to, or substantially more accessible from, such place than the nearest hospital within the United States which was adequately equipped to deal with, and was available for the treatment of, such individual’s illness or injury. “payment to providers or services “Sec. 1815. The Secretary shall periodically determine the amount which should be paid under this part to each provider of services with respect to the services furnished by it, and the provider of services shall be paid, at such time or times as the Secretary believes appropriate (but not less often than monthly) and prior to audit or settlement by the General Accounting Office, from the Federal Hospital Insurance Trust Fund, the amounts so determined, with necessary *Post*, p. 299.adjustments on account of previously made overpayments or underpayments; except that no such payments shall be made to any provider unless it has furnished such information as the Secretary may request in order to determine the amounts due such provider under this part, for the period with respect to which the amounts are being paid or any prior period. “use of public agencies or private organizations to facilitate payment to providers of services “Sec. 1816.
(a)If any group or association of providers of services wishes to have payments under this part to such providers made through a national, State, or other public or private agency or organization and nominates such agency or organization for this purpose, the Secretary is authorized to enter into an agreement with such agency or organization providing for the determination by such agency or organization (subject to such review by the Secretary as may be provided for by the agreement.) of the amount of the payments required pursuant to this part, to be made to such providers, and for the making of such payments by such agency or organization to such providers. Such agreement may also include provision for the agency or organization to do all or any part of the following:
(1)to provide consultative services to institutions or agencies to enable them to establish and maintain fiscal records necessary for purposes of this part and otherwise to qualify as hospitals, extended care facilities, or home health agencies, and
(2)with respect to the providers of services which are to receive payments through it
(A)to serve as a center for, and communicate to providers, any information or instructions furnished to it by the Secretary, and serve as a channel of communication from providers to the Secretary;
(B)to make such audits of the records of providers as may be necessary to insure that proper payments are made under this part; and
(C)to perform such other functions as are necessary to carry out this subsection. 79 Stat. 298 “(b) The Secretary shall not enter into an agreement with any agency or organization under this section unless
(1)he finds
(A)that to do so is consistent with the effective and efficient administration of this part, and
(B)that such agency or organization is willing and able to assist the providers to which payments are made through it under this part in the application of safeguards against unnecessary utilization of services furnished by them to individuals entitled *Ante*, p. 290.to Hospital insurance benefits under section 226, and the agreement provides for such assistance, and
(2)such agency or organization agrees to furnish to the Secretary such of the information acquired by it in carrying out its agreement under this section as the Secretary may find necessary in performing his functions under this part. “(c) An agreement with any agency or organization under this section may contain such terms and conditions as the Secretary finds necessary or appropriate, may provide for advances of funds to the agency or organization for the making of payments by it under subsection (a), and shall provide for payment of so much of the cost of administration of the agency or organization as is determined by the Secretary to be necessary and proper for carrying out the functions covered by the agreement. “(d) If the nomination of an agency or organization as provided in this section is made by a group or association of providers of services, it shall not be binding on members of the group or association which notify the Secretary of their election to that effect Any provider may, upon such notice as may be specified in the agreement under this section with an agency or organization, withdraw its nomination to receive payments through such agency or organization. Any provider which has withdrawn its nomination, and any provider which has not made a nomination, may elect to receive payments from any agency or organization which has entered into an agreement with the Secretary under this section if the Secretary and such agency or organization agree to it. “(e) An agreement with the Secretary under this section may be terminated— “(1) by the agency or organization which entered into such agreement at such time and upon such notice to the Secretary, to the public, and to the providers as may be provided in regulations, or “(2) by the Secretary at such time and upon such notice to the agency or organization, to the providers which have nominated it for purposes of this section, and to the public, as may be provided in regulations, but only if he finds, after reasonable notice and opportunity for hearing to the agency or organization, that
(A)the agency or organization has failed substantially to carry out the agreement, or
(B)the continuation of some or all of the functions provided for in the agreement with the agency or organization is disadvantageous or is inconsistent with the efficient administration of this part. “(f) An agreement with an agency or organization under this section may require any of its officers or employees certifying payments or disbursing funds pursuant to the agreement, or otherwise participating in carrying out the agreement, to give surety bond to the United States in such amount as the Secretary may deem appropriate. 79 Stat. 299 “(g)
(1)No individual designated pursuant to an agreement, under this section as a certifying officer shall, in the absence of gross negligence or intent to defraud the United States, be liable with respect to any payments certified by him under this section. “(2) No disbursing officer shall, in the absence of gross negligence or intent to defraud the United States, be liable with respect, to any payment by him under this section if it was based upon a voucher signed by a certifying officer designated as provided in paragraph
(1)of this subsection. “(3) No such agency or organization shall be liable to the United States for any payments referred to in paragraph
(1)or (2). “federal hospital insurance trust fund “Sec. 1817.
(a)There is hereby created on the books of the Treasury of the United States a trust, fund to be known as the ‘Federal Hospital Insurance Trust Fund’ (hereinafter in this section referred to as the ‘Trust Fund’). The Trust Fund shall consist of such amounts as may be deposited in, or appropriated to, such fund as provided in this part. There are hereby appropriated to the Trust Fund for the fiscal year ending June 30, 1966, and for each fiscal year thereafter, out of any moneys in the Treasury not otherwise appropriated, amounts equivalent to 100 per centum of— “(1) the taxes imposed by sections 3101
(b)and 3111(b) of the Internal Revenue Code of 1954 with respect to wages reported*Post*, pp, 395, 396. to the Secretary of the Treasury or his delegate pursuant to subtitle F of such Code after December 31, 1965, as determined by [26 USC 6001 *et seq*](/us/usc/t26/s6001).the Secretary of the Treasury by applying the applicable rates of tax under such sections to such wages, which wages shall be certified by the Secretary of Health, Education, and Welfare on the basis of records of wages established and maintained by the Secretary of Health, Education, and Welfare in accordance with such reports; and “(2) the taxes imposed by section 1401(b) of the Infernal Revenue Code of 1954 with respect to self-employment income *Post*, p. 394.reported to the Secretary of the Treasury or his delegate on tax returns under subtitle F of such Code, as determined by the Secretary of the Treasury by applying the applicable rate of tax under such section to such self-employment income, which self-employment income shall be certified by the Secretary of Health, Education, and Welfare on the basis of records of self-employment established and maintained by the Secretary of Health, Education, and Welfare in accordance with such returns. The amounts appropriated by the preceding sentence shall be transferred from time to time from the general fund in the Treasury to the Trust Fund, such amounts to be determined on the basis of estimates by the Secretary of the Treasury of the taxes, specified in the preceding sentence, paid to or deposited into the Treasury; and proper adjustments shall be made in amounts subsequently transferred to the extent prior estimates were in excess of or were less than the taxes specified in such sentence. “(b) With respect to the Trust Fund, there is hereby created a Board of Trustees.body to be known as the Board of Trustees of the Trust Fund (hereinafter in this section referred to as the ‘Board of Trustees’) composed of the Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health, Education, and Welfare, all ex officio. The Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees (hereinafter in this section referred to as the 79 Stat. 300‘Managing Trustee’), The Commissioner of Social Security shall Reports to Congress.serve as the Secretary of the Board of Trustees. The Board of Trustees shall meet not less frequently than once each calendar year. It shall be the duty of the Board of Trustees to— “(1) Hold the Trust. Fund; “(2) Report to the Congress not later than the first day of March of each year on the operation and status of the Trust Fund during the preceding fiscal year and on its expected operation and status during the current fiscal year and the next 2 fiscal years; “(3) Report immediately to the Congress whenever the Board is of the opinion that the amount of the Trust Fund is unduly small; and “(4) Review the general policies followed in managing the Trust Fund, and recommend changes in such policies, including necessary changes in the provisions of law which govern the way in which the Trust Fund is to be managed. The report, provided for in paragraph
(2)shall include a statement of the assets of, and the disbursements made from, the Trust Fund during the preceding fiscal year, an estimate of the expected income to, and disbursements to be made from, the Trust Fund during the current fiscal year and each of the next 2 fiscal years, and a statement of the actuarial status of the Trust Fund. Such report shall be printed as a House document of the session of the Congress to which the report is made. “(c) Investment of Fund monies. It shall be the duty of the Managing Trustee to invest such portion of the Trust. Fund as is not, in his judgment, required to meet current withdrawals. Such investments may be made only in interest-bearing obligations of the United States or in obligations guaranteed as to both principal and interest by the United States. For such purpose such obligations may be acquired
(1)on original issue at the issue price, or
(2)by purchase of outstanding obligations at the market price. The purposes for which obligations of the [40 Stat. 288](/us/stat/40/288).[31 USC 774](/us/usc/t31/s774).United States may be issued under the Second Liberty Bond Act, as amended, are hereby extended to authorize the issuance at par of public-debt obligations for purchase by the Trust Fund. Such obligations issued for purchase by the Trust Fund shall have maturities fixed with due regard for the needs of the Trust. Fund and shall bear interest at a rate equal to the average market yield (computed by the Managing Trustee on the basis of market quotations as of the end of the calendar month next preceding the date of such issue) on all marketable interest-bearing obligations of the United States then forming a part of the public debt which are not due or callable until after the expiration of 4 years from the end of such calendar month; except that where such average market yield is not a multiple of one--eighth of 1 per centum, the rate of interest on such obligations shall be the multiple of one-eighth of 1 per centum nearest such market yield. The Managing Trustee may purchase other interest-bearing obligations of the United States or obligations guaranteed as to both principal and interest by the United States, on original issue or at the market, price, only where he determines that the purchase of such other obligations is in the public interest. “(d) Any obligations acquired by the Trust Fund (except public-debt obligations issued exclusively to the Trust Fund) may be sold by the Managing Trustee at the market price, and such public-debt obligations may be redeemed at par plus accrued interest. 79 Stat. 301 “(e) The interest on, and the proceeds from the sale or redemption of, any obligations held in the Trust Fund shall be credited to and form a part of the Trust Fund. _ “(f)
(1)The Managing Trustee is directed to pay from time to time from the Trust Fund into the Treasury the amount estimated by him as taxes imposed under section 3101(b) which are subject to*Post*, p. 395.*Post*, p. 393. refund under section 6413(c) of the Internal Revenue Code of 1954 with respect to wages paid after December 31, 1965. Such taxes shall be determined on the basis of the records of wages established and maintained by the Secretary of Health, Education, and Welfare in accordance with the wages reported to the Secretary of the Treasury or his delegate pursuant to subtitle F of the Internal Revenue Code [26 USC 6001 *et seq*](/us/usc/t26/s6001).of 1954, and the Secretary of Health, Education, and Welfare shall furnish the Managing Trustee such information as may be required by the Managing Trustee for such purpose. The payments by the Managing Trustee shall be covered into the Treasury as repayments to the account for refunding internal revenue collections. “(2) Repayments made under paragraph
(1)shall not be available for expenditures but shall be carried to the surplus fund of the Treasury. If it subsequently appears that the estimates under such paragraph in any particular period were too high or too low, appropriate adjustments shall be made by the Managing Trustee in future payments. “(g) There shall be transferred periodically (but not less often than once each fiscal year) to the Trust Fund from the Federal Old-Age and Survivors Insurance Trust Fund and from the Federal Disability Insurance Trust Fund amounts equivalent to the amounts not previously so transferred which the Secretary of Health, Education, and Welfare shall have certified as overpayments (other than amounts so certified to the Railroad Retirement Board) pursuant to section 1870(b) of this Act. There shall be transferred periodically *Post*, p. 331.(but not less often than once each fiscal year) to the Trust Fund from the Railroad Retirement Account amounts equivalent to the amounts not previously so transferred which the Secretary of Health, Education, and Wei fare shall have certified as overpayments to the Railroad Retirement Board pursuant to section 1870(b) of this Act. “(h) The Managing Trustee shall also pay from time to time from the Trust Fund such amounts as the Secretary of Health, Education, and Welfare certifies are necessary to make the payments provided for by this part, and the payments with respect to administrative expenses in accordance with section 201 (g)(1).*Post*, p. 338. “Part B— Supplementary Medical Insurance Benefits for the Aged “establishment of supplementary medical insurance program for the aged “Sec. 1831. There is hereby established a voluntary insurance program to provide medical insurance benefits in accordance with the provisions of this part for individuals 65 years of age or over who elect to enroll under such program, to be financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government. 79 Stat. 302 “scope of benefits “Sec. 1832.
(a)The benefits provided to an individual by the insurance program established by this part shall consist of— “(1) entitlement to have payment made to him or on his behalf (subject to the provisions of this part) for medical and other health services, except those described in paragraph (2)(B);and “(2) entitlement to have payment made on his behalf (subject to the provisions of this part) for— “(A) home health services for up to 100 visits during a calendar year; and “(B) medical and other health services (other than physicians services unless furnished by a resident or intern of a hospital) furnished by a provider of services or by others under arrangements with them made by a provider of services. “(b) *Post*, p. 313. For definitions of ‘spell of illness’, ‘medical and other health services’, and other terms used in this part, see section 1861. “payment of benefits “Sec. 1833.
(a)Subject to the succeeding provisions of this section, there shall be paid from the Federal Supplementary Medical *Post*, p. 308.Insurance Trust Fund, in the case of each individual who is covered under the insurance program established by this part and incurs expenses for services with respect to which benefits are payable under this part, amounts equal to— “(1) in the case of services described in section 1832(a)(1)—80 percent of the reasonable charges for the services; except that an organization which provides medical and other health services (or arranges for their availability) on a prepayment basis may elect to be paid 80 percent of the reasonable cost of services for which payment may be made under this part on behalf of individuals enrolled in such organization in lieu of 80 percent of the reasonable charges for such services if the organization undertakes to charge such individuals no more than 20 percent of such reasonable cost plus any amounts payable by them as a result of subsection (b); and “(2) in the case of services described in section 1832(a)(2)—80 percent of the reasonable cost of the services (as determined *Post*, p. 322.under section 1861 (v)). “(b) Deductible provision. Before applying subsection
(a)with respect to expenses incurred by an individual during any calendar year, the total amount of the expenses incurred by such individual during such year (which would, except for this subsection, constitute incurred expenses from which benefits payable under subsection
(a)are determinable) shall be reduced by a deductible of $50; except that
(1)the amount of the deductible for such calendar year as so determined shall first be reduced by the amount of any expenses incurred by such individual in the last three months of the preceding calendar year (or regarded under clause
(2)as incurred in such preceding year with respect to services furnished in such last three months) and applied toward such individual’s deductible under this section for such preceding year, and
(2)the *Ante*, p. 292.amount of any deduction imposed under section 1813(a)(2)(A) with 79 Stat. 303respect to outpatient hospital diagnostic services furnished in any calendar year shall be regarded as an incurred expense under this part for such year. “(c) Notwithstanding any other provision of this part, with respect Mental disorders.to expenses incurred in any calendar year in connection with the treatment of mental, psychoneurotic, and personality disorders of an individual who is not an inpatient of a hospital at the time such expenses are incurred, there shall be considered as incurred expenses for purposes of subsections
(a)and
(b)only whichever of the following amounts is the smaller: “(1) $312.50, or “(2) 62½ percent of such expenses. “(d) No payment may be made under this part with respect be any services furnished an individual to the extent that such individual is entitled (or would be entitled except for section 1813 other than*Ante*, p. 292. subsection (a)(2)(A) thereof) to have payment made with respect to such services under part A. “(e) No payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period. “limitation on home health services “Sec. 1834.
(a)Payment under this part may be made for home health services furnished an individual during any calendar year only for 100 visits during such year. The number of visits to be charged for purposes of the limitation in the preceding sentence, in connection with items and services described in section 1861 (m), shall be determined *Post*, p. 319.in accordance with regulations. “(b) For purposes of subsection (a), home health services shall be taken into account only if payment under this part is or would be, except for this section or the failure to comply with the request and certification requirements of or under section 1835(a), made with respect to such services. “procedure for payment of claims of providers of services “Sec. 1835.
(a)Payment for services described in section 1832(a)(2) furnished an individual may be made only to providers of services which are eligible therefor under section 1866(a), and only if—*Post*, p. 327. “(1) written request, signed by such individual except in cases in which the Secretary finds it impracticable for the individual to do so, is filed for such payment in such form, in such manner, within such time, and by such person or persons as the Secretary may by regulations prescribe; and “(2) a physician certifies (and recertifies, where such services are furnished over a period of time, in such cases, with such frequency, and accompanied by such supporting material, appropriate to the case involved, as may be provided by regulations) that— “(A) in the case of home health services
(i)such services are or were required because the individual is or was confined to his home (except when receiving items and services referred to in section 1861 (m)(7)) and needed skilled nursing care on an intermittent basis, or physical or speech therapy 79 Stat. 304,
(ii)a plan for furnishing such services to such individual has been established and is periodically reviewed by a physician, and
(iii)such services are or were furnished while the individual is or was under the care of a physician; and “(B) in the case of medical and other health services, such services are or were medically required. To the extent provided by regulations, the certification and recertification requirements of paragraph
(2)shall be deemed satisfied where, at a later date, a physician makes a certification of the kind provided in subparagraph
(A)or
(B)of paragraph (2)(whichever would have applied), but only where such certification is accompanied by such medical and other evidence as may be required by such regulations. “(b) No payment may be made under this part to any Federal provider of services or other Federal agency, except a provider of services which the Secretary determines is providing services to the public generally as a community institution or agency; and no such payment may be made to any provider of services or other person for any item or service which such provider or person is obligated by a law of, or a contract with, the United States to render at public expense. “eligible individuals “Sec. 1836. Every individual who— “(1) has attained the age of 65, and “(2)
(A)is a resident of the United States, and is either
(i)a citizen or
(ii)an alien lawfully admitted for permanent residence who has resided in the United States continuously during the 5 years immediately preceding the month in which he applies for enrollment under this part, or
(B)is entitled to hospital insurance benefits under part A, is eligible to enroll in the insurance program established by this part. “enrollment periods “Sec. 1837.
(a)An individual may enroll in the insurance program established by this part only in such manner and form as may be prescribed by regulations, and only during an enrollment period prescribed in or under this section. “(b)
(1)No individual may enroll for the first time under this part more than 3 years after the close of the first enrollment period during which he could have enrolled under this part. “(2) An individual whose enrollment under this part has terminated may not enroll for the second time under this part unless he does so in a general enrollment period (as provided in subsection (e)) which begins within 3 years after the effective date of such termination. No individual may enroll under this part more than twice. “(c) In the case of individuals who first, satisfy paragraphs
(1)and
(2)of section 1836 before January 1, 1966, the initial general enrollment period shall begin on the first day of the second month which begins after the date of enactment of this title and shall end on March 31, 1966. For purposes of this subsection and subsection (d), an individual who satisfies paragraph
(2)of section 1836 solely by reason of subparagraph
(B)thereof shall be treated as satisfying such paragraph
(2)on the first day on which he is (or on filing application would be) entitled to hospital insurance benefits under part A. “(d) In the case of an individual who first satisfies paragraphs
(1)and
(2)of section 1836 on or after January 1, 1966, his initial enroll- 79 Stat. 305ment period shall begin on the first day of the third month before the month in which he first satisfies such paragraphs and shall end seven months later. “(e) There shall be a general enrollment period, after the period described in subsection (c), during the period beginning on October 1 and ending on December 31 of each odd-numbered year beginning with 1967. “coverage period “Sec. 1838.
(a)The period during which an individual is entitled to benefits under the insurance program established by this part (hereinafter referred to as his ‘coverage period’) shall begin on whichever of the following is the latest: “(1) July 1, 1966; or “(2)
(A)in the case of an individual who enrolls pursuant to subsection
(d)of section 1837 before the month in which he first satisfies paragraphs
(1)and
(2)of section 1836, the first day of such month, or “(B) in the case of an individual who enrolls pursuant to such subsection
(d)in the month in which he first satisfies such paragraphs, the first day of the month following the month in which he so enrolls, Or “(C) in the case of an individual who enrolls pursuant to such subsection
(d)in the month following the month in which he first satisfies such paragraphs, the first day of the second month following the month in which he so enrolls, or “(D) in the case of an individual who enrolls pursuant to such subsection
(d)more than one month following the month in which he satisfies such paragraphs, the first day of the third month following the month in which he so enrolls, or “(E) in the case of an individual who enrolls pursuant to subsection
(e)of section 1837, the July 1 following the month in which he so enrolls. “(b) An individual’s coverage period shall continue until his enrollment has been terminated— “(1) by the filing of notice, during a general enrollment period described in section 1837(e), that the individual no longer wishes to participate in the insurance program established by this part, or “(2) for nonpayment of premiums. The termination of a coverage period under paragraph
(1)shall take effect at the close of December 31 of the year in which the notice is filed. The termination of a coverage period under paragraph
(2)shall take effect on a date determined under regulations, which may be determined so as to provide a grace period (not in excess of 90 days) in which overdue premiums may be paid and coverage continued. “(c) No payments may be made under this part with respect to the expenses of an individual mi less such expenses were incurred by such individual during a period which, with respect to him, is a coverage period. “amounts of premiums “Sec. 1839.
(a)The monthly premium of each individual enrolled under this part for each month before 1968 shall be $3. “(b)
(1)The monthly premium of each individual enrolled under this part for each month after 1967 shall be the amount determined under paragraph (2), 79 Stat. 306 “(2) The Secretary shall, between July 1 and October 1 of 1967 and of each odd-numbered year thereafter, determine and promulgate the dollar amount which shall be applicable for premiums for months occurring in either of the two succeeding calendar years. Such dollar amount shall be such amount as the Secretary estimates to be necessary so that the aggregate premiums for such two succeeding calendar years will equal one-half of the total of the benefits and administrative costs which he estimates will be payable from the Federal Supplementary *Post*, p. 308.Medical Insurance Trust Fund for such two succeeding calendar years. In estimating aggregate benefits payable for any period, the Secretary shall include an appropriate amount for a contingency margin. “(c) In the case of an individual whose coverage period began pursuant to an enrollment after his initial enrollment period (determined pursuant to subsection
(c)or
(d)of section 1837), the monthly premium determined under subsection
(b)shall be increased by 10 percent of the monthly premium so determined for each full 12 months in which he could have been but was not enrolled. For purposes of the preceding sentence, there shall be taken into account
(1)the months which elapsed between the close of his initial enrollment period and the close of the enrollment period in which he enrolled, plus (in the case of an individual who enrolls for a second time)(2) the month which elapsed between the date of the termination of his first coverage period and the close of the enrollment period in which he enrolled for the second time. “(d) If any monthly premium determined under the foregoing provisions of this section is not a multiple of 10 cents, such premium shall be rounded to the nearest multiple of 10 cents. “payment of premiums “Sec. 1840. [53 Stat. 1363](/us/stat/53/1363).[42 USC 402](/us/usc/t42/s402).
(1)In the case of an individual who is entitled to monthly benefits under section 202, his monthly premiums under this part shall (except, as provided in subsection (d)) be collected by deducting the amount thereof from the amount of such monthly benefits. Such deduction shall be made in such manner and at such times as the Secretary shall by regulation prescribe. “(2) [70 Stat. 819](/us/stat/70/819).[42 USC 401](/us/usc/t42/s401). The Secretary of the Treasury shall, from time to time, transfer from the Federal Old-Age and Survivors Insurance Trust Fund or the Federal Disability Insurance Trust Fund to the Federal Supplementary *Post*, p. 308.Medical Insurance Trust Fund the aggregate amount deducted under paragraph
(1)for the period to which such transfer relates from benefits under section 202 which are payable from such Trust Fund. Such transfer shall be made on the basis of a certification by the Secretary of Health, Education, and Welfare and shall be appropriately adjusted to the extent that prior transfers were too great or too small. “(b) Railroad Retirement Act annuitants.*Post*, pp. 335, 340, 400.
(1)In the case of an individual who is entitled to receive for a month an annuity or pension under the Railroad Retirement Act of 1937, Ids monthly premiums under this part shall (except as provided in subsection (d)) be collected by deducting the amount thereof from such annuity or pension. Such deduction shall be made in such manner and at such times as the Secretary shall by regulations prescribe. Such regulations shall be prescribed only after consultation with the Railroad Retirement Board. “(2) [45 USC 228o](/us/usc/t45/s228o). The Secretary of the Treasury shall, from time to time, transfer from the Railroad Retirement Account to the Federal Supplementary Medical Insurance Trust Fund the aggregate amount 79 Stat. 307deducted under paragraph
(1)for the period to which such transfer relates. Such transfers shall be made on the basis of a certification by the Railroad Retirement Board and shall be appropriately adjusted to the extent that prior transfers were too great or too small. “(c) In the case of an individual who is entitled both to monthly benefits under section 202 and to an annuity or pension under the Railroad Retirement Act of 1937 at the time he enrolls under this part, subsection
(a)shall apply so long as lie continues to be entitled both to such benefits and such annuity or pension. In the case of an individual who becomes entitled both to such benefits and such an annuity or pension after [42 USC 402](/us/usc/t43/s402).*Post*, pp. 335, 340, 400.he enrolls under this part-, subsection
(a)shall apply if the first month for which he was entitled to such benefits was the same as or earlier than the first month for which he was entitled to such annuity or pension, and otherwise subsection
(b)shall apply. “(d) If an individual to whom subsection
(a)or
(b)applies estimates that the amount which will be available for deduction under such subsection for any premium payment period will be less than the amount of the monthly premiums for such period, he may (under regulations) pay to the Secretary such portion of the monthly premiums for such period as he desires. “(e)
(1)In the case of an individual receiving an annuity under the Civil Service Retirement Act annuitants.[70 Stat. 743](/us/stat/70/743).[5 USC 2251 note](/us/usc/t5/s2251).Civil Service Retirement Act, or other Act. administered by the Civil Service Commission providing retirement or survivorship protection, to whom neither subsection
(a)nor subsection
(b)applies, his monthly premiums under this part (and the monthly premiums of the spouse of such individual under this part if neither subsection
(a)nor subsection
(b)applies to such spouse and if such individual agrees) shall, upon notice from the Secretary of Health, Education, and Welfare to the Civil Service Commission, be collected by deducting the amount thereof from each installment of such annuity. Such deduction shall be made in such manner and at such times as the Civil Service Commission may determine. The Civil Service Commission shall furnish such information as the Secretary of Health, Education, and Welfare may reasonably request in order to carry out his functions under this part with respect to individuals to whom this subsection applies. “(2) The Secretary of the Treasury shall, from time to time, but not less often than quarterly, transfer from the Civil Service Retirement and Disability Fund, or the account (if any) applicable in the case of such other Act administered by the Civil Service Commission, to the Federal Supplementary Medical Insurance Trust Fund the aggregate amount deducted under paragraph
(1)for the period to which such transfer relates. Such transfer shall be made on the basis of a certification by the Civil Service Commission and shall be appropriately adjusted to the extent that prior transfers were too great or too small. “(f) In the case of an individual who participates in the insurance program established by this part, but with respect to whom none of the preceding provisions of this section applies, or with respect to whom subsection
(d)applies, the premiums shall be paid to the Secretary at such times, and in such manner, as the Secretary shall by regulations prescribe. “(g) Amounts paid to the Secretary under subsection
(d)or
(f)shall be deposited in the Treasury to the credit of the Federal Supplementary Medical Insurance Trust Fund. 79 Stat. 308 “(h) In the case of an individual who participates in the insurance program established by this part, premiums shall be payable for the period commencing with the first month of his coverage period and ending with the month in which he dies or, if earlier, in which his coverage under such program terminates. “federal supplementary medical insurance trust fund “Sec. 1841.
(a)There is hereby created on the books of the Treasury of the United States a trust fund to be known as the ‘Federal Supplementary Medical Insurance Trust Fund’ (hereinafter in this section referred to as the ‘Trust Fund’). The Trust Fund shall consist of such amounts as may be deposited in, or appropriated to, such fund as provided in this part. “(b) Board of Trustees. With respect to the Trust. Fund, there is hereby created a body to lie known as the Board of Trustees of the Trust Fund (hereinafter in this section referred to as the ‘Board of Trustees’) composed of the Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health, Education, and Welfare, all ex officio. The Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees (hereinafter in this section referred to as the ‘Managing Trustee’). The Commissioner of Social Security shall serve as the Secretary of the Board of Trustees. The Board of Trustees shall meet not less Reports to Congress.frequently than once each calendar year. It shall be the duty of the Board of Trustees to— “(1) Hold the Trust Fund; “(2) Report, to the Congress not later than the first day of March of each year on the operation and status of the Trust Fund during the preceding fiscal year and on its expected operation and status during the current fiscal year and the next 2 fiscal years; “(3) Report immediately to the Congress whenever the Board is of the opinion that the amount of the Trust Fund is unduly small; and “(4) Review the general policies followed in managing the Trust Fund, and recommend changes in such polities, including necessary changes in the provisions of law which govern the way in which the Trust Fund is to be managed. The report provided for in paragraph
(2)shall include a statement of the assets of, and the disbursements made from, the Trust Fund during the preceding fiscal year, an estimate of the expected income to, and disbursements to be made from, the Trust Fund during the current fiscal year and each of the next 2 fiscal years, and a statement, of the actuarial status of the Trust Fund. Such report shall be printed as a House document of the session of the Congress to which the report is made. “(c) Investment of Fund monies. It shall be the duty of the Managing Trustee to invest such portion of the Trust Fund as is not, in his judgment, required to meet current withdrawals. Such investments may be made only in interest-bearing obligations of the United States or in obligations guaranteed as to both principal and interest by the United States. For such purpose such obligations may be acquired
(1)on original issue at the issue price, or
(2)by purchase of outstanding obligations at the market price. The purposes for which obligations of the [40 Stat. 288](/us/stat/40/288).[31 USC 774](/us/usc/t31/s774).United States may be issued under the Second Liberty Bond Act, as amended, are hereby extended to authorize the issuance at par of public-debt obligations for purchase by the Trust Fund. Such obligations issued for purchase by the Trust Fund shall have matu-79 Stat. 309rities fixed with due regard for the needs of the Trust Fund and shall bear interest at a rate equal to the average market yield (computed by the Managing Trustee on the basis of market quotations as of the end of the calendar month next preceding the date of such issue) on all marketable interest-bearing obligations of the United States then forming a part of the public debt which are not due or callable until after the expiration of 4 years from the end of such calendar month; except that where such average market yield is not a multiple of one-eighth of 1 per centum, the rate of interest on such obligations shall be the multiple of one-eighth of 1 per centum nearest such market yield. The Managing Trustee may purchase other interest-bearing obligations of the United States or obligations guaranteed as to both principal and interest by the United States, on original issue or at the market price, only where he determines that the purchase of such other obligations is in the public interest. “(d) Any obligations acquired by the Trust Fund (except public-debt obligations issued exclusively to the Trust Fund) may be sold by the Managing Trustee at the market price, and such public-debt obligations may be redeemed at par plus accrued interest. “(e) The interest on, and the proceeds from the sale or redemption of, any obligations held in the Trust Fund shall be credited to and form a part of the Trust Fund. “(f) There shall be transferred periodically (but not less often than once each fiscal year) to the Trust Fund from the Federal Old-Age and Survivors Insurance Trust Fund and from the Federal Disability Insurance Trust Fund amounts equivalent to the amounts not previously so transferred which the Secretary of Health, Education, and Welfare shall have certified as overpayments (other than amounts so certified to the Railroad Retirement Board) pursuant to section 1870(b) of this Act. There shall be transferred periodically (but *Post*, p. 331.not less often than once each fiscal year) to the Trust Fund from the Railroad Retirement Account amounts equivalent to the amounts not previously so transferred which the Secretary of Health, Education, and Welfare shall have certified as overpayments to the Railroad Retirement Board pursuant to section 1870(b) of this Act. “(g) The Managing Trustee shall pay from time to time from the Trust Fund such amounts as the Secretary of Health, Education, and Welfare certifies are necessary to make the payments provided for by this part, and the payments with respect to administrative expenses in accordance with section 201(g)(1).*Post*, p. 338. “(h) The Managing Trustee shall pay from time to time from the Trust Fund such amounts as the Secretary of Health, Education, and Welfare certifies are necessary to pay the costs incurred by the. Civil Service Commission in making deductions pursuant to section 1840(e). During each fiscal year, or after the close of such fiscal year, the Civil Service Commission shall certify to the Secretary the amount of the costs it incurred in making such deductions, and such certified amount shall be the basis for the amount of such costs certified by the Secretary to the Managing Trustee. “use of carriers for administration of benefits “Sec. 1842.
(a)In order to provide for the administration of the benefits under this part with maximum efficiency and convenience for individuals entitled to benefits under this part and for providers of services and other persons furnishing services to such individuals, and with a view to furthering coordination of the administration of the 79 Stat. 310benefits under part A and under this part, the Secretary is authorized to enter into contracts with carriers, including carriers with which *Ante*, p. 297.agreements under section 1816 are in effect, which will perform some or all of the following functions (or, to the extent provided in such Contracts, will secure performance thereof by other organizations); and, with respect to any of the following functions which involve payments for physicians’ services, the Secretary shall to the extent possible enter into such contracts: “(1)
(A)make determinations of the rates and amounts of payments required pursuant to this part to be made to providers of services and other persons on a reasonable cost or reasonable charge basis (as maybe applicable); “(B) receive, disburse, and account for funds in making such payments; and “(C) make such audits of the records of providers of services as may be necessary to assure that proper payments are made under this part; “(2)
(A)determine compliance with the requirements of section 1861
(k)as to utilization review; and “(B) assist providers of services and other persons who furnish services for which payment may be made under this part in the development of procedures relating to utilization practices, make studies of the effectiveness of such procedures and methods for their improvement, assist in the application of safeguards against unnecessary utilization of services furnished by providers of services and other persons to individuals entitled to benefits under this part, and provide procedures for and assist in arranging, where necessary, the establishment of groups outside hospitals *Post*, p. 318.(meeting the requirements of section 1861(k)(2)) to make reviews of utilization; “(3) serve as a channel of communication of information relating to the administration of this part; and “(4) otherwise assist, in such manner as the contract may provide, in discharging administrative duties necessary to carry out the purposes of this part. “(b) Contracts with carriers.[41 USC 5](/us/usc/t41/s5).
(1)Contracts with carriers under subsection
(a)may be entered into without regard to section 3769 of the Revised Statutes or any other provision of law requiring competitive bidding. “(2) No such contract shall be entered into with any carrier unless the Secretary finds that such carrier will perform its obligations under the contract efficiently and effectively and will meet such requirements as to financial responsibility, legal authority, and other matters as he finds pertinent. “(3) Each such contract shall provide that the carrier— “(A) will take such action as may be necessary to assure that, where payment under this part for a service is on a cost, basis, the cost is reasonable cost (as determined under section 1861 (v)); “(B) *Post*, p. 322. will take such action as may be necessary to assure that, where payment under this part for a service is on a charge basis,
(i)such charge will be reasonable and not higher than the charge applicable, for a comparable service and under comparable circumstances, to the policyholders and subscribers of the carrier, and
(ii)such payment will be made on the basis of a receipted bill, or on the basis of an assignment, under the terms of which the reasonable charge is the full charge for the service; “(C) will establish and maintain procedures pursuant to which an individual enrolled under this part will be granted an oppor-79 Stat. 311tunity for a fair hearing by the carrier when requests for payment under this part with respect to services furnished him are denied or are not acted upon with reasonable promptness or when the amount of such payment is in controversy; “(D) will furnish to the Secretary such timely information and reports as he may find necessary in performing his functions under this part; and “(E) will maintain such records and afford such access thereto as the Secretary finds necessary to assure the correctness and verification of the information and reports under subparagraph
(D)and otherwise to carry out the purposes of this part; and shall contain such other terms and conditions not inconsistent with this section as the Secretary may find necessary or appropriate. In determining the reasonable charge for services for purposes of this paragraph, there shall be taken into consideration the customary charges for similar services generally made by the physician or other person furnishing such services, as well as the prevailing charges in the locality for similar services. “(4) Each contract under this section shall be for a term of at least one year, and may be made automatically renewable from term to term in the absence of notice by either party of intention to terminate at the end of the current term; except that the Secretary may terminate any such contract at any time (after such reasonable notice and opportunity for hearing to the carrier involved as he may provide in regulations) if he finds that the carrier has failed substantially to carry out the contract or is carrying out the contract in a manner inconsistent with the efficient and effective administration of the insurance program established by this part. “(c) Any contract entered into with a carrier under this section shall provide for advances of funds to the carrier for the making of payments by it under this part, and shall provide for payment of the cost of administration of the carrier, as determined by the Secretary to be necessary and proper for carrying out the functions covered by the contract. “(d) Any contract with a carrier under this section may require such carrier or any of its officers or employees certifying payments or disbursing funds pursuant to the contract, or otherwise participating in carrying out the contract, to give surety bond to the United States in such amount as the Secretary may deem appropriate. “(e)
(1)No individual designated pursuant to a contract under this section as a certifying officer shall, in the absence of gross negligence or intent to defraud the United States, be liable with respect to any payments certified by him under this section. “(2) No disbursing officer shall, in the absence of gross negligence or intent to defraud the United States, be liable with respect to any payment by him under this section if it was based upon a voucher signed by a certifying officer designated as provided in paragraph
(1)of this subsection. “(3) No such carrier shall be liable to the United States for any payments referred to in paragraph
(1)or (2). “(f) For purposes of this part, the term ‘carrier’ means—“Carrier.” “(1) with respect to providers of services and other persons, a voluntary association, corporation, partnership, or other non-governmental organization which is lawfully engaged in providing, paying for, or reimbursing the cost of, health services under group insurance policies or contracts, medical or hospital service agreements, membership or subscription contracts, or similar 79 Stat. 312group arrangements, in consideration of premiums or other periodic charges payable to the carrier, including a health benefits plan duly sponsored or underwritten by an employee organization; and “(2) with respect to provider’s of services only, any agency or organization (not described in paragraph (1)) with which an *Ante*, p. 297.agreement is in effect under section 1816. “state agreements for coverage of eligible individuals who are receiving money payments under public assistance programs “Sec. 1843.
(a)The Secretary shall, at the request of a State made before January 1, 1968, enter into an agreement with such State pursuant to which all eligible individuals in either of the coverage groups described in subsection (b)(as specified in the agreement) will be enrolled under the program established by this part. “(b) An agreement entered into with any State pursuant to subsection
(a)may be applicable to either of the following coverage groups: “(1) individuals receiving money payments under the plan of such State approved under title I or title XVI; or “(2) individuals receiving money payments under all of the plans of such State approved under titles I, IV, X, XIV, and [42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381).XVI; except that there shall be excluded from any coverage group any [42 USC 401](/us/usc/t42/s401).individual who is entitled to monthly insurance benefits under title II or who is entitled to receive an annuity or pension under the Railroad*Post*, pp. 335, 340, 400. Retirement Act of 1937. “(c) For purposes of this section, an individual shall be treated as an eligible individual only if he is an eligible individual (within *Ante*, p. 304.the meaning of section 1836) on the date an agreement covering him is entered into under subsection
(a)or he becomes an eligible individual (within the meaning of such section) at any time after such date and before January 1, 1968; and he shall be treated as receiving money payments described in subsection
(b)if he receives such payments for the month in which the agreement is entered into or any month thereafter before January 1968. “(d) In the case of any individual enrolled pursuant to this section— “(1) the monthly premium to be paid by the State shall be determined under section 1839 (without any increase under subsection
(c)thereof); “(2) his coverage period shall begin on whichever of the following is the latest: “(A) July 1, 1966; “(B) the first day of the third month following the month in which the State agreement, is entered into; “(C) the first day of the first month in which he is both an eligible individual and a member of a coverage group specified in the agreement under this section; or “(D) such date (not later than January 1, 1968) as may be specified in the agreement; and “(3) his coverage period attributable to the agreement with the State under this section shall end on the last day of whichever of the following first occurs: “(A) the month in which he is determined by the State agency to have become ineligible for money payments of a kind specified in the agreement, or 79 Stat. 313 “(B) the month preceding the first month for which lie becomes entitled to monthly benefits under title II or to an [42 USC 401](/us/usc/t42/s401).annuity or pension under the Railroad Retirement Act of 1937.*Post*, pp. 335, 340, 400. “(e) Any individual whose coverage period attributable to the State agreement is terminated pursuant to subsection (d)(3) shall be deemed for purposes of this part (including the continuation of his coverage period under this part) to have enrolled under section 1837 in the initial general enrollment period provided by section *Ante*, p. 304.1837(c). “(f) With respect to eligible individuals receiving money payments under the plan of a State approved under title I, IV, X, XlV,[42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381). or XVI, if the agreement entered into under this section so provides, the term ‘carrier’ as defined in section 18–12
(f)also includes the State agency, specified in such agreement, which administers or supervises the administration of the plan of such State approved under title I, XVI, or XIX. The agreement shall also contain such provisions as will facilitate the financial transactions of the State and the carrier with respect to deductions, coinsurance, and otherwise, and as will lead to economy and efficiency of operation, with respect to individuals receiving money payments under plans of the State approved under titles I, IV, X, XIV, and XVI. “appropriations to cover government contributions and contingency reserve “Sec. 1844.
(a)There are authorized to be appropriated from time to time, out of any moneys in the Treasury not otherwise appropriated, to the Federal Supplementary Medical Insurance Trust Fund, a Government. contribution equal to the aggregate premiums payable under this part. “(b) In order to assure prompt payment of benefits provided under this part and the administrative expenses thereunder during the early months of the program established by this part, and to provide a contingency reserve, there is also authorized to be appropriated, out of any moneys in the Treasury not otherwise appropriated, to remain available through the calendar year 1967 for repayable advances (without interest) to the Trust Fund, an amount equal to $18 multiplied by the number of individuals (as estimated by the Secretary) who could be covered in July 1966 by the insurance program established by this part if they had theretofore enrolled under this part. “Part C— Miscellaneous Provisions “definitions of services, institutions, etc. “Sec. 1861. For purposes of this title— “Spell of Illness “(a) The term ‘spell of illness’ with respect to any individual means a period of consecutive days— “(1) beginning with the first day (not included in a previous spell of illness)(A) on which such individual is furnished inpatient hospital services or extended care services, and
(B)which occurs in a month for which he is entitled to benefits under part A, and*Ante*, p. 291. 79 Stat. 314 “(2) ending with the close of the first period of 60 consecutive days thereafter on each of which he is neither an inpatient of a hospital nor an inpatient of an extended care facility. “Inpatient Hospital Services “(b) The term ‘inpatient hospital services’ means the following items and services furnished to an inpatient of a hospital and (except as provided in paragraph (3)) by the hospital— “(1) bed and board; “(2) such nursing services and other related services, such use of hospital facilities, and such medical social services as are ordinarily furnished by the hospital for the care and treatment of inpatients, and such drugs, biologicals, supplies, appliances, and equipment, for use in the hospital, as are ordinarily furnished by such hospital for the care and treatment of inpatients; and “(3) such other diagnostic or therapeutic items or services, furnished by the hospital or by others under arrangements with them made by the hospital, as are ordinarily furnished to inpatients either by such hospital or by others under such arrangements; excluding, however— “(4) medical or surgical services provided by a physician, resident, or intern: and “(5) the services of a private-duty nurse or other private-duty attendant. Paragraph
(4)shall not apply to services provided in the hospital by an intern or a resident-in-training under a teaching program approved by the Council on Medical Education of the American Medical Association or, in the case of an osteopathic hospital, approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association, or, in the case of services in a hospital or osteopathic hospital by an intern or resident-in-training in the field of dentistry, approved by the Council on Dental Education of the American Dental Association. “Inpatient Psychiatric Hospital Services “(c) The term ‘inpatient psychiatric hospital services’ means inpatient hospital services furnished to an inpatient of a psychiatric hospital. “Inpatient Tuberculosis Hospital Services “(d) The term ‘inpatient tuberculosis hospital services’ means inpatient hospital services furnished to an inpatient of a tuberculosis hospital “Hospital “(e) *Ante*, p. 296. The term ‘hospital’ (except for purposes of section 1814(d), subsection (a)(2) of this section, paragraph
(7)of this subsection, and subsections
(i)and
(n)of this section) means an institution which— “(1) is primarily engaged in providing, by or under the supervision of physicians, to inpatients
(A)diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons, or
(B)rehabilitation services for the rehabilitation of injured, disabled, or sick persons; “(2) maintains clinical records on all patients; 79 Stat. 315 “(3) has bylaws in effect with respect to its staff of physicians; “(4) has a requirement that every patient must be under the care of a physician; “(5) provides 24-hour nursing service rendered or supervised by a registered professional nurse, and has a licensed practical nurse or registered professional nurse on duty at all times; “(6) has in effect a hospital utilization review plan which meets the requirements of subsection (k); “(7) in the case of an institution in any State in which State or applicable local law provides for the licensing of hospitals,
(A)is licensed pursuant to such law or
(B)is approved, by the agency of such State or locality responsible for licensing hospitals, as meeting the standards established for such licensing; and “(8) meets such other requirements as the Secretary finds necessary in the interest of the health and safety of individuals who are furnished services in the institution, except that such other requirements may not be higher than the comparable requirements prescribed for the accreditation of hospitals by the Joint Commission on Accreditation of Hospitals (subject to the second sentence of section 1863).*Post*, p. 326. For purposes of subsection (a)(2), such term includes any institution which meets the requirements of paragraph
(1)of this subsection. For purposes of sections 1814(d)(including determination of whether *Ante*, p. 296.an individual received inpatient hospital services for purposes of such section and subsections
(i)and
(n)of this section, such term includes any institution which meets the requirements of paragraphs (1), (2), (3), (4), (5), and
(7)of this subsection. Notwithstanding the preceding provisions of this subsection, such term shall not, except for purposes of subsection (a)(2), include any institution which is primarily for the care and treatment of mental diseases or tuberculosis unless it is a tuberculosis hospital (as defined in subsection (g)) or unless it is a psychiatric hospital (as defined in subsection (f)). The term ‘hospital’ also includes a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts, but only with respect to items and services ordinarily furnished by such institution to inpatients, and payment may be made with respect to services provided by or in such an institution only to such extent and under such conditions, limitations, and requirements (in addition to or in lieu of the conditions, limitations, and requirements otherwise applicable) as may be provided in regulations. For provisions deeming certain requirements of this subsection to be met in the case of accredited institutions, see section 1865. “Psychiatric Hospital “(f) The term ‘psychiatric hospital’ means an institution which— “(1) is primarily engaged in providing, by or under the supervision of a physician, psychiatric services for the diagnosis and treatment of mentally ill persons; “(2) satisfies the requirements of paragraphs
(3)through
(8)of subsection (e); “(3) maintains clinical records on all patients and maintains such records as the Secretary finds to be necessary to determine the degree and intensity of the treatment provided to individuals entitled to hospital insurance benefits under part A; 79 Stat. 316 “(4) meets such staffing requirements as the Secretary finds necessary for the institution to carry out an active program of treatment for individuals who are furnished services in the institution; and “(5) is accredited by the Joint Commission on Accreditation of Hospitals. In the case of an institution which satisfies paragraphs
(1)and
(2)of the preceding sentence and which contains a distinct part which also satisfies paragraphs
(3)and
(4)of such sentence, such distinct part shall be considered to be a ‘psychiatric hospital’ if the institution is accredited by the Joint Commission on Accreditation of Hospitals or if such distinct part meets requirements equivalent to such accreditation requirements as determined by the Secretary. “Tuberculosis Hospital “(g) The term ‘tuberculosis hospital’ means an institution which— “(1) is primarily engaged in providing, by or under the supervision of a physician, medical services for the diagnosis and treatment of tuberculosis; “(2) satisfies the requirements of paragraphs
(3)through
(8)of subsection (e); “(3) maintains clinical records on all patients and maintains such records as the Secretary finds to be necessary to determine the degree and intensity of the treatment provided to individuals covered by the insurance program established by part A; “(4) meets such staffing requirements as the Secretary finds necessary for the institution to carry out an active program of treatment for individuals who are furnished services in the institution; and “(5) is accredited by the Joint Commission on Accreditation of Hospitals. In the case of an institution which satisfies paragraphs
(1)and
(2)of the preceding sentence and which contains a distinct part which also satisfies paragraphs
(3)and
(4)of such sentence, such distinct part, shall be considered to be a. ‘tuberculosis hospital’ if the institution is accredited by the Joint Commission on Accreditation of Hospitals or if such distinct part meets requirements equivalent to such accreditation requirements as determined by the Secretary. “Extended Care Services “(h) The term ‘extended care services’ means the following items and services furnished to an inpatient of an extended care facility and (except as provided in paragraphs
(3)and (6)) by such extended care facility— “(1) nursing care provided by or under the supervision of a registered professional nurse; “(2) bed and board in connection with the furnishing of such nursing care; “(3) physical, occupational, or speech therapy furnished by the extended care facility or by others under arrangements with them made by the facility; “(4) medical social services; “(5) such drugs, biologicals, supplies, appliances, and equipment, furnished for use in the extended care facility, as are ordinarily furnished by such facility for the care and treatment of inpatients; 79 Stat. 317 “(6) medical services provided by an intern or resident-in-training or a hospital with which the facility has in effect a transfer agreement (meeting the requirements of subsection (1)), under a teaching program of such hospital approved as provided in the last sentence of subsection (b), and other diagnostic or therapeutic services provided by a hospital with which the facility has such an agreement in effect; and “(7) such other services necessary to the health of the patients as are generally provided by extended care facilities; excluding, however, any item or service if it. would not be included under subsection
(b)if furnished to an inpatient of a hospital. “Post-Hospital Extended Care Services “(i) The term ‘post-hospital extended care services’ means extended care services furnished an individual after transfer from a hospital hi which he was an inpatient for not less than 3 consecutive days before his discharge from the hospital in connection with such transfer. For purposes of the preceding sentence, items and services shall be deemed to have been furnished to an individual after transfer from a hospital, and he shall be deemed to have been an inpatient in the hospital immediately before transfer therefrom, if he is admitted to the extended care facility within 14 days after discharge from such hospital; and an individual shall be deemed not to have been discharged from an extended care facility if, within 14 days after discharge therefrom, he is admitted to such facility or any other extended care facility. “Extended Care Facility “(j) The term ‘extended care facility’ means (except for purposes of subsection (a)(2)) an institution (or a distinct part of an institution) which has in effect a transfer agreement (meeting the requirements of subsection (1)) with one or more hospitals having agreements in effect under section 1866 and which—*Post*, p. 327. “(1) is primarily engaged in providing to inpatients
(A)skilled nursing care and related services for patients who require medical or nursing care, or
(B)rehabilitation services for the rehabilitation of injured, disabled, or sick persons; “(2) has policies, which are developed with the advice of (and with provision of review of such policies from time to time by) a group of professional personnel, including one or more physicians and one or more registered professional nurses, to govern the skilled nursing care and related medical or other services it provides; “(3) has a physician, a registered professional nurse, or a medical staff responsible for the execution of such policies; “(4)
(A)has a requirement that the health care of every patient must be under the supervision of a physician, and
(B)provides for having a physician available to furnish necessary medical care in case of emergency; “(5) maintains clinical records on all patients; “(6) provides 24-hour nursing service which is sufficient to meet nursing needs in accordance with the policies developed as provided in paragraph (2), and has at least one registered professional nurse employed full time; “(7) provides appropriate methods and procedures for the dispensing and administering of drugs and biologicals; 79 Stat. 318 “(8) has in effect a utilization review plan which meets the requirements of subsection (k); “(9) in the case of an institution in any State in which State or applicable local law provides for the licensing of institutions of this nature,
(A)is licensed pursuant to such law, or
(B)is approved, by the agency of such State or locality responsible for licensing institutions of this nature, as meeting the standards established for such licensing; and “(10) meets such other conditions relating to the health and safety of individuals who are furnished services in such institution or relating to the physical facilities thereof as the Secretary may find necessary (subject to the second sentence of section 1863); except that such term shall not (other than for purposes of subsection (a)(2)) include any institution which is primarily for the care and treatment of mental diseases or tuberculosis. For purposes of subsection (a)(2), such term includes any institution which meets the requirements of paragraph
(1)of this subsection. The term ‘extended care facility’ also includes an institution described in paragraph
(1)of subsection (y), to the extent and subject to the limitations provided in such subsection. “Utilization Review “(k) A utilization review plan of a hospital or extended care facility shall be considered sufficient if it is applicable to services furnished by the institution to individuals entitled to insurance benefits under this title and if it provides— “(1) for the review, on a sample or other basis, of admissions to the institution, the duration of stays therein, and the professional services (including drugs and biologicals) furnished,
(A)with respect to the medical necessity of the services, and
(B)for the purpose of promoting the most efficient use of available health facilities and services; “(2) for such review to be made by either
(A)a staff committee of the institution composed of two or more physicians, with or without participation of other professional personnel, or
(B)a group outside the institution which is similarly composed and
(i)which is established by the local medical society and some or all of the hospitals and extended care facilities in the locality, or
(ii)if (and for as long as) there has not been established such a group which serves such institution, which is established in such other manner as may be approved by the Secretary; “(3) for such review, in each case of inpatient hospital services or extended care services furnished to such an individual during a continuous period of extended duration, as of such days of such period (which may differ for different classes of cases) as may be specified in regulations, with such review to be made as promptly as possible, after each day so specified, and in no event later than one week following such day; and “(4) for prompt notification to the institution, the individual, and his attending physician of any finding (made after opportunity for consultation to such attending physician) by the physician members of such committee or group that any further stay in the institution is not medically necessary. The review committee must be composed as provided in clause
(B)of paragraph
(2)rather than as provided in clause
(A)of such paragraph in the case of any hospital or extended care facility where, because of the small size of the institution, or (in the case of an 79 Stat. 319extended care facility) because of lack of an organized medical staff, or for such other reason or reasons as may be included in regulations, it is impracticable for the institution to nave a properly functioning staff committee for the purposes of this subsection. “Agreements for Transfer Between Extended Care Facilities and Hospitals “(l) A hospital and an extended care facility shall be considered to have a transfer agreement in effect if, by reason of a written agreement between them or (in case, the two institutions are under common control) by reason of a written undertaking by the person or body which controls them, there is reasonable assurance that— “(1) transfer of patients will be effected between the hospital and the extended care facility whenever such transfer is medically appropriate as determined by the attending physician; and “(2) there will be interchange of medical and other information necessary or useful in the care and treatment of individuals transferred between the institutions, or in determining whether such individuals can be adequately cared for otherwise than in either of such institutions. Any extended care facility which does not have such an agreement in effect, but which is found by a State agency (of the State in which such facility is situated) with which an agreement under section 1864 *Post*, p. 326.is in effect (or, in the case of a State in which no such agency has an agreement under section 1864, by the Secretary) to have attempted in good faith to enter into such an agreement with a hospital sufficiently close to the facility to make feasible the transfer between them of patients and the information referred to in paragraph (2), shall be considered to have such an agreement in effect if and for so long as such agency (or the Secretary, as the case may be) finds that to do so is in the public interest and essential to assuring extended care services for persons in the community who are eligible for payments with respect to such services under this title. “Home Health Services “(m) The term ‘home health services’ means the following items and services furnished to an individual, who is under the care of a physician, by a home health agency or by others under arrangements with them made by such agency, under a plan (for furnishing such items and services to such individual) established and periodically reviewed by a physician, which items and services are, except as provided in paragraph (7), provided on a visiting basis in a place of residence used as such individual’s home— “(1) part-time or intermittent nursing care provided by or under the supervision of a registered professional nurse; “(2) physical, occupational, or speech therapy; “(3) medical social services under the direction of a physician; “(4) to the extent permitted in regulations, part-time or intermittent services of a home health aide; “(5) medical supplies (other than drugs and biologicals), and the use of medical appliances, while under such a plan; “(6) in the ease of a home health agency which is affiliated or under common control with a hospital, medical services provided by an intern or resident-in-training of such hospital, under a teaching program of such hospital approved as provided in the last sentence or subsection (b); and 79 Stat. 320 “(7) any of the foregoing items and services which are provided on an outpatient basis, under arrangements made by the home health agency, at a hospital or extended care facility, or at a rehabilitation center which meets such standards as may be prescribed in regulations, and— “(A) the furnishing of which involves the use of equipment of such a nature that the items and services cannot readily be made available to the individual in such place of residence, or “(B) which are furnished at such facility while he is there to receive any such item or service described in clause (A), but not including transportation of the individual in connection with any such item or service; excluding, however, any item or service if it would not be included under subsection
(b)if furnished to an inpatient of a hospital. “Post-Hospital Home Health Services “(n) The term ‘post-hospital home health services’ means home health services furnished an individual within one year after his most recent discharge from a hospital of which he was an inpatient for not less than 3 consecutive days or (if later) within one year after his most recent discharge from an extended care facility of which he was an inpatient, entitled to payment under part A for post-hospital extended care services, but only if the plan covering the home health services (as described in subsection (m)) is established within 14 days after his discharge from such hospital or extended care facility. “Home Health Agency “(o) The term ‘home health agency’ means a public agency or private organization, or a subdivision of such an agency or organization. which— “(1) is primarily engaged in providing skilled nursing services and other therapeutic services; “(2) has policies, established by a group of professional personnel (associated with the agency or organization), including one or more physicians and one or more registered professional nurses, to govern the services (referred to in paragraph (1)) which it provides, and provides for supervision of such services by a physician or registered professional nurse; “(3) maintains clinical records on all patients; “(4) in the case of an agency or organization in any State in which State or applicable local law provides for the licensing of agencies or organizations of this nature,
(A)is licensed pursuant to such law, or
(B)is approved, by the agency of such State or locality responsible for licensing agencies or organizations of this nature, as meeting the standards established for such licensing; and “(5) meets such other conditions of participation as the Secretary may find necessary in the interest of the health and safety of individuals who are furnished services by such agency or organization; except that such term shall not include a private organization which is not a nonprofit organization exempt from Federal income taxation [68A Stat. 163](/us/stat/68A/163).[26 USC 501](/us/usc/t26/s501).under section 501 of the Internal Revenue Code of 1954 (or a subdivision of such organization) unless it is licensed pursuant to State law and it meets such additional standards and requirements as may be 79 Stat. 321prescribed in regulations; and except that for purposes of part A such term shall not include any agency or organization which is primarily for the care and treatment or mental diseases. “Outpatient Hospital Diagnostic Services “(p) The term ‘outpatient hospital diagnostic services’ means diagnostic services— “(1) which are furnished to an individual as an outpatient by a hospital or by others under arrangements with them made by a hospital; and “(2) which are ordinarily furnished by such hospital (or by others under such arrangements) to its outpatients for the purpose of diagnostic study; excluding, however— “(3) any item or service if it would not be included under subsection
(b)if furnished to an inpatient of a hospital; and “(4) any services furnished under such arrangements unless furnished m the hospital or in other facilities operated by or under the supervision of the hospital or its organized medical staff. “Physicians’ Services “(q) The term ‘physicians’ services’ means professional services performed by physicians, including surgery, consultation, anti home, office, and institutional calls (but not. including services described in the last sentence of subsection (b)). “Physician “(r) The term ‘physician’, when used in connection with the performance of any function or action, means
(1)a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he performs such function or action (including a physician within the meaning of section 1101(a)(7)), or
(2)a doctor of[64 Stat. 559](/us/stat/64/559).[42 USC 1301](/us/usc/t42/s1301). dentistry or of dental or oral surgery who is legally authorized to practice dentistry by the State in which he performs such function but only with respect to
(A)surgery related to the jaw or any structure contiguous to the jaw or
(B)the reduction of any fracture of the jaw or any facial bone, “Medical and Other Health Services “(s) The term ‘medical and other health services’ means any of the following items pr services (unless they would otherwise constitute inpatient hospital services, extended care services, or home health services) : “(1) physicians’ services; “(2) services and supplies (including drugs and biologicals which cannot, as determined in accordance with regulations, be self-administered) furnished as an incident, to a physician’s professional service, of kinds which are commonly furnished in physicians’ offices and are commonly either rendered without charge or included in the physicians’ bills, and hospital services (including drugs and biologicals which cannot, as determined in accordance with regulations, be self-administered) incident to physicians’ services rendered to outpatients; 79 Stat. 322 “(3) diagnostic X-ray tests, diagnostic laboratory tests, and other diagnostic tests; “(4) X-ray, radium, and radioactive isotope therapy, including materials and services of technicians; “(5) surgical dressings, and splints, casts, and other devices used for reduction of fractures and dislocations; “(6) rental of durable medical equipment, including iron lungs, oxygen tents, hospital beds, and wheelchairs used in the patient’s home (including an institution used as his home) : “(7) ambulance service where the use of other methods of transportation is contraindicated by the individual’s condition, but only to the extent provided in regulations; “(8) prosthetic devices (other than dental) which replace all or part of an internal body organ, including replacement of such devices; and “(9) leg, arm, back, and neck braces, and artificial legs, arms, and eyes, including replacements if required because of a change in the patient’s physical condition. No diagnostic tests performed in any laboratory which is independent of a physician’s office or a hospital shall lie included within paragraph
(3)unless such laboratory— “(10) if situated in any State in which State or applicable local law provides for licensing of establishments of this nature,
(A)is licensed pursuant to such law, or
(B)is approved, by the agency of such State or locality responsible for licensing establishments of this nature, as meeting the standards established for such licensing; and “(11) meets such other conditions relating to the health and safety of individuals with respect to whom such tests are performed as the Secretary may find necessary. “Drugs and Biologicals “(t) The term ‘drugs’ and the term ‘biologicals’, except for purposes of subsection (m)(5) of this section, include only such drugs and biologicals, respectively, as are included (or approved for inclusion) in the United States Pharmacopoeia, the National Formulary, or the United States Homeopathic Pharmacopoeia, or in New Drugs or Accepted Dental Remedies (except for any drugs and biologicals unfavorably evaluated therein), or as are approved by the pharmacy and drug therapeutics committee (or equivalent committee) of the medical staff of the hospital furnishing such drugs and biologicals for use in such hospital. “Provider of Services “(u) The term ‘provider of services’ means a hospital, extended care facility, or home health agency. “Reasonable Cost “(v)
(1)The reasonable cost of any services shall be determined in accordance with regulations establishing the method or methods to be used, and the items to be included, in determining such costs for various types or classes of institutions, agencies, and services; except that in any case to which paragraph
(2)or
(3)applies, the amount of the payment determined under such paragraph with respect to the services involved shall be considered the reasonable cost of such services. In prescribing the regulations referred to in the preceding 79 Stat. 323sentence, the Secretary shall consider, among other things, the principles generally applied by national organizations or established prepayment organizations (which have developed such principles) in computing the amount of payment, to be made by persons other than the recipients of services, to providers of services on account of services furnished to such recipients by such providers. Such regulations may provide for determination of the costs of services on a per diem, per unit, per capita, or other basis, may provide for using different methods in different circumstances, may provide for the use of estimates of costs of particular items or services, and may provide for the use of charges or a percentage of charges where this method reasonably reflects the costs. Such regulations shall
(A)take into account both direct and indirect costs of providers of services in order that, under the methods of determining costs, the costs with respect to individuals covered by the insurance programs established by this title will not be borne by individuals not so covered, and the costs with respect to individuals not so covered will not be borne by such insurance programs, and
(B)provide for the making of suitable retroactive corrective adjustments where, for a provider of services for any fiscal period, the aggregate reimbursement produced by the methods of determining costs proves to be either inadequate or excessive. “(2)
(A)If the bed and board furnished as part of inpatient hospital services (including inpatient tuberculosis hospital services and inpatient psychiatric hospital services) or post-hospital extended care services is in accommodations more expensive than semiprivate accommodations, the amount taken into account for purposes of payment under this title with respect to such services may not exceed an amount equal to the reasonable cost of such services if furnished in such semiprivate accommodations unless the more expensive accommodations were required for medical reasons. “(B) Where a provider of services which has an agreement in effect under this title furnishes to an individual items or services which are in excess of or more expensive than the items or services with respect to which payment may be made under part A or part B, as the case may *Ante*, pp. 291, 301.be, the Secretary shall take into account for purposes of payment to such provider of services only the equivalent of the reasonable cost of the items or services with respect to which such payment may be made. “(3) If the bed and board furnished as part of inpatient hospital services (including inpatient tuberculosis hospital services and inpatient psychiatric hospital services) or post-hospital extended care services is in accommodations other than, but not more expensive than, semiprivate accommodations and the use of such other accommodations rather than semiprivate accommodations was neither at the request of the patient nor for a reason which the Secretary determines is consistent with the purposes of this title, the amount of the payment with respect to such bed and board under part A shall be the reasonable cost of such bed and board furnished in semiprivate accommodations (determined pursuant to paragraph (1)) minus the difference between the charge customarily made by the hospital or extended care facility for bed and board in semiprivate accommodations and the charge customarily made by it for bed and board in the accommodations furnished. “(4) For purposes of this subsection, the term ‘semiprivate accommodations’ “Semi-private accommodations.” means two-bed, three-bed, or four-bed accommodations. 79 Stat. 324 “Arrangements for Certain Services “(w) The term ‘arrangements’ is limited to arrangements under which receipt of payment by the hospital, extended care facility, or home health agency (whether in its own right or as agent), with respect to services for which an individual is entitled to have payment made under this title, discharges the liability of such individual or any other person to pay for the services. “State and United States “(x) [74 Stat. 937](/us/stat/74/937).[42 USC 410](/us/usc/t42/s410). The terms ‘State’ and ‘United States’ have the meaning given to them by subsections
(h)and (i), respectively, of section 210. “Post-Hospital Extended Care in Christian Science Extended Care Facilities “(y)
(1)The term ‘extended care facility’ also includes a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts, but only (except for purposes of subsection (a)(2)) with respect to items and services ordinarily furnished by such an institution to inpatients, and payment may be made with respect to services provided by or in such an institution only to such extent and under such conditions, limitations, and requirements (in addition to or in lieu of the conditions, limitations, and requirements otherwise applicable) as may be provided in regulations. “(2) Notwithstanding any other provision of this title., payment under part A may not be made for services furnished an individual in an extended care facility to which paragraph
(1)applies unless such individual elects, in accordance with regulations, for a spell of illness to have such services treated as post-hospital extended care services for purposes of such part; and payment under part-A may not be made for post-hospital extended care services— “(A) furnished an individual during such spell of illness in an extended care facility to which paragraph
(1)applies after— “(i) such services have been furnished to him in such a facility for 30 days during such spell, or “(ii) such services have been furnished to him during such spell in an extended care facility to which such paragraph does not apply; or “(B) furnished an individual during such spell of illness in an extended care facility to which paragraph
(1)does not apply after such services have been furnished to him during such spell in an extended care facility to which such paragraph applies. “(3) The amount payable under part A for post-hospital extended care services furnished an individual during any spell of illness in an extended care facility to which paragraph
(1)applies shall be reduced by a coinsurance amount equal to one-eighth of the inpatient hospital deductible for each day before the 31st day on which he is furnished such services in such a facility during such spell (and the reduction under this paragraph shall be in lieu of any reduction under section *Ante*, p. 292.1813(a)(4)). “(4) For purposes of subsection (i), the determination of whether services furnished by or in an institution described in paragraph
(1)constitute post-hospital extended care services shall be made in accordance with and subject to such conditions, limitations, and requirements as may be provided in regulations. 79 Stat. 325 “exclusions from coverage “Sec. 1862.
(a)Notwithstanding any other provision of this title, no payment may be made under part A or part B for any expenses *Ante*, pp, 291, 301.incurred for items or services— “(1) which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member; “(2) for which the individual furnished such items or services has no legal obligation to pay, and which no other person (by reason of such individual’s membership in a prepayment plan or otherwise) has a legal obligation to provide or pay for; “(3) which are paid for directly or indirectly by a governmental entity (other than under this Act and other than under a health benefits or insurance plan established for employees of such an entity), except in such cases as the Secretary may specify; “(4) which are not provided within the United States (except for emergency inpatient hospital services furnished outside the United States under the conditions described in section 1814 (f));*Ante*, p. 294. “(5) which are required as a result of war, or of an act of w, occurring after the effective date of such individual’s current coverage under such part; “(6) which constitute personal comfort items; “(7) where such expenses are for routine physical checkups, eyeglasses or eye examinations for the purpose of prescribing, fitting, or changing eyeglasses, hearing aids or examinations therefor, or immunizations; “(8) where such expenses are for orthopedic shoes or other supportive devices for the feet; “(9) where such expenses are for custodial care; “(10) where such expenses are for cosmetic surgery or are incurred in connection therewith, except as required for the prompt repair of accidental injury or for improvement of the functioning of a malformed body member; “(11) where such expenses constitute charges imposed by immediate relatives of such individual or members of his household; or “(12) where such expenses are for services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth. “(b) Payment under this title may not be made with respect to any item or service to the extent that payment has been made, or can reasonably be expected to be made (as determined in accordance with regulations), with respect to such item or service, under a workmen’s compensation law or plan of the United States or a State. Any payment under this title with respect to any item or service shall be conditioned on reimbursement to the appropriate Trust Fund established by this title when notice or other information is received that payment for such item or service has been made under such a law or plan. “consultation with state agencies and other organizations to develop conditions of participation for providers of services “Sec. 1863. In carrying out his functions, relating to determination of conditions of participation by providers of services, under subsections (e)(8), (f)(4), (g)(4), (j)(10), and (o)(5) of section 1861, the Secretary shall consult with the Health Insurance Benefits Advisory Council established by section 1867, appropriate State agencies, 79 Stat. 326and recognized national listing or accrediting bodies, and may consult with appropriate local agencies. Such conditions prescribed under any of such subsections may be varied for different areas or different classes of institutions or agencies and may, at the request-of a State, provide higher requirements for such State than for other States; except that, in the case of any State or political subdivision of a State which imposes higher requirements on institutions as a condition to the purchase of services (or of certain specified services) in such institutions [42 USC 301](/us/usc/t42/s301), *Post*, p. 343.under a State plan approved under title I, XVI, or XIX, the Secretary shall impose like requirements as a condition to the payment for services (or for the services specified by the State or subdivision) in such institutions in such State or subdivision. “use of state agencies to determine compliance by providers of services with conditions of participation “Sec. 1864.
(a)The Secretary shall make an agreement with any State which is able and willing to do so under which the services of the State health agency or other appropriate State agency (or the appropriate local agencies) will be utilized by him for the purpose of determining whether an institution therein is a hospital or extended care facility, or whether an agency therein is a home health agency, or whether a laboratory meets the requirements of paragraphs
(10)*Ante*, p. 321.and
(11)of section 1861 (s). To the extent that the Secretary finds it appropriate, an institution or agency which such a State (or local) agency certifies is a hospital, extended care facility, or home health agency (as those terms are defined in section 1861) may be treated as such by the Secretary. The Secretary may also, pursuant to agreement, utilize the services of State health agencies and other appropriate State agencies (and the appropriate local agencies) to do any one or more of the following:
(1)to provide consultative services to institutions or agencies to assist them
(A)to establish and maintain fiscal records necessary for purposes of this title, or otherwise to qualify as hospitals, extended care facilities, or home health agencies, or
(B)to provide information which may be necessary to permit determination under this title as to whether payments are due and the amounts thereof, and
(2)to provide consultative services to institutions, agencies, or organizations to assist in the establishment of utilization review procedures meeting the requirements of section 1861
(k)and in evaluating their effectiveness. “(b) The Secretary shall pay any such Stale, in advance or by way of reimbursement, as may be provided in the agreement with it (and may make adjustments in such payments on account-of overpayments or underpayments previously made), for the reasonable cost of performing the functions specified in subsection (a), and for the Federal*Ante*, p. 299. Hospital Insurance Trust Fund’s fair share of the costs attributable to the planning and other efforts directed toward coordination of activities in carrying out its agreement and other activities related to the provision of services similar to those for which payment may be made under part A, or related to the facilities and personnel required for the provision of such services, or related to improving the quality of such services. “effect of accreditation “Sec. 1865, Except as provided in the second sentence of section 1863, an institution shall be deemed to meet the requirements of the numbered paragraphs of section 1861(e)(except paragraph
(6)thereof) if such institution is accredited as a hospital by the Joint Commission on Accreditation of Hospitals. If such Commission, as 79 Stat. 327a condition for accreditation of a hospital, requires a utilization review plan or imposes another requirement which serves substantially the same purpose, the Secretary is authorized to find that all institutions so accredited by the Commission comply also with section 1861 (e)(6), In addition, if the Secretary finds that accreditation of an institution or agency by the American Osteopathic Association or any other national accreditation body provides reasonable assurance that, any or all of the conditions of section 1861 (e), (]), or (o), as the case may be, are met, he may, to the extent he deems it appropriate, treat such institution or agency as meeting the condition or conditions with respect to which he made such finding. “agreements with providers of services “Sec. 1866.
(1)Any provider of services shall be qualified to participate under this title and shall be eligible for payments under this title if it files with the Secretary an agreement— “(A) not to charge, except as provided in paragraph (2), any individual or any other person for items or services for which such individual is entitled to have payment made under this title (or for which he would be so entitled if such provider of services had complied with the procedural and other requirements under or pursuant to this title or for which such provider is paid pursuant to the provisions of section 1814(e)), and*Ante*, p. 296. “(B) to make adequate provision for return (or other disposition, in accordance with regulations) of any moneys incorrectly collected from such individual or other person. “(2)
(A)A provider of services may charge such individual or other person
(i)the amount of any deduction or coinsurance amount imposed pursuant to section 1813 (a)(1), (a)(2), or (a)(4), section 1833 (b),or section 1861 (y)(3) with respect to such items and services (not in excess of the amount customarily charged for such items and services by such provider), and
(ii)an amount equal to 20 per centum of the reasonable charges for such items and services (not in excess of 20 per centum of the amount customarily charged for such items and services by such provider) for which payment is made under part B or, in the case of outpatient hospital diagnostic services, for which payment is made under part A. In the case of items and services described in section 1833(c), clause
(ii)of the preceding sentence shall be applied by substituting for 20 percent the proportion which is appropriate under such section. “(B) Where a provider of services has furnished, at the request of such individual, items or services which are in excess of or more expensive than the items or services with respect to which payment may be made under this title, such provider of services may also charge such individual or other person for such more expensive items or services to the extent that the amount customarily charged by it for the items or services furnished at such request exceeds the amount customarily charged by it for the items or services with respect to which payment may be made under this title. “(C) A provider of services may also charge any such individual for any whole blood furnished him with respect to which a deductible is imposed under section 1813(a)(3), except that
(i)any excess of such charge over the cost to such provider for the blood shall be deducted from any payment to such provider under this title,
(ii)no such charge may be imposed for the cost of administration of such 79 Stat. 328blood, and
(iii)such charge may not be made to the extent such blood has been replaced on behalf of such individual or arrangements have been made for its replacement on his behalf. “(b) Termination of agreements. An agreement with the Secretary under this section may be terminated— “(1) by the provider of services at such time and upon such notice to the Secretary and the public as may be provided in regulations, except that notice of more than 6 months shall not be required, or “(2) by the Secretary at such time and upon such reasonable notice to the provider of services and the public as may be specified in regulations, but only after the Secretary has determined
(A)that such provider of services is not complying substantially with the provisions of such agreement, or with the provisions of this title and regulations thereunder, or
(B)that such provider of services no longer substantially meets the applicable provisions of section 1861, or
(C)that such provider of services has failed to provide such information as the Secretary finds necessary to determine whether payments are or were due under this title and the amounts thereof, or has refused to permit such examination of its fiscal and other records by or on behalf of the Secretary as may be necessary to verify such information. Any termination shall be applicable— “(3) in the case of inpatient hospital services (including inpatient tuberculosis hospital services and inpatient psychiatric hospital services) or post-hospital extended care services, with respect to such services furnished to any individual who is admitted to the hospital or extended care facility furnishing such services on or after the effective date of such termination, “(4)
(A)with respect to home health services furnished to an individual under a plan therefor established on or after the effective date of such termination, or
(B)if a plan is established before such effective date, with respect to such services furnished to such individual after the calendar year in which such termination is effective, and “(5) with respect, to any other items and services furnished on or after the effective date of such termination. “(c) Where an agreement, filed under this title by a provider of services has been terminated by the Secretary, such provider may not file another agreement under this title unless the Secretary finds that the reason for the termination has been removed and that there is reasonable assurance that it will not recur. “(d) If the Secretary finds that there is a substantial failure to make timely review in accordance with section 1861(k) of long-stay cases in a hospital or extended care facility, he may, in lieu of terminating his agreement with such hospital or facility, decide that, with respect to any individual admitted to such hospital or facility after a subsequent date specified by him, no payment shall be made under this title for inpatient hospital services (including inpatient tuberculosis hospital services and inpatient psychiatric hospital services) after the 20th day of a continuous period of such services or for post-hospital extended care services after such day of a continuous period of such care as is prescribed in or pursuant to regulations, as the case may be. Such decision may lie made effective only after such notice to the hospital, or (in the case of an extended care facility) to the facility and the hospital or hospitals with which it has a transfer agreement, and to the public, as may be prescribed by regulations, and its effectiveness 79 Stat. 329shall terminate when the Secretary finds that the reason therefor has been removed and that there is reasonable assurance that it will not recur. The Secretary shall not make any such decision except after reasonable notice and opportunity for hearing to the institution or agency affected thereby. “health insurance benefits advisory council “Sec. 1867. For the purpose of advising the Secretary on matters of general policy in the administration of this title and in the formulation of regulations under this title, there is hereby created a Health Insurance Benefits Advisory Council which shall consist, of 16 persons, not otherwise in the employ of the United States, appointed by the Secretary without, regard to the civil service laws. The Secretary shall from time to time appoint one of the members to serve as Chairman. The members shall include persons who are outstanding in fields related to hospital, medical, and other health activities, and at least one person who is representative of the general public. Each member shall hold office for a term of 4 years, except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term, and except that the terms of office of the members first, taking office shall expire, as designated by the Secretary at. the time of appointment, four at the end of the first year, four at the end of the second year, four at the end of the third year, and four at the end of the fourth year after the date of appointment. A member shall not be eligible to serve continuously for more than 2 terms. The Secretary may, at the request of the Council or otherwise, appoint such special advisory professional or technical committees as may be useful in carrying out this title. Members of the Advisory Council and members of any such advisory or technical committee, while attending meetings or conferences thereof or otherwise serving on business of the Advisory Council or of such committee, shall be entitled to receive compensation at rates fixed by the Secretary, but not exceeding $100 per day, including travel time, and while so serving away from their homes or regular places of business they may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section 5 of the Administrative Expenses Act of 1946 (5 U.S.C. 73b–2) for persons in the [60 Stat. 808](/us/stat/60/808); [75 Stat. 339, 340](/us/stat/75/339/340).Government service employed intermittently. The Advisory Council shall meet as frequently as the Secretary deems necessary. Upon request of 4 or more members, it shall be the duty of the Secretary to call a meeting of the Advisory’ Council. “national medical review committee “Sec. 1868.
(a)There is hereby created a National Medical Review Committee (hereinafter in this section referred to as the ‘Committee’) which shall consist of nine persons, not otherwise in the employ of the United States, appointed by the Secretary without regard to the civil service laws. The Secretary shall from time to time appoint one of the members to serve as chairman. The members shall be selected from among individuals who are representative of organizations and associations of professional personnel in the field of medicine and other individuals who are outstanding in the field of medicine or in related fields; except that at least one member shall be representative of the general public, and at least a majority of the members shall be physicians. Each member shall hold office for a term of three years, except 79 Stat. 330that any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term, and except that the terms of office of the members first taking office shall expire, as designated by the Secretary at the time of appointment, three at the end of the first year, three at the end of the second year, and three at the end of the third year after the date of appointment. A member shall not be eligible to serve continuously for more than two terms. “(b) Members of the Committee, while attending meetings or conferences thereof or otherwise serving on business of the Committee, shall be entitled to receive compensation at rates fixed by the Secretary, but not exceeding $100 per day, including travel time, and while so serving away from their homes or regular places of business they may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section 5 of the Administrative Expenses Act [60 Stat. 808](/us/stat/60/808); [75 Stat. 339, 340](/us/usc/t75/s339/340).of 1946 (5 U.S.C. 73b–2) for persons in the Government service employed intermittently. “(c) It shall be the function of the Committee to study the utilization of hospital and other medical care and services for which payment may be made under this title with a view to recommending any changes which may seem desirable in the way in which such care and services are utilized or in the administration of the programs established by this title, or in the provisions of this title. The CommitteeReport to Congress. shall make an annual report to the Secretary of the results of its study, including any recommendations it may have with respect thereto, and such report shall be transmitted promptly by the Secretary to the Congress. “(d) The Committee is authorized to engage such technical assistance as may be required to carry out its functions, and the Secretary shall, in addition, make available to the Committee such secretarial, clerical, and other assistance and such pertinent data obtained and prepared by the Department of Health, Education, and Welfare as the Committee may require to carry out its functions. “determinations; appeals “Sec. 1869.
(a)The determination of whether an individual is entitled to benefits under part. A or part B, and the determination of the amount of benefits under part A, shall be made by the Secretary in accordance with regulations prescribed by him. “(b) Any individual dissatisfied with any determination under subsection
(a)as to entitlement under part A or part B, or as to amount of benefits under part A where the matter in controversy is $100 or more, shall be entitled to a hearing thereon by the Secretary [42 USC 405](/us/usc/t42/s405).to the same extent as is provided in section 205(b), and, in the case of a determination as to entitlement or as to amount of benefits where the amount in controversy is $1,000 or more, to judicial review of the Secretary’s final decision after such hearing as is provided in section 205(g). “(c) Any institution or agency dissatisfied with any determination by the Secretary that it is not a provider of services, or with any determination described in section 1866(b)(2), shall be entitled to a hearing thereon by the Secretary (after reasonable notice and opportunity for hearing) to the same extent as is provided in section 205(b), and to judicial review of the Secretary’s final decision after such hearing as is provided in section 205(g). 79 Stat. 331 “overpayments on behalf of individuals “Sec. 1870.
(a)Any payment under this title to any provider of services or other person with respect to any items or services furnished any individual shall be regarded as a payment to such individual. “(b) Where— “(1) more than the correct amount is paid under this title to a provider of services or other person for items or services furnished an individual end the Secretary determines that, within such period as he may specify, the excess over the correct amount cannot be recouped from such provider of services or other person, or “(2) any payment has been made under section 1814(e) to a *Ante*, p. 294.provider of services or other person for items or services furnished on individual, proper adjustments shall be made, under regulations prescribed (after consultation with the Railroad Retirement Board) by the Secretary, by decreasing subsequent payments— “(3) to which such individual is entitled under title II of this Act or under the Railroad Retirement Act of 1937, as the case [42 USC 401](/us/usc/t42/s401).*Post*, pp. 335, 340, 400.may be, or “(4) if such individual dies before such adjustment has been completed, to which any other individual is entitled under title II of this Act or under the Railroad Retirement Act of 1937, as the case may be, with respect to the wages and self-employment income or the compensation constituting the basis of the benefits of such deceased individual under title II of such Act. As soon as practicable after any adjustment under paragraph
(3)or
(4)is determined to be necessary, the Secretary, for purposes of this section, section 1817(g), and section 1841(f), shall certify (to the Railroad Retirement Board if the adjustment, is to be made by decreasing subsequent payments under the Railroad Retirement Act of 1937) the amount of the overpayment as to which the adjustment is to be made. “(c) There shall be no adjustment as provided in subsection (b)(nor shall there be recovery) in any case where the incorrect payment has been made (including payments under section 1814(e)) with respect to an individual who is without fault and where such adjustment (or recovery) would defeat the purposes of title II or would be against equity and good conscience. “(d) No certifying or disbursing officer shall be held liable for any amount certified or paid by him to any provider of services or other person where the adjustment or recovery of such amount is waived under subsection
(c)or where adjustment under subsection
(b)is not completed prior to the death of all persons against whose benefits such adjustment is authorized. “regulations “Sec. 1871. The Secretary shall prescribe such regulations as may be necessary to carry out the administration of the insurance programs under this title. When used in this title, the term ‘regulations’ means, unless the context otherwise requires, regulations prescribed by the Secretary. 79 Stat. 332 “application of certain provisions of title ii “Sec. 1872. [42 USC 401–425](/us/usc/t42/s401–425). The provisions of sections 206, 208, and 216(j), and of subsections (a), (d), (e), (f), (h), (i), (j), (k), and
(l)of section 205, shall also apply with respect to this title to the same extent as they are applicable with respect to title II. “designation of organization or publication by name “Sec. 1873. Designation in this title, by name, of any nongovernmental organization or publication shall not be affected by change of name or such organization or publication, and shall apply to any successor organization or publication which the Secretary finds serves the purpose for which such designation is made. “administration “Sec. 1874.
(a)Except as otherwise provided in this title, the insurance programs established by this title shall be administered by the Secretary. The Secretary may perform any of his functions under this title directly, or by contract providing for payment in .advance or by way of reimbursement, and in such installments, as the Secretary may deem necessary. “(b) The Secretary may contract with any person, agency, or institution to secure on a reimbursable basis such special data, actuarial information, and other information as may be necessary in the carrying out of his functions under this title. “studies and recommendations “Sec. 1875.
(a)The Secretary shall carry on studies and develop recommendations to be submitted from time to time to the Congress relating to health care of the aged, including studies and recommendations concerning
(1)the adequacy of existing personnel and facilities for health care for purposes of the programs under parts A and B; *Ante*, pp. 291, 301.(2) methods for encouraging the further development of efficient and economical forms of health care which are a constructive alternative to inpatient hospital care; and
(3)the effects of the deductibles and coinsurance provisions upon beneficiaries, persons who provide health services, and the financing, of the program. “(b) Reports to Congress. The Secretary shall make a continuing study of the operation and administration of the insurance programs under parts A and B, and shall transmit to the Congress annually a report concerning the operation of such programs.” "
(b)If—
(1)an individual was eligible to enroll under section 1837(c) of the Social Security Act before April 1, 1966, but failed to enroll before such date, and
(2)it is shown to the satisfaction of the Secretary of Health, Education, and Welfare that there was good cause for such failure to enroll before April 1, 1966, such individual may enroll pursuant to this subsection at any time before October 1, 1966. The determination of what constitutes good cause for purposes of the preceding sentence shall be made in accordance with regulations of the Secretary. In the case of any individual who enrolls pursuant to this subsection, the coverage period (within the meaning of section 1838 of the .Social Security Act) shall begin on the first day of the 6th month after the month in which he so enrolls. 79 Stat. 333 transitional provision on eligibility of presently uninsured individuals for hospital insurance benefits Sec. 103.
(a)Anyone who—
(1)has attained the age of 65,
(A)attained such age before 1968, or
(B)has not less than 3 quarters of coverage (as defined in title II of the Social Security Act or section 5(1) of the Railroad Retirement Act of [42 USC 401](/us/usc/t42/s401).[60 Stat. 733](/us/stat/60/733).[45 USC 228e](/us/usc/t45/s228e).1937), whenever acquired, for each calendar year elapsing after 1965 and before the year in which he attained such age,
(3)is not, and upon filing application for monthly insurance benefits under section 202 of the Social Security Act would not[42 USC 402](/us/usc/t42/s402). be, entitled to hospital insurance benefits under section 226 of*Ante*, p. 290. such Act, and is not certifiable as a qualified railroad retirement beneficiary under section 21 of the Railroad Retirement Act of 1937 (as added by section 105
(a)of this Act),
(4)is a resident of the United States (as defined in section 210(i) of the[74 Stat. 937](/us/stat/74/937).[42 USC 410](/us/usc/t42/s410). Social Security Act), and is
(A)a citizen of the United States or
(B)an alien lawfully admitted for permanent residence who has resided in the United States (as so defined) continuously during the 5 years immediately preceding the month in which he files application under this section, and
(5)has filed an application under this section in such manner and in accordance with such other requirements as may be prescribed in regulations of the Secretary, shall (subject to the limitations in this section) be deemed, solely for purposes of section 226 of the Social Security Act, to be entitled to monthly insurance benefits under such section 202 for each month, beginning with the first month in which he meets the requirements of this subsection and ending with the month in which he dies, or, if earlier, the month before the month in which he becomes (or upon filing application for monthly insurance benefits under section 202 of such Act would become) entitled to hospital insurance benefits under section 226 or becomes certifiable as a qualified railroad retirement beneficiary. An individual who would have met the preceding requirements of this subsection in any month had he filed application under paragraph
(5)hereof before the end of such month shall be deemed to have met such requirements in such month if he files such application before the end of the twelfth month following such month. No application under this section which is filed by an individual more than 3 month before the first month in which he meets the requirements of paragraphs (1), (2), (3), and
(4)shall be accepted as an application for purposes of this section.
(b)The provisions of subsection
(a)shall not apply to any individual who—
(1)is, at the beginning of the first month in which he meets the requirements of subsection (a), a member of any organization referred to in section 210(a)(17) of the Social Security Act,[70 Stat. 839](/us/stat/70/839).[42 USC 410](/us/usc/t42/s410).
(2)has, prior to the beginning of such first month, been convicted of any offense listed in section 202
(u)of the Social Security Act, or*Post*, p. 334.
(A)at the beginning of such first month is covered by an enrollment in a health benefits plan under the Federal Employees Health Benefits Act of 1959,[73 Stat. 708](/us/stat/73/708).[5 USC 3001 note](/us/usc/t5/s3001).
(B)was so covered on February 16, 1965, or 79 Stat. 334
(C)could have been so covered for such first month if he or some other person had availed himself of opportunities to enroll in a health benefits plan under such Act and to continue such enrollment (but this subparagraph shall not apply unless he or such other person was a Federal employee at any time after February 15, 1965). Paragraph
(3)shall not apply in the case of any individual for the month (or any month thereafter) in which coverage under such a health benefits plan ceases (or would have ceased if he had had such coverage) by reason of his or some other person’s separation from Federal service, if he or such other person was not (or would not have been) eligible to continue such coverage after such separation.
(c)There are authorized to be appropriated to the Federal Hospital Insurance Trust Fund (established by section 1817 of the Social Security Act) from time to tune such sums as the Secretary deems necessary for any fiscal year, on account of—
(1)*Ante*, p. 291. payments made or to be made during such fiscal year from such Trust Fund under part A of title XVIII of such Act with respect to individuals who are entitled to hospital insurance benefits under section 226 of such Act solely by reason of this*Ante*, p. 290. section,
(2)the additional administrative expenses resulting or expected to result therefrom, and
(3)any loss in interest to such Trust Fund resulting from the payment of such amounts, in order to place such Trust Fund in the same position at the end of such fiscal year in which it would have been if the preceding subsections of this section had not been enacted. suspension in case of aliens; persons convicted of subversive activities Sec. 104. [70 Stat. 835](/us/stat/70/835).[42 USC 402](/us/usc/t42/s402).
(1)Section 202(t) of the Social Security Act is amended by adding at the end thereof the following new paragraph: " “(9) No payments shall be made under part A of title XVIII with respect to items or services furnished to an individual in any month for which the prohibition in paragraph
(1)against payment of benefits to him is applicable (or would be if he were entitled to any such benefits).” "
(2)Section 202
(u)of such Act is amended by striking out “and” before the phrase “in determining the amount of any such benefit payable to such individual for any such month,” and inserting after such phrase “and in determining whether such individual is entitled to insurance benefits under part A of title XVIII for any such month,”.
(b)*Ante*, p. 301.
(1)No payments shall be made under part. B of title XVIII of the Social Security Act with respect to expenses incurred by an individual during any month for which such individual may not be paid monthly benefits under title II of such Act (or for which such monthly benefits would be suspended if he were otherwise entitled thereto) by reason of section 202(t) of such Act (relating to suspension of benefits of aliens who are outside the United States).
(2)An individual who has been convicted of any offense under
(A)chapter 37 (relating to espionage and censorship), chapter 105 (relating to sabotage), or chapter 115 (relating to treason, sedition, 79 Stat. 335and subversive activities) of title 18 of the United States Code, or
(B)[18 USC 792, 2151, 2381](/us/usc/t18/s792/2151/2381).[64 Stat. 991, 1029](/us/stat/64/991/1029).[50 USC 783, 822, 823](/us/usc/t50/s783/822/823).section 4,112, or 113 of the Internal Security Act of 1950, as amended, may not enroll under part B of title XVIII of the Social Security Act. railroad retirement amendments Sec. 105.
(1)The Railroad Retirement Act of 1937 is amended [50 Stat. 307](/us/stat/50/307).[45 USC 2280–228z–1](/us/usc/t45/s2280–228z–1).by adding after section 20 the following new section: " “hospital insurance benefits for the aged “Sec. 21. For the purposes of part A of title XVIII of the Social *Ante*, p. 291.Security Act, in order to provide hospital insurance benefits for annuitants, pensioners, and certain other aged individuals, the Board shall, upon request of the Secretary of Health, Education, and Welfare, certify to the Secretary the name of any individual who has attained age 65 and who
(1)is entitled to an annuity or pension under this Act,
(2)would be entitled to such an annuity had he
(i)ceased compensated service and (in the case of a spouse) had such spouse’s husband or wife ceased compensated service and
(ii)applied for such annuity, or
(3)bears a relationship to an employee which, by reason of section 3(e) of this Act, has been, or would be, taken into account in calculating the amount of an annuity of such employee or his survivors. Such a certification shall include such additional information as may be necessary to carry out the provisions of part A of title XVIII of the Social Security Act, and shall become effective on the date of certification or on such earlier date not. more than one year prior to the date of certification as the Board states that such individual first met the requirements for certification. The Board shall notify the Secretary or the date on which such individual no longer meets the requirements of this section.” "
(2)For purposes of section 21 of the Railroad Retirement Act of 1937 (and sections 1840, 1843, and 1870 of the Social Security Act), entitlement to an annuity or pension under the Railroad Retirement Act of 1937 shall be deemed to include entitlement under the Railroad Retirement. Act of 1935.[45 USC 215–228](/us/usc/t45/s215–228).
(1)Section 3201 of the Internal Revenue Code of 1954 (relating to rate of tax on employees under the Railroad Retirement Tax Act) [73 Stat. 28](/us/stat/73/28).[26 USC 3201](/us/usc/t26/s3201).is amended by striking out “the rate of the tax imposed with respect to wages by section 3101 at such time exceeds the rate provided by paragraph
(2)of such section 3101 as amended by the Social Security Amendments of 1956” and inserting in lieu thereof “the rate of the tax imposed with respect to wages by section 3101(a) at such time *Post*, p. 395.exceeds 2% percent (the rate provided by paragraph
(2)of section 3101 as amended by the Social Security Amendments of 1956)”.[70 Stat. 845](/us/stat/70/845).
(2)Section 3211 of such Code (relating to the rate of tax on [73 Stat. 29](/us/stat/73/29).[26 USC 3211](/us/usc/t26/s3211).employee representatives under the Railroad Retirement Tax Act) is amended by striking out “the rate of the tax imposed with respect to wages by section 3101 at such time exceeds the rate provided by paragraph
(2)of such section 3101 as amended by the Social Security Amendments of 1956” and inserting in lieu thereof “the rate of the tax imposed with respect to wages by section 3101(a) at such time exceeds 2% percent (the rate provided by paragraph
(2)of section 3101 as amended by the Social Security Amendments of 1956)”.
(3)Section 3221(b) of such Code (relating to the rate of tax on [26 USC 3221](/us/usc/t26/s3221).employers under the Railroad Retirement Tax Act) is amended by striking out “the rate of the tax imposed with respect to wages by section 3111 at such time exceeds the rate provided by paragraph
(2)79 Stat. 336of such section 3111 as amended by the Social Security Amendments of 1956” and inserting in lieu thereof “the rate of the tax imposed with *Post*, p. 336.respect to wages by section 3111(a) at such time exceeds 2% percent (the rate provided by paragraph
(2)of section 3111 as amended by [70 Stat. 845](/us/stat/70/845).the Social Security Amendments of 1956)”.
(4)The amendments made by this subsection shall be effective with respect to compensation paid for services rendered after December 31, 1965.
(c)For amendments preserving relationship between the railroad retirement and old-age, survivors, and disability insurance systems, see *Post*, p. 400.section 326 of this Act. medical expense deduction Sec. 106. [74 Stat. 133](/us/stat/74/133).[26 USC 213](/us/usc/t26/s213).
(a)Subsection
(a)of section 213 of the Internal Revenue Code of 1954 (relating to allowance of deduction) is amended to read as follows: " “(a) Allowance of Deduction.— There shall be allowed as a deduction the following amounts, not. compensated for by insurance or otherwise— “(1) the amount by which the amount of the expenses paid during the taxable year (reduced by any amount deductible under paragraph (2)) for medical care of the taxpayer, his spouse, and dependents (as defined in section 152) exceeds 3 percent of the [68A Stat. 43](/us/stat/68A/43).[26 USC 152](/us/usc/t26/s152).adjusted gross income, and “(2) an amount (not in excess of $150) equal to one-half of the expenses paid during the taxable year for insurance which constitutes medical care for the taxpayer, his spouse, and dependents.” "
(b)Repeal. The second sentence of section 213(b) of such Code (relating to limitation with respect to medicine and drugs) is repealed.
(c)Section 213(e) of such Code (relating to definitions) is amended by renumbering paragraph
(2)as paragraph (4), and by striking out paragraph
(1)and inserting in lieu thereof the following: " “(1) “Medical care.” The term ‘medical care’ means amounts paid— “(A) for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body, “(B) for transportation primarily for and essential to medical care referred to in subparagraph (A), or “(C) *Ante*, p. 301. for insurance (including amounts paid as premiums under part B of title XVIII of the Social Security Act, relating to supplementary medical insurance for the aged) covering medical care referred to in subparagraphs
(A)and (B). “(2) In the case of an insurance contract under which amounts are payable for other than medical care referred to in subparagraphs
(A)and
(B)of paragraph (1)— “(A) no amount shall be treated as paid for insurance to which paragraph (1)(C) applies unless the charge for such insurance is either separately stated in the contract, or furnished to the policyholder by the insurance company in a separate statement, “(B) the amount taken into account as the amount paid for such insurance shall not exceed such charge, and “(C) no amount shall be treated as paid for such insurance if the amount specified in the contract (or furnished to the 79 Stat. 337policyholder by the insurance company in a separate statement) as the charge for such insurance is unreasonably large in relation to the total charges under the contract. “(3) Subject to the limitations of paragraph (2), premiums paid during the taxable year by a taxpayer before he attains the age of 65 for insurance covering medical care (within the meaning of subparagraphs
(A)and
(B)of paragraph (1)) for the taxpayer, his spouse, or a dependent after the taxpayer attains the age of 65 shall be treated as expenses paid during the taxable year for insurance which constitutes medical care if premiums for such insurance are payable (on a level payment basis) under the contract for a period of 10 years or more or until the year in which the taxpayer attains the age of 65 (but in no case for a period of less than 5 years).” "
(1)Section 213 of such Code (relating to medical, dental, etc., [72 Stat. 1613](/us/stat/72/1613).[26 USC 213](/us/usc/t26/s213).expenses) is amended by striking out subsections
(c)and
(g)of such section.
(A)Section 72(m)(5)(A)(i) of such Code (relating to special [76 Stat. 821](/us/stat/76/821).[26 USC 72](/us/usc/t26/s72).rules applicable to employment, annuities and distributions under employee plans) is amended by striking out “section 213(g)(3)” and inserting in lieu thereof “paragraph
(7)of this subsection”.
(B)Section 72
(m)of such Code is further amended by adding at the end thereof the following new paragraph: " “(7) Meaning of disabled.— For purposes of this section, an individual shall be considered to be disabled if he is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result, in death or to be of long-continued and indefinite duration. An individual shall not be considered to be disabled unless he furnishes proof of the existence thereof in such form and manner as the Secretary or his delegate may require.” "
(C)Subparagraphs (A)(iii) and (B)(iii) of section 72(d)(1) of such Code (relating to treatment of certain distributions with respect to contributions by self-employed individuals) are each amended by striking out “section 213(g)(3)” and inserting in lieu thereof “subsection (m)(7)”.
(3)Section 79(b)(1) of such Code (relating to groupterm life [78 Stat. 36](/us/stat/78/36).[26 USC 79](/us/usc/t26/s79).insurance purchased for employees) is amended by striking out “paragraph
(3)of section 213(g), determined without regard to paragraph
(4)thereof” and inserting in lieu thereof “section 72(m)(7)”.
(4)Section 401(d)(4)(B) of such Code (relating to additional [76 Stat. 809](/us/stat/76/809).[26 USC 401](/us/usc/t26/s401).requirements for qualification of trusts and plans benefiting owner-employees) is amended by striking out. “section 213(g)(3)” and inserting in lieu thereof “section 72 (m)(7)”.
(5)Section 405(b)(1)(D)(ii) of such Code (relating to qualified [26 USC 405](/us/usc/t26/s405).bond purchase plans) is amended by striking out “section 213(g)(3)” and inserting in lieu thereof “section 72(m)(7)”.
(e)The amendments made by this section shall apply to taxable years beginning after December 31, 1966. receipts for employees must show taxes separately Sec. 107. Section 6051(c) of the Internal Revenue Code of 1954 [68A Stat. 747](/us/stat/68A/747).[26 USC 6051](/us/usc/t26/s6051).(relating to additional requirements) is amended by adding at the end thereof the following new sentence: “The statements required under this section shall also show the proportion of the total amount 79 Stat. 338*Post*, p. 395.*Ante*, p. 291.with held as tax under section 3101 which is for financing the cost of hospital insurance benefits under part A of title XVIII of the Social Security Act.” technical and administrative amendments relating to trust funds Sec. 108. [70 Stat. 819](/us/stat/70/819).[42 USC 401](/us/usc/t42/s401).
(1)Section 201(a)(3) of the Social Security Act is amended by inserting “(other than sections 3101(b) and 3111(b))” after “chapter 21” each place it appears therein.
(2)Section 201(a)(4) of such Act is amended by inserting “(other than section 1401 (b))” after “chapter 2” and after “such subchapter or chapter”.
(3)Section 201(g)(1) of such Act is amended to read as follows: " “(1)
(A)There are authorized to be made available for expenditure, out of any or all of the Trust Funds (which for purposes of this paragraph shall include also the Federal Hospital Insurance Trust *Ante*, pp, 299, 308.Fund and the Federal Supplementary Medical Insurance Trust Fund established by title XVIII), such amounts as the Congress may deem appropriate to pay the costs of the part of the administration of this title and title XVIII for which the Secretary of Health, Education, and Welfare is responsible. During each fiscal year or after the close of such fiscal year (or at both times), (he Secretary of Health, Education, and Welfare shall analyze the costs of administration of this title and title XVIII during the appropriate part or all of such fiscal year in order to determine the port ion of such costs which should be borne by each of the Trust Funds and shall certify to the Managing Trustee the amount, if any, which should be transferred among such Trust Funds in order to assure that each of the Trust Funds bears its proper share of the costs incurred during such fiscal year for the part of the administration of this title and title XVIII for which the Secretary of Health, Education, and Welfare is responsible. The Managing Trustee is authorized and directed to transfer any such amount (determined under the preceding sentence) among such Trust Funds in accordance with any certification so made. “(B) The Managing Trustee is directed to pay from the Trust Funds into the Treasury the amounts estimated by him which will be expended, out of moneys appropriated from the general funds in the Treasury, during each calendar quarter by the Treasury Department for the part of the administration of this title and title XVIII for which the Treasury Department is responsible and for the administration [68A Stat. 353, 415](/us/stat/68A/353/415).[26 USC 1401–1403, 3101–3126](/us/usc/t26/s1401–1403/3101–3126).of chapters 2 and 21 of the Internal Revenue Code of 1954. Such payments shall lie covered into the Treasury as repayment to the account for reimbursement of expenses incurred in connection with such administration of this title and title XVIII and chapters 2 and 21 of the Internal Revenue Code of 1954.” "
(4)Section 201(g)(2) of such Act is amended by inserting after “the amount estimated by him as taxes” the following: “imposed under section 3101(a)”.
(5)Section 201(h) of such Act is amended by inserting “(other than section 226)” after “this title”.
(b)[70 Stat. 823](/us/stat/70/823).[42 USC 418](/us/usc/t42/s418). Section 218(h)(1) of such Act is amended by striking out “Trust. Funds in the ratio in which amounts are appropriated to such Funds pursuant to subsections (a)(3) and (b)(1) of section 201” and inserting in lieu thereof “Trust Funds and the Federal Hospital Insurance Trust Fund in the ratio in which amounts are appropriated to such Funds pursuant to subsection (a)(3) of section 201, subsection *Ante*, p. 299.(b)(1) of such section, and subsection (a)(1) of section 1817, respectively”. 79 Stat. 339
(c)Section 1106(b) of such Act is amended by striking out “and [72 Stat. 1055](/us/stat/72/1055).[42 USC 1306](/us/usc/t42/s1306).the Federal Disability Insurance Trust Fund” and inserting in lieu thereof “, the Federal Disability Insurance Trust Fund, the Federal Hospital Insurance Trust Fund, and the Federal Supplementary Medical Insurance Trust. Fund”. advisory council on social security Sec. 109.
(a)Title VII of the Social Security Act is amended by [49 Stat. 635](/us/stat/49/635).[42 USC 901–906](/us/usc/t42/s901–906).adding at the end thereof the following new section: " “adivosry council on social security “Sec. 706.
(a)During 1968 and every fifth year thereafter, the Secretary shall appoint an Advisory Council on Social Security for the purpose of reviewing the status of the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, the Federal Hospital Insurance Trust Fund, and the [42 USC 401](/us/usc/t42/s401).*Ante*, pp. 299, 308.Federal Supplementary Medical Insurance Trust Fund in relation to the long-term commitments of the old-age, survivors, and disability insurance program and the programs under parts A and B of title XVIII, and of reviewing the scope of coverage and the adequacy of *Ante*, pp. 291, 301.benefits under, and all other aspects of, these programs, including their impact on the public assistance programs under this Act. “(b) Each such Council shall consist of the Commissioner of Social Security, as Chairman, and 12 other persons, appointed by the Secretary without regard to the civil service laws. The appointed members shall, to the extent possible, represent organizations of employers and employees in equal numbers, and represent self-employed persons and the public. “(c)
(1)Any Council appointed hereunder is authorized to engage such technical assistance, including actuarial services, as may be required to carry out its functions, and the Secretary shall, in addition, make available to such Council such secretarial clerical, and other assistance and such actuarial and other pertinent data prepared by the Department of Health, Education, and Welfare as it may require to carry out such functions. “(2) Appointed members of any such Council, while serving on business of the Council (inclusive of travel time), shall receive compensation at rates fixed by the Secretary, but not exceeding $100 per day and, while so serving away from their homes or regular places of business, they may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section 5 of the Administrative Expenses Act of 1946 (5 U.S.C. 73b–2) for persons in the Government [60 Stat. 808](/us/stat/60/808); [75 Stat. 339, 340](/us/stat/75/339/340).employed intermittently. “(d) Each such Council shall submit reports of its findings and Reports to Congress.recommendations to the Secretary not later than January 1 of the second year after the year in which it is appointed, and such reports and recommendations shall thereupon be transmitted to the Congress and to the Board of Trustees of each of the Trust Funds. The reports required by this subsection shall include— “(1) a separate report with respect to the old-age, survivors, and disability insurance program under title II and of the taxes [42 USC 401](/us/usc/t42/s401).imposed under sections 1401(a), 3101(a), and 3111(a) of the Internal Revenue Code of 1954,*Post*, pp. 394–396. “(2) a separate report with respect to the hospital insurance program under part A of title XVIII and of the taxes imposed by sections 1401(b), 3101(b), and 3111(b) of the Internal Revenue Code of 1954, and 79 Stat. 340 “(3) *Ante*, p. 301. a separate report with respect to the supplementary medical insurance program established by part B of title XVIII and of the financing thereof. After the date of the transmittal to the Congress of the reports required by this subsection, the Council shall cease to exist.” "
(b)Repeal.[74 Stat. 994](/us/stat/74/994).[42 USC 401a](/us/usc/t42/s401a). Effective January 1, I960, section 116(e) of the Social Security Amendments of 1956 is repealed. meaning of term “secretary” Sec. 110. As used in this Act, and in the provisions content the Social Security Act amended by this Act, the term “Secretary”, unless the context otherwise requires, means the Secretary of Health, Education, and Welfare. rule of the railroad retirement board in the administration of hospital insurance for the aged Sec. 111. *Ante*, p. 332.*Ante*, p. 335; *Post*, p. 400.
(a)The first sentence of section 1874(a) of the Social Security Act is amended to read as follows: “Except as otherwise provided in this title and in the Railroad Retirement Act of 1937, the insurance programs established by this title shall be administered by the Secretary.”
(1)Section 21 of the Railroad Retirement Act of 1937 (as added by section 105 of this Act) is amended to read as follows: " “hospital insurance benefits for the aged “Sec. 21.
(a)For the purposes of this section, the Board shall have the same authority to determine the rights of individuals described in subsection
(b)of this section to have payments made on their behalf for hospital insurance benefits consisting of inpatient hospital services, post-hospital extended care services, post-hospital home health services, and outpatient hospital diagnostic services (all hereinafter referred to *Ante*, pp. 290, 291, 313.as ‘services’) under section 226, and parts A and C of title XVIII, of the Social Security Act as the Secretary of Health, Education, and Welfare has under such section and such parts with respect to individuals to whom such section and such parts apply. For purposes of [45 USC 228k](/us/usc/t45/s228k).section 11, a determination with respect to the rights of an individual under this section shall, except in the case of a provider of services, be considered to be a decision with respect to an annuity. “(b) Except as otherwise provided in this section, every individual who— “(1) has attained age 65, and “(2)
(A)is entitled to an annuity under this Act, or
(B)would be entitled to such an annuity had he ceased compensated service and, in the case of a spouse, had such spouse’s husband or wife ceased compensated service, or
(C)had been awarded a pension [45 USC 228f](/us/usc/t45/s228f).[45 USC 228c](/us/usc/t45/s228c).under section 6, or
(D)bears a relationship to an employee which, by reason of section 3 (e), has been, or would be, taken into account in calculating the amount of an annuity of such employee or his survivors, shall be certified to the Secretary of Health, Education and Welfare as a qualified railroad retirement beneficiary under section 226 of the Social Security Act. “(c) The Board and the Secretary of Health, Education, and Welfare shall furnish each other with such information, records, and doc-79 Stat. 341uments as may be considered necessary to the administration of this section or section 226, and part A of title XVIII, of the Social Security*Ante*, pp. 290, 291. Act. “(d) For purposes of this section (and sections 1840, 1843, and 1870 of the Social Security Act), entitlement to an annuity or pension *Ante*, pp. 306, 312, 331.under this Act shall be deemed to include entitlement under the Railroad Retirement Act of 1935.[45 USC 215–228](/us/usc/t45/s215–228). “(e) The rights of individuals described in subsection
(b)of this section to have payment made on their behalf for the services referred to in subsection
(a)of this section but provided in Canada shall be the same as those of individuals to whom section 226 and part A of title XVIII of the Social Security Act apply, and this subsection shall lie administered by the Board as if the provisions of section 226 and part A of title XVIII of the Social Security Act were applicable, as if references to the Secretary of Health, Education, and Welfare were to the Board, as if references to the Federal Hospital Insurance Trust Fund were to the Railroad Retirement Account, as if references to the United States or a State included Canada or a subdivision thereof, and as if the provisions of sections 1862(a)(4), 1863, 1864, 1867, 1868, 1869, 1874(b). and 1875 of such title XVIII were not included in such title. The payments for services herein provided for in Canada shall be made from the Railroad Retirement. Account (in accordance with, and subject to, the conditions applicable under section 10(b) in making payment of other benefits) to the hospital, extended care facility, or home health agency providing such services in Canada to individuals to whom subsection
(b)of this section applies, but only to the extent that the amount, of payments for services otherwise hereunder provided for an individual exceeds the amount payable for like services provided pursuant to the law in effect, in the place in Canada where such services are furnished. For the purposes of section 9 of this Act, any overpayment under this subsection shall[45 USC 2281](/us/usc/t45/s2281). be treated as if it were an overpayment of an annuity.” "
(2)Section 5(k)(2) of such Act is amended—[45 USC 228e](/us/usc/t45/s228e).
(A)by striking out subparagraphs
(A)and
(B)and redesignating subparagraphs (C), (D), and
(E)as subparagraphs (A), (B), and (C), respectively;
(B)by striking out the second sentence and the last sentence of subdivision
(i)of the subparagraph redesignated as subparagraph
(A)by subparagraph
(A)of this paragraph; and by striking out from such subdivision
(i)“the Retirement Account” and inserting in lieu thereof “the Railroad Retirement Account (hereinafter termed ‘Retirement Account’)”;
(C)by adding at the end of the subparagraph redesignated as subparagraph
(A)by subparagraph
(A)of this paragraph the following new subdivision: " “(iii) At the close of the fiscal year ending June 30, 1966, and each fiscal year thereafter, the Board and the Secretary of Health, Education, and Welfare shall determine the amount, if any, which, if added to or subtracted from the Federal Hospital Insurance Trust Fund, would place such fund in the same position in which it would have been if service as an employee after December 31, 1936, had been included in the term ‘employment’ as defined in the Social Security Act and in the Federal Insurance Contributions Act. Such determination shall be made no later than *Post*, pp. 395, 396.June 15 following the close of the fiscal year. If such amount is to be added to the Federal Hospital Insurance Trust Fund, the Board shall, within ten days after the determination, 79 Stat. 342certify such amount to the Secretary of the Treasury for transfer from the Retirement Account to the Federal Hospital Insurance Trust Fund; and if such amount is to be subtracted from the Federal Hospital Insurance Trust Fund the Secretary of Health, Education, and Welfare shall, within ten days after the determination, certify such amount to the Secretary of the Treasury for transfer from the Federal Hospital Insurance Trust Fund to the Retirement Account. The amount so certified shall further include interest (at the rate determined under subparagraph
(B)for the fiscal year under consideration) payable from the dose of such fiscal year until the date of certification.”; "
(D)by striking out “subparagraph (D)” where it appears in the subparagraph redesignated as subparagraph
(A)by subparagraph
(A)of this paragraph, and inserting in lieu thereof “subparagraph (B)”;
(E)by striking out “subparagraphs
(B)and (C)” where it appears in the subparagraph redesignated as subparagraph
(B)by subparagraph
(A)of this paragraph and inserting in lieu thereof “subparagraph (A)”; and
(F)by amending the subparagraph redesignated as subparagraph
(C)by subparagraph
(A)of this paragraph to read as follows: " “(C) The Secretary of the Treasury is authorized and directed to transfer to the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, or the Federal Hospital Insurance Trust Fund from the Retirement Account or to the Retirement Account from the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, or the Federal Hospital Insurance Trust Fund, as the case may be, such amounts as, from time to time, may be determined by the Board and the Secretary of Health, Education, and Welfare pursuant to the provisions of subparagraph (A), and certified by the Board or the Secretary of Health, Education, and Welfare for transfer from the Retirement Account or from the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, or the Federal Hospital Insurance Trust Fund.” "
(c)*Ante*, p. 335.
(1)Section 3201 of the Internal Revenue Code of 1954 (relating to rate of tax on employees under the Railroad Retirement Tax Act) is amended by striking out “section 3101(a)” and inserting in lieu thereof “section 3101
(a)plus the rate imposed by section 3101 (b)”.
(2)*Ante*, p. 335. Section 3211 of such Code (relating to the rate of tax on employee representatives under the Railroad Retirement Tax Act) is amended by striking out “section 3101(a)” and inserting in lieu thereof “section 3101(a) plus the rate imposed by section 3101(b)”.
(3)*Ante*, p. 335. Section 3221
(b)of such Code (relating to the rate of tax on employers under the Railroad Retirement Tax Act) is amended by striking out “section 3111(a)” and inserting in lieu thereof “section 3111
(a)plus the rate imposed by section 3111(b)”.
(4)*Post*, p. 394. Section 1401 (b)(as amended by section 321 of this Act) of such Code (relating to the rate of tax under the Self-Employment Contributions Act) is amended by striking out the last sentence.
(5)*Post*, p. 395. Section 3101(b) of such Code (relating to the rate of tax on employees under the Federal Insurance Contributions Act) is amended by striking out “, but without regard to the provisions of paragraph
(9)thereof insofar as it relates to employees”. 79 Stat. 343
(6)Section 3111(b) of such Code (relating to the rate of tax on *Post*, p. 396.employers under the Federal Insurance Contributions Act) is amended by striking out “, but without regard to the provisions of paragraph
(9)thereof insofar as it relates to employees”.
(d)There are authorized to be appropriated to the Federal Hospital Insurance Trust Fund (established by section 1817 of the Social Security Act) from time to time such sums as the Secretary deems*Ante*, p. 299. necessary for any fiscal year, on account of—
(1)payments made or to be made during such fiscal year from such Trust Fund under part A of title XVIII of such Act with *Ante*, p. 291.respect to individuals who are qualified railroad retirement beneficiaries (as defined in section 226(c) of such Act) and who are *Ante*, p. 290.not, and upon filing application for monthly insurance benefits under section 202 of such Act would not be, entitled to such benefits [42 USC 402](/us/usc/t42/s402).if service as an employee (as defined in the *Ante*, pp, 335, 340; *Post*, p. 400.Railroad Retirement Act of 1937) after December 31, 1936, had been included in the term “employment” as defined in the Social Security Act,
(2)the additional administrative expenses resulting or expected to result therefrom, and
(3)any loss of interest to such Trust Fund resulting from the payment of such amounts, in order to place such Trust Fund in the same position at the end of such fiscal year in which it would have been if the individuals described in paragraph
(1)had not been entitled to benefits under part A of title XVIII of the Social Security Act.
(1)The amendments made by the preceding provisions of this section shall apply to the calendar year 1966 or to any subsequent calendar year, but only if the requirement in paragraph
(2)has been met with respect to such calendar year.
(2)The requirement referred to in paragraph
(1)shall be deemed to have been met with respect to any calendar year if, as of the October 1 immediately preceding such calendar year, the Railroad Retirement Tax Act provides that the maximum amount of monthly compensation [26 USC 3201](/us/usc/t26/s3201).taxable under such Act during all months of such calendar year will be an amount equal to one-twelfth of the maximum wages which the Federal Insurance Contributions Act provides may be counted for *Post*, pp. 395, 396.such calendar year. Part 2— Grants to States for Medical Assistance Programs establishment of programs Sec. 121.
(a)The Social Security Act is amended by adding at the end thereof (after the new title XVIII added by section 102) the *Ante*, p. 291.following new title: " “TITLE XIX— GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS “appropriation “Sec. 1901. For the purpose of enabling each State, as far as practicable under the conditions in such State, to furnish
(1)medical assistance on behalf of families with dependent children and of aged, blind, or permanently and totally disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services, and
(2)rehabilitation and other services to help such families and individuals attain or retain capability for independence or 79 Stat. 344self-care, there is hereby authorized to be appropriated for each fiscal year a sum sufficient to carry out the purposes of this title. The sums made available under this section shall be used for making payments to States which have submitted, and had approved by the Secretary of Health, Education, and Welfare, State plans for medical assistance. “state plans for medical assistance “Sec. 1902.
(a)A State plan for medical assistance must— “(1) provide that it shall be in effect in all political subdivisions of the State, and, if administered by them, be mandatory upon them; “(2) provide for financial participation by the State equal to not less than 40 per centum of the non-Federal share of the expenditures under the plan with respect to which payments under section 1903 are authorized by this title; and, effective July 1, 1970, provide for financial participation by the State equal to all of such non-Federal share or provide for distribution of funds from Federal or State sources, for carrying out the State plan, on an equalization or other basis which will assure that the lack of adequate funds from local sources will not result in lowering the amount, duration, scope, or quality of care and services available under the plan; “(3) provide for granting an opportunity for a fair hearing before the State agency to any individual whose claim for medical assistance under the plan is denied or is not acted upon with reasonable promptness; “(4) provide such methods of administration (including methods relating to the establishment and maintenance of personnel standards on a merit basis, except that the Secretary shall exercise no authority with respect to the selection, tenure or office, and compensation of any individual employed in accordance with such methods, and including provision for utilization of professional medical personnel in the administration and, where administered locally, supervision of administration of the plan) as are found by the Secretary to be necessary for the proper and efficient operation of the plan; “(5) either provide for the establishment or designation of a single State agency to administer the plan, or provide for the establishment or designation of a single State agency to supervise the administration of the plan, except that the determination of eligibility for medical assistance under the plan shall be made by the State or local agency administering the State plan approved [42 USC 301–306, 1381–1385](/us/usc/t42/s301–306/1381–1385).under title I or XVI (insofar as it relates to the aged); “(6) provide that the State agency will make such reports, in such form and containing such information, as the Secretary may from time to time require, and comply with such provisions as the Secretary may from time to time find necessary to assure the correctness and verification of such reports; “(7) provide safeguards which restrict the use or disclosure of information concerning applicants and recipients to purposes directly connected with the administration of the plan; “(8) provide that all individuals wishing to make application for medical assistance under the plan shall have opportunity to do so, and that such assistance shall be furnished with reasonable promptness to all eligible individuals; 79 Stat. 345 “(9) provide for the establishment or designation of a State authority or authorities which shall be responsible for establishing and maintaining standards for private or public institutions in which recipients of medical assistance under the plan may receive care or services: ... . “(10) provide for making medical assistance available to all individuals receiving aid or assistance under State plans approved under titles I, IV. X, XIV, and XVI; and—[42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381). “(A) provide that the medical assistance made available to individuals receiving aid or assistance under any such State plan— “(i) shall not be less in amount, duration, or scope than the medical assistance made available to individuals receiving aid or assistance under any other such State plan, and “(ii) shall not be less in amount, duration, or scope than the medical or remedial care and services made available to individuals not receiving aid or assistance under any such plan; and “(B) if medical or remedial care and services are included for any group of individuals who are not receiving aid or assistance under any such State plan and who do not meet the income and resources requirements of the one of such State plans which is appropriate, as determined in accordance with standards prescribed by the Secretary, provide— “(i) for making medical or remedial care and services available to all individuals who would, if needy, be eligible for aid or assistance under any such State plan and who have insufficient (as determined in accordance with comparable standards) income and resources to meet the costs of necessary medical or remedial care and services, and “(ii) that the medical or remedial care and services made available to all individuals not receiving aid or assistance under any such State plan shall be equal in amount, duration, and scope; except that the making available of the services described in paragraph
(4)or
(14)of section 1905(a) to individuals meeting *Post*, p. 351.the age requirement prescribed therein shall not, by reason of this paragraph (10), require the making available of any such services, or the making available of such services of the same amount, duration, and scope, to individuals of any other ages; “(11) provide for entering into cooperative arrangements with the State agencies responsible for administering or supervising the administration of health services and vocational rehabilitation services in the State looking toward maximum utilization of such services in the provision of medical assistance tinder the plan; “(12) provide that, in determining whether an individual is blind, there shall be an examination by a physician skilled in the diseases of the eye or by an optometrist, whichever the individual may select; “(13) provide for inclusion of some institutional and some noninstitutional care and services, and, effective July 1, 1967. provide
(A)for inclusion of at least the care and services listed in clauses
(1)through
(5)of section 1905(a), and
(B)for 79 Stat. 346payment of the reasonable cost (as determined in accordance with standards approved by the Secretary and included in the plan) of inpatient hospital services provided under the plan; “(14) provide that
(A)no deduction, cost sharing, or similar charge will be imposed under the plan on the individual with respect to inpatient hospital services furnished him under the plan, and
(B)any deduction, cost sharing, or similar charge imposed under the plan with respect to any other medical assistance furnished him thereunder, and any enrollment, fee, premium, or similar charge imposed under the plan, shall be reasonably related (as determined in accordance with standards approved by the Secretary and included in the plan) to the recipient’s income or his income and resources; “(15) in the case of eligible individuals 65 years of age or older who are covered by either or both of the insurance programs *Ante*, p. 291.established by title XVIII, provide— “(A) for meeting the full cost of any deductible imposed with respect to any such individual under the insurance program established by part A of such title; and “(B) where, under the plan, all of any deductible, cost sharing, or similar charge imposed with respect to any such individual under the insurance program established by part B of such title is not met, the portion thereof which is met shall be determined on a basis reasonably related (as determined in accordance with standards approved by the Secretary and included in the plan) to such individual’s income or his income and resources; “(16) provide for inclusion, to the extent required by regulations prescribed by the Secretary, of provisions (conforming to such regulations) with respect to the furnishing of medical assistance under the plan to individuals who are residents of the State but are absent therefrom; “(17) include reasonable standards (which shall be comparable for all groups) for determining eligibility for and the extent of medical assistance under the plan which
(A)are consistent with the objectives of this title,
(B)provide for taking into account only such income and resources as are, as determined in accordance with standards prescribed by the Secretary, available to the applicant or recipient and (in the case of any applicant or recipient who would, if he met the requirements as to need, be eligible for aid or assistance in the form of money payments under a State [42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381).plan approved under title I, IV, X, XIV, or XVI) as would not be disregarded (or set aside for future needs) in determining his eligibility for and amount of such aid or assistance under such plan,
(C)provide for reasonable evaluation of any such income or resources, and
(D)do not take into account the financial responsibility of any individual for any applicant or recipient of assistance under the plan unless such applicant or recipient is such individual’s spouse or such individual’s child who is under age 21 or is blind or permanently and totally disabled; and provide for flexibility in the application of such standards with respect to income by taking into account, except to the extent prescribed by the Secretary, the costs (whether in the form of insurance premiums or otherwise) incurred for medical care or for any other type of remedial care recognized under State law; 79 Stat. 347 “(18) provide that no lien may be imposed against the property of any individual prior to his death on account of medical assistance paid or to be paid on his behalf under the plan (except pursuant to the judgment of a court on account of benefits incorrectly paid on behalf of such individual), and that there shall be no adjustment or recovery (except, in the case of an individual who was 65 years of age or older when he received such assistance, from his estate, and then only after the death of his surviving spouse, if any, and only at a time when he has no surviving child who is under age 21 or is blind or permanently and totally disabled) of any medical assistance correctly paid on behalf of such individual under the plan; “(19) provide such safeguards as may be necessary to assure that eligibility for care and services under the plan will be determined, and such care and services will be provided, in a manner consistent with simplicity of administration and the best interests of the recipients; “(20) if the State plan includes medical assistance in behalf of individuals 65 years of age or older who are patients in institutions for mental diseases— “(A) provide for having in effect such agreements or other arrangements with State authorities concerned with mental diseases, and, where appropriate, with such institutions, as may be necessary for carrying out the State plan, including arrangements for joint planning and for development of alternate methods of care, arrangements providing assurance of immediate readmittance to institutions where needed for individuals under alternate plans of care, and arrangements providing for access to patients and facilities, for furnishing information, and for making reports; “(B) provide for an individual plan for each such patient to assure that the institutional care provided to him is in his best interests, including, to that end, assurances that there will be initial and periodic review of his medical and other needs, that he will be given appropriate medical treatment within the institution, and that there will be a periodical determination of his need for continued treatment in the institution; “(C) provide for the development of alternate plans of care, making maximum utilization of available resources, for recipients 65 years of age or older who would otherwise need care in such institutions, including appropriate medical treatment and other aid or assistance; for services referred to in section 3(a)(4)(A)(i) and
(ii)or section 1603(a)(4)(A)(i) and
(ii)which are appropriate for such recipients and[76 Stat. 173, 200](/us/stat/76/173/200).[42 USC 303, 1383](/us/usc/t42/s303/1383). for such patients; and for methods of administration necessary to assure that the responsibilities of the State agency under the State plan with respect to such recipients and such patients will be effectively carried out; and “(D) provide methods of determining the reasonable cost of institutional care for such patients; “(21) if the State plan includes medical assistance in behalf of individuals 65 years of age or older who are patients in public institutions for mental diseases, show that, the State is making satisfactory progress toward developing and implementing a comprehensive mental health program, including provision for utilization of community mental health centers, nursing homes, and other alternatives to care in public institutions for mental diseases; and 79 Stat. 348 “(22) include descriptions of
(A)the kinds and numbers of professional medical personnel and supporting staff that will be used in the administration of the plan and of the responsibilities they will have,.
(B)the standards, for private or public institutions in which recipients of medical assistance under the plan may receive care or services, that will be utilized by the State authority or authorities responsible for establishing and maintaining such standards,
(C)the cooperative arrangements with State health agencies and State vocational rehabilitation agencies entered into with a view to maximum utilization of and coordination of the provision of medical assistance with the services administered or supervised by such agencies, and
(D)other standards and methods that the State will use to assure that medical or remedial care and services provided to recipients of medical assistance are of high quality. Notwithstanding paragraph (5), if on January 1, 1965, and on the date on which a State submits its plan for approval under this title, the State agency which administered or supervised the administration of [42 USC 1201–1206, 1381–1385](/us/usc/t42/s1201–1206/1381–1385).the plan of such State approved under title X (or title XVI, insofar as it relates to the blind) was different from the State agency which administered or supervised the administration of the State plan [42 USC 301–306](/us/usc/t42/s301–306).approved under title I (or title XVI, insofar as it relates to the aged), the State agency which administered or supervised the administration of such plan approved under title X (or title XVI, insofar as it relates to the blind) may be designated to administer or supervise the administration of the portion of the State plan for medical assistance which relates to blind individuals and a different State agency may be established or designated to administer or supervise the administration of the rest of the State plan for medical assistance; and in such case the part of the plan which each such agency administers, or the administration of which each such agency supervises, shall be regarded as a separate plan for purposes of this title (except for purposes of paragraph (10)). “(b) The Secretary shall approve any plan which fulfills the conditions specified in subsection (a), except, that he shall not approve any plan which imposes, as a condition of eligibility for medical assistance under the plan— “(1) an age requirement of more than 65 years; or “(2) effective July 1, 1967, any age requirement which excludes any individual who has not attained the age of 21 and is or would, [78 Stat. 1042](/us/stat/78/1042).[42 USC 606](/us/usc/t42/s606).[42 USC 601–609](/us/usc/t42/s601–609).except for the previsions of section 406(a)(2), be a dependent child under title TV; or “(3) any residence requirement which excludes any individual who resides in the State; or “(4) any citizenship requirement which excludes any citizen of the United States. “(c) Notwithstanding subsection (b), the Secretary shall not approve any State plan for medical assistance if he determines that the approval and operation of the plan will result in a reduction in aid or assistance (other than so much of the aid or assistance as is provided for under the plan of the State approved under this title) provided for eligible individuals under a plan of such State approved [42 USC 301 *et seq*](/us/usc/t42/s301).under title I, IV, X, XIV, or XVI. 79 Stat. 349 “payment to states “Sec. 1903.
(a)From the sums appropriated therefor, the Secretary (except as otherwise provided in this section and section 1117) *Post*, p. 420.shall pay to each State which has a plan approved under this title, for each quarter, beginning with the quarter commencing January 1, 1966— “(1) an amount equal to the Federal medical assistance percentage (as defined in section 1905(b)) of the total amount expended during such quarter as medical assistance under the State plan (including expenditures for premiums under part 13 of title XVIII, for individuals who are recipients of money payments*Ante*, p. 301. under a State plan approved under title I, IV, X, XIV, or XVI, and other insurance premiums for medical or any other [42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381).type of remedial care or the cost thereof); plus “(2) an amount equal to 75 per centum of so much of the sums expended during such quarter (as found necessary by the Secretary for the proper and efficient administration of the State plan) as are attributable to compensation or training of skilled professional medical personnel, and staff directly supporting such personnel, of the State agency (or of the local agency administering the State plan in the political subdivision); plus “(3) an amount equal to 50 per centum of the remainder of the amounts expended during such quarter as found necessary by the Secretary for the proper and efficient administration of the State plan, “(b) Notwithstanding the preceding provisions of this section, the amount determined under such provisions for any State for any quarter which is attributable to expenditures with respect to individuals 65 years of age or older who are patients in institutions for mental diseases shall be paid only to the extent that the State makes a showing satisfactory to the Secretary that total expenditures from Federal, State, and local sources for mental health services (including payments to or in behalf of individuals with mental health problems) under State and local public health and public welfare programs for such quarter exceed the average of the total expenditures from such sources for such services under such programs for each quarter of the fiscal year ending June 30, 1965. For purposes of this subsection, expenditures for such services for each quarter in the fiscal year ending June 30, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the first determination by him under this subsection for such State; and expenditures for such services for any quarter beginning after December 31, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the determination under this subsection for such State for such quarter; and determinations so made shall be conclusive for purposes or this subsection. “(c)
(1)If the Secretary finds, on the basis of satisfactory information furnished by a State, that the Federal medical assistance percentage for such State applicable to any quarter in the period beginning January 1, 1966, and ending with the close of June 30, 1969, is less than 105 per centum of the Federal share of medical expenditures by the State during the fiscal year ending June 30, 1965 (as determined under paragraph (2)), then 105 per centum of such Federal share shall be the Federal medical assistance percentage (instead of the percentage determined under section 1905(b)) for such State for 79 Stat. 350such quarter and each quarter thereafter occurring in such period and prior to the first quarter with respect to which such a finding is not applicable. “(2) For purposes of paragraph (1), the Federal share of medical expenditures by a State during the fiscal year ending June 30, 1965, means the percentage which the excess of— “(A) [42 USC 303, 603, 1203, 1353, 1383](/us/usc/t42/s303/603/1203/1353/1383). the total of the amounts determined under sections 3, 403, 1003, 1403, and 1603 with respect to expenditures by such State during such year as aid or assistance under its State plans approved under titles I, IV, X, XIV, and XVI, over “(B) the total of the amounts which would have been determined under such sections with respect to such expenditures during such year if expenditures as aid or assistance in the form of medical or any other type of remedial care had not been counted, is of the total expenditures as aid or assistance in the form of medical or any other type of remedial care under such plans during such year. “(d)
(1)Prior to the beginning of each quarter, the Secretary shall estimate the amount to which a State will be entitled under subsections (a), (b), and
(c)for such quarter, such estimates to be based on
(A)a report filed by the State containing its estimate of the total sum to be expended in such quarter in accordance with the provisions of such subsections, and stating the amount appropriated or made available by the State and its political subdivisions for such expenditures in such quarter, and if such amount is less than the State’s proportionate share of the total sum of such estimated expenditures, the source or sources from which the difference is expected to be derived, and
(B)such other investigation as the Secretary may find necessary. “(2) The Secretary shall then pay to the State, in such installments as he may determine, the amount so estimated, reduced or increased to the extent of any overpayment or underpayment which the Secretary determines was made under this section to such State for any prior quarter and with respect to which adjustment has not already teen made under this subsection. “(3) The pro rata share to which the United States is equitably entitled, as determined by the Secretary, of the net amount recovered during any quarter by the State or any political subdivision thereof with respect to medical assistance furnished under the State plan shall be considered an overpayment to be adjusted under this subsection. “(4) Upon the making of any estimate by the Secretary under this subsection, any appropriations available for payments under this section shall be deemed obligated. “(e) The Secretary shall not make payments under the preceding provisions of this section to any State unless the State makes a satisfactory showing that it is making efforts in the direction of broadening the scope of the care and services made available under the plan and in the direction of liberalizing the eligibility requirements for medical assistance, with a view toward furnishing by July 1, 1975, comprehensive care and services to substantially ail individuals who meet the plan’s eligibility standards with respect to income and resources, including services to enable such individuals to attain or retain independence or self-care. 79 Stat. 351 “operation of state plans “Sec. 1904. If the Secretary, after reasonable notice and opportunity for hearing to the State agency administering or supervising the administration of the State plan approved under this title, finds— “(1) that the plan has been so changed that it no longer complies with the provisions of section 1902; or “(2) that in the administration of the plan there is a failure to comply substantially with any such provision; the Secretary shall notify such State agency that further payments will not be made to the State (or, in his discretion, that payments will be limited to categories under or parts of the State plan not affected by such failure), until the Secretary is satisfied that there will no longer be any such failure to comply. Until he is so satisfied he shall make no further payments to such State (or shall limit payments to categories under or parts of the State plan not affected by such failure). “definitions “Sec. 1905. For purposes of this title— “(a) The term ‘medical assistance’ means payment of part or all of the cost of the following care and services (if provided in or after the third month before the month in which the recipient makes application for assistance) for individuals who are— “(i) under the age of 21, “(ii) relatives specified in section 406(b)(1) with whom a [64 Stat. 551](/us/stat/64/551); [76 Stat. 189, 190](/us/stat/76/189/190).[42 USC 606](/us/usc/t42/s606).[78 Stat. 1042](/us/stat/78/1042); *Post*, p. 422.[42 USC 601–609](/us/usc/t42/s601–60).child is living if such child, except for section 406(a)(2), is (or would, if needy, be) a dependent child under title IV, “(iii) 65 years or age or older, “(iv) blind, or “(v) 18 years of age or older and permanently and totally disabled, but whose income and resources are insufficient to meet all of such cost— “(1) inpatient hospital services (other than services in an institution for tuberculosis or mental diseases); “(2) outpatient hospital services; “(3) other laboratory and X-ray services; “(4) skilled nursing home services (other than services in an institution for tuberculosis or mental diseases) for individuals 21 years of age or older; “(5) physicians’ services, whether furnished in the office, the patient’s home, a hospital, or a skilled nursing home, or elsewhere; “(6) medical care, or any other type of remedial care recognized under State law, furnished by licensed practitioners within the scope of their practice as defined by State law; “(7) home health care services; “(8) private duty nursing services; “(9) clinic services; “(10) dental services; “(11) physical therapy and related services; “(12) prescribed drugs, dentures, and prosthetic devices; and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist, whichever the individual may select; “(13) other diagnostic, screening, preventive, and rehabilitative services; 79 Stat. 352 “(14) inpatient hospital services and skilled nursing home services for individuals 65 years of age or over in an institution for tuberculosis or mental diseases; and “(15) any other medical care, and any other type of remedial care recognized under State law, specified by the Secretary; except that such term does not include— “(A) any such payments with respect to care or services for any individual who is an inmate of a public institution (except as a patient in a medical institution); or “(B) any such payments with respect to care or services for any individual who has not attained 65 years of age and who is a patient in an institution for tuberculosis or mental diseases. “(b) The term ‘Federal medical assistance percentage’ for any State shall be 100 per centum less the State percentage; and the State percentage shall be that percentage which bears the same ratio to 45 per centum as the square of the per capita income of such State bears to the square of the per capita income of the continental United States (including Alaska) and Hawaii; except that
(1)the Federal medical assistance percentage shall in no case be less than 50 per centum or more than 83 per centum, and
(2)the Federal medical assistance percentage for Puerto Rico, the Virgin Islands, and Guam shall be 55 per centum. The Federal medical assistance percentage for any State [72 Stat. 1050](/us/stat/72/1050).[42 USC 1301](/us/usc/t42/s1301).shall be determined and promulgated in accordance with the provisions of subparagraph
(B)of section 1101 (a)(8); except that the Secretary shall promulgate such percentage as soon as possible after the enactment of this title, which promulgation shall be conclusive for each of the six quarters in the period beginning January 1, 1966, and ending with the close of June 30, 1967.” "
(b)[42 USC 301 *et seq*](/us/usc/t42/s301).*Ante*, p. 343. No payment may be made to any State under title I, IV, X, XIV, or XVI of the Social Security Act with respect to aid or assistance in the form of medical or any other type of remedial care for any period for which such State receives payments under title XIX of such Act, or for any period after December 31, 1969.
(c)[74 Stat. 985](/us/stat/74/985); [76 Stat. 206](/us/stat/76/206).[42 USC 1301](/us/usc/t42/s1301).[66 Stat. 778](/us/stat/66/778).[42 USC 1309](/us/usc/t42/s1309).
(1)Effective January 1, 1966, section 1101(a)(1) of the Social Security Act is amended by striking out “and XVI” and inserting in lieu thereof “XVI, and XIX”.
(2)Section 1109 of such Act is amended to read as follows: " “amounts disregarded not to be taken into account in determining eligibility of other individuals “Sec. 1109. Any amount which is disregarded (or set aside for future needs) in determining the eligibility of and amount of the aid or assistance for any individual under a State plan approved under title I, IV, X, XIV, XVI, or XIX shall not be taken into consideration in determining the eligibility of and amount of aid or assistance for any other individual under a State plan approved under any other of such titles.” "
(3)[76 Stat. 192](/us/stat/76/192).[42 USC 1315](/us/usc/t42/s1315). Effective January 1, 1966, section 1115 of such Act is amended by striking out “or XVI”, “or 1602”, and “or 1603” and inserting in lieu thereof “XVI, or XIX”, “1602, or 1902”, and “1603, or 1903”, respectively. 79 Stat. 353 payment by states of premiums for supplementary medical insurance Sec. 122. Sections 3(a), 403(a), 1003(a), 1403(a), and 1603(a) of the Social Security Act are each amended by inserting “premiums [76 Stat. 194, 174, 195, 200](/us/stat/76/194/174/195/200).[42 USC 303, 603, 1203, 1353, 1383](/us/usc/t42/s303/603/1203/1353/1383).under part B of title XVIII for individuals who are recipients of money payments under such plan and other” after “expenditures for” in the parenthetical phrase appearing in so much of paragraph
(1)thereof as precedes clause (A), and in the parenthetical phrase appearing in paragraph
(2)thereof. TITLE II— OTHER AMENDMENTS RELATING TO HEALTH CARE Part 1— Maternal and Child Health and Crippled Children’s Services increase in maternal and child health services Sec. 201.
(a)The first sentence of section 501 of the Social Security Act is amended by striking out “$40,000,000” and all that follows and [77 Stat. 273](/us/stat/77/273).[42 USC 701](/us/usc/t42/s701).inserting in lieu thereof “$45,000,000 for the fiscal year ending June 30, 1966, $50,000,000 for the fiscal year ending June 30, 1967, $55,000,000 for the fiscal year ending June 30, 1968, $55,000,000 for the fiscal year ending June 30, 1969, and $60,000,000 for the fiscal year ending June 30, 1970, and each fiscal year thereafter.”
(b)Section 504 of such Act is amended by adding at the end [49 Stat. 630](/us/stat/49/630).[42 USC 704](/us/usc/t42/s704).thereof the following new subsection: " “(d) Notwithstanding the preceding provisions of this section, no payment shall be made to any State thereunder for any period after June 30, 1966, unless it makes a satisfactory showing that the State is extending the provision of maternal and child health services in the State with a view to making such services available by July 1, 1975, to children in all parts of the State.” " increase in crippled children’s services Sec. 202.
(a)The first sentence of section 511 of the Social Security Act is amended by striking out “$40,000,000” and all that follows and [77 Stat. 273](/us/stat/77/273).[42 USC 711](/us/usc/t42/s711).inserting in lieu thereof “$45,000,000 for the fiscal year ending June 30, 1966, $50,000,000 for the fiscal year ending June 30, 1967, $55,000,000 for the fiscal year ending June 30, 1968, $55,000,000 for the fiscal year ending June 30, 1969, and $60,000,000 for the fiscal year ending June 30, 1970, and each fiscal year thereafter.”
(b)Section 514 of such Act is amended by adding at the end [49 Stat. 632](/us/stat/49/632); [53 Stat. 1381](/us/stat/53/1381).[42 USC 714](/us/usc/t42/s714).thereof the following new subsection: " “(d) Notwithstanding the preceding provisions of this subsection, no payment shall be made to any State thereunder for any period after June 30, 1966, unless it makes a satisfactory showing that the State is extending the provision of crippled children’s services in the State with a view to making such services available by July 1, 1975, to children in all parts of the State.” " training of professional personnel for the care of crippled children Sec. 203.
(a)Part 2 of title V of the Social Security Act is amended [49 Stat. 631](/us/stat/49/631).[42 USC 711–715](/us/usc/t42/s711–715).by adding at the end thereof the following new section: 79 Stat. 354 " “training of professional personnel “Sec. 516. There are authorized to be appropriated $5,000,000 for the fiscal year ending June 30, 1967, $10,000,000 for the fiscal year ending June 30, 1968, and $17,500,000 for each fiscal year thereafter, for grants by the Secretary to public or other nonprofit institutions of higher learning for training professional personnel for health and related care of crippled children, particularly mentally retarded children and children with multiple handicaps.” "
(b)[83 Stat. 1381](/us/stat/83/1381).[42 USC 714](/us/usc/t42/s714). The second sentence of section 514(c) of such Act is amended by striking out “section 512(b)” and inserting in lieu thereof “section 512(b) or 516”. payment for inpatient hospital services Sec. 204. [49 Stat. 630](/us/stat/49/630).[42 USC 703](/us/usc/t42/s703).
(a)Section 503(a) of the Social Security Act is amended by striking out “and” before clause
(7)and by inserting before the period at the end thereof the following new clause: “; and
(8)effective July 1, 1967, provide for payment of the reasonable cost (as determined in accordance with standards approved by the Secretary and included in the plan) of inpatient hospital services provided under the plan”.
(b)[42 USC 713](/us/usc/t42/s713). Section 513(a) of such Act is amended by striking out “and” before clause
(6)and by inserting before the period at the end thereof the following new clause: “; and
(7)effective July 1, 1967, provide for payment of the reasonable cost (as determined in accordance with standards approved by the Secretary and included in the plan) of inpatient hospital services provided under the plan”. special project grants for health of school and preschool children Sec. 205. [77 Stat. 274](/us/stat/77/274).[42 USC 729, 729a](/us/usc/t42/s729/729a). Part 4 of title V of the Social Security Act is amended
(1)by revising the heading thereof to read as follows: “Part 4—Grants for Special Maternity and Infant Care Projects, for Projects for Health of School and Preschool Children, and for Research Projects”;
(2)by redesignating section 532 as section 533; and
(3)by inserting after section 531 the following new section: " “special project grants for health of school and preschool children “Sec. 532.
(a)In order to promote the health of children and youth of school or preschool age, particularly in areas with concentrations of low-income families, t lie re are authorized to be appropriated $15,000,000 for the fiscal year ending June 30, 1966, $35,000,000 for the fiscal year ending June 30, 1967, $40,000,000 for the fiscal year ending June 30, 1968, $45,000,000 for the fiscal year ending June 30, 1969, and $50,000,000 for the fiscal year ending June 30, 1970, for grants as provided in this section. “(b) From the sums appropriated pursuant to subsection (a), the Secretary is authorized to make grants to the State health agency of any State and (with the consent of such agency) to the health agency of any political subdivision of the State, to the State agency of the State administering or supervising the administration of the State plan approved under section 513, to any school of medicine (with appropriate participation by a school of dentistry), and to any teaching hospital affiliated with such a school, to pay not to exceed 75 per centum of the cost of projects of a comprehensive nature for health 79 Stat. 355care and services for children and youth of school age or for preschool children (to help them prepare to start school). No project shall be eligible for a grant, under this section unless it provides
(1)for the coordination of health care and services provided under it with, and utilization (to the extent feasible) of, other State or local health, welfare, and education programs for such children,
(2)for payment of the reasonable cost (as determined in accordance with standards approved by the Secretary) of inpatient hospital services provided under the project? and
(3)that any treatment, correction of defects, or aftercare provided under the project is available only to children who would not otherwise receive it because they are from low-income families or for other reasons beyond their control; and no such project for children and youth of school age shall be considered to be of a comprehensive nature for purposes of this section unless it includes (subject to the limitation in the preceding provisions of this sentence) at least such screening, diagnosis, preventive services, treatment, correction of defects, and aftercare, both medical and dental, as may be provided for in regulations of the Secretary. “(c) Payment of grants under this section may be made (after necessary adjustment on account of previously made underpayments or overpayments) in advance or by way of reimbursement, and in such installments and on such conditions, as the Secretary may determine.” " evaluation and report Sec. 206. The Secretary shall submit to the President for transmission Report to President and Congressto the Congress before July 1, 1969, a full report of the administration of the provisions of section 532 of the Social Security Act (as added by section 205 of this Act), together with an evaluation of the program established thereby and his recommendations as to continuation of and modifications in that program. increase in child welfare services Sec. 207. Section 521 of the Social Security Act is amended by striking [42 USC 721](/us/usc/t42/s721).out “$40,000,000” and all that follows and inserting in lieu thereof “$40,000,000 for the fiscal year ending June 30, 1965, $45,000,000 for the fiscal year ending June 30, 1966, $50,000,000 for the fiscal year ending June 30, 1967, $55,000,000 for the fiscal year ending June 30, 1968, $55,000,000 for the fiscal year ending June 30, 1969, and $60,000,000 for the fiscal year ending June 30, 1970, and each fiscal year thereafter.” day care services Sec. 208.
(1)Part 3 of title V of the Social Security Act is amended by striking out section 527.[76 Stat. 183](/us/stat/76/183).[42 USC 727](/us/usc/t42/s727).[42 USC 1308](/us/usc/t42/s1308).
(2)The second sentence of section 1108 of such Act is amended by striking out “522(a), and 527(a)” and inserting in lieu thereof “and 522(a)” and by striking out “(or, in the case of section 527(a), the minimum)”.
(b)Section 522 of such Act is amended to read as follows:[42 USC 722](/us/usc/t42/s722). " “allotments to states “Sec. 522. The sum appropriated pursuant to section 521 for each fiscal year shall be allotted by the Secretary for use by cooperating State public welfare agencies which have plans developed jointly by the State agency and the Secretary, as follows: He shall allot $70,000 79 Stat. 356to each State, and shall allot to each State an amount which bears the same ratio to the remainder of the sum so appropriated for such year as the product of
(1)the population of such State under the age of 21 and
(2)the allotment percentage of such State (as determined under [42 USC 724](/us/usc/t42/s724).section 524) bears to the sum of the corresponding products of all the States.” "
(c)[42 USC 723](/us/usc/t42/s723). Section 523(a)(1)(B) of such Act is amended by striking out “and” at the end of clause
(lii)and by inserting after clause
(iv)the following new clause: " “(v) that day care provided under the plan will be provided only in facilities (including private homes) which are licensed by the State, or approved (as meeting the standards established for such licensing) by the State agency responsible for licensing facilities of this type, and”. "
(d)Effective date. The amendments made by this section shall take effect on January 1, 1966. Part 2— Implementation of Mental Retardation Planning authorization of appropriations Sec. 211. [77 Stat. 275](/us/stat/77/275).[42 USC 1391](/us/usc/t42/s1391).
(a)Section 1701 of the Social Security Act is amended by adding at the end thereof the following new sentence: “There are also authorized to be appropriated, for assisting such States in initiating the implementation and carrying out of planning and other steps to combat mental retardation, $2,750,000 for the fiscal year ending June 30, 1966, and $2,750,000 for the fiscal year ending June 30, 1967.”
(b)[42 USC 1392](/us/usc/t42/s1392). The first sentence of section 1702 of such Act is amended by inserting “the first sentence of” before “section 1701” and by inserting the following before the period at the end thereof “; and the sums appropriated pursuant to the second sentence of such section for the fiscal year ending June 30, 1966, shall be available for such grants during such year and the next two fiscal years, and sums appropriated pursuant thereto for the fiscal year ending June 30, 1967, shall be available for such grants during such year and the succeeding fiscal year”. Part 3— Public Assistance Amendments Relating to Health Care removal of limitations on federal participation in assistance to individuals with tuberculosis or mental disease Sec. 221. [64 Stat. 549](/us/stat/64/549); [74 Stat. 991](/us/stat/74/991); *Post*, p. 415.[42 USC 306](/us/usc/t42/s306).
(1)Section 6(a) of the Social Security Act is amended to read as follows: " “(a) For the purposes of this title, the term ‘old-age assistance’ means money payments to, or (if provided in or after the third month before the month in which the recipient, makes application for assistance) medical care in behalf of or any type of remedial care recognized under State law in behalf of, needy individuals who are 65 years of age or older, but does not include any such payments to or care in behalf of any individual who is an inmate of a public institution (except as a patient in a medical institution).” "
(2)Section 6(b) of such Act is amended by striking out all that follows clause
(12)and inserting in lieu thereof the following: “except that such term does not include any such payments with respect to care or services for any individual who is an inmate of a public institution (except as a patient in a medical institution).” 79 Stat. 357
(3)Section 2(a) of such Act is amended
(A)by striking out “and” [74 Stat. 987](/us/stat/74/987).[42 USC 302](/us/usc/t42/s302).at the end of paragraph (10);
(B)by striking out the period at the end of paragraph
(11)and inserting in lieu thereof a semicolon; and
(C)by adding after paragraph
(11)the following new paragraphs: " “(12) if the State plan includes assistance to or m behalf of individuals who are patients in institutions for mental diseases— “(A) provide for having in effect such agreements or other arrangements with State authorities concerned with mental diseases, and, where appropriate, with such institutions, as may be necessary for carrying out the State plan, including arrangements for joint planning and for development of alternate methods of care, arrangements providing assurance of immediate readmittance to institutions where needed for individuals under alternate plans of care, and arrangements providing for access to patients and facilities, for furnishing information, and for making reports; “(B) provide for an individual plan for each such patient to assure that the institutional care provided to him is in his best, interests, including, to that end, assurances that there will be initial and periodic review of his medical and other needs, that he will be given appropriate medical treatment within the institution, and that there will be a periodic determination of his need for continued treatment in the institution; “(C) provide for the development of alternate plans of care, making maximum utilization of available resources, for recipients who would otherwise need care in such institutions, including appropriate medical treatment and other assistance; for services referred to in section 3(a)(4)(A)(i) and (ii)[76 Stat. 173](/us/stat/76/173).[42 USC 303](/us/usc/t42/s303). which are appropriate for such recipients and for such patients; anti for methods of administration necessary to assure that the responsibilities of the State agency under the State plan with respect to such recipients and such patients will be effectively carried out; and “(D) provide methods of determining the reasonable cost of institutional care for such patients; and “(13) if the State plan includes assistance to or in behalf of Îpatients in public institutions for mental diseases, show that the State is making satisfactory progress toward developing and implementing a comprehensive mental health program, including provision for utilization of community mental health centers, nursing homes, and other alternatives to care in public institutions for mental diseases.” "
(4)Section 3 of such Act is amended by adding at the end thereof [53 Stat. 1361](/us/stat/53/1361); [76 Stat. 179](/us/stat/76/179).[42 USC 303](/us/usc/t42/s303).the following new subsection: " “(d) Notwithstanding the preceding provisions of this section, the amount determined under such provisions for any State for any quarter which is attributable to expenditures with respect to patients in institutions for mental diseases shall be paid only to the extent that the State makes a showing satisfactory to the Secretary that total expenditures in the State from Federal, State, and local sources for mental health services (including payments to or in behalf of individuals with mental health problems) under State and local public health and public welfare programs for such quarter exceed the average of the total expenditures in the State from such sources for such services under such programs for each quarter of the fiscal year ending June 30, 1965. For purposes of this subsection, expenditures for such services for each quarter in the fiscal year ending June 30, 1965, in the 79 Stat. 358case of any State shall be determined on the basis of the latest, data, satisfactory to the Secretary, available to him at the time of the first determination by him under this subsection for such State; and expenditures for such services for any quarter beginning after December 31, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the determination under this subsection for such State for such quarter; and determinations so made shall be conclusive for purposes of this subsection.” "
(b)[64 Stat. 554](/us/stat/64/554); *Post*, p. 416.[42 USC 1206](/us/usc/t42/sUSC 1206). Section 1006 of such Act is amended by striking out clauses
(a)and
(b)and inserting in lieu thereof the following: “who is a patient in an institution for tuberculosis or mental diseases”,
(c)*Post*, p. 417.[42 USC 1355](/us/usc/t42/s1355). Section 1405 of such Act is amended by striking out clauses
(a)and
(b)and inserting in lieu thereof the following: “who is a patient in an institution for tuberculosis or mental diseases”.
(d)[76 Stat. 204](/us/stat/76/204); *Post*, p. 416.[42 USC 1385](/us/usc/t42/s1385).
(1)Section 1605(a) of such Act is amended to read as follows: " “(a) For purposes of this title, the term ‘aid to the aged, blind, or disabled’ means money payments to, or (if provided in or after the third month before the month in which the recipient makes application for aid) medical care in behalf of or any type of remedial care recognized under State law in behalf of, needy individuals who are 65 years of age or older, are blind, or are 18 years of age or over and permanently and totally disabled, but such term does not include— “(1) any such payments to or care in behalf of any individual who is an inmate of a public institution (except as a patient in a medical institution); or “(2) any such payments to or care in behalf of any individual who has not attained 65 years of age and who is a patient in an institution for tuberculosis or mental diseases.” "
(2)Section 1605(b) of such Act is amended by striking out all that follows clause
(12)and inserting in lieu thereof the following: " “except, that such term does not include any such payments with respect to care or services for any individual who is an inmate of a public institution (except as a patient in a medical institution).” "
(3)*Post*, p. 418. Section 1602(a) of such Act (as amended by section 403(e) of this Act) is amended
(A)by striking out “and” at the end of paragraph (14);
(B)by striking out the period at the end of paragraph
(15)and inserting in lieu thereof a semicolon; and
(C)by adding after paragraph
(15)the following new paragraphs: " “(16) if the State plan includes aid or assistance to or in behalf of individuals 65 years of age or older who are patients in institutions for mental diseases— “(A) provide for having in effect such agreements or other arrangements with State authorities concerned with mental diseases, and, where appropriate, with such institutions, as may be necessary for carry mg out the State plan, including arrangements for joint planning and for development of alternate methods of care, arrangements providing assurance of immediate readmittance to institutions where needed for individuals under alternate plans of care, and arrangements providing for access to patients and facilities, for furnishing information, and for making reports; “(B) provide for an individual plan for each such patient to assure that the institutional care provided to him is in his best interests, including, to that end, assurances that there will be initial and periodic review of his medical and other needs, that he will be given appropriate medical treatment 79 Stat. 359within the institution, and that there will be a periodic determination of his need for continued treatment in the institution; “(C) provide for the development of alternate plans of care, making maximum utilization of available resources, for recipients 65 years of age or older who would otherwise need care in such institutions, including appropriate medical treatment and other aid or assistance; tor services referred to in section 1603(a)(4)(A)(i) and
(ii)which [76 Stat. 200](/us/stat/76/200).[42 USC 13S3](/us/usc/t42/s13S3).are appropriate for such recipients and for such patients; and for methods of administration necessary to assure that the responsibilities of the State agency under the State plan with respect to such recipients and” such patients will be effectively carried out; and “(D) provide methods of determining the reasonable cost of institutional care for such patients; and “(17) if the State plan includes aid or assistance to or in behalf of individuals 65 years of age or older who are patients in public institutions for mental diseases, show that the State is making satisfactory progress toward developing and implementing a comprehensive mental health program, including provision for utilization of community mental health centers, nursing homes, and other alternatives to care in public institutions for mental diseases.” "
(4)Section 1603 of such Act is amended by adding at the end thereof the following new subsection: " “(d) Notwithstanding the preceding provisions of this section, the amount determined under such provisions for any State for any quarter which is attributable to expenditures with respect to individuals 65 years of age or older who are patients in institutions for mental diseases shall be paid only to the extent that the State makes a showing satisfactory to the Secretary that total expenditures in the State from Federal, State, and local sources for mental health services (including payments to or in behalf of individuals with mental health problems) under State and local public health and public welfare programs for such quarter exceed the average of the total expenditures in the State from such sources for such services under such programs for each quarter of the fiscal year ending June 30, 1965. For purposes of this subsection, expenditures for such services for each quarter in the fiscal year ending June 30, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the first determination by him under this subsection for such State; and expenditures for such services for any quarter beginning after December 31, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the determination under this subsection for such State for such quarter; and determinations so made shall be conclusive for purposes of this subsection.” "
(e)The amendments made by this section shall apply in the case of expenditures made after December 31, 1965, under a State plan approved under title I, X, XIV, or XVI of the Social Security Act.[42 USC 301 *et seq*](/us/usc/t42/s301). 79 Stat. 360 amendment to definition of medical assistance for the aged Sec. 222. [74 Stat. 991](/us/stat/74/991).[42 USC 306](/us/usc/t42/s306).
(a)Section 6
(b)of the Social Security Act is amended by striking out “who are not recipients of old-age assistance” and inserting in lieu thereof “who are not recipients of old-age assistance (except, for any month, for recipients of old-age assistance who are admitted to or discharged from a medical institution during such month)”.
(b)[76 Stat. 204](/us/stat/76/204).[42 USC 1385](/us/usc/t42/s1385). Section 1605(b) of such Act is amended by striking out “who are not. recipients of aid to the aged, blind, or disabled” and inserting in lieu thereof “who are not recipients of aid to the aged, blind, or disabled (except, for any month, for recipients of aid to the aged, blind, or disabled who are admitted to or discharged from a medical institution during such month)”.
(c)The amendments made by this section shall apply in the case of expenditures under a State plan approved under title I or XVI of [42 USC 301, 1385](/us/usc/t42/s301/1385).the Social Security Act with respect to care and services provided under such plan after June 1965. Part 4— Miscellaneous Amendments Relating to Health Care health study of resources relating to children’s emotional illness Sec. 231. Program grants.
(a)The Secretary of Health, Education, and Welfare is authorized, upon the recommendation of the National Advisory Mental Health Council and after securing the advice of experts in pediatrics and child welfare, to make grants for carrying out a program of research into and study of our resources, methods, and practices for diagnosing or preventing emotional illness in children and of treating, caring for, and rehabilitating children with emotional illnesses.
(b)Such grants may be made to one or more organizations, but only on condition that the organization will undertake and conduct, or if more than one organization is to receive such grants, only on condition that such organizations have agreed among themselves to undertake and conduct, a coordinated program of research into and study of all aspects of the resources, methods, and practices referred to in subsection (a).
(c)“Organization.” As used tn subsection (b), the term “organization” means a nongovernmental agency, organization, or commission, composed of representatives of leading national medical, welfare, educational, and other professional associations, organizations, or agencies active in the field of mental health of children.
(d)Appropriation. There are authorized to be appropriated for the fiscal year ending June 30, 1966, the sum of $500,000 to be used for a grant or grants to help initiate the research and study provided for in this section; and the sum of $500,000 for the succeeding fiscal year for the making of such grants as may be needed to carry the research and Reports to Congress.study to completion. The terms of any such grant shall provide that the research and study shall be completed not later than two years from the date it is inaugurated; that the grantee shall file annual reports with the Congress, the Secretary, and the Governors of the several States, among others that the grantee may select; and that the final report shall be similarly filed. 79 Stat. 361 TITLE III— SOCIAL SECURITY AMENDMENTS short title Sec. 300. This title may be cited as the “Old-Age, Survivors, and Old-Age, Survivors, and Disability Insurance Amendments of 1965.Disability Insurance Amendments of 1965”, increase in old-age, survivors, and disability insurance benefits Sec. 301.
(a)Section 215(a) of the Social Security Act is amended [72 Stat. 1014](/us/stat/72/1014).[42 USC 415](/us/usc/t42/s415).by striking out the table and inserting in lieu thereof the following: " table for determining primary insurance amount and maximum family benefits “I II III IV V (Primary insurance benefit under 1939 Act, as modified); (Primary insurance amount under 1958 Act, as modified) (Average monthly wage) (Primary insurance amount) (Maximum family benefits) If an individual’s primary insurance benefit (as determined under subsec. (d)) is— Or his primary Insurance amount (as determined under subsec. (c)) is— Or his average monthly wage (as determined under subsec. (b)) is— The amount referred to In the preceding paragraphs of this subsection shall be— And the maximum amount of benefits payable (as provided In sec. 203(a)) on the basis of his wages and self-employment fir come shall be— At least— But not more than— At least— But not more than— ..... $13.48 $40 .... $67 $44.00 $66.00 $13.49 14.00 41 $68 69 45.00 67.69 14,01 14.43 42 70 70 46,00 89.00 14.49 15.00 43 71 72 47.00 70.50 15.01 15,60 44 73 74 48.00 72.00 15.61 16.20 45 75 76 49.00 73.50 16.21 16,84 46 77 78 50.00 75.00 16.85 17.60 47 79 so 51.01 78.60 17.61 18,40 48 81 81 52.00 78.00 18.41 19.24 49 82 83 53.00 79.50 19.25 20.00 50 84 85 54.00 81.00 20.01 20.64 51 85 87 55.00 82.60 20.65 21.28 52 88 89 56.00 84.00 21.29 21.88 53 90 00 57.00 85.80 21.89 22.28 54 91 92 58.00 87.00 22.29 22.68 55 93 94 69.00 88.50 22.69 23.08 56 95 95 00.90 90.00 23.09 23.44 57 97 97 61.00 91.50 23.45 23.76 58 98 99 62.10 93.20 23.77 24.20 59 100 101 63.20 94.80 24.21 24.80 60 102 102 04.20 96.30 24.61 25.00 61 103 104 65.30 98.00 25.01 25.48 62 105 106 00,40 99.60 25.49 25.92 63 107 107 67.50 101.30 25.93 26.40 64 108 109 08.50 102.80 26.41 26.94 65 110 113 69.60 104.40 26.95 27.46 66 111 118 70.70 108.10 27.47 28.00 67 119 122 71.70 107.60 28 01 28.68 68 123 127 72.80 109.20 28.69 29.25 69 128 132 73.90 110.90 29.26 29.68 70 133 136 74.90 112.40 29.69 30.36 71 137 141 76.00 114.00 30.37 30.92 72 142 146 77.10 116.80 30.93 31.36 73 147 150 78.20 120.00 31.37 32.00 74 151 155 79.20 124.00 32.01 32.60 75 156 160 80.30 128.00 32.61 33.20 76 161 164 81.40 131.20 33.21 33.88 77 165 169 82.40 135.20 33,89 34.50 78 170 174 83.50 135.20 34.51 35.00 79 175 178 84.60 142,40 35.01 35.80 80 179 183 85.60 146.40 35.81 36,40 81 IM 188 86.70 150.40 36.41 37.08 82 189 193 87.80 154.40 3ZO9 37.60 83 194 197 88.90 157.60 37,61 38.20 84 198 202 89.90 161.60 38,21 39,12 85 203 207 91.00 165.60 39.13 39.68 86 208 211 92.10 168.80 39.69 40.33 87 212 216 93.10 172.80 40.34 41.12 88 217 221 94.20 176.80 41.13 41.76 89 222 225 95.30 180.00 41.77 42.44 90 226 230 96,30 184.00 42.45 43.20 91 231 235 97.40 188.00 79 Stat. 362 table for determining primary insurance amount and maximum family benefits “I II III IV V (Primary insurance benefit under 1939 Act, as modified); (Primary insurance amount under 1958 Act, as modified) (Average monthly wage) (Primary insurance amount) (Maximum family benefits) If an individual’s primary insurance benefit (as determined under subsec. (d)) is— Or his primary Insurance amount (as determined under subsec. (c)) is— Or his average monthly wage (as determined under subsec. (b)) is— The amount referred to In the preceding paragraphs of this subsection shall be— And the maximum amount of benefits payable (as provided In sec. 203(a)) on the basis of his wages and self-employment fir come shall be— At least— But not more than— At least— But not more than— $43.21 $43.76 $92 $238 $239 $98.50 $191.20 43.77 44.44 93 240 244 99.60 195.20 44.45 41.88 94 246 249 100.60 199.20 44.89 45.60 95 250 253 101.70 202.40 96 254 258 102.80 206.40 97 259 263 103.80 210,40 98 204 267 104.90 213.60 99 268 272 100.00 217.60 100 273 277 107.00 221.60 101 278 281 108.00 224,80 102 282 286 109.20 223.80 103 287 291 110.30 232,80 104 292 293 111.30 236.00 105 290 300 112.40 240,00 106 301 305 113.50 244.00 107 306 309 114.50 247.20 108 310 314 115.60 251.20 109 315 319 116.70 255.20 110 320 323 117.70 258.40 111 324 323 118.80 262.40 112 329 333 113.90 266.40 113 334 337 121.00 269.60 114 338 342 122.00 273.60 115 343 347 123.10 277.60 118 348 351 124.20 280.00 117 352 356 125.20 284.80 118 357 361 126.30 288.80 119 362 365 127.40 292.00 120 366 370 128.40 296.00 121 371 375 129.50 298.00 122 376 379 130.50 299.60 123 380 384 131.70 301.00 124 385 389 132.70 303.00 125 390 393 133.80 305.20 126 394 398 134.90 307.20 127 399 403 135.90 309.20 404 407 137.00 310.80 408 412 138.00 312.80 413 417 139.00 314,80 418 421 14(100 316.40 422 426 14L00 318.40 427 431 142.00 320.40 432 436 143.00 322.40 437 440 144.00 32AM 441 445 145,00 320,00 446 450 146.00 328.00 461 454 147.00 329.60 455 450 148.00 331.60 460 464 149.00 333.60 465 468 150.00 335.20 469 473 151.00 337.20 474 478 152.00 339.20 479 482 153.00 340.80 483 487 154.00 342.80 488 492 155,00 344.80 493 496 156.00 346,40 497 501 157.00 348.40 602 506 156.00 350.40 507 510 159.00 352.00 511 516 160.00 354.00 516 520 161.00 356.00 521 524 162.00 357.60 525 529 163.00 359.60 530 534 164.00 361.60 535 638 165,00 363.20 539 543 166.00 365,20 544 548 167.00 387.20 549 550 168.00 368.00” " 79 Stat. 363
(b)Section 215(c) of such Act is amended to read as follows:[72 Stat. 1016](/us/stat/72/1016).[42 USC 415](/us/usc/t42/s415). " “Primary Insurance Amount Under 1958 Act, as Modified “(c)
(1)For the purposes of column II of the table appearing in subsection
(a)of this section, an individual’s primary insurance amount shall be computed as provided in, and subject to the limitations specified in,
(A)this section as in effect prior to the enactment of the Social Security Amendments of 1965, and
(B)the applicable provisions of the Social Security Amendments of 1960.[74 Stat. 924](/us/stat/74/924).[42 USC 301 note](/us/usc/t42/s301). “(2) The provisions of this subsection shall be applicable only in the case of an individual who became entitled to benefits under section 202(a) or section 223 before the date of enactment of the Social[64 Stat. 482](/us/stat/64/482); [70 Stat. 815](/us/stat/70/815).[42 USC 402, 423](/us/usc/t42/s402/423).[72 Stat. 1017](/us/stat/72/1017); *Post*, p. 378.[42 USC 403](/us/usc/t42/s403). Security Amendments of 1965 or who died before such date.” "
(c)Section 203(a) of such Act is amended by striking out paragraphs
(2)and
(3)and inserting in lieu thereof the following: " “(2) when two or more persons were entitled (without the application of section 202(j)(1) and section 223(b)) to monthly benefits under section 202 or 223 for any month which begins after December 1964 and before the enactment of the Social Security Amendments of 1965, on the basis of the wages and self-employment income of such insured individual, such total of benefits for any month occurring after December 1964 shall not be reduced to less than the larger of— “(A) the amount determined under this subsection without regard to this paragraph, or “(B)
(i)with respect to the month in which such Amendments are enacted or any prior month, an amount equal to the sum of the amounts derived by multiplying the benefit amount determined under this title (including this subsection. but without the application of section 222(b), section 202(q), and subsections (b), (c), and
(d)of this section), [70 Stat. 817](/us/stat/70/817); [75 Stat. 131](/us/stat/75/131).[42 USC 422, 402](/us/usc/t42/s422/402).as in effect prior to the enactment of such Amendments, for each such person (other than a person who would not be entitled to such benefits for such month without the application of the amendments made by section 306 of the Social Security Amendments of 1965), for such month, by 107 percent and raising each such increased amount, if it is not a multiple of $0.10, to the next higher multiple of $0.10, and “(ii) with respect to any month after the month in which such Amendments are enacted, an amount equal to the sum of the amounts derived by multiplying the benefit amount determined under this title (including this subsection, but without the application of section 222(b), section 202 (q), and subsections (b), (c), and
(d)of this section), as in effect prior to the enactment of such Amendments, for each such person (other than a person who would not be entitled to such benefits for such month without the application of the amendments made by section 306 of the Social Security Amendments of 1965) for the month of enactment, by 107 percent and raising each such increased amount, if it is not a multiple of $0.10, to the next higher multiple of $0.10; but in any such case
(I)paragraph
(1)of this subsection shall not be applied to such total of benefits after the application of subparagraph
(B)of this paragraph, and
(II)if section 202(k)[64 Stat. 487](/us/stat/64/487).[42 USC 402](/us/usc/t42/s402).(2)(A) was applicable in the case of any of such benefits for any such month beginning before the enactment of the Social Secu-79 Stat. 364rity Amendments of 1965, and ceases to apply [42 USC 402](/us/usc/t42/s402).after such month, the provisions of subparagraph
(B)shall be applied, for and after the month in which such section 202(k)(2)(A) ceases to apply, as though paragraph
(1)had not been applicable to such total of benefits for such month beginning prior to such enactment.” "
(d)The amendments made by subsections (a),(b), and
(c)of this section shall apply with respect to monthly benefits under title II of the [42 USC 401](/us/usc/t42/s401).Social Security Act for months after December 1964 and with respect to lump-sum death payments under such title in the case of deaths occurring in or after the month in which this Act is enacted.
(e)[70 Stat. 815](/us/stat/70/815).[42 USC 423](/us/usc/t42/s423). If an individual is entitled to a disability insurance benefit under section 223 of the Social Security Act for December 1964 on the basis of an application filed after enactment of this Act and is entitled to [42 USC 402](/us/usc/t42/s402).old-age insurance benefits under section 202(a) of such Act for January 1965, then, for purposes of section 215(a)(4) of the Social Security [75 Stat. 135](/us/stat/75/135); *Post*, p. 370.[42 USC 415](/us/usc/t42/s415).*Ante*, p. 361.Act (if applicable) the amount in column IV of the table appearing in such section 215(a) for such individual shall be the amount in such column on the June on which in column II appears his primary insurance amount (as determined under section 215(c) of such Act) instead of the amount in column IV equal to his disability insurance benefit. computation and recomputation of benefits Sec. 302. [74 Stat. 960](/us/stat/74/960).[42 USC 415](/us/usc/t42/s415).
(1)Subparagraph
(C)of section 215 (b)(2) of the Social Security Act is amended to read as follows: " “(C) For purposes of subparagraph (B), ‘computation base years’ include only calendar years in the period after 1950 and prior to the earlier of the following years— “(i) [64 Stat. 487](/us/stat/64/487).[42 USC 402](/us/usc/t42/s402). the year in which occurred (whether by reason of section 202(j)(1) or otherwise) the first month for which the individual was entitled to old-age insurance benefits, or “(ii) the year succeeding the year in which he died. Any calendar year all of which is included in a period of disability shall not be included as a computation base year.” "
(2)[75 Stat. 135](/us/stat/75/135). Clauses (A), (B), and
(C)of the first sentence of section 215(b)(3) of such Act are amended to read as follows: " “(A) in the case of a woman, the year in which she died or, if it occurred earlier but after 1960, the year in which she attained age 62, “(B) in the case of a man who has died, the year in which he died or, if it occurred earlier but after I960, the year in which he attained age 65, or “(C) in the case of a man who has not died, the year occurring after 1960 in which he attained (or would attain) age 65.” "
(3)[74 Stat. 960](/us/stat/74/960). Paragraphs
(4)and
(5)of section 215(b) of such Act are amended to read as follows: " “(4) The provisions of this subsection shall be applicable only in the case of an individual— “(A) [64 Stat. 482](/us/stat/64/482); [70 Stat. 815](/us/stat/70/815).[42 USC 402, 42](/us/usc/t42/s402/42). who becomes entitled, after December 1965, to benefits under section 202(a) or section 223; or “(B) who dies after December 1965 without being entitled to benefits under section 202
(a)or section 223; or “(C) whose primary insurance amount is required to be recomputed under subsection (f)(2), as amended by the Social Security *Post*, p. 365.Amendments of 1965; except that it shall not apply to any such individual for purposes of monthly benefits for months before January 1966. 79 Stat. 365 “(5) For the purposes of column III of the table appearing in subsection
(a)of this section, the provisions of this subsection, as in effect prior to the enactment of the Social Security Amendments of 1965, snail apply— “(A) in the case of an individual to whom the provisions of this subsection are not made applicable by paragraph (4), but who, on or after the date of the enactment of the Social Security Amendments of 1965 and prior to 1966, met the requirements of this paragraph or paragraph (4), as in effect prior to such enactment, and “(B) with respect to monthly benefits for months before January 1966, in the case of an individual to whom the provisions of this subsection are made applicable by paragraph (4).” "
(1)Subparagraph
(A)of section 215(a)(1) of such Act is [74 Stat. 961](/us/stat/74/961).[42 USC 415](/us/usc/t42/s415).amended by striking out “(2)(C)(i) and (3)(A)(i)” and inserting in lieu thereof “(2)(C) and (3)”, by striking out “December 31, 1936,” and inserting in lieu thereof “1936”, and by striking out “December 31, 1950” and inserting in lieu thereof “1950”.
(2)Section 215(d)(3) of such Act is amended by striking out “1960” and inserting in lieu thereof “1965” and by striking out “but without regard to whether such individual has six quarters oi coverage after 1950”
(c)Section 215(e) of such Act is amended by inserting “and” [64 Stat. 508](/us/stat/64/508).after the semicolon at the end of paragraph (1), by striking out “; and” at the end of paragraph
(2)and insert mg in lieu thereof a period, and by striking out paragraph (3).
(1)Paragraph
(2)of section 215(f) of such Act is amended [68 Stat. 1066](/us/stat/68/1066).to read as follows: " “(2) With respect to each year— “(A) which begins after December 31, 1964, and “(B) for any part of which an individual is entitled to old-age insurance benefits, the Secretary shall, at. such time or times and within such period as he may by regulations prescribe, recompute the primary insurance amount of such individual. Such recomputation shall be made— “(C) as provided in subsection (a)(1) and
(3)if such year is either the year in which he became entitled to such old-age insurance benefits or the year preceding such year, or “(D) as provided in subsection (a)(1) in any other case; and in all cases such recomputation shall be made as though the year with respect to which such recomputation is made is the last year of the period specified in paragraph (2)(C) of subsection (b). A recomputation under this paragraph with respect to any year shall be effective— “(E) in the case of an.individual who did not die in such year, for monthly benefits beginning with benefits for January of the following year; or “(F) in the case of an individual who died in such year (including any individual whose increase in his primary insurance amount is attributable to compensation which, upon his death, is treated as remuneration for employment under section 205 (o)), [64 Stat. 520](/us/stat/64/520).[42 USC 405](/us/usc/t42/s405).for monthly benefits beginning with benefits for the month in which he died.” "
(2)Effective January 2, 1966, paragraphs (3), (4). and
(7)of such section are repealed, and paragraphs
(5)and
(6)of such section are redesignated as paragraphs
(3)and (4), respectively. 79 Stat. 366
(e)[74 Stat. 964](/us/stat/74/964); *Post*, p. 370.[42 USC 423](/us/usc/t42/s423).
(1)The first sentence of section 223(a)(2) of such Act is amended by inserting before the period at the end thereof “and was entitled to an old-age insurance benefit for each month for which (pursuant to subsection (b)) he was entitled to a disability insurance benefit”.
(2)The last sentence of section 223 (a)(2) of such Act is amended by striking out “first year” and inserting in lieu thereof “year”; and by striking out the phrase “both was fully insured and had” both times it appears in such sentence.
(1)The amendments made by subsection
(c)shall apply only to individuals who become entitled to old-age insurance benefits under [64 Stat. 482](/us/stat/64/482).[42 USC 402](/us/usc/t42/s402).section 202(a) of the Social Security Act after 1965.
(2)Any individual who would, upon filing an application prior to January 2, 1966, be entitled to a recomputation of his monthly benefit [42 USC 401](/us/usc/t42/s401).amount for purposes of title II of the Social Security Act shall be deemed to have filed such application on the earliest date on which such application could have been filed, or on the day on which this Act is enacted, whichever is the later.
(3)In the case of an individual who died after 1960 and prior to I960 and who was entitled to old-age insurance benefits under section 202(a) of the Social Security Act at the time of his death, the provisions of [74 Stat. 963](/us/stat/74/963); [68 Stat. 1068](/us/stat/68/1068).sections 215(f)(3)(B) and 215(f)(4) of such Act as in effect before the enactment of this Act shall apply.
(4)In the case of a man who attains age 65 prior to 1966, or dies before such year, the provisions of section 215(f)(7) of the Social Security Act as in effect before the enactment of this Act shall apply.
(5)The amendments made by subsection
(e)of this section shall apply in the case of individuals who become entitled to disability insurance benefits under section 223 of the Social Security Act after [70 Stat. 815](/us/stat/70/815).[42 USC 423](/us/usc/t42/s423).December 1965.
(6)[74 Stat. 964](/us/stat/74/964).[43 USC 415 note](/us/usc/t43/s415). Section 303 (g)(1) of the Social Security Amendments of 1960 is amended—
(A)by striking out “notwithstanding the amendments made by the preceding subsections of this section,” in the first sentence and inserting in lieu thereof “notwithstanding the amendments made by the preceding subsections of this section, or the amendments made by section 302 of the Social Security Amendments of 1965,”; and
(B)by striking out “Social Security Amendments of 1960,” in the second sentence and inserting in lieu thereof “Social Security Amendments of 1960, or (if such individual becomes entitled to old-age insurance benefits after 1965, or dies after 1965 without becoming so entitled) as amended by the Social Security Amendments of 1965,”.
(7)Repeal.[68 Stat. 1070](/us/stat/68/1070).[42 USC 415 note](/us/usc/t42/s415). Effective January 2, 1966, subparagraph
(B)of section 102(f)(2) of the Social Security Amendments of 1954 is repealed. disability insurance benefits Sec. 303. [68 Stat. 1080](/us/stat/68/1080).[42 USC 416](/us/usc/t42/s416).
(1)Clause
(A)of the first sentence of section 216 (i)(1) of the Social Security Act is amended by striking out “or to be of long-continued and indefinite duration” and inserting in lieu thereof “or has lasted or can be expected to last for a continuous period of not less than 12 months”. 79 Stat. 367
(2)So much of section 223 (c)(2) of such Act as precedes the second [70 Stat. 815](/us/stat/70/815); *Post*, p. 413.[42 USC 423](/us/usc/t42/s423).sentence thereof is amended to read as follows: " “(2) The term ‘disability’ means— “(A) inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months; or”, "
(1)Paragraph
(2)of section 216
(i)of such Act is amended *Post*, p. 370.[42 USC 416](/us/usc/t42/s416).to read as follows: " “(2)
(A)The term ‘period of disability’ means a continuous period “Period of dis ability.”(beginning and ending as hereinafter provided in this subsection) during which an individual was under a disability (as defined in paragraph (1)), but only if such period is of not less than 6 full calendar months’ duration or such individual was entitled to benefits under section 223 for one or more months in such period.[42 USC 423](/us/usc/t42/s423). “(B) No period of disability shall begin as to any individual unless such individual files an application for a disability determination with respect to such period; and no such period shall begin as to any individual after such individual attains the age of 65. “(C) A period of disability shall begin— “(i) on the day the disability began, but only if the individual satisfies the requirements of paragraph
(3)on such day; or “(ii) if such individual does not satisfy the requirements of paragraph
(3)on such day, then on the first day of the first quarter thereafter in which he satisfies such requirements. “(D) A period of disability shall end with the close of whichever of the following months is the earlier:
(i)the month preceding the month in which the individual attains age 65, or
(ii)the second month following the month in which the disability ceases. “(E) No application for a disability determination which is filed more than 12 months after the month prescribed by subparagraph
(D)as the month in which the period of disability ends (determined without regard to subparagraph
(B)and this subparagraph) shall be accepted as an application for purposes of this paragraph. "
(2)Section 216(i)(3) of such Act is amended by striking out [72 Stat. 1021](/us/stat/72/1021); *Post*, p. 412.“clauses
(A)and
(B)of paragraph (2)” and inserting in lieu thereof “clauses
(i)and
(ii)of paragraph (2)(C)”.
(3)Subparagraph
(D)of section 223(a)(1) of such Act is amended [42 USC 423](/us/usc/t42/s423).*Poatt* p. 413.by striking out “at the time such application is filed,”. So much of such section 223(a)(1) as follows subparagraph
(D)is amended by striking out “the first month for which he is entitled to old-age insurance benefits,”.
(4)Section 223(c)(3)(A) of such Act is amended by striking out[72 Stat. 1020](/us/stat/72/1020).[42 USC 423](/us/usc/t42/s423). “which continues until such application is filed”.
(c)Section 223(b) of such Act is amended by striking out the last sentence and inserting in lieu thereof the following: “An individual who would have been entitled to a disability insurance benefit for any month had he filed application therefor before the end of such month shall be entitled to such benefit for such month if he files such application before the end of the 12th month immediately succeeding such month.”
(d)The second sentence of section 202(j)(1) of such Act is amended [64 Stat. 487](/us/stat/64/487).[42 USC 402](/us/usc/t42/s402).by inserting “under this title” after “Any benefit”.
(e)So much of section 215(a)(4) of such Act as precedes “the [75 Stat. 135](/us/stat/75/135); *Post*, p. 370.[42 USC 415](/us/usc/t42/s415).amount in column IV” is amended to read as follows: " “(4) In the case of an individual who was entitled to a disability insurance benefit for the month before the month in which he died, became entitled to old-age insurance benefits, or attained age 65,”, " 79 Stat. 368
(1)The amendments made by subsection (a), paragraphs
(3)and
(4)of subsection (b), and subsections
(c)and (d), and the provisions *Ante*, p. 367.of subparagraphs
(B)and
(E)of section 216(i)(2) of the Social Security Act (as amended by subsection (b)(1) of this section), shall be effective with respect to applications for disability insurance[70 Stat. 815](/us/stat/70/815).[42 USC 423](/us/usc/t42/s423). benefits under section 223, and for disability determinations under section 216(i), of the Social Security Act filed—
(A)in or after the month in which this Act is enacted, or
(B)before the month in which this Act is enacted, if the applicant has not died before such month and if—
(i)notice of the final decision of the Secretary of Health, Education, and Welfare has not been given to the applicant before such month; or
(ii)the notice referred to in subparagraph
(i)has been so given before such month but a civil action with respect to such final decision is commenced under section 205(g) of the [53 Stat. 1370](/us/stat/53/1370).[42 USC 405](/us/usc/t42/s405).Social Security Act (whether before, in, or after such month) and the decision in such civil action has not become final before such month; except, that no monthly insurance benefits under title II of the Social Security Act shall be payable or increased by reason of the amendments made by subsections
(a)and
(b)for months before the second month following the month in which this Act is enacted. The preceding sentence shall also be applicable in the case of applications for[42 USC 401](/us/usc/t42/s401). monthly insurance benefits under title II of the Social Security Act based on the wages and self-employment income of an applicant with respect to whose application for disability insurance benefits under section 223 of such Act such preceding sentence is applicable.
(2)The amendment made by subsection
(e)shall apply in the case of the primary insurance amounts of individuals who attain age 65 after the date of enactment of this Act. payment of disability insurance benefits after entitlement to other monthly insurance benefits Sec. 304. [64 Stat. 487](/us/stat/64/487).[42 USC 402](/us/usc/t42/s402).
(a)Section 202(h) of the Social Security Act is amended by adding at the end thereof the following new paragraph: " “(4) Any individual who, under this section and section 223, is entitled for any month to both an old-age insurance benefit and a disability insurance benefit under this title shall be entitled to only the larger of such benefits for such month, except, that, if such individual so elects, he shall instead be entitled to only the smaller of such benefits for such month.” "
(b)[75 Stat. 131](/us/stat/75/131); *Post*, p. 374. The heading of section 202(q) of such Act is amended to read as follows: " “Reduction of Old-Age, Disability, Wife’s, Husband’s, or Widow’s Insurance Benefit Amounts” "
(c)Section 202(a) of such Act is further amended by renumbering paragraphs (2), (3). (4), (5), (6), and
(7)as paragraphs (3), (4), (5), (6), (7), and (8), respectively, by renumbering the cross references in such section accordingly, and by inserting after paragraph
(1)the following new paragraph: " “(2) If an individual is entitled to a disability insurance benefit for a month after a month for which such individual was entitled to an old-age insurance benefit, such disability insurance benefit for each month shall be reduced by the amount such old-age insurance 79 Stat. 369benefit would be reduced under paragraphs
(1)and
(4)for such month had such individual attained age 65 in the first month for which he most recently became entitled to a disability insurance benefit.” "
(d)Subparagraph
(B)of paragraph (3)(as redesignated by subsection
(c)of this section) of section 202(q) of such Act is amended by—
(1)striking out “benefit” the first time it appears and inserting in lieu thereof “benefit and is not entitled to a disability insurance benefit,”; .
(2)striking out in clause
(i)thereof “(1),” and inserting in lieu thereof “(1) for such month,”; and
(3)striking out in clause
(ii)thereof “(1)” and inserting in lieu thereof “(1) for such month”.
(e)Subparagraph
(C)of paragraph (3)(as redesignated by subsection
(c)of this section) of section 202
(q)of such Act is amended to read as follows: " “(C) For any month for which such individual is entitled to a disability insurance benefit, such individual’s wife’s, husband’s, or widow’s insurance benefit shall be reduced by the sum of— “(i) the amount by which such disability insurance benefit is reduced under paragraph
(2)for such month (if such paragraph applied to such Benefit), and “(ii) the amount by which such wife’s, husband’s, orwidow’s insurance benefit would be reduced under paragraph
(I)for such month if it were equal to the excess of such wife’s, husoand’s, or widow’s insurance benefit (before reduction under this subsection) over such disability insurance benefit (before reduction under this subsection).” "
(f)Paragraph (3)(as redesignated by subsection
(c)of this section) of section 202(q) is further amended by adding after subparagraph (E)(added by section 307(b)(4) of this Act) the following *Post*, p. 374.new subparagraphs: " “(F) If the first month for which an individual is entitled to a disability insurance benefit (when such first month occurs with or after the month in which such individual attains the age of 62) is a month for which such individual is also (or would, but for subsection (e)(1), be) entitled to a widow’s insurance benefit to which such individual was first entitled for a month before she attained retirement age, then such disability insurance benefit for each month shall be reduced by whichever of the following is larger: “(i) the amount by which (but for this subparagraph) such disability insurance benefit would have been reduced under paragraph (2), or “(ii) the amount equal to the sum of the amount by which such widow’s insurance benefit was reduced for the month in which such individual attained retirement age and the amount by which such disability insurance benefit would be reduced under paragraph
(2)if it were equal to the excess of such disability insurance benefit (before reduction under this subsection) over such widow’s insurance benefit (before reduction under this subsection). “(G) If the first month for which an individual is entitled to a disability insurance benefit (when such first month occurs before the month in which such individual attains the age of 62) is a month for which such individual is also (or would, but for subsection (e)(1), be) entitled to a widow’s insurance benefit, then such disability insurance benefit for each month shall be reduced by the amount such widow’s insurance benefit would be reduced under paragraphs
(1)and 79 Stat. 370(4) for such month had such individual attained age 62 in the first month for which he most recently became entitled to a disability insurance benefit.” "
(g)Paragraph (4)(as redesignated by subsection
(c)of this section) of section 202(q) of such Act is amended by striking out in subparagraph
(A)thereof “under” and inserting in lieu thereof: “under paragraph
(1)or (31 of”.
(h)Paragraph (7)(as redesignated by subsection
(c)of this section and as amended by section 307(b)(c) of this Act) of section 202(q) of such Act is amended by adding after subparagraph
(E)the following new subparagraph: " “(F) in the case of old-age insurance benefits, any month for which such individual was entitled to a disability insurance benefit.” "
(i)Paragraph (8)(as redesignated by subsection
(c)of this section) of section 202(q) of such Act is amended by striking out “(1)” and inserting in lieu thereof “(1), (2),”.
(j)[75 Stat. 133](/us/stat/75/133).[42 USC 402](/us/usc/t42/s402).*Ante*, p. 368.[75 Stat. 135](/us/stat/75/135); *Ante*, p. 367.[42 USC 415](/us/usc/t42/s415). Section 202 (r)(2) of such Act is amended by inserting after “eligible” the following: “(but for section 202(k)(4))”.
(k)Section 215(a)(4) of such Act is amended by striking out “such disability insurance benefit” and inserting in lieu thereof “the primary insurance amount upon which such disability insurance benefit is based”.
(l)[42 USC 416](/us/usc/t42/s416).*Ante*, p. 367. Section 216(i)(2) of such Act is amended by striking out “(subject to section 223(a)(3))”.
(m)[74 Stat. 964](/us/stat/74/964); *Ante*, p. 366.[42 USC 423](/us/usc/t42/s423). Section 223(a)(2) of such Act is amended by striking out the word “Such” and inserting in lieu thereof “Except as provided in section 202 (q), such”,
(n)Section 223(a)(3) of such Act is repealed.
(o)[42 USC 401](/us/usc/t42/s401). The amendments made by this section shall apply with respect to monthly insurance benefits under title II of the Social Security Act for and after the second month following the month in which this Act is enacted, but only on the basis of applications filed in or after the month in which this Act is enacted. disability insurance trust fund Sec. 305. [70 Stat. 820](/us/stat/70/820).[42 USC 401](/us/usc/t42/s401).
(a)Section 201(b)(1) of the Social Security Act is amended by inserting “and before January 1, 1966,” after “December 31, 1956,”, and by inserting after “1954,” the following: “and 0.70 of 1 per centum of the wages (as so defined) paid after December 31, 1965, and so reported,”.
(b)Section 201(b)(2) of such Act is amended by inserting after “December 31, 1956,” the following: “and before January 1, 1966, and 0.525 of 1 per centum of the amount of self-employment income (as so defined) so reported for any taxable year beginning after December 31, 1965,”. payment of child’s insurance benefits after attainment of age 18 in case of child attending school Sec. 306. [72 Stat. 1022](/us/stat/72/1022).[42 USC 402](/us/usc/t42/s402).
(a)Section 202(d)(1)(B) of the Social Security Act is amended to read as follows: " “(B) at the time such application was filed was unmarried and
(i)either had not attained the age of 18 or was a full-time student and had not attained the age of 22, or
(ii)is under a disability (as [70 Stat. 815](/us/stat/70/815).*Ante*, p. 367.defined in section 223(c)) which began before he attained the age of 18, and”. " 79 Stat. 371
(1)So much of the first sentence of section 202(d)(1) of such [72 Stat. 1022](/us/stat/72/1022); *Post*, p. 307.[42 USC 402](/us/usc/t42/s402).Act as follows subparagraph
(C)is amended to read as follows: “shall be entitled to a child’s insurance benefit for each month, beginning with the first month after August 1950 in which such child becomes so entitled to such insurance benefits and ending with the month preceding whichever of the following first occurs— " “(D) the month in which such child dies, marries, or is adopted (except for adoption by a stepparent, grandparent, aunt, or uncle subsequent to the death of such fully or currently insured individual), “(E) the month in which such child attains the age of 18, but only if he
(i)is not under a disability (as so defined) at the time he attains such age, and
(ii)is not a full-time student during any part of such month, “(F) if such child was not under a disability (as so defined) at the time he attained the age of 18, the earlier ot— “(i) the first, month during no part of which he is a full-time student, or “(ii) the month in which he attains the age of 22, or “(G) if such child was under a disability (as so defined) at the time he attained the age of 18, the third month following the month in which he ceases to be under such disability or (if later) the earlier of— “(i) the first month during no part of which he is a full-time student, or “(ii) the month in which he attains the age of 22.” "
(2)The second sentence of section 202(d)(1) of such Act is repealed.
(3)Section 202(d) of such Act is further amended by adding at the end thereof the following new paragraphs: " “(7) A child whose entitlement to child’s insurance benefits on the basis of the wages and self-employment, income of an insured individual terminated with the month preceding the month in which such child attained the age of 18, or with a subsequent month, may again become entitled to such benefits (provided no event specified in paragraph (1)(D) has occurred) beginning with the first month thereafter in which he is a full-time student and has not attained the age of 22 if he has filed application for such reentitlement. Such reentitlement shall end with the month preceding whichever of the following first occurs: The first month during no part of which he is a full-time student, the month in which he attains the age of 22, or the first month in which an event specified in paragraph (1)(D) occurs. “(8) For the purposes of this subsection— “(A) A ‘full-time student’ is an individual who is in full-time “Full-time student”.attendance as a student at an educational institution, as determined by the Secretary (in accordance with regulations prescribed by him) in the light of the standards and practices or the institutions involved, except that no individual shall be considered a ‘full-time student’ if he is paid by his employer while attending an educational institution at the request, or pursuant to a requirement, of his employer. “(B) Except to the extent provided in such regulations, an individual shall be deemed to be a full-time student during any period of nonattendance at an educational institution at which he has been in full-time attendance if
(i)such period is 4 calendar months or less, and
(ii)he shows to the satisfaction of the Secretary that he intends to continue to be in full-time attendance at an educational institution immediately following such period. An 79 Stat. 372individual who does not meet the requirement of clause
(ii)with respect to such period of nonattendance shall be deemed to have met such requirement (as of the beginning of such period) if he is in full-time attendance at an educational institution immediately following such period. “(C) “Educational institution.” An ‘educational institution’ is
(i)a school or college or university operated or directly supported by the United States, or by any State or local government or political subdivision thereof, or
(ii)a school or college or university which has been approved by a State or accredited by a State-recognized or nationally-recognized accrediting agency or body, or
(hi)a non-accredited school or college or university whose credits are accepted, on transfer, by not less than three institutions which are so accredited, for credit on the same basis as if transferred from an institution so accredited.” "
(c)[42 USC 402](/us/usc/t42/s402).
(1)Section 202 of such Act is amended by inserting immediately after subsection
(r)the following new subsection: " “Child Aged 18 or Over Attending School “(a)
(1)For the purposes of subsections (b)(1), (g)(1), (q)(5), and (q)(7) of this section and paragraphs (2), (3), and
(4)of section [42 USC 403](/us/usc/t42/s403).203(c), a child who is entitled to child’s insurance benefits under subsection
(d)for any month, and who has attained the age of 18 but is not in such month under a disability (as defined in section 223(c)) which began before he attained such age, shall be deemed not entitled to such benefits for such month, unless he was under such a disability m the third month before such month. “(2) Subsection (f)(4), and so much of subsections (b)(3), (d)(6), (e)(3), (g)(3), and (h)(4) of this section as precedes the semi-colon, shall not apply in the case of any child unless such child, at the time of the marriage referred to therein, was under a disability (as*Ante*, p. 367.[42 USC 423](/us/usc/t42/s423). defined in section 223 (c)) which began before such child attained the age of 18 or had been under such a disability in the third month before the month in which such marriage occurred. “(3) Subsections (c)(2)(B) and (f)(2)(B) of this section, so much of subsections (b)(3), (d)(6), (e)(3), (g)(3), and (h)(4) of this section as follows the semicolon, the last sentence of subsection [74 Stat. 954, 955](/us/stat/74/954/955); *Post*, p. 373.[42 USC 403](/us/usc/t42/s403).[72 Stat. 1026–1028](/us/stat/72/1026–1028).[42 USC 416](/us/usc/t42/s416).(c) of section 203, subsection (f)(1)(C) of section 203, and subsections (b)(3)(B), (c)(6)(B), (f)(3)(B), and (g)(6)(B) of section 216 shall not apply in the case of any child with respect to any month referred to therein unless in such month or the third month prior thereto such child was under a disability (as defined in section 223(c)) which began before such child attained the age of 18.” "
(2)[72 Stat. 1026](/us/stat/72/1026); *Post*, p. 405.[42 USC 402](/us/usc/t42/s402). So much of subsection (c)(2) of such section 202 as precedes subparagraph
(A)is amended by inserting “(subject to subsection (s))” after “shall”.
(3)So much of subsection (d)(6) of such section 202 as follows subparagraph
(B)is amended by inserting “but subject to subsection (s)” after “notwithstanding the provisions of paragraph (1)”.
(4)So much of subsection (e)(3) of such section 202 as follows subparagraph
(B)is amended by inserting “but subject to subsection (s)” after “notwithstanding the provisions of paragraph (1)”.
(5)So much of subsection (f)(2) of such section 202 as precedes subparagraph
(A)is amended by inserting “(subject to subsection (s))” after “shall”. 79 Stat. 373
(6)So much of subsection (f)(4) of such section 202 as follows subparagraph
(B)is amended by inserting “but subject to subsection (s)” after “notwithstanding the provisions of paragraph (1)”.
(7)So much of the first sentence of subsection (g)(1) of such section 202 as follows subparagraph
(F)is amended by inserting “(subject [64 Stat. 486](/us/stat/64/486); *Post*, p. 378.[42 USC 402](/us/usc/t42/s402).to subsection (s))” after “shall”.
(8)So much of subsection (g)(3) of such section 202 as follows subparagraph
(B)is amended by inserting “but subject to subsection (s)” after “notwithstanding the provisions of paragraph (1)”.
(9)So much of subsection (h)(4) of such section 202 as follows [72 Stat. 1032](/us/stat/72/1032).subparagraph
(B)is amended by inserting “but subject to subsection (s)” after “notwithstanding the provisions of paragraph (1)”.
(10)The next to last sentence of subsection
(c)of section 203 of [42 USC 403](/us/usc/t42/s403).such Act is amended by striking out “for any month in which” and inserting in lieu thereof “for any month in which paragraph
(1)of section 202
(s)applies or”.
(11)The last sentence of subsection
(c)of such section 203 is amended by striking out “No” and inserting in lieu thereof “Subject to paragraph
(3)of such section 202 (s), no”.*Ante*, p. 372.
(12)The last sentence of subsection (f)(1) of such section 203 is amended by inserting “but subject to section 202 (s)” after “Notwithstanding the preceding provisions of this paragraph”.
(13)Subsections (b), (c), (f), and
(g)or section 216 of such Act *Past*, pp. 404, 405.[42 USC 416](/us/usc/t42/s416).are each amended by inserting before the period at the end thereof “(subject, however, to section 202 (s))”.
(14)Section 222(b) of such Act is amended by adding at the end [42 USC 422](/us/usc/t42/s422).thereof the following new paragraph: " “(4) The provisions of paragraph
(1)shall not apply to any child entitled to benefits under section 202(d), if he has attained the age of *Ante*, pp. 370, 371.[42 USC 402](/us/usc/t42/s402).18 but has not attained the age of 22, for any month during which he is a full-time student (as defined and determined under section 202(d)).” "
(15)Section 225 of such Act is amended by adding at the end [70 Stat. 817](/us/stat/70/817).[42 USC 425](/us/usc/t42/s425).thereof the following new sentence: “The first sentence of this section shall not apply to any child entitled to benefits under section 202(d), if he has attained the age of 18 but has not attained the age of 22, for any month during which he is a full-time student (as defined and determined under section 202(d)).”
(d)The amendments made by this section shall apply with respect to monthly insurance benefits under section 202 of the Social Security Act for months after December 1964; except that—[64 Stat. 482](/us/stat/64/482).[42 USC 402](/us/usc/t42/s402).
(1)in the case of an individual who was not entitled to a child’s insurance benefit under subsection
(d)of such section for the month in which this Act is enacted, such amendments shall apply only on the basis of an application filed in or after the month in which this Act is enacted, and
(2)no monthly insurance benefit shall be payable for any month before the second month following the month in which this Act is enacted by reason of section 202(d)(1)(B)(ii) of the Social Security Act. as amended by this section.*Ante*, p. 370. reduced benefits for widows at age 60 Sec. 307.
(1)Paragraph (1)(B) of section 202(e) of the Social Security Act (as amended by section 308(b) of this Act) is amended *Post*, p. 376.by striking out “age 62” and inserting in lieu thereof “age 60”.
(2)Paragraph
(2)of such section (as so amended) is amended by striking put “Such” and inserting in lieu thereof “Except as provided in subsection (q), such”. 79 Stat. 374
(b)[75 Stat. 131](/us/stat/75/131).[42 USC 402](/us/usc/t42/s402).
(1)Paragraph
(1)of section 202(g) of such Act is amended to read as follows: " “(1) If the first month for which an individual is entitled to an old-age, wife’s, husband’s, or widow’s insurance benefit is a month before the month in which such individual attains retirement age, the amount of such benefit for each month shall, subject to the succeeding paragraphs of this subsection, be reduced by— “(a) 5/9 of 1 percent of such amount if such benefit is an old-age or widow’s insurance benefit, or 25/36 of 1 percent of such amount if such benefit is a wife’s or husband’s insurance benefit, multiplied by “(B)
(i)the number of months in the reduction period for such benefit (determined under paragraph (6)), if such benefit is for a month before the month in which such individual attains retirement age, or “(ii) the number of months in the adjusted reduction period for such benefit (determined under paragraph (7)), if such benefit is for the month in which such individual attains retirement age or for any month thereafter.” "
(2)*Ante*, p. 368. Paragraph (3)(A)(os renumbered by section 304(c) of this Act) of such section is amended—
(A)by striking out “wife’s or husband’s insurance benefit” each place it appears and inserting in lieu thereof “wife’s, husband’s, or widow’s insurance benefit”; and
(B)by striking out “age 62” and inserting in lieu thereof “age 62 (in the case of a wife’s or husband’s insurance benefit) or age 60 (in the case of a widow’s insurance benefit)”.
(3)Paragraph (3)(D)(as so renumbered) of such section is amended by striking out “wife’s or husband’s” and inserting in lieu thereof “wife’s, husband’s, or widow’s”.
(4)Paragraph (3)(as so renumbered) of such section is amended by adding at the end thereof the following new subparagraph: " “(E) If the first month for which an individual is entitled to an old-age insurance benefit (whether such first month occurs before, with, or after the month in which such individual attains the age of 65) is a month for which such individual is also (or would, but for subsection (e)(1), be) entitled to a widow’s insurance benefit to which such individual was first entitled for a month before she attained retirement age, then such old-age insurance benefit shall be reduced by whichever of the following is the larger: “(i) the amount by which (but for this subparagraph) such old-age insurance benefit would have been reduced under paragraph (1), “(ii) the amount equal to the sum of the amount by which such widow’s insurance benefit was reduced for the month in which such individual attained retirement age and the amount by which such old-age insurance benefit would be reduced under paragraph
(1)if it were equal to the excess of such old-age insurance benefit (before reduction under this subsection) over such widow’s insurance benefit (before reduction under this subsection).” "
(5)Paragraph (5)(as so renumbered) of such section is amended by adding at the end thereof the following new subparagraph: " “(D) No widow’s insurance benefit for a month in which she has in her care a child of her deceased husband (or deceased former husband) entitled to child’s insurance benefits shall be reduced under this subsection below the amount to which she would have been 79 Stat. 375entitled had she been entitled for such month to mother’s insurance benefits on the basis of her deceased husband’s (or deceased former husband’s) wages and self-employment income.” "
(6)Paragraph (6)(as so renumbered) of such section is amended—
(A)by striking out “wife’s, or husband’s” and inserting in lieu thereof “wife’s, husband’s, or widow’s”;
(B)by striking out “or husband’s” in subparagraph (A)(i) and inserting in lieu thereof “, husband’s, or widow’s”; and
(C)by striking out “age 65” in subparagraph
(B)and inserting in lieu thereof “retirement age”.
(7)Paragraph (7)(as so renumbered) of such section is amended—
(A)by striking out “wife’s, or husband’s” and inserting in lieu thereof “wife’s, husband’s, or widow’s”; and
(B)by striking out “and” at the end of subparagraph (B), by striking out the period at the end of subparagraph
(C)and inserting in lieu thereof a comma, and by adding at the end thereof the following new subparagraphs: " “(D) in the case of widow’s insurance benefits, any month in which the reduction in the amount of such benefit was determined under paragraph (5)(D), “(E) in the case of widow’s insurance benefits, any month before the month in which she attained retirement age for which she was not entitled to such benefit because of the occurrence of an event that terminated her entitlement to such benefits, and”. "
(8)Section 202(a) of such Act (as amended by section 304(c) of this Act) is further amended by adding at the end thereof the *Ante*, p. 368.following new paragraph: " “(9) For purposes of this subsection, the term ‘retirement age’ means age 65 with respect to an old-age, wife’s, or husband’s insurance benefit and age 62 with respect to a widow’s insurance benefit.” "
(c)The amendments made by this section shall apply with respect to monthly insurance benefits under section 202 of the Social Security Act for and after the second month following the month in which this[64 Stat. 482](/us/stat/64/482).[42 USC 402](/us/usc/t42/s402). Act is enacted, but only on the basis of applications filed in or after the month in which this Act is enacted. wife’s and widow’s benefits for divorced women Sec. 308.
(a)Section 202
(b)of the Social Security Act is amended to read as follows: " “Wife’s Insurance Benefits “(b)
(1)The wife (as defined in section 216(b)) and every divorced wife (as defined in section 216(d)) of an individual entitled to old-age *Post*, p. 377.[42 USC 416](/us/usc/t42/s416).or disability insurance benefits, if such wife or such divorced wife— “(A) has filed application for wife’s insurance benefits, “(B) has attained age 62 or (in the case of a wife) has in her care (individually or jointly with such individual) at the time of filing such application a child entitled to a child’s insurance benefit on the basis of the wages and self-employment income of such individual, “(C) in the case of a divorced wife, is not married, “(D) in the case of a divorced wife, was receiving at least one-half of her support, as determined in accordance with regulations prescribed by the Secretary, from such individual, or was receiving substantial contributions from such individual (pursuant to a written agreement) or there was in effect a court order for substantial contributions to her support from such individual— 79 Stat. 376 “(i) if be had a period of disability which did not end before the month in which he became entitled to old-age or disability insurance benefits? at the beginning of such period or at the time he became entitled to such benefits, or “(ii) if he did not have such a period of disability, at the time he became entitled to old-age insurance benefits, and “(E) is not entitled to old-age or disability insurance benefits, or is entitled to old-age or disability insurance benefits based on a primary insurance amount which is less than one-half of the primary insurance amount of such individual, shall (subject to subsection (s)) be entitled to a wire’s insurance benefit for each month, beginning with the first month in which she becomes so entitled to such insurance benefits and ending with the month preceding the first month in which any of the following occurs— “(F) she dies, “(G) such individual dies, “(H) in the case of a wife? they are divorced and either
(i)she has not attained age 62, or
(ii)she has attained age 62 but has not been married to such individual for a period of 20 years immediately before the date the divorce became effective, “(I) in the case of a divorced wife, she marries a person other than such individual, “(J) in the case or a wife who has not attained age 62, no child of such individual is entitled to a child’s insurance benefit, “(K) she becomes entitled to an old-age or disability insurance benefit based on a primary insurance amount which is equal to or exceeds one-half of the primary insurance amount of such individual, or “(L) such individual is not entitled to disability insurance benefits and is not entitled to old-age insurance benefits. “(2) Except as provided in subsection (q), such wife’s insurance benefit for each month shall be equal to one-half of the primary insurance amount of her husband (or, in the case of a divorced wife, her former husband) for such month. “(3) In the case of any divorced wife who marries— “(A) an individual entitled to benefits under subsection
(f)or
(h)of this section, or “(B) an individual who has attained the age of 18 and is entitled to benefits under subsection (d), such divorced wife’s entitlement to benefits under this subsection shall, notwithstanding the provisions of paragraph (1)(but subject to subsection (s)), not be terminated by reason of such marriage; except that, in the case of such a marriage to an individual entitled to benefits under subsection (d), the preceding provisions of this paragraph shall not apply with respect to benefits for months after the last month for which such individual is entitled to such benefits under subsection
(d)unless he ceases to be so entitled by reason of his death.” "
(b)[42 USC 402](/us/usc/t42/s402).
(1)Paragraphs
(1)and
(2)of section 202(e) of such Act are amended to read as follows: " “(1) *Post*, p. 377. The widow (as defined in section 216(c)) and every surviving divorced wife (as defined in section 216(d)) of an individual who died a fully insured individual, if such widow or such surviving divorced wife— “(A) is not married, “(B) has attained age 62, 79 Stat. 377 “(C)
(i)has filed application for widow’s insurance benefits, or was entitled, after attainment of age 62, to wife’s insurance benefits, on the basis of the wages and self-employment income of such individual, for the month preceding the month in which he died, or “(ii) was entitled, on the basis of such wages and self-employment income, to mother’s insurance benefits for the month preceding the month in which she attained age 62, “(D) in the case of a surviving divorced wife who was not entitled to wife’s insurance benefits on the basis of the wages and self-employment income of such individual for the month preceding the month in which he died, was receiving at least one-half of her support, as determined in accordance with regulations prescribed by the Secretary, from such individual, or was receiving substantial contributions from such individual (pursuant to a written agreement) or there was in effect a court order for substantial contributions to her support from such individual— “(i) at the time of his death (or, if such individual had a period of disability which did not end prior to the month in which he died, at the time such period began or at the time of his death), or “(ii) at the time he became entitled to old-age insurance benefits or disability insurance benefits (or, if such individual had a period of disability which did not end before the month in which he became entitled to such benefits, at the time such period began or at the time he became entitled to such benefits; and “(E) is not entitled to old-age insurance benefits or is entitled to old-age insurance benefits each of which is less than 82½ percent of the primary insurance amount of such deceased individual, shall be entitled to a widow’s insurance benefit for each month, beginning with the first month in which she becomes so entitled to such insurance benefits and ending with the month preceding the first month in which any of the following occurs: she remarries, dies, or becomes entitled to an old-age insurance benefit equal to or exceeding 82½ percent of the primary insurance amount of such deceased individual. “(2) Such widow’s insurance benefit for each month shall be equal to 82½ percent of the primary insurance amount of such deceased individual.” "
(2)Paragraph
(3)of section 202(e) of such Act is repealed.[42 USC 402](/us/usc/t42/s402).
(3)Section 202(e) of such Act is amended by redesignating paragraph
(4)as paragraph
(3)and such paragraph is further amended by striking out “widow” and inserting in lieu thereof “widow or surviving divorced wife” and by striking out “widow’s” and inserting in lieu thereof “widow’s or surviving divorced wife’s”.
(c)Section 216(d) of such Act is amended to read as follows:[72 Stat. 1028](/us/stat/72/1028).[42 USC 416](/us/usc/t42/s416). " “Divorced Wives; Divorce “(d)
(1)The term ‘divorced wife’ means a woman divorced from an individual, but only if she had been married to such individual for a period of 20 years immediately before the date the divorce became effective. “(2) The term ‘surviving divorced wife’ means a woman divorced from an individual who has died, but only if she had been married to the individual for a period of 20 years immediately before the date the divorce became effective. 79 Stat. 378 “(3) The term ‘surviving divorced mother’ means a woman divorced from an individual who has died, but only if
(A)she is the mother of his son or daughter,
(B)she legally adopted his son or daughter while she was married to him and while such son or daughter was under the age of 18,
(C)he legally adopted her son or daughter while she was married to him and while such son or daughter was under the age of 18, or
(D)she was married to him at the time both of them legally adopted a child under the age of 18. “(4) The terms ‘divorce’ and ‘divorced’ refer to a divorce a vinculo matrimonii.” "
(d)[64 Stat. 483](/us/stat/64/483).[42 USC 402](/us/usc/t42/s402).
(1)Section 202(c)(1) of such Act is amended by striking out “divorced a vinculo matrimonii,” and inserting in lieu thereof “divorced,”,
(2)[72 Stat. 1030–1032](/us/stat/72/1030–1032).
(A)Subsections (d)(6)(A), (f)(4)(A), and (h)(4)(A) of section 202 of such Act are each amended by inserting “(b),” before “(e),”.
(B)[64 Stat. 510](/us/stat/64/510); [72 Stat. 1027](/us/stat/72/1027).[42 USC 416](/us/usc/t42/s416). Subsections
(b)and
(c)of section 216 of such Act are each amended by striking out “(e) or” and inserting in lieu thereof “(b), (e),or”
(3)*Ante*, p. 373.[42 USC 402](/us/usc/t42/s402). Subparagraph
(A)of section 202(g)(1) of such Act is amended by striking out “has not remarried” and inserting in lieu thereof “is not married”.
(4)Subparagraph
(F)of section 202 (g)(1) of such Act is amended to read as follows: " “(F) in the case of a surviving divorced mother— “(i) at the time of such individual’s death (or, if such individual had a period of disability which did not end before the month in which he died, at the time such period began or at the time of such death)— “(I) she was receiving at least one-half of her support, as determined in accordance with regulations prescribed by the Secretary, from such individual, or “(II) she was receiving substantial contributions from such individual (pursuant to a written agreement), or “(III) there was a court order for substantial contributions to her support, from such individual, “(ii) the child referred to in subparagraph
(E)is her son, daughter, or legally adopted child, and “(iii) the benefits referred to in such subparagraph are payable on the basis of such individual’s wages and self-employment income,”. "
(5)Section 202(g) of such Act is further amended by striking out “former wife divorced” each place it appears and inserting in lieu thereof “surviving divorced mother”.
(6)*Ante*, p. 363. Section 203(a) of such Act (as amended by section 301(c) of this Act) is amended by striking out the period at the end of the first (sentence and inserting in lieu thereof “, or” and by adding the following new paragraph: " “(3) when any of such individuals is entitled to monthly benefits as a divorced wife under section 202(b) or as a surviving divorced wife under section 202(e) for any month, the benefit to which she is entitled on the basis of the wages and self-employment income of such insured individual for such month shall be determined without regard to this subsection, and the benefits of all other individuals who are entitled for such month to monthly benefits under section 202 on the wages and self-79 Stat. 379employment income of such insured individual shall be determined as if no such divorced wife or surviving divorced wife were entitled to benefits for such month.” "
(7)Section 203(c)(4) of such Act is amended by striking out[41 USC 403](/us/usc/t41/s403). “former wife divorced” and inserting in lieu thereof “surviving divorced mother”.
(8)Section 203(d)(1) of such Act is amended by striking out “wife,” and inserting in lieu thereof “wife, divorced wife,”.
(9)The second sentence of section 205(b) of such Act is amended by striking out “wife, widow, former wife divorced,” and inserting in lieu thereof “wife, divorced wife, widow, surviving divorced wife, surviving divorced mother,”.
(10)Section 205(c)(1)(C) of such Act. is amended by striking out [42 USC 405](/us/usc/t42/s405).“former wife divorced,” and inserting in lieu thereof “surviving divorced wife, surviving divorced mother”.
(11)Section 222(b)(3) of such Act is amended by inserting [42 USC 422](/us/usc/t42/s422).“divorced wife,” after “wife,”.
(12)Paragraph
(3)of section 202(g) of such Act is repealed.Repeal.[42 USC 402](/us/usc/t42/s402).
(13)Section 202(g) of such Act is amended by redesignating paragraph
(4)as paragraph (3).
(e)The amendments made by this section shall be applicable with respect to monthly insurance benefits under title II of the Social Security Act beginning with the second month following the month in which this Act is enacted; but, in the case of an individual who was not entitled to a monthly insurance benefit under section 202 of such Act for the first month [42 USC 401](/us/usc/t42/s401).following the month in which this Act is enacted, only on the basis of an application filed in or after the month in which this Act is enacted. transitional insured status Sec. 309.
(a)Title II of the Social Security Act is further amended by adding at the end thereof (after the new section 226 added by section 101 of this Act) the following new section:*Ante*, p. 290. " “transitional insured status “Sec. 227.
(a)In the case of any individual who attains the age of 72 before 1969 but who does not meet the requirements of section 214(a), the 6 quarters of coverage referred to in so much of[75 Stat. 137](/us/stat/75/137).[42 USC 414](/us/usc/t42/s414). paragraph
(1)of section 214(a) as follows clause
(C)shall, instead, be 3 quarters of coverage for purposes of determining entitlement of such individual to benefits under section 202(a), and of his wife[42 USC 402](/us/usc/t42/s402). to benefits under section 202(b), but, in the case of such wife, only if. *Ante*, p. 375.she attains the age of 72 before 1969 and only with respect to wife’s insurance benefits under section 202(b) for and after the month in which she attains such age. For each month before the month in which any such individual meets the requirements of section 214(a), the amount of his old-age insurance benefit shall, notwithstanding the provisions of section 202(a), be $35 and the amount of the wife’s insurance benefit of his wife shall, notwithstanding the provisions of section 202(b), be $17.50. “(b) In the case of any individual who has died, who does not meet the requirements of section 214(a), and whose widow attains age 72 before 1969, the 6 quarters of coverage referred to in paragraph
(3)of section 214(a) and in so much of paragraph
(1)thereof as follows clause
(C)shall, for purposes of determining her entitle-79 Stat. 380*Ante*, pp. 376, 377.[42 USC 402](/us/usc/t42/s402).ment to widow’s insurance benefits under section 202 (e), instead be— “(1) 3 quarters of coverage if such widow attains the age of 72 in or before 1966, “(2) 4 quarters of coverage if such widow attains the age of 72 in 1967, or “(3) 5 quarters of coverage if such widow attains the age of 72 in 1968. The amount of her widow’s insurance benefit for each month shall, notwithstanding the provisions of section 202(e)(and section 202 [68 Stat. 1073](/us/stat/68/1073).[42 USC 402](/us/usc/t42/s402).(m)), be $35. “(c) In the case of any individual who becomes, or upon filing application therefor would become, entitled to benefits under section 202(a) by reason of the application of subsection
(a)of this section, who dies, and whose widow attains the age of 72 before 1969, such deceased individual shall be deemed to meet the requirements of subsection
(b)of this section for purposes of determining entitlement of such widow to widow’s insurance benefits under section 202(e).” "
(b)The amendment made by subsection
(a)shall apply in the case of monthly benefits under title II of the Social Security Act for and after the second month following the month in which this Act is enacted on the basis of applications filed in or after the month in which this Act is enacted. increase in amount an individual is permitted to earn without suffering full deductions from benefits Sec. 310.
(1)Paragraphs (1), (3), and (4)(B) of subsection [42 USC 403](/us/usc/t42/s403).(f) of section 203 of the Social Security Act are each amended by striking out “$100” wherever it appears therein and inserting in lieu thereof “$125”.
(2)The first sentence of paragraph
(3)of such subsection
(f)is amended by striking out “$500” each place it appears therein and inserting in lieu thereof “$1,200”.
(3)Paragraph (1)(A) of subsection
(h)of section 203 of such Act is amended by striking out “$100” and inserting in lieu thereof “$125”.
(b)The amendments made by subsection
(a)shall apply with respect to taxable years ending after December 31, 1965. coverage for doctors of medicine Sec. 311. [42 USC 411](/us/usc/t42/s411).
(1)Section 211(c)(5) of the Social Security Act is amended to read as follows: " “(5) The performance of service by an individual in the exercise of bis profession as a Christian Science practitioner.” "
(2)Section 211
(c)of such Act is further amended by striking out the last two sentences and inserting in lieu thereof the following: “The provisions of paragraph
(4)or
(5)shall not apply to service (other than service performed by a member of a religious order who has taken a vow of poverty as a member of such order) performed by an individual during the period for which a certificate filed by *Post*, p. 381.him under section 1402(e) of the Internal Revenue Code of 1954 is in effect.”
(3)[68 Stat. 1053](/us/stat/68/1053).[42 USC 410](/us/usc/t42/s410). Section 210(a)(6)(C)(iv) of such Act is amended by inserting before the semicolon at the end thereof the following: “, other than as a medical or dental intern or a medical or dental resident in training”. 79 Stat. 381
(4)Section 210(a)(13) of such Act is amended by striking out all [64 Stat. 497](/us/stat/64/497); [68 Stat. 1052](/us/stat/68/1052).[42 USC 410](/us/usc/t42/s410).[70 Stat. 841](/us/stat/70/841).[26 USC 1402](/us/usc/t26/s1402).that follows the first semicolon.
(1)Section 1402(c)(5) of the Internal Revenue Code of 1954 (relating to definition of trade or business) is amended to read as follows: " “(5) the performance of service by an individual in the exercise of his profession as a Christian Science practitioner.” "
(2)Section 1402(c) of such Code is further amended by striking[68 Stat. 1088](/us/stat/68/1088). out the last.two sentences and inserting in lieu thereof the following: “The provisions of paragraph
(4)or
(5)shall not apply to service (other than service performed by a member of a religious order who has taken a vow of poverty as a member of such order) performed by an individual during the period for which a certificate filed by him under subsection
(e)is in effect.”
(A)Section 1402(e)(1) of such Code (relating to filing of waiver certificate by ministers, members of religious orders, and Christian Science practitioners) is amended by striking out “extended to service” and all that follows and inserting in lieu thereof “extended to service described in subsection (c)(4) or (c)(5) performed by him.”
(B)Clause
(A)of section 1402(e)(2) of such Code (relating to time for filing waiver certificate) is amended to read as follows: “(A) the due date of the return (including any extension thereof) for his second taxable year ending after 1954 for which he has net earnings from self-employment (computed without regard to subsections (c)(4) and (c)(5)) of $400 or more, any part of which was derived from the performance of service described in subsection (c)(4) or (c)(5); or .
(4)Section 3121(b)(6)(C)(iv) of such Code (relating to definition [68 Stat. 1092](/us/stat/68/1092).[26 USC 3121](/us/usc/t26/s3121).of employment) is amended by inserting before the semicolon at the end thereof the following: “, other than as a medical or dental intern or a medical or dental resident in training”.
(5)Section 3121 (b)(13) of such Code is amended by striking out[68A Stat. 422](/us/stat/68A/422); [68 Stat. 1091](/us/stat/68/1091). all that follows the first semicolon.
(c)The amendments made by paragraphs
(1)and
(2)of subsection (a), and by paragraphs (1). (2), and
(3)of subsection (b), shall apply only with respect to taxable years ending on or after December 31, 1965. The amendments made by paragraphs
(3)and
(4)of subsection (a), and by paragraphs
(4)and
(5)of subsection (b), shall apply only with respect to services performed after 1965. gross income of farmers Sec. 312.
(a)The second sentence following paragraph
(8)in section 211(a) of the Social Security Act is amended by striking out [43 USC 411](/us/usc/t43/s411).“$1,800” each place it appears and inserting in lieu thereof “$2,400”, and by striking out “$1,000” each place it appears and inserting in lieu thereof “$1,600”.
(b)The second sentence following paragraph
(9)in section 1402(a) of the Internal Revenue Code of 1954 (relating to net earnings from self-employment) is amended by striking out “$1,800” each place it appears and inserting in lieu thereof “$2,400”, and by striking out “$1,200” each place it appears and inserting in lieu thereof “$1,600”.
(c)The amendments made by this section shall apply only with respect to taxable years beginning after December 31, 1965. 79 Stat. 382 coverage of tips Sec. 313. [64 Stat. 492](/us/stat/64/492); [78 Stat. 1077](/us/stat/78/1077).[42 USC 409](/us/usc/t42/s409).
(1)Section 209 of the Social Security Act is amended by striking out “or” at the end of subsection (j), by striking out the period at the end of subsection
(k)and inserting in lieu thereof “; or”, and by adding immediately after subsection
(k)the following new subsection: " “(l)
(1)Tips paid in any medium other than cash; “(2) Cash tips received by an employee in any calendar month in the course of his employment by an employer unless the amount of such cash tips is $20 or more.” "
(2)Section 209 of such Act is-further amended by adding at the end thereof the following new paragraph: " “For purposes of this title, tips received by an employee in the course of his employment shall be considered remuneration for employment. Such remuneration shall be deemed to be paid at the time a written statement including such tips is furnished to the employer pursuant to section 6053(a) of the Internal Revenue Code *Post*, p. 384.of 1954 or (if no statement including such tips is so furnished) at the time received.” "
(b)[68A Stat. 152](/us/stat/68A/152).[26 USC 451](/us/usc/t26/s451). Section 451 of the Internal Revenue Code of 1954 (relating to general rule for taxable year of inclusion) is amended by adding at the end thereof the following new subsection: " “(c) Special Rum for Employee Tips.— For purposes of subsection (a), tips included in a written statement furnished an employer by an employee pursuant to section 6053(a) shall be deemed to be received at the time the written statement including such tips is furnished to the employer.” "
(c)[26 USC 3102](/us/usc/t26/s3102).
(1)Section 3102 of such Code (relating to deduction of tax from wages) is amended by adding at the end thereof the following new subsection: " “(c) Special Rule for Tips.— “(1) In the case of tips which constitute wages, subsection
(a)shall be applicable only to such tips as are included in a written statement furnished to the employer pursuant to section 6053(a), and only to the extent that collection can be made by the employer, at or after the time such statement is so furnished and before the close of the 10th day following the calendar month (or, if paragraph
(3)applies, the 30th day following the quarter) in which the tips were deemed paid, by deducting the amount of the tax from such wages of the employee (excluding tips, but including funds turned over by the employee to the employer pursuant to paragraph (2)) as are under control of the employer. “(2) *Post*, p. 395. If the tax imposed by section 3101, with respect to tips which are included in written statements furnished in any month to the employer pursuant to section 6053(a), exceeds the wages of the employee (excluding tips) from which the employer is required to collect the tax under paragraph (1), the employee may furnish to the employer on or before the 10th day of the following month (or if paragraph
(3)applies, on or before the 30th day of the following quarter) an amount of money equal to the amount of the excess. “(3) The Secretary or his delegate may, under regulations prescribed by him. authorize employers— “(A) to estimate the amount of tips that will be reported by the employee pursuant to section 6053(a) in any quarter of the calendar year, 79 Stat. 383 “(B) to determine the amount to be deducted upon each payment of wages (exclusive of tips) during such quarter as if the tips so estimated constituted the actual tips so reported, and “(C) to deduct upon any payment of wages (other than tips, but including funds turned over by the employee to the employer pursuant to paragraph (2)) to such employee during such quarter (and within 30 days thereafter) such amount as may be necessary to adjust the amount actually deducted upon such wages of the employee during the quarter to the amount required to be deducted in respect of tips included in written statements furnished to the employer during the quarter.*Post*, p. 395. “(4) If the tax imposed by section 3101 with respect to tips which constitute wages exceeds the portion of such tax which can be collected by the employer from the wages of the employee pursuant to paragraph
(1)or paragraph (3), such excess shall be paid by the employee.” "
(2)The second sentence of section 3102
(a)of such Code is amended [68A Stat. 415](/us/stat/68A/415); [68 Stat. 1093](/us/stat/68/1093).[26 USC 3102](/us/usc/t26/s3102).by inserting before the period at the end thereof the following: “; and an employer who is furnished by an employee a written statement of tips (received in a calendar month) pursuant to section 6053(a) to *Post*, p. 384.[26 USC 3121](/us/usc/t26/s3121).which paragraph (12)(B) of section 3121
(a)is applicable may deduct an amount equivalent to such tax with respect to such tips from any wages of the employee (exclusive of tips) under his control, even though at the time such statement is furnished the total amount of the tips included in statements furnished to the employer as having been received by the employee in such calendar month in the course of his employment by such employer is less than $20”.
(3)Section 3121(a) of such Code (relating to definition of wages under the Federal Insurance Contributions Act) is amended by striking out “or” at the end of paragraph (10), by striking out the period at the end of paragraph
(11)and inserting in lieu thereof “; or ”, and by adding after paragraph
(11)the following new paragraph: " “(12)
(A)tips paid in any medium other than cash; “(B) cash tips received by an employee in any calendar month in the course of his employment by an employer unless the amount of such cash tips is $20 or more.” "
(4)Section 3121 of such Code is further amended by adding at the end thereof the following new subsection: " “(q) Tips Included for Employee Taxes.— For purposes of this chapter other than for purposes of the taxes imposed by section 3111, *Post*, p. 396.tips received by an employee in the course of his employment shall be considered remuneration for employment. Such remuneration shall be deemed to be paid at the time a written statement including such tips is furnished to the employer pursuant to section 6053(a) or (if no statement including such tips is so furnished) at the time received.” "
(1)Section 3401 of such Code (relating to definitions for purposes [68A Stat. 455](/us/stat/68A/455).[26 USC 3401](/us/usc/t26/s3401).of collecting income tax at source on wages) is amended by adding at the end thereof the following new subsection: " “(f) Tips.— For purposes of subsection (a), the term ‘wages’ “Wages.”includes tips received by an employee in the course of his employment. Such wages shall be deemed to be paid at the time a written statement including such tips is furnished to the employer pursuant to section 6053(a) or (if no statement including such tips is so furnished) at the time received.” " 79 Stat. 384
(2)[59 Stat. 616](/us/stat/59/616); [75 Stat. 625](/us/stat/75/625); [78 Stat. 36, 52](/us/stat/78/36/52).[26 USC 3401](/us/usc/t26/s3401). Section 3401(a) of such Code (relating to definition of wages for purposes of collecting income tax at source) is amended by striking out “r” at the end of paragraph
(6)and inserting in lieu thereof “; or”, by striking out the period at the end of paragraph
(12)and inserting in lieu thereof “; or”, by striking out the period at the end of paragraph
(15)and inserting in lieu thereof “; or”, and by adding after paragraph
(15)the following new paragraph: " “(16)
(A)as tips in any medium other than cash; “(B) as cash tips to an employee in any calendar month in the course of his employment by an employer unless the amount of such cash tips is $20 or more.” "
(3)[68A Stat. 457](/us/stat/68A/457); [69 Stat. 605](/us/stat/69/605).[26 USC 3402](/us/usc/t26/s3402). Subsection
(a)of section 3402 of such Code (relating to income tax collected at source) is amended by striking out “subsection (j)” and inserting in lieu thereof “subsections
(j)and (k)”.
(4)Section 3402(h)(3) of such Code (relating to income tax withholding on basis of average wages) is amended by inserting after “quarter” the first place it appears the following: “(and, in the case of tips referred to in subsection (k), within 30 days thereafter)”.
(5)Section 3402 of such Code is further amended by adding at the end thereof the following new subsection: " “(k) Tips.— In the case of tips which constitute wages, subsection *Infra*.(a) shall be applicable only to such tips as are included in a written statement furnished to the employer pursuant to section 6053(a), and only to the extent that the tax can be deducted and withheld by the employer, at or after the time such statement is so furnished and before the close of the calendar year in which such statement is furnished, from such wages of the employee (excluding tips, but including funds turned over by the employee to the employer for the purpose of such deduction and withholding) as are under the control of the employer; and an employer who is furnished by an employee a written statement of tips (received in a calendar month) pursuant to section 6053(a) to which paragraph (16)(B) of section 3401(a) is applicable may deduct and withhold the tax with respect to such tips from any wages of the employee (excluding tips) under his control, even though at the time such statement is furnished the total amount of the tips included in statements furnished to the employer as having been received by the employee in such calendar month in the course of his employment by such employer is less than $20. Such tax shall not at any time be deducted and withheld in an amount which exceeds the aggregate of such wages and funds (including funds *Ante*, p. 382.*Ante*, p. 383.[68A Stat. 747](/us/stat/68A/747).[26 USC 6051](/us/usc/t26/s6051).turned over under section 3102(c)(2)) minus any tax required by section 3102(a) to be collected from such wages and funds.” "
(1)Section 6051(a) of such Code (relating to receipts for employees) is amended by adding at the end thereof the following new sentence: “In the case of tips received by an employee in the course of his employment, the amounts required to be shown by paragraphs
(3)and
(5)shall include only such tips as are included in statements furnished to the employer pursuant to section 6053(a).”
(A)Subpart C of part III of subchapter A of chapter 61 of such Code (relating to information regarding wages paid employees) is amended by adding at the end thereof the following new section: " “SEC. 6053. REPORTING OF TIPS. “(a) Reports by Employees.— Every employee who, in the course of his employment by an employer, receives in any calendar month tips[26 USC 3121, 3401](/us/usc/t26/s3121/3401). which are wages (as defined in section 3121(a) or section 3401(a)) shall report all such tips in one or more written statements furnished to his employer on or before the 10th day following such month. Such 79 Stat. 385statements shall be furnished by the employee under such regulations, at such other times before such 10th day, and in such form and manner, as may be prescribed by the Secretary or his delegate. “(b) Statements Furnished by Employers.— If the tax imposed by section 3101 with respect to tips reported by an employee pursuant *Post*, p. 395.to subsection
(a)exceeds the tax which can be collected by the employer pursuant to section 3102, the employer shall furnish to the employee [26 USC 3102](/us/usc/t26/s3102).a written statement showing the amount of such excess. The statement required to be furnished pursuant to this subsection shall be furnished at such time, shall contain such other information, and shall be in such form as the Secretary or his delegate may by regulations prescribe. When required by such regulations, a duplicate of any such statement shall be filed with the Secretary or his delegate.” "
(B)Section 6652(b) of such Code (relating to failure to file information [76 Stat. 1057](/us/stat/76/1057).[26 USC 6652](/us/usc/t26/s6652).returns) is amended by inserting after “income tax withheld) the following: “and in the case of each failure to furnish a statement required by section 6053(b)(relating to statements furnished by employers *Supra*.with respect to tips),”.
(C)Section 6674 of such Code (relating to fraudulent statement or [68A Stat. 828](/us/stat/68A/828).[26 USC 6674](/us/usc/t26/s6674).failure to furnish statement to employee) is amended by striking out “6051” each place it appears and inserting in lieu thereof “6051 or [68A Stat. 747](/us/stat/68A/747).[26 USC 6051](/us/usc/t26/s6051).6053(b)”.
(D)The table of sections for such subpart C is amended by adding at the end thereof the following: " “Sec. 6053. Reporting of tips.” "
(3)Section 6652 of such Code (relating to failure to file certain information returns) is amended by redesignating subsection
(c)as subsection
(d)and by inserting after subsection
(b)the following new subsection: " “(c) Failure To Report Tips.— In the case of failure by an employee to report to his employer on the date and in the manner prescribed therefor any amount of tips required to be so reported by section 6053(a) which are wages (as defined in section 3121(a)), unless *Ante*, p. 384.[26 USC 3121](/us/usc/t26/s3121).it is shown that such failure is due to reasonable cause and not due to willful neglect, there shall be paid by the employee, in addition to the tax imposed by section 3101 with respect to the amount of tips which *Post*, p. 395.he so failed to report, an amount equal to 50 percent of such tax,” "
(f)The amendments made by this section shall apply only with respect to tips received by employees after 1965. inclusion of alaska among states permitted to divide their retirement systems Sec. 314. The first sentence of section 218(d)(6)(C) of the Social Security Act is amended by inserting “Alaska,” before “California”.[72 Stat. 1038](/us/stat/72/1038).[42 USC 418](/us/usc/t42/s418). additional period for electing coverage under divided retirement system Sec. 315. The first sentence of section 218(d)(6)(F) of the Social Security Act is amended by striking out “1963” and inserting in lieu [72 Stat. 1039](/us/stat/72/1039); [75 Stat. 139](/us/stat/75/139).[42 USC 418](/us/usc/t42/s418).thereof “1967”. 79 Stat. 386 employees of nonprofit organizations Sec. 316.
(1)Section 3121(k)(1)(B)(iii) of the Internal Revenue [72 Stat. 1044](/us/stat/72/1044).[26 USC 3121](/us/usc/t26/s3121).Code of 1954 (relating to effective date of exemption of religious, charitable, and certain other organizations) is amended to read as follows: " “(iii) the first day of any calendar quarter preceding the calendar quarter in which the certificate is filed, except that such date may not be earlier than the first day of the twentieth calendar quarter preceding the quarter in which such certificate is filed.” "
(2)The amendment made by paragraph
(1)shall apply in the case of any certificate filed under section 3121 (k)(1)(A) of such Code after the date of the enactment of this Act.
(b)Section 3121 (k)(1) of such Code (relating to waiver of exemption by religious, charitable, and certain other organizations) is further amended by adding at the end thereof the following new subparagraph: " “(H) An organization which files a certificate under subparagraph
(A)before 1966 may amend such certificate during 1965 or 1966 to make the certificate effective with the first day of any calendar quarter preceding the quarter for which such certificate originally became effective, except that such date may not be earlier than the first day of the twentieth calendar quarter preceding the quarter in which such certificate is so amended. If an organization amends its certificate pursuant to the preceding sentence, such amendment shall b effective with respect to the service of individuals who concurred in the filing of such certificate (initially or through the filing of a supplemental list) and who concur in the filing of such amendment. An amendment to a certificate filed pursuant to this subparagraph shall be filed with such official and in such form and manner as may be prescribed by regulations made under this chapter. If an amendment is filed pursuant to this subparagraph— “(i) [68A Stat. 821](/us/stat/68A/821).[26 USC 6651](/us/usc/t26/s6651). for purposes of computing interest and for purposes of section 6651 (relating to addition to tax for failure to file tax return), the due date for the return and payment of the tax for any calendar quarter resulting from the filing of such an amendment shall be the last day of the calendar month following the calendar quarter in which the amendment is filed; and “(ii) the statutory period for the assessment of such tax shall not expire before the expiration of three year’s from such due date.” "
(c)[74 Stat. 943](/us/stat/74/943).[26 USC 3121 note](/us/usc/t26/s3121).
(1)Section 105(b) of the Social Security Amendments of 1960 is amended to read as follows: " “(b)
(1)If— “(A) an individual performed service in the employ of an organization with respect to which remuneration was paid before the first day of the calendar quarter in which the organization filed a waiver certificate pursuant to section 3121 (k)(1) of the Internal Revenue Code of 1954, and such service is excepted from employment under section 210(a)[72 Stat. 1035](/us/stat/72/1035).[42 USC 410](/us/usc/t42/s410).(8)(B) of the Social Security Act, “(B) such service would have constituted employment as defined in section 210 of such Act if the requirements of section 3121(k)(1) of such Code were satisfied, 79 Stat. 387 “(C) such organization paid, on or before the due date of the tax return for the calendar quarter before the calendar quarter in which the organization filed a certificate pursuant to section 3121(k)(1) of such Code, any amount, as taxes [72 Stat. 1044](/us/stat/72/1044).[26 USC 3121](/us/usc/t26/s3121).*Post*, pp. 395, 396.imposed by sections 3101 and 3111 of such Code, with respect to such remuneration paid by the organization to the individual for such service, “(D) such individual, or a fiduciary acting for such individual or his estate, or his survivor (within the meaning of section 205(c)(1)(C) of such Act), requests that such [64 Stat. 518](/us/stat/64/518); *Ante*, p. 379.remuneration be deemed to constitute remuneration for employment for purposes of title II of such Act, and[42 USC 401](/us/usc/t42/s401). “(E) the request is made in such form and manner, and with such official, as may be prescribed by regulations made by the Secretary of Health, Education, and Welfare, then, subject to the conditions stated in paragraphs (2), (3), (4), and (5), the remuneration with respect to which the amount has been paid as taxes shall be deemed to constitute remuneration for employment for purposes of title II of such Act. “(2) Paragraph
(1)shall not apply with respect to an individual unless the organization referred to in paragraph (1)(A), on or before the date on which the request described in paragraph
(1)is made, has filed a certificate pursuant to section 3121(k)(1) of such Code. “(3) Paragraph
(1)shall not apply with respect to an individual who is employed by the organization referred to in paragraph
(2)on the date the certificate is filed. “(4) If credit or refund of any portion of the amount referred to in paragraph (1)(C)(other than a credit or refund which would be allowed if the service constituted employment for purposes of chapter 21 of such Code) has been obtained, paragraph
(1)shall [68A Stat. 415](/us/stat/68A/415).[26 USC 3101–3126](/us/usc/t26/s3101–3126).[68A Stat. 819](/us/stat/68A/819).[26 USC 6611](/us/usc/t26/s6611).not apply with respect to the individual unless the amount credited or refunded (including any interest under section 6611 of such Code) is repaid before January 1, 1968, or, if later, the first day of the third year after the year in which the organization filed a certificate pursuant to section 3121 (k)(1) of such Code. “(5) Paragraph
(1)shall not apply to any service performed for the organization in a period for winch a certificate filed pursuant to section 3121 (k)(1) of such Code is not in effect.” "
(2)The amendment made by paragraph
(1)shall take effect on the date of the enactment of this Act. The provisions of section 105(b) of the Social Security Amendments of 1960 which were in [74 Stat. 943](/us/stat/74/943).[26 USC 3121 note](/us/usc/t26/s3121).effect before the date of the enactment of this Act shall be applicable with respect to any request filed under section 105(b)(1) of such Amendments before such date. Nothing in the preceding sentence shall prevent the filing of a request under section 105(b)(1) of such Amendments as amended by this Act.
(d)If—
(1)an individual performed service with respect to which remuneration was paid before the date of enactment of this Act by an organization which, before, such date, filed a waiver certificate pursuant to section 3121 (k)(1) of the Internal Revenue Code,
(2)such service is excluded from employment under title II of the Social Security Act but would not be excluded therefrom if the requirements of such section 3121 (k)(1) had been met with respect to such service,
(3)such service was performed during the period such certificate was in effect, and 79 Stat. 388
(4)such individual was listed pursuant to such section 3121 [72 Stat. 1044](/us/stat/72/1044).[26 USC 3121](/us/usc/t26/s3121).(k)(1) at any time during such period and before the date of enactment of this Act as an employee who concurred in the filing of such certificate or such individual filed a request for coverage pursuant to section 105(b) of the Social Security Amendments of[74 Stat. 943](/us/stat/74/943).[26 USC 3121 note](/us/usc/t26/s3121). 1960, as in effect prior to the enactment of this Act (but such listing or request was not effective with respect to the service described above), then, subject to the conditions stated in subparagraphs (B), (C), (D), and
(E)of paragraph (1), and paragraph (4), of section 105(b) of the Social Security Amendments of 1960, as amended by this section, the remuneration of such individual which was paid with respect to such excluded service shall be deemed to constitute remuneration for [42 USC 401](/us/usc/t42/s401).employment for purposes of such title II; except that, for purposes of this subsection, in applying subparagraph
(C)of paragraph
(1)of such section 105(b) the date of enactment of this Act shall be considered to be the date on which the organization filed its certificate under section 3121(k)(1) and any reference, in paragraph
(4)of such section, to such paragraph
(1)shall be considered a reference to the preceding provisions of this subsection. coverage of temporary employees of the district of columbia Sec. 317. [74 Stat. 936](/us/stat/74/936).[42 USC 410](/us/usc/t42/s410).
(a)Section 210(a)(7) of the Social Security Act is amended—
(1)by striking out “or” at the end of subparagraph (B),
(2)by striking out the semicolon at the end of subparagraph (C)(ii) and inserting in lieu thereof “, or”, and
(3)by adding after subparagraph
(C)the following new subparagraph: " “(D) service performed in the employ of the District of Columbia or any instrumentality which is wholly owned thereby, if such service is not covered by a retirement system established by a law of the United States; except that the provisions of this subparagraph shall not be applicable to service performed— “(i) in a hospital or penal institution by a patient or inmate thereof; “(ii) by any individual as an employee included under section 2 of the Act of August 4, 1947 (relating to certain interns, student nurses, and other student employees of hospitals of the District of Columbia Government; 5 U.S.C.[61 Stat. 727](/us/stat/61/727); [63 Stat. 972](/us/stat/63/972). 1052), other than as a medical or dental intern or as a medical or dental resident in training; “(iii) by any individual as an employee serving on a temporary basis in case of fire, storm, snow, earthquake, flood, or other similar emergency; or “(iv) by a member of a board, committee, or council of the District of Columbia, paid on a per diem, meeting, or other fee basis;”. "
(b)[74 Stat. 938](/us/stat/74/938).[26 USC 3121](/us/usc/t26/s3121). Section 3121(b)(7) of the Internal Revenue Code of 1954 (relating to certain services not included in definition of employment) is amended—
(1)by striking out “or” at the end of subparagraph (A),
(2)by striking out the semicolon at the end of subparagraph
(B)and inserting in lieu thereof “, or”, and
(3)by adding after subparagraph
(B)the following new subparagraph: 79 Stat. 389 " “(C) service performed in the employ of the District of Columbia or any instrumentality which is wholly owned thereby, if such service is not covered by a retirement system established by a law of the United States; except that the provisions of this subparagraph shall not be applicable to service performed— “(i) in a hospital or penal institution by a patient or inmate thereof; “(ii) by any individual as an employee included under section 2 of the Act of August 4, 1947 (relating to certain interns, student nurses, and other student employees of hospitals of the District of Columbia Government; 5 U.S.C. 1052), other than as a medical or dental intern or as a medical [61 Stat. 727](/us/stat/61/727); [63 Stat. 972](/us/stat/63/972).or dental resident in training; “(iii) by any individual as an employee serving on a temporary basis in case of fire, storm, snow, earthquake, flood or other similar emergency; or “(iv) by a member of a board, committee, or council of the District of Columbia, paid on a per diem, meeting, or other fee basis;”. "
(1)Section 3125 of such Code (relating to returns in the case [74 Stat. 939](/us/stat/74/939).[26 USC 3125](/us/usc/t26/s3125).of governmental employees in Guam and American Samoa) is amended by adding at the end thereof the following new subsection: " “(c) District of Columbia.— In the case of the taxes imposed by this chapter with respect to service performed in the employ of the District of Columbia or in the employ of any instrumentality which is wholly owned thereby, the return and payment of the taxes may be made by the Commissioners of the District of Columbia or by such agents as they may designate. The person making such return may, for convenience of administration, make payments of the tax imposed by section 3111 with respect to such service without regard to the*Post*, p. 396.*Post* p. 393. $6,600 limitation in section 3121(a)(1).” "
(2)The heading of such section 3125 is amended by striking out **“AND AMERICAN SAMOA”** and inserting in lieu thereof **“, AMERICAN SAMOA AND THE DISTRICT OF COLUMBIA”**
(3)The table of sections for subchapter C of chapter 21 of such Code (relating to general provisions for Federal Insurance Contributions Act) is amended by striking out " “Sec. 3125. Returns in the ease of governmental employees in Guam and American Samoa.” " and inserting in lieu thereof " “Sec. 3125. Returns in the case of governmental employees in Guam, American Samoa, and the District of Columbia.” "
(d)Section 6205(a) of such Code (relating to adjustment of tax) [68A Stat. 768](/us/stat/68A/768); [74 Stat. 940](/us/stat/74/940).[26 USC 6205](/us/usc/t26/s6205).is amended by adding at the end thereof the following new paragraph: " “(4) District of columbia as employer.— For purposes of this subsection, in the case of remuneration received during any calendar year from the District of Columbia or any instrumentality which is wholly owned thereby, the Commissioners of the District of Columbia and each agent designated by them who makes a return pursuant to section 3125 shall be deemed a separate employer.” "
(e)Section 6413(a) of such Code (relating to adjustment of certain [68A Stat. 797](/us/stat/68A/797); [74 Stat. 940](/us/stat/74/940).[26 USC 6413](/us/usc/t26/s6413).employment taxes) is amended by adding at the end thereof the following paragraph: " “(4) District of columbia as employer.— For purposes of this subsection, in the case of remuneration received during any calendar year from the District of Columbia or any instrumentality 79 Stat. 390which is wholly owned thereby, the Commissioners of the District of Columbia and each agent designated by them who makes [74 Stat. 939](/us/stat/74/939).[26 USC 3125](/us/usc/t26/s3125).[68A Stat. 797](/us/stat/68A/797).[26 USC 6413](/us/usc/t26/s6413).a return pursuant to section 3125 shall be deemed a separate employer.” "
(1)Section 6413(c)(2) of such Code (relating to applicability of special refunds to certain employment taxes) is amended by adding at the end thereof the following new subparagraph: " “(F) Governmental employees in the district of Columbia.— In the case of remuneration received from the District of Columbia or any instrumentality wholly owned thereby, during any calendar year, the Commissioners of the District of Columbia and each agent designated by them who makes *Ante*, p. 389.a return pursuant to section 3125(c) shall, for purposes of this subsection, be deemed a separate employer.” "
(2)The heading of such section 6413(c)(2) is amended by striking out “and american samoa” and inserting in. lieu thereof “, american samoa, and the district of columbia”.
(g)The amendments made by this section shall apply with respect to service performed after the calendar quarter in which this section is enacted and after the calendar quarter in which the Secretary of the Treasury receives a certification from the Commissioners of the District of Columbia expressing their desire to have the insurance system established by title II (and part A of title XVIII) of the Social [42 USC 401](/us/usc/t42/s401); *Ante*, p. 291.Security Act extended to the officers and employees coming under the provisions of such amendments. coverage for certain additional hospital employees in california Sec. 318. [74 Stat. 935](/us/stat/74/935).[42 USC 418 note](/us/usc/t42/s418). Section 102(k) of the Social Security Amendments of 1960 is amended by inserting “(1)” immediately after “(k)”, and by adding at the end thereof the following new paragraph: " “(2) Such agreement, as modified pursuant to paragraph (1), may at the option of such State be further modified, at any time prior to the seventh month after the month in which this paragraph is enacted, so as to apply to services performed for any hospital affected by such earlier modification by any individual who after December 31, 1959, is or was employed by such State (or any political subdivision thereof) in any position described in paragraph (1). Such modification shall be effective with respect to
(A)all services performed by such individual in any such position on or after January 1, 1962, and
(B)all such services, performed before such date, with respect to which amounts equivalent to the sum of the taxes which would have been imposed by *Post*, pp. 395, 396.[68A Stat. 415](/us/stat/68A/415).[26 USC 3101–3126](/us/usc/t26/s3101–3126).sections 3101 and 3111 of the Internal Revenue Code of 1954 if such services had constituted employment for purposes of chapter 21 of such Code at the time they were performed have, prior to the date of the enactment of this paragraph, been paid.” " tax exemption for religious groups opposed to insurance Sec. 319. [68A Stat. 353](/us/stat/68A/353).[26 USC 1402](/us/usc/t26/s1402).
(a)Subsection
(c)of section 1402 of the Internal Revenue Code of 1954 is amended by striking out “or” at the end of paragraph (4), by striking out the period at the end of paragraph
(5)and inserting in lieu thereof “; or”, and by adding after paragraph
(5)the following new paragraph: " “(6) *Post*, p. 391. the performance of service by an individual during the period for which an exemption under subsection
(h)is effective with respect to him.” " 79 Stat. 391
(b)Subsection
(c)of section 211 of the Social Security Act is [64 Stat. 5O2](/us/stat/64/5O2).[42 USC 411](/us/usc/t42/s411).amended by striking out “or” at the end of paragraph (4), by striking out the period at the end of paragraph
(5)and inserting in lieu thereof “; or”, and by adding after paragraph
(5)the following new paragraph: " “(6) The performance of service by an individual during the period for which an exemption under section 1402(h) of the Internal Revenue Code of 1954 is effective with respect to him.” "
(c)Section 1402 of the Internal Revenue Code of 1954 is further [68A Stat. 353](/us/stat/68A/353).[26 USC 1402](/us/usc/t26/s1402).amended by adding at the end thereof the following new subsection: " “(h) Members of Certain Religious Faiths.— “(1) Exemption.— Any individual may file an application (in such form and manner, and with such official, as may be prescribed by regulations under this chapter) for an exemption from the tax imposed by this chapter if he is a member of a recognized religious sect or division thereof and is an adherent of established tenets or teachings of such sect or division by reason of which he is conscientiously opposed to acceptance of the benefits of any private or public insurance which makes payments in the event of death, disability, old-age, or retirement or makes payments toward the cost of, or provides services for, medical care (including the benefits of any insurance system established by the Social Security Act). Such exemption may be granted only if the application[49 Stat. 620](/us/stat/49/620).[42 USC 1305](/us/usc/t42/s1305). contains or is accompanied by— “(A) such evidence of such individual’s membership in, and adherence to the tenets or teachings of, the sect or division thereof as the Secretary or his delegate may require for purposes of determining such individual’s compliance with the preceding sentence, and “(B) his waiver of all benefits and other payments under titles II and XVIII of the Social Security Act on the basis [42 USC 401](/us/usc/t42/s401); *Ante*, p. 291.of his wages and self-employment income as well as all such benefits and other payments to him on the basis of the wages and self-employment income of any other person, and only if the Secretary of Health, Education, and Welfare finds that— “(C) such sect or division thereof has the established tenets or teachings referred to in the preceding sentence, “(D) it is the practice, and has been for a period of time which he deems to be substantial, for members of such sect or division thereof to make provision for their dependent members which in his judgment is reasonable in view of their general level of living, and “(E) such sect or division thereof has been in existence at all times since December 31, 1950. An exemption may not be granted to any individual if any benefit or other payment referred to in subparagraph
(B)became payable (or, but for section 203 or 222(b) of the Social Security Act, [53 Stat. 1367](/us/stat/53/1367); [72 Stat. 1032](/us/stat/72/1032).[42 USC 403, 422](/us/usc/t42/s403/422).would have become payable) at or before the time of the filing of such waiver. “(2) Time for filing application.— For purposes of this subsection, an application must be filed— “(A) In the case of an individual who has self-employment income (determined without regard to this subsection and subsection (c)(6)) for any taxable year ending before *Ante*, p. 390.December 31, 1965, on or before April 15, 1966, and 79 Stat. 392 “(B) In any other case, on or before the time prescribed for filing the return (including any extension thereof) for the first taxable year ending on or after December 31, 1965, for which he has self-employment income (as so determined). “(3) Period for which exemption effective.— An exemption granted to any individual pursuant to this subsection shall apply with respect to all taxable years beginning after December 31, 1950, except that such exemption shall not apply for any taxable year— “(A) beginning
(i)before the taxable year in which such individual first met the requirements of the first sentence of paragraph (1), or
(ii)before the time as of which the Secretary of Health, Education, and Welfare finds that the sect or division thereof of which such individual is a member met the requirements of subparagraphs
(C)and (D), or “(B) ending
(i)after the time such individual ceases to meet the requirements of the first sentence of paragraph (1), or
(ii)after the time as of which the Secretary of Health, Education, and Welfare finds that the sect or division thereof of which he is a member ceases to meet the requirements of subparagraph
(C)or (D). “(4) Application by fiduciaries or survivors.— In any case where an individual who has self-employment income dies before the expiration of the time prescribed by paragraph
(2)for filing an application for exemption pursuant to this subsection, such an application may be filed with respect to such individual within such time by a fiduciary acting for such individual’s estate or by such individual’s survivor (within the meaning of section 205 [64 Stat. 518](/us/stat/64/518).[42 USC 405](/us/usc/t42/s405).[64 Stat. 482](/us/stat/64/482); [70 Stat. 838](/us/stat/70/838).[42 USC 402](/us/usc/t42/s402).(c)(1)(C) of the Social Security Act).” "
(d)Section 202 of the Social Security Act is amended by adding at the end thereof the following new subsection: " “Waiver of Benefits “(v) Notwithstanding any other provisions of this title, in the case of any individual who files a waiver pursuant to section 1402(h) *Ante*, p. 391.of the Internal Revenue Code of 1954 and is granted a tax exemption thereunder, no benefits or other payments shall be payable under this title to him, no payments shall be made on his behalf under part A*Ante*, p. 291. of title XVIII, and no benefits or other payments under this title shall be payable on the basis of his wages and self-employment income to any other person, after the filing of such waiver; except that, if thereafter such individual’s tax exemption under such section 1402(h) ceases to be effective, such waiver shall cease to be applicable in the case of benefits and other payments under this title and part A of title XVIII to the extent, based on his self-employment income for and after the first taxable year for which such tax exemption ceases to be effective and on his wages for and after the calendar year (if any) which begins in or with the beginning of such taxable year.” "
(e)The amendments made by this section shall apply with respect to taxable years beginning after December 31, 1950. For such purpose, [68A Stat. 353](/us/stat/68A/353).[26 USC 1401–1403](/us/usc/t26/s1401–1403).chapter 2 of the Internal Revenue Code of 1954 shall be treated as applying to all taxable years beginning after such date.
(f)If refund or credit of any overpayment resulting from the enactment of this section is prevented on the date of the enactment of this Act or at any time on or before April 15, 1966, by the operation of any law or rule of law, refund or credit of such overpayment may, 79 Stat. 393nevertheless, be made or allowed if claim therefor is filed on or before April 15, 1966. No interest shall be allowed or paid on any overpayment resulting from the enactment of this section. increase of earnings counted for benefit and tax purposes Sec. 320.
(A)Section 209(a)(3) of the Social Security Act [72 Stat. 1019](/us/stat/72/1019).[42 USC 409](/us/usc/t42/s409).is amended by inserting “and prior to 1966” after “1958”,
(B)Section 209(a) of such Act is further amended by adding at the end thereof the following new paragraph: " “(4) That part of remuneration which, after remuneration (other than remuneration referred to in the succeeding subsections of this section) equal to $6,600 with respect to employment has been paid to an individual during any calendar year after 1965, is paid to such individual during such calendar year;”. "
(A)Section 211 (b)(1)(C) of such Act is amended by inserting[42 USC 411](/us/usc/t42/s411). “and prior to 1966” after “1958”, and by striking out “; or” and inserting in lieu thereof “; and”.
(B)Section 211(b)(1) of such Act is further amended by adding at the end thereof the following new subparagraph: " “(D) For any taxable year ending after 1965,
(i)$6,600, minus
(ii)the amount of the wages paid to such individual during the taxable year; or”. "
(A)Section 213(a)(2)(ii) of such Act is amended by striking[72 Stat. 1019](/us/stat/72/1019); [74 Stat. 949](/us/stat/74/949).[42 USC 413](/us/usc/t42/s413). out “after 1958” and inserting in lieu thereof “after 1958 and before 1966, or $6,600 in the case of a calendar year after 1965”.
(B)Section 213(a)(2)(iii) of such Act is amended by striking out “after 1958” and inserting in lieu thereof “after 1958 and before 1966, or $6,600 in the case of a taxable year ending after 1965”.
(4)Section 215(e)(1) of such Act is amended by striking out “and [42 USC 415](/us/usc/t42/s415).the excess over $4,800 in the case of any calendar year after 1958” and inserting in lieu thereof “the excess over $4,800 in the case of any calendar year after 1958 and before 1966, and the excess over $6,600 in the case of any calendar year after 1965”.
(A)Section 1402(b)(1)(C) of the Internal Revenue Code of 1954 (relating to definition of self-employment income) is amended [26 USC 1402](/us/usc/t26/s1402).by inserting “and before 1966” after “1958”, and by striking out “; or” and inserting in lieu thereof “; and”.
(B)Section 1402(b)(1) of such Code is further amended by adding at the end thereof the following new subparagraph: " “(D) for any taxable year ending after 1965,
(i)$6,600, minus
(ii)the amount of the wages paid to such individual during the taxable year; or”. "
(2)Section 3121(a)(1) of such Code (relating to definition of [68A Stat. 417](/us/stat/68A/417); [72 Stat. 1042](/us/stat/72/1042).[26 USC 3121](/us/usc/t26/s3121).wages) is amended by striking out “$4,800” each place it appears and inserting in lieu thereof “$6,600”.
(3)The second sentence of section 3122 of such Code (relating to [26 USC 3122](/us/usc/t26/s3122).Federal service) is amended by striking out “$4,800” and inserting in lieu thereof “$6,600”.
(4)Section 3125 of such Code (relating to returns in the case of [74 Stat. 939](/us/stat/74/939).[26 USC 3125](/us/usc/t26/s3125).governmental employees in Guam and American Samoa) is amended by striking out “$4,800” where it appears in subsections
(a)and
(b)and inserting in lieu thereof “$6,600”.
(5)Section 6413(c)(1) of such Code (relating to special refunds [72 Stat. 1043](/us/stat/72/1043).[26 USC 6413](/us/usc/t26/s6413).of employment taxes) is amended—
(A)by inserting “and prior to the calendar year 1966” after “the calendar year 1958”; 79 Stat. 394
(B)by inserting after “exceed $4,800,” the following: “or
(C)during any calendar year after the calendar year 1965, the wages received by him during such year exceed $6,600”.
(C)by inserting before the period at the end thereof the following: “and before 1966, or which exceeds the tax with respect to the first $6,600 of such wages received in such calendar year after 1965”.
(6)[72 Stat. 1043](/us/stat/72/1043).[26 USC 6413](/us/usc/t26/s6413). Section 6413(c)(2)(A) of such Code (relating to refunds of employment taxes in the case of Federal employees) is amended by striking out “or $4,800 for any calendar year after 1958” and inserting in lieu thereof “$4,800 for the calendar year 1959, 1960, 1961, 1962, 1963, 1964, or 1965, or $6,600 for any calendar year after 1965”.
(c)The amendments made by subsections (a)(1) and (a)(3)(A), and the amendments made by subsection (b)(except paragraph
(1)thereof), shall apply only with respect to remuneration paid after December 1965. The amendments made by subsections (a)(2), (a)(3)(B), and (b)(1) shall apply only with respect to taxable years ending after 1965. The amendment made by subsection (a)(4) shall apply only with respect to calendar years after 1965. changes in tax schedules Sec. 321. [75 Stat. 140](/us/stat/75/140).[26 USC 1401](/us/usc/t26/s1401).
(a)Section 1401 of the Internal Revenue Code of 1954 (relating to rate of tax under the Self-Employment Contributions Act) is amended to read as follows: " “SEC. 1401. RATE OF TAX. “(a) Old-Age, Survivors, and Disability Insurance.— In addition to other taxes, there shall be imposed for each taxable year, on the self-employment income of every individual, a tax as follows: “(1) in the case of any taxable year beginning after December 31, 1965, and before January 1, 1967, the tax shall be equal to 5.8 percent of the amount of the self-employment income for such taxable year; “(2) in the case of any taxable year beginning after December 31, 1966, and before January 1, 1969, the tax shall be equal to 5.9 percent of the amount of the self-employment income for such taxable year; “(3) in the case of any taxable year beginning after December 31, 1968, and before January 1, 1973, the tax shall be equal to 6.6 percent of the amount of the self-employment income for such taxable year; and “(4) in the case of any taxable year beginning after December 31, 1972, the tax shall be equal to 7.0 percent of the amount of the self-employment income for such taxable year. “(b) Hospital Insurance.— In addition to the tax imposed by the preceding subsection, there shall be imposed for each taxable year, on the self-employment income of every individual, a tax as follows: “(1) in the case of any taxable year beginning after December 31, 1965, and before January 1, 1967, the tax shall be equal to 0.35 percent of the amount of the self-employment income for such taxable year; “(2) in the case of any taxable year beginning after December 31, 1966, and before January 1, 1973, the tax shall be equal to 0.50 percent of the amount of the self-employment income for such taxable year; 79 Stat. 395 “(3) in the case of any taxable year beginning after December 31, 1972, and before January 1, 1976, the tax snail be equal to 0.55 percent of the amount of the self-employment income for such taxable year; “(4) in the case of any taxable year beginning after December 31, 1975, and before January 1, 1980, the tax shall be equal to 0.60 percent of the amount of the self-employment income for such taxable year; “(5) in the case of any taxable year beginning after December 31, 1979, and before January 1, 1987, the tax shall be equal to 0.70 percent of the amount of the self-employment income for such taxable year; and “(6) in the case of any taxable year beginning after December 31, 1986, the tax shall be equal to 0.80 percent of the amount of the self-employment income for such taxable year. For purposes of the tax imposed by this subsection, the exclusion of employee representatives by section 1402(c)(3) shall not apply.”[68A Stat. 355](/us/stat/68A/355).[26 USC 1402](/us/usc/t26/s1402).[75 Stat. 141](/us/stat/75/141).[26 USC 3101](/us/usc/t26/s3101). "
(b)Section 3101 of the Internal Revenue Code of 1954 (relating to rate of tax on employees under the Federal Insurance Contributions Act) is amended to read as follows: " “SEC. 3101. RATE OF TAX. “(a) Old-Age, Survivors, and Disability Insurance.— In addition to other taxes, there is hereby imposed on the income of every individual a tax equal to the following percentages of the wages (as defined in section 3121(a)) received by him with respect to employment [68A Stat. 417](/us/stat/68A/417).[26 USC 3121](/us/usc/t26/s3121).(as defined in section 3121 (b))— “(1) with respect to wages received during the calendar year 1966, the rate shall be 3.85 percent; “(2) with respect to wages received during the calendar years 1967 and 1968, the rate shall be 3.9 percent; “(3) with respect to wages received during the calendar years 1969, 1970, 1971, and 1972, the rate shall be 4.4 percent; and “(4) with respect to wages received after December 31, 1972, the rate shall be 4.85 percent. “(b) Hospital Insurance.— In addition to the tax imposed by the preceding subsection, there is hereby imposed on the income of every individual a tax equal to the following percentages of the wages (as defined in section 3121(a)) received by him with respect to employment (as defined in section 3121(b), but without regard to the provisions of paragraph
(9)thereof insofar as it relates to employees)— “(1) with respect to wages received during the calendar year 1966, the rate shall be 0.35 percent; “(2) with respect to wages received during the calendar years 1967, 1968, 1969, 1970, 1971, and 1972, the rate shall be 0.50 percent; “(3) with respect to wages received during the calendar years 1973, 1974, and 1975, the rate shall be 0.55 percent; “(4) with respect to wages received during the calendar years 1976, 1977, 1978, and 1979, the rate shall be 0.60 percent; “(5) with respect to wages received during the calendar years 1980, 1981, 1982, 1983, 1984, 1985, and 1986, the rate shall be 0.70 percent; and “(6) with respect to wages received after December 31, 1986, the rate shall be 0,80 percent.” " 79 Stat. 396
(c)[75 Stat. 141](/us/stat/75/141).[26 USC 3111](/us/usc/t26/s3111). Section 3111 of the Internal Revenue Code of 1954 (relating to rate of tax on employers under the Federal Insurance Contributions Act) is amended to read as follows: " “SEC. 3111. RATE OF TAX. “(a) Old-Age, Survivors, and Disability Insurance.— In addition to other taxes, there is hereby imposed on every employer an excise tax, with respect to having individuals in his employ, equal to [68A Stat. 417](/us/stat/68A/417).[26 USC 3121](/us/usc/t26/s3121).the following percentages of the wages (as defined in section 3121(a)) paid by him with respect to employment (as defined in section 3121(b))— “(1) with respect to wages paid during the calendar year 1966, the rate shall be 3.85 percent; “(2) with respect to wages paid during the calendar years 1967 and 1968, the rate shall be 3.9 percent; “(3) with respect to wages paid during the calendar years 1969, 1970, 1971, and 1972, the rate shall be 4.4 percent; and “(4) with respect to wages paid after December 31, 1972, the rate shall be 4.85 percent. “(b) Hospital Insurance.— In addition to the tax imposed by the preceding subsection, there is hereby imposed on every employer an excise tax, with respect to having individuals in his employ, equal to the following percentages of the wages (as defined in section 3121 (a)) paid by him with respect to employment (as defined in section 3121(b), but without regard to the provisions of paragraph
(9)thereof insofar as it relates to employees)— “(1) with respect to wages paid during the calendar year 1966, the rate shall be 0.35 percent; “(2) with respect to wages paid during the calendar years 1967, 1968, 1969, 1970, 1971, and 1972, the rate shall be 0.50 percent; “(3) with respect to wages paid during the calendar years 1973, 1974, and 1975, the rate shall be 0.55 percent; “(4) with respect to wages paid during the calendar years 1976, 1977, 1978, and 1979, the rate shall be 0.60 percent; “(5) with respect to wages paid during the calendar years 1980, 1981, 1982, 1983, 1984, 1985, and 1986, the rate shall be 0.70 percent; “(6) with respect to wages paid after December 31, 1986, the rate shall be 0.80 percent.” "
(d)The amendments made by subsection
(a)shall apply only with respect to taxable years beginning after December 31, 1965. The amendments made by subsections
(b)and
(c)shall apply only with respect to remuneration paid after December 31, 1965. reimbursement of trust-funds for cost of noncontributory military service credits Sec. 322. [70 Stat. 875](/us/stat/70/875).[42 USC 417](/us/usc/t42/s417). Section 217
(g)of the Social Security Act is amended to read as follows: " “(g)
(1)In September 1965, and in every fifth September thereafter up to and including September 2010, the Secretary shall determine the amount which, if paid in equal installments at the beginning of each fiscal year in the period beginning— “(A) with July 1, 1965, in the case of the first such determination, and “(B) with the July 1 following the determination in the case of all other such determinations, 79 Stat. 397 and ending with tie close of June 30, 2015, would accumulate, with interest compounded annually, to an amount equal to the amount needed to place each of the Trust Funds and the Federal Hospital Insurance Trust Fund in the same position at the close of June 30, *Ante*, p. 299.2015, as he estimates they would otherwise be in at the close of that date if section 210 of this Act as in effect prior to the Social Security [42 USC 410](/us/usc/t42/s410).[64 Stat. 477](/us/stat/64/477).[42 USC 301 note](/us/usc/t42/s301).[70 Stat. 819](/us/stat/70/819).[42 USC 401](/us/usc/t42/s401).Act Amendments of 1950, and this section, had not been enacted. The rate of interest to be used in determining such amount shall be the rate determined under section 201(d) for public-debt obligations which were or could have been issued for purchase by the Trust Funds in the June preceding the September in which such determination is made. “(2) There are authorized to be appropriated to the Trust Funds and the Federal Hospital Insurance Trust Fund— “(A) for the fiscal year ending June 30, 1966. an amount equal to the amount determined under paragraph
(1)in September 1965, and “(B) for each fiscal year in the period beginning with July 1, 1966, and ending with the close of June 30, 2015, an amount equal to the annual installment for such fiscal year under the most recent determination under paragraph
(1)which precedes such fiscal year. “(3) For the fiscal year ending June 30, 2016, there is authorized to be appropriated to the Trust Funds and the Federal Hospital Insurance Trust Fund such sums as the Secretary determines would place toe Trust Funds and the Federal Hospital Insurance Trust Fund in the same position in which they would have been at the close of June 30, 2015, if section 210 of this Act as in effect prior to the Social Security Act Amendments of 1950, and this section, had not been enacted. “(4) There are authorized to be appropriated to the Trust Funds and the Federal Hospital Insurance Trust Fund annually, as benefits under this title and part A of title XVIII are paid after June 30,*Ante*, p. 291. 2015, such sums as the Secretary determines to be necessary to meet the additional costs, resulting from subsections (a), (b), and (e), of such benefits (including lump-sum death payments).” " adoption of child by retired worker Sec. 323.
(a)Section 202
(d)of the Social Security Act is amended—[72 Stat. 1022](/us/stat/72/1022).[42 USC 402](/us/usc/t42/s402).
(1)by striking out the last sentence in paragraph (1), and
(2)by adding at the end thereof (after the new paragraphs added by section 306 of this Act) the following new paragraphs:*Ante*, p. 370. " “(9) In the case of— “(A) an individual entitled to disability insurance benefits, or “(B) an individual entitled to old-age insurance benefits who was entitled to disability insurance benefits for the month preceding the first month for which he was entitled to old-age insurance benefits, a child of such individual adopted after such individual became entitled to such disability insurance benefits shall be deemed not to meet the requirements of clause
(i)or
(iii)of paragraph (1)(C) unless such child— “(C) is the natural child or stepchild of such individual (including such a child who was legally adopted by such individual), or “(D) was legally adopted by such individual before the end of the 24-month period beginning with the month after the month in which such individual most, recently became entitled to disability insurance benefits, but only if— 79 Stat. 398 “(i) proceedings for such adoption of the child had been instituted by such individual in or before the month in which began the period of disability of such individual which still exists at the time of such adoption (or, if such child was adopted by such individual after such individual attained age 65, the period of disability of such individual which existed in the month preceding the month in which he attained age 65), or “(ii) such adopted child was living with such individual in such month. “(10) If an individual entitled to old-age insurance benefits (but not an individual included under paragraph (9)) adopts a child after such individual becomes entitled to such benefits, such child shall be deemed not to meet the requirements of clause
(i)of paragraph (1)(C) unless such child— “(A) is the natural child or stepchild of such individual (including such a child who was legally adopted by such individual), or “(B) was legally adopted by such individual before the end of the 24-month period beginning with the month after the month in which such individual became entitled to old-age insurance benefits, but only if— “(i) such child had been receiving at least one-half of his support from such individual for the year before such individual filed his application for old-age insurance benefits or, if such individual had a period of disability which continued until he had become entitled to old-age insurance benefits, for the year before such period of disability began, and “(ii) either proceedings for such adoption of the child had been instituted by such individual in or before the month in which the individual filed his application for old-age insurance benefits or such adopted child was living with such individual in such month.” "
(b)The amendments made by subsection
(a)of this section shall be applicable to persons who file applications, or on whose behalf applications are filed, for benefits under section 202(d) of the Social [72 Stat. 1022](/us/stat/72/1022).[42 USC 402](/us/usc/t42/s402).*Supra*.Security Act on or after the date this section is enacted. The time limit provided by section 202(d)(10)(B) of such Act as amended by this section for legally adopting a child shall not apply in the case of any child who is adopted before the end of the 12-month period following the month in which this section is enacted. extension of period for filing proof of support and applications for lump-sum death payment Sec. 324. [70 Stat. 832](/us/stat/70/832).[42 USC 402](/us/usc/t42/s402).
(a)Section 202
(p)of the Social Security Act is amended to read as follows: " “Extension of Period for Filing Proof of Support and Applications for Lump-Sum Death Payment “(p) In any case in which there is a failure— “(1) to file proof of support under subparagraph
(C)of subsection (c)(1), clause
(i)or
(ii)of subparagraph
(D)of subsection (f)(1), or subparagraph
(B)of subsection (h)(1). or 79 Stat. 399tinder clause
(B)of subsection (f)(1) of this section as in effect prior to the Social Security Act Amendments of 1950, within the [64 Stat. 477](/us/stat/64/477).[42 USC 301 note](/us/usc/t42/s301).period prescribed by such subparagraph or clause, or “(2) to file, in the case of a death after 1946, application for a lump-sum death payment under subsection (i), or under subsection
(g)of this section as in effect prior to the Social Security [42 USC 402](/us/usc/t42/s402).Act Amendments of 1950, within the period prescribed by such subsection, any such proof or application, as the case may be, which is filed after the expiration of such period shall be deemed to have been filed within such period if it is shown to the satisfaction of the Secretary that there was good cause for failure to file such proof or application within such period. The determination of what constitutes good cause for purposes of this subsection shall be made in accordance with regulations of the Secretary.” "
(b)The amendments made by this section shall be effective with respect to
(1)applications for lump-sum death payments filed in or after the month in which this Act is enacted, and
(2)monthly benefits based on applications filed in or after such month. treatment of certain royalties for retirement test purposes Sec. 325.
(1)Subparagraph
(B)of section 203 (f)(5) of the Social Security Act is amended to read as follows:[74 Stat. 956](/us/stat/74/956).[42 USC 403](/us/usc/t42/s403). " “(B) For purposes of this section— “(i) an individual’s net earnings from self-employment for any taxable year shall be determined as provided in section [42 USC 411](/us/usc/t42/s411).211, except that paragraphs (1), (4), and
(5)of section 211(c) shall not apply and the gross income shall be computed by excluding the amounts provided by subparagraph (D), and “(ii) an individual’s net loss from self-employment for any taxable year is the excess of the deductions (plus his distributive share of loss described in section 702(a)(9) of the Internal Revenue Code of 1954) taken into account under [68A Stat. 239](/us/stat/68A/239).[26 USC 702](/us/usc/t26/s702).clause
(i)over the gross income (plus his distributive share of income so described) taken into account under clause (i).” "
(2)Such section 203(f)(5) is further amended by adding at the end thereof the following new subparagraph: " “(D) In the case of an individual— “(i) who has attained the age of 65 on or before the last day of the taxable year, and “(ii) who shows to the satisfaction of the Secretary that lie is receiving royalties attributable to a copyright or patent obtained before the taxable year in which he attained the age of 65 and that the property to which the copyright or patent relates was created by his own personal efforts, there shall be excluded from gross income any such royalties.” "
(b)The amendments made by subsection
(a)shall apply with respect to the computation of net earnings from self-employment and the net loss from self-employment for taxable years beginning after 1964. 79 Stat. 400 amendments preserving relationship between railroad retirement and old-age, survivors, and disability insurance systems Sec. 326. [80 Stat. 307](/us/stat/80/307); [75 Stat. 142](/us/stat/75/142).[45 USC 228a](/us/usc/t45/s228a).[73 Stat. 27](/us/stat/73/27).[45 USC 228e](/us/usc/t45/s228e).
(a)Section l(q) of the Railroad Retirement Act of 1937 is amended by striking out “1961” and inserting in lieu thereof “1965”.
(b)Section 5(1)(9) of such Act is amended by striking out “after 1958 is.less than $4,800” and inserting in lieu thereof the following: “after 1958 and before 1966 is less than $4,800 or for any calendar year after 1965 is less than $6,600”; and by striking out “and $4,800 for years after 1958”, and inserting in lieu thereof the following: “$4,800 for years after 1958 and before 1966, and $6,600 for years after 1965”. technical amendment relating to meetings of board of trustees of the old-age, survivors, and disability insurance trust funds Sec. 327. [70 Stat. 819](/us/stat/70/819).[42 USC 401](/us/usc/t42/s401). Section 201(c) of the Social Security Act is amended by striking out “six months” in the fourth sentence and inserting in lieu thereof “calendar year”. applications for benefits Sec. 328. [64 Stat. 487](/us/stat/64/487).[42 USC 402](/us/usc/t42/s402).
(a)Section 202(j)(2) of the Social Security Act. is amended to read as follows: " “(2) An application for any monthly benefits under this section filed before the first month in which the applicant satisfies the requirements for such benefits shall be deemed a valid application only if the applicant satisfies the requirements for such benefits before the Secretary makes a final decision on the application. If upon final decision by the Secretary, or decision upon judicial review thereof, such applicant is found to satisfy such requirements, the application shall be deemed to have been filed in such first month.” "
(b)*Ante*, p. 367. Section 216(i)(2) of such Act (as amended by subsection (b)(1) of section 303) is amended by inserting after subparagraph
(E)the following: " “(F) An application for a disability determination filed before the first day on which the applicant satisfies the requirements for a period of disability under this subsection shall be deemed a valid application only if the applicant satisfies the requirements for a period of disability before, the Secretary makes a final decision on the application. If upon final decision by the Secretary, or decision upon judicial review thereof, such applicant is found to satisfy such requirements, the application shall be deemed to have been filed on such first day.” "
(c)[70 Stat. 815](/us/stat/70/815).[42 USC 423](/us/usc/t42/s423). The first sentence of section 223(b) of such Act is amended to read as follows: “An application for disability insurance benefits filed before the first month in which the applicant satisfies the requirements for such benefits (as prescribed in subsection (a)(1)) shall be deemed a valid application only if the applicant satisfies the requirements for such benefits before the Secretary makes a final decision on the application. If, upon final decision by the Secretary, or decision upon judicial review thereof, such applicant is found to satisfy such requirements, the application shall be deemed to have been filed in such first month.” 79 Stat. 401
(d)The amendments made by this section shall apply with respect to
(1)applications filed on or after the date of enactment of this Act,
(2)applications as to which the Secretary has not made a final decision before the date of enactment of this Act, and
(3)if a civil action with respect to final decision by the Secretary has been commenced under section 205(g) of the Social Security Act before the [53 Stat. 1370](/us/stat/53/1370).[42 USC 405](/us/usc/t42/s405).date of enactment of this Act. applications as to which there has been no final judicial decision before the date of enactment of this Act. underpayments Sec. 329. Section 204 of the Social Security Act is amended by [42 USC 404](/us/usc/t42/s404).adding at the end thereof the following new subsection: " “(d) Notwithstanding the provisions of subsection (a), if an individual dies before any payment due him under this title is completed, and the total amount due at the time of his death does not exceed the amount of the monthly insurance benefit to which he was entitled for the month preceding the month in which he died, payment of the amount due shall be made— “(1) to the person, if any, determined by the Secretary to be the surviving spouse of the deceased individual and to have been living in the same .household with the deceased at the time of his death, or “(2) if there is no such person, or if such person dies before receiving payment, to the legal representative of the estate of such deceased individual.” " payments to two or more individuals of the same family Sec. 330. Section 205
(n)of the Social Security Act is amended to read as follows:" “(n) The Secretary may, in his discretion, certify to the Managing Trustee any two or more individuals of the same family for joint payment of the total benefits payable to such individuals for any month, and if one of such individuals dies before a check representing such joint payment is negotiated, payment of the amount of such unnegotiated check to the surviving individual or individuals may be authorized in accordance with regulations of the Secretary of the Treasury; except that appropriate adjustment or recovery shall be made under section 204(a) with respect to so much of the amount of such check as exceeds the amount to which such surviving individual or individuals are entitled under this title for such month.” " validating certificates filed by ministers Sec. 331.
(a)Section 1402(e) of the Internal Revenue Code of 1954 (relating to certificates to waive tax exemption on self-employment [68 Stat. 1088](/us/stat/68/1088).[26 USC 1402](/us/usc/t26/s1402).income in the case of ministers, members of religious orders, and Christian Science practitioners) is amended by striking out paragraphs
(5)and
(6)and inserting in lieu thereof the following: " “(5) Optional provision for certain certificates filed on or before April is, leer.—Notwithstanding any other provision of this section, in any case where an individual has derived earnings in any taxable year ending after 1954 from the performance of service described in subsection (c)(4), or in subsection (c)(5) insofar as it related to the performance of service by an individual 79 Stat. 402in the exercise of his profession as a Christian Science practitioner, and has reported such earnings as self-employment income on a return filed on or before the due date prescribed for filing such return (including any extension thereof)— “(A) a certificate filed by such individual on or before April 15, 1966, which (but for this subparagraph) is ineffective for the first taxable year ending after 1954 for which such a return was filed shall be effective for such first taxable year and for all succeeding taxable years, provided a supplemental certificate is filed by such individual (or a fiduciary acting for such individual or his estate, or his survivor within the meaning of section 205(c)(1)(C) of the Social Security [64 Stat. 158](/us/stat/64/158).[42 USC 405](/us/usc/t42/s405).Act) after the date of enactment of the Social Security Amendments of 1965 and on or before April 15, 1967, and “(B) a certificate filed after the date of enactment of the Social Security Amendments of 1965 and on or before April 15, 1967, by a survivor (within the meaning of section 205 (c)(1)(C) of the Social Security Act) of such an individual who died on or before April 15, 1966, may be effective, at the election of the person filing such a certificate, for the first taxable year ending after 1954 for which such a return was filed and for all succeeding years, but only if— “(i) *Ante*, p. 394. the tax under section 1401 in respect to all such individual’s self-employment income (except for underpayments of tax attributable to errors made in good faith), for each such year described in subparagraphs
(A)and
(B)ending before January 1, 1966, is paid on or before April 15, 1967, and “(ii) in any case where refund has been made of any such tax which (but for this paragraph) is an overpayment, the amount refunded (including any interest paid under section [68A Stat. 819](/us/stat/68A/819).[26 USC 6611](/us/usc/t26/s6611).[26 USC 6401](/us/usc/t26/s6401).6611) is repaid on or before April 15, 1967. The provisions of section 6401 shall not apply to any payment or repayment described in this paragraph.” "
(b)In the case of a certificate or supplemental certificate filed pursuant to section 1402(e)(5) of the Internal Revenue Code of 1954, as amended by subsection (a)—
(1)for purposes of computing interest, the due date for the payment of the tax under section 1401 of such Code which is due for any taxable year ending before January 1, 1966, solely by reason of the filing of a certificate which is effective under such section 1402(e)(5) shall be April 15, 1967;
(2)[26 USC 6501](/us/usc/t26/s6501). for purposes of section 6501 of such Code, the statutory period for the assessment of any tax for any taxable year for which tax is due solely by reason of the filing of such certificate shall not expire before April 16, 1970; and
(3)[26 USC 6651](/us/usc/t26/s6651). for purposes of section 6651 of such Code (relating to addition to tax for failure to file tax return), the amount of tax required to be shown on the return shall not include tax under section 1401 of such Code which is due for any taxable year ending before January 1, 1966, solely by reason or the filing of a certificate which is effective under section 1402(e)(5).
(c)[74 Stat. 933](/us/stat/74/933).[42 USC 405](/us/usc/t42/s405). Notwithstanding any provision of section 205(c)(5)(F) of the Social Security Act, the Secretary of Health, Education, and Welfare may conform, before April 16, 1970, his records to tax returns or state- 79 Stat. 403meats of earnings which constitute self-employment income solely by reason of the filing of a certificate which is effective under section 1402(e)(5) of such Code.
(d)The amendments made by this section shall be applicable (except as otherwise specifically provided therein) only to certificates with respect to which supplemental certificates are filed pursuant to section 1402(e)(5)(A) of such Code after the date of the enactment of *Ante*, p. 401.this Act, and to certificates filed pursuant to section 1402(e)(5)(B) after such date; except that no monthly benefits under title II of the Social Security Act for the month in which this Act is enacted or any [42 USC 401](/us/usc/t42/s401).prior month snail be payable or increased by reason of such amendments, and no lump-sum death payment under such title shall be payable or increased by reason of such amendments in the case of any individual who died prior to the date of the enactment of this Act. The provisions of section 1402(e)(5) and
(6)of the Internal Revenue Code of 1954 which were in effect before the date of enactment of this Act[74 Stat. 927](/us/stat/74/927); [75 Stat. 141](/us/stat/75/141).[26 USC 1402](/us/usc/t26/s1402). shall be applicable with respect to any certificate filed pursuant thereto before such date if a supplemental certificate is not filed with respect to such certificate as provided in this section. determination of attorneys’ fees in court proceedings under title ii Sec. 332. The heading of section 206 of the Social Security Act [53 Stat. 1372](/us/stat/53/1372).[42 USC 406](/us/usc/t42/s406).is amended to read “representation of claimants”. Such section is further amended by inserting “(a)” after “Sec. 206.” and by adding at the end of such section the following new subsection: " “(b)
(1)Whenever a court renders a judgment favorable to a claimant under this title who was represented before the court by an attorney, the court may determine and allow as part of its judgment a reasonable fee for such representation, not in excess of 25 percent of the total of the past-due benefits to which the claimant is entitled by reason of such judgment, and the Secretary may, notwithstanding the provisions of section 205(i), certify the amount of such fee for payment [42 USC 405](/us/usc/t42/s405).to such attorney out of, and not in addition to, the amount of such past-due benefits. In case of any such judgment, no other fee may he payable or certified for payment for such representation except as provided in this paragraph. “(2) Any attorney who charges, demands, receives, or collects for services rendered in connection with proceedings before a court to which paragraph
(1)is applicable any amount in excess of that allowed by the court thereunder shall be guilty of a misdemeanor and upon conviction thereof shall be subject to a fine of not more than $500, or imprisonment for not more than one year, or both.” " continuation of widow’s and widower’s insurance benefits after remarriage Sec. 333.
(1)Subsection
(e)of section 202 of the Social Security Act., as amended by section 308 of this Act, is amended by adding *Ante*, p. 376.at the end thereof the following new paragraph: " “(4) If a widow, after attaining the age of 60, marries an individual (other than one described in subparagraph
(A)or
(B)of paragraph (3)), such marriage shall, for purposes of paragraph (1), be deemed not to have occurred; except that, notwithstanding the provisions of paragraph
(2)and subsection (q), such widow’s insur-*Ante*, pp. 373, 374. 79 Stat. 404ance benefit for the month in which such marriage occurs and each month thereafter prior to the month in which the husband dies or such marriage is otherwise terminated, shall be equal to 50 per centum of the primary insurance amount of the deceased individual on whose wages and self-employment income such benefit is based.” "
(2)*Ante*, p. 373. Paragraph
(2)of such subsection, as amended by section 307 of this Act, is further amended by inserting before the comma “and paragraph
(4)of this subsection”.
(b)[64 Stat. 485](/us/stat/64/485).[42 USC 402](/us/usc/t42/s402).
(1)Subsection
(f)of such section is amended by adding at the end thereof the following new paragraph: " “(5) If a widower, after attaining the age of 62, marries an individual (other than one described in subparagraph
(A)or
(B)of paragraph (4)), such marriage shall, for purposes of paragraph (1), be deemed not to have occurred; except that, notwithstanding the *Ante*, p. 374.provisions of paragraph
(3)and subsection (q), such widower’s insurance benefit for the month in which such marriage occurs and each month thereafter prior to the month in which the wife dies or such marriage is otherwise terminated, shall be equal to 50 per centum of the primary insurance amount of the deceased individual on whose wages and self-employment income such benefit is based.” "
(2)Paragraph
(3)of such subsection is amended by striking out “Such” and inserting in lieu thereof “Except as provided in paragraph (5), such”.
(1)Paragraph (2)(B) of subsection
(k)of such section 202 is amended by inserting “other than an individual to whom subsection *Ante*, p. 403.(e)(4) or (f)(5) applies)” after “Any individual” and by adding at the end thereof the following new sentence: “Any individual who is entitled for any month to more than one widow’s or widower’s insurance benefit to which subsection (e)(4) or (f)(5) applies shall be entitled to only one such benefit for such month, such benefit to be the largest-of such benefits.”.
(2)Paragraph
(3)of such subsection is amended by inserting “(A)” after “(3)” and by adding at the end thereof the following new subparagraph: " “(B) If an individual is entitled for any month to a widow’s or widower’s insurance benefit to which subsection (e)(4) or (f)(5) applies and to any other monthly insurance benefit under section 202 (other than an old-age insurance benefit), such other insurance benefit for such month, after any reduction under subparagraph (A), any reduction under subsection (q), and any reduction under section [72 Stat. 1017](/us/stat/72/1017).[42 USC 403](/us/usc/t42/s403).203(a), shall be reduced, but not below zero, by an amount equal to such widow’s or widower’s insurance benefit after any reduction or reductions under such subparagraph
(A)and such section 203(a).” "
(d)The amendments made by this section shall apply with respect to monthly insurance benefits under section 202 of the Social Security Act beginning with the second month following the month in which this Act is enacted; but, in the case of an individual who was not *Ante*, pp. 376, 403; *Supra*.entitled to a monthly insurance benefit under section 202(e) or
(f)of such Act for the first month following the month in which this Act is enacted, only on the basis of an application filed in or after the month in which this Act is enacted. changes in definitions of wife, widow, husband, and widower Sec. 334.
(a)*Ante*, p. 373. Section 216(b) of the Social Security Act, as amended by section 306 of this Act, is amended by striking out “or” at the end of clause (3)(A), and by inserting immediately before the period at the end thereof the following: “, or
(C)was entitled to, or upon appli-79 Stat. 405cation therefor and attainment of the required age (if any) would have been entitled to, a widow’s, child’s (after attainment or age 18), or parent’s insurance annuity under section 5 of the Railroad Retirement Act of 1937, as amended”.[50 Stat. 312](/us/stat/50/312).[45 USC 228e](/us/usc/t45/s228e).
(b)Section 216(c) of such Act, as amended by section 306 of this *Ante*, p. 373.Act, is amended by striking out “or” at the end of clause (6)(A), and by inserting immediately before the period at the end thereof the following: “, or
(C)she was entitled to, or upon application therefor and attainment or the required age (if any) would nave been entitled to, a widow’s, child’s (after attainment of age 18), or parent’s insurance annuity under section 5 of the Railroad Retirement Act of 1937, as amended”.
(c)Section 216(f) of such Act, as amended by section 306 of this Act, is amended by striking out “or” at the end or clause (3)(A), and by inserting immediately before the period at the end thereof the following: “, or
(C)he was entitled to, or upon application therefor and attainment of the required age (if any) he would have been entitled to, a widower’s, child’s (after attainment of age 18), or parent’s insurance annuity under section 5 of the Railroad Retirement Act of 1937, as amended”.
(d)Section 216(g) of such Act, as amended by section 306 of this Act, is amended by striking out “or” at the end of clause (6)(A), and by inserting immediately lief ore the period at the end there or the following: “, or
(C)he was entitled to, or on application therefor and attainment of tire required age (if any) he would have been entitled to, a widower’s, child’s (after attainment of age 18), or parent’s insurance annuity under section 5 of the Railroad Retirement Act of 1937, as amended”.
(e)Section 202(c)(2) is amended by striking out “or” at the end[72 Stat. 1026](/us/stat/72/1026); *Ante*, p. 372.[42 USC 402](/us/usc/t42/s402). of subparagraph (A), by striking out the period at the end of subparagraph
(B)and inserting in lieu thereof “; or”, and by adding after such subparagraph
(B)the following new subparagraph: " “(C) in the month prior to the month of his marriage to such individual he was entitled to, or on application therefor and attainment of the required age (if any) would have been entitled to, a widower’s, child’s (after attainment of age 18), or parent’s insurance annuity under section 5 of the Railroad Retirement Act of 1937, as amended.” "
(f)Section 202(f)(2) of such Act is amended by striking out “or” at the end of subparagraph (A), by striking out the period at the end of subparagraph
(B)and inserting in lieu thereof “; or”, and by adding after such subparagraph
(B)the following new subparagraph: " “(C) in the month prior to the month of his marriage to such individual he was entitled to, or on application therefor and attainment of the required age (if any), would have been entitled to, a widower’s, child’s (after attainment of age 18), or parent’s insurance annuity under section 5 of the Railroad Retirement Act of 1937, as amended.” "
(g)The amendments made by this section shall be applicable only with respect to monthly insurance benefits under title II of the Social Security Act beginning with the second month following the month [42 USC 401](/us/usc/t42/s401).in which this Act is enacted, but only on the basis of applications filed in or after the month in which this Act is enacted. 79 Stat. 406 reduction of benefits on receipt of workmen’s compensation Sec. 335. [42 USC 401](/us/usc/t42/s401). Effective with respect to benefits under title II of the Social Security Act for months after December 1965 based on the wages and self-employment income of an individual who is entitled [70 Stat. 815](/us/stat/70/815).[42 USC 423](/us/usc/t42/s423).to benefits under section 223 of such Act and whose period of disability (as defined in such title) began after June 1, 1965, title II of such Act is amended by inserting after section 223 the following new section: " “reduction of benefits based on disability on account of receipt of workmen’s compensation “Sec. 224.
(a)If for any month prior to the month in which an individual attains the age of 62— “(1) such individual is entitled to benefits under section 223, and “(2) such individual is entitled for such month, under a workmen’s compensation law or plan of the United States or a State, to periodic benefits for a total or partial disability (whether or not permanent), and the Secretary has, in a prior month, received notice of such entitlement for such month, [64 Stat. 482](/us/stat/64/482).[42 USC 402](/us/usc/t42/s402).the total of his benefits under section 223 for such month and of any benefits under section 202 for such month based on his wages and self-employment income shall be reduced (but not below zero) by the amount by which the sum of— “(3) such total of benefits under sections 223 and 202 for such month, and “(4) such periodic benefits payable (and actually paid) for such month to such individual under the workmen’s compensation law or plan, exceeds the higher of— “(5) 80 per centum of his ‘average current earnings’, or “(6) the total of such individual’s disability insurance benefits under section 223 for such month and of any monthly insurance benefits under section 202 for such month based on his wages and self-employment income, prior to reduction under this section. In no case shall the reduction in the total of such benefits under sections 223 and 202 for a month (in a continuous period of months) induce such total below the sum of— “(7) the total of the benefits under sections 223 and 202, after reduction under this section, with respect to all persons entitled to benefits on the basis of such individual’s wages and self-employment income for such month which were determined for such individual and such persons for the first month for which reduction under this section was made (or which would have been so determined if all of them had been so entitled in such first month), and “(8) any increase in such benefits with respect to such individual and such persons, before reduction under this section, which is made effective for months after the first month for which reduction under this section is made. For purposes of clause (5), an individual’s average current earnings means the larger of
(A)the average monthly wage used for purposes of computing his benefits under section 223, or
(B)one-sixtieth of the total or his wages and self-employment income for the five consecutive calendar years after 1950 for which such wages and self-employment income were highest. 79 Stat. 407 “(b) If any periodic benefit under a workmen’s compensation law or plan is payable on other than a monthly basis (excluding a benefit payable as a lump sum except to the extent that it is a commutation of, or a substitute for, periodic payments), the reduction under this section shall be made at such time or times and in such amounts as the Secretary finds will approximate as nearly as practicable the reduction prescribed by subsection (a). “(c) Reduction of benefits under this section shall be made after any reduction under subsection
(a)of section 203, but before deductions*Ante*, p. 363, 378.[70 Stat. 817](/us/stat/70/817).[42 USC 422](/us/usc/t42/s422). under such section and under section 222(b). “(d) The reduction of benefits required by this section shall not be made if the workmen’s compensation law or plan under which a periodic benefit is payable provides for the reduction thereof when anyone is entitled to benefits under this title on the basis of the wages and self-employment income of an individual entitled to benefits under section 223.[70 Stat. 815](/us/stat/70/815).[42 USC 423](/us/usc/t42/s423). “(e) If it appears to the Secretary that an individual may be eligible for periodic benefits under a workmen’s compensation law or plan which would give rise to reduction under this section, he may require, as a condition of certification for payment of any benefits under section 223 to any individual for any month and of any benefits under section 202 for such month based on such individual’s wages and self-employment [64 Stat. 482](/us/stat/64/482).[42 USC 402](/us/usc/t42/s402).income, that such individual certify
(i)whether he has filed or intends to file any claim for such periodic benefits, and
(ii)if he has so filed, whether there has been a decision on such claim. The Secretary may, in the absence of evidence to the contrary, rely upon such a certification by such individual that he has not filed and does not intend to file such a claim, or that he has so filed and no final decision thereon has been made, in certifying benefits for payment pursuant to section 205 (i).[83 Stat. 1371](/us/usc/t83/s1371).[42 USC 405](/us/usc/t42/s405). “(f)
(1)In the second calendar year after the year in which reduction under this section in the total of an individual’s benefits under section 223 and any benefits under section 202 based on his wages and self-employment income was first required (in a continuous period of months), and in each third year thereafter, the Secretary shall redetermine the amount of such benefits which are still subject to reduction under this section; but such redetermination shall not result in any decrease in the total amount of benefits payable under this title on the basis of such individual’s wages and self-employment income. Such redetermined benefit, shall be determined as of, and shall become effective with, the January following the year in which such redetermination was made. “(2) In making the redetermination required by paragraph (1), the individual’s average current earnings (as defined in subsection (a)) shall be deemed to be the product of his average current earnings as initially determined under subsection
(a)and the ratio of
(i)the average of the taxable wages of all persons for whom taxable wages were reported to the Secretary for the first calendar quarter of the calendar year in which such redetermination is made, to
(ii)the average of the taxable wages of such persons reported to the Secretary for the first calendar quarter of the taxable year in which the reduction was first computed (but not counting any reduction made in benefits for a previous period of disability). Any amount determined under the preceding sentence which is not a multiple of $1 shall be reduced to the next lower multiple of $1. 79 Stat. 408 “(g) Whenever a reduction in the total of benefits for any month based on an individual’s wages and self-employment income is made under this section, each benefit, except the disability insurance benefit, shall first be proportionately decreased, and any excess of such reduction over the sum of all such benefits other than the disability insurance benefit shall then be applied to such disability insurance benefit.” " payment of costs of rehabilitation services from the trust funds Sec. 336. [70 Stat. 817](/us/stat/70/817).[42 USC 422](/us/usc/t42/s422). Section 222 of the Social Security Act is amended by adding at the end thereof the following new subsection: " “costs of rehabilitation services from trust funds “(d)
(1)For the purpose of making vocational rehabilitation services more readily available to disabled individuals who are— “(A) entitled to disability insurance benefits under section [70 Stat. 815](/us/stat/70/815).[42 USC 423](/us/usc/t42/s423).[64 Stat. 482](/us/stat/64/482).[42 USC 402](/us/usc/t42/s402).223, or “(B) entitled to child’s insurance benefits under section 202
(d)after having attained age 18 (and are under a disability), to the end that savings will result to the Trust Funds as a result of rehabilitating the maximum number of such individuals into productive activity, there are authorized to be transferred from the Trust Funds such sums as may be necessary to enable the Secretary to pay the costs of vocational rehabilitation services for such individuals (including
(i)services during their waiting periods, and
(ii)so much of the expenditures for the administration of any State plan as is attributable to carrying out this subsection); except that the total amount so made available pursuant to this subsection in any fiscal year may not exceed 1 percent of the total of the benefits*Ante*, pp. 370, 397. under section 202(d) for children who have attained age 18 and are under a disability, and the benefits under section 223, which were certified for payment in the preceding year. The selection of individuals (including the order in which they shall be selected) to receive such services shall be made in accordance with criteria formulated by the Secretary which are based upon the effect the provision of such services would have upon the Trust Funds. “(2) In the case of each State which is willing to do so, such vocational rehabilitation services shall be furnished under a State plan for vocational rehabilitation services which— “(A) has been approved under section 5 of the Vocational [68 Stat. 656](/us/stat/68/656).[29 USC 35](/us/usc/t29/s35).Rehabilitation Act, “(B) provides that, to the extent funds provided under this subsection are adequate for the purpose, such services will be furnished, to any individual in the State who meets the criteria prescribed by the Secretary pursuant to paragraph (1), with reasonable promptness and in accordance with the order of selection determined under such criteria, and “(C) provides that such services will be furnished to any individual without regard to
(i)his citizenship or place of residence,
(ii)his need for financial assistance except as provided in regulations of the Secretary in the case of maintenance during rehabilitation, or
(iii)any order of selection which would otherwise be followed under the State plan pursuant to section 5(a)(4) of the Vocational Rehabilitation Act. “(3) In the case of any State which does not have a plan which meets the requirements of paragraph (2), the Secretary may provide such services by agreement or contract with other public or private agencies, organizations, institutions, or individuals. 79 Stat. 409 “(4) Payments under this subsection may be made in installments, and in advance or by way of reimbursement, with necessary adjustments on account of overpayments or underpayments. “(5) Money paid from the Trust Funds under this subsection to pay the costs of providing services to individuals who are entitled to benefits under section 223 (including services during their waiting periods),[70 Stat. 815](/us/stat/70/815).[42 USC 423](/us/usc/t42/s423).[64 Stat. 482](/us/stat/64/482); *Ante*, pp. 370, 397.[42 USC 402](/us/usc/t42/s402).*Ante*, p. 370. or who are entitled to benefits under section 202(d) on the basis of the wages and self-employment income of such individuals shall be charged to the Federal Disability Insurance Trust Fund, and all other money paid out from the Trust. Funds under this subsection shall be charged to the Federal Old-Age and Survivors Insurance Trust Fund. The Secretary shall determine according to such methods and procedures as he may deem appropriate— “(A) the total cost of the services provided under this subsection, and “(B) subject to the provisions of the preceding sentence, the amount of such cost which should be charged to each of such Trust Funds. “(6) For the purposes of this subsection the term ‘vocational rehabilitation services’ shall have the meaning assigned to it in the Vocational Rehabilitation Act, except that such services may be limited in [68 Stat. 652](/us/stat/68/652).[29 USC 31 note](/us/usc/t29/s31).type, scope, or amount in accordance with regulations of the Secretary designed to achieve the purposes of this subsection.” " teachers in the state of maine Sec. 337.
(a)Section 316 of the Social Security Amendments of 1958 [72 Stat. 1040](/us/stat/72/1040); [78 Stat. 240](/us/stat/78/240).[42 USC 418 note](/us/usc/t42/s418).is amended by striking out “July 1, 1965” and inserting in lieu thereof “July 1, 1967”.
(b)The amendment made by this section shall be effective as of July 1, 1965. modification of agreement with north dakota and iowa with respect to certain students Sec. 338. Notwithstanding any provision of section 218 of the Social Security Act, the agreements with the States of North Dakota [64 Stat. 514](/us/stat/64/514).[42 USC 418](/us/usc/t42/s418).and Iowa entered into pursuant to such section may, at the option of the State, be modified so as to exclude service performed in any calendar qua it er in the employ of a school, college, or university if such service is performed by a student who is enrolled and is regularly attending classes at such school, college, or university and if the remuneration for such service is less than $50. Any modification of either of such agreements pursuant to this Act shall be effective with respect to services performed after an effective date specified in such modification, except that such date shall not be earlier than the date of enactment of this Act. qualification of children not qualified under state law Sec. 339.
(a)Section 216(h) of the Social Security Act is amended [71 Stat. 519](/us/stat/71/519); [72 Stat. 1030](/us/stat/72/1030).[42 USC 416](/us/usc/t42/s416).by adding at the end thereof the following new paragraph: " “(3) An applicant who is the son or daughter of a fully or currently insured individual, but who is not (and is not deemed to be) the child of such insured individual under paragraph (2), shall nevertheless be deemed to be the child of such insured individual if: “(A) in the case of an insured individual entitled to old-age insurance benefits (who was not, in the month preceding such entitlement, entitled to disability insurance benefits)— 79 Stat. 410 “(i) such insured individual— “(I) has acknowledged in writing that the applicant is his son or daughter, “(II) has been decreed by a court to be the father of the applicant, or “(III) has been ordered by a court to contribute to the support of the applicant because the applicant is his son or daughter, and such acknowledgment, court decree, or court order was made not less than one year before such insured individual became entitled to old-age insurance benefits or attained age 65, whichever is earlier; or “(ii) such insured individual is shown by evidence satisfactory to the Secretary to be the father of the applicant and was living with or contributing to the support of the applicant at the time such insured individual became entitled to benefits or attained age 65, whichever first occurred; “(B) in the case of an insured individual entitled to disability insurance benefits, or who was entitled to such benefits in the month preceding the first month for which he was entitled to old-age insurance benefits— “(i) such insured individual— “(I) has acknowledged in writing that the applicant is his son or daughter, “(II) has been decreed by a court to be the father of the applicant, or “(III) has been ordered by a court to contribute to the support of the applicant because the applicant is his son or daughter, and such acknowledgment, court decree, or court order was made before such insured individual’s most recent period of disability began; or “(ii) such insured individual is shown by evidence satisfactory to the Secretary to be the father of the applicant and was living with or contributing to the support of that applicant at the time such period of disability began; “(C) in the case of a deceased individual— “(i) such insured individual— “(I) had acknowledged in writing that the applicant is his son or daughter, “(II) had been decreed by a court to be the father of the applicant, or “(III) had been ordered by a court to contribute to the support of the applicant because the applicant was his son or daughter, and such acknowledgment, court decree, or court order was made before the death of such insured individual, or “(ii) such insured individual is shown by evidence satisfactory to the Secretary to have been the father of the applicant, and such insured individual was living with or contributing to the support of the applicant at the time such insured individual died.” "
(b)[74 Stat. 952](/us/stat/74/952).[42 USC 402](/us/usc/t42/s402). Section 202(d) of such Act is amended by inserting after “216(h)(2)(B)” the following: “or section 216(h)(3)”. 79 Stat. 411
(c)The amendments made by subsections
(a)and
(b)shall be applicable with respect to monthly insurance benefits under title II of the Social Security Act beginning with the second month following [42 USC 401](/us/usc/t42/s401).the month in which this Act is enacted but only on the basis of an application filed in or after the month in which this Act is enacted. disclosure, under certain circumstances, to courts and interested welfare agencies of whereabouts of individuals Sec. 340. Section 1106 of the Social Security Act is amended by [64 Stat. 559](/us/stat/64/559).[42 USC 1306](/us/usc/t42/s1306).adding at the end thereof the following new subsection: " “(c)
(1)Upon request (filed in accordance with paragraph
(2)of this subsection) of any State or local agency participating in administration of the State plan approved under title I, IV, X, XIV, XVI, or XIX, or participating in the administration of any other State or [42 USC 301 *et seq*](/us/usc/t42/s301).local public assistance program, for the most recent address of any individual included in the files of the Department of Health, Education, and Welfare maintained pursuant to section 205, the Secretary [53 Stat. 1368](/us/stat/53/1368).[42 USC 405](/us/usc/t42/s405).shall furnish such address, or the address of the most recent employer, or both, if such agency certifies that— “(A) an order has been issued by a court of competent jurisdiction against such individual for the support and maintenance of his child or children who are under the age of 16 in destitute or necessitous circumstances, “(B) such child or children are applicants for or recipients of assistance available under such a plan or program, “(C) such agency has attempted without success to secure such information from all other sources reasonably available to it, and “(D) such information is requested (for its own use, or on the request and for the use of the court which issued the order) for the purpose of obtaining such support and maintenance. “(2) A request under paragraph
(1)shall be filed in such manner and form as the Secretary may prescribe, and shall be accompanied by a certified copy of the order referred to in paragraph (1)(A). “(3) The penalties provided in the second sentence of subsection
(a)shall apply with respect to use of information provided under paragraph
(1)of this subsection except for the purpose authorized by subparagraph
(D)thereof. “(4) The Secretary, in such cases and to such extent as he may prescribe in accordance with regulations, may require payment for the cost of information provided under paragraph (1); and the provisions of the second sentence of subsection
(b)shall apply also with respect to payment under this paragraph.” " additional period for filing ministers certificates Sec. 341.
(a)Clause
(B)of section 1402(e)(2) of the Internal Revenue Code of 1954 (relating to time for filing waiver certificate by [71 Stat. 521](/us/stat/71/521); [78 Stat. 1076](/us/stat/78/1076).[26 USC 1402](/us/usc/t26/s1402).ministers, members of religious orders, and Christian Science practitioners) is amended by striking out “his second taxable year ending after 1962” and inserting in lieu thereof “his second taxable year ending after 1963”.
(b)Section 1402(e)(3) of such Code (relating to effective date of [74 Stat. 926](/us/stat/74/926); [78 Stat. 1077](/us/stat/78/1077).certificate) is amended by adding at the end thereof the following new subparagraph: 79 Stat. 412 " “(D) Notwithstanding the first sentence of subparagraph (A), if an individual files a certificate after the date of the enactment of this subparagraph and on or before the due date of the return (including any extension thereof) for his second taxable year ending after 1963, such certificate shall be effective for his first taxable year ending after 1962 and all succeeding years.” "
(c)The amendments made by subsections
(a)and
(b)shall be applicable only with respect to certificates filed pursuant to section 1402 [26 USC 1402](/us/usc/t26/s1402).(e) of the Internal Revenue Code of 1954 after the date of the enactment of this Act; except that no monthly benefits under title II of the [42 USC 401](/us/usc/t42/s401).Social Security Act for the month in which this Act is enacted or any prior month shall be payable or increased by reason of such amendments. rectifying error in interpreting law with respect to certain school employees in alaska Sec. 342. [64 Stat. 514](/us/stat/64/514).[42 USC 418](/us/usc/t42/s418). For purposes of the agreement under section 218 of the Social Security Act entered into by the State of Alaska, or its predecessor the Territory of Alaska, where employees of an integral unit of a political subdivision of the State or Territory of Alaska have in good faith been included under the State or Territory’s agreement as a coverage group on the basis that such integral unit of a political subdivision was a political subdivision, then such unit of the political subdivision shall, for purposes of section 218(b)(2) of such Act, be deemed to be a political subdivision, and employees performing services within such unit shall be deemed to be a coverage group, effective with the effective date specified in such agreement or modification of such agreement with respect to such coverage group and ending with the last day of the year in which this Act is enacted. continuation of child’s insurance benefits after adoption by brother or sister Sec. 343. *Ante*, p. 371.
(a)Section 202(d)(1)(D) of the Social Security Act (as amended by section 306(b) of this Act) is further amended by striking out “or uncle” and inserting in lieu thereof “uncle, brother, or sister”.
(b)The amendment made by subsection
(a)shall apply only with respect to monthly insurance benefits under title II of the Social Security Act for months after the month in which this Act is enacted; except that, in the case of an individual who was not entitled to child’s [64 Stat. 482](/us/stat/64/482); *Ante*, pp. 370, 397.[42 USC 402](/us/usc/t42/s402).insurance benefits under section 202(d) of such Act for the month in which this Act was enacted, such amendment shall apply only on the basis of an application filed in or after the month in which this Act is enacted. disability insurance benefits for the blind; special provisions Sec. 344. *Ante*, p. 367.
(a)Section 216(i)(3) of the Social Security Act (as amended by section 303 of this Act) is further amended by striking out subparagraph
(B)and all that follows and inserting in lieu thereof the following: " “(B)
(i)he had not less than 20 quarters of coverage during the 40-quarter period which ends with such quarter, or “(ii) if such quarter ends before he attains (or would attain) age 31 and he is under a disability by reason of blindness (as 79 Stat. 413defined in paragraph (1)), not less than one-half (and not less than 6) oi the quarters during the period ending with such quarter and beginning after he attained the age of 21 were quarters of coverage, or (if the number of quarters in such period is less than 12) not less than 6 of the quarters in the 12-quarter period ending with such quarter were quarters of coverage; except that the provisions of subparagraph
(A)of this paragraph shall not apply in the case of an individual with respect to whom a period of disability would, but for such subparagraph, begin before 1951. For purposes of subparagraph
(B)of this paragraph, when the number of quarters in any period is an odd number, such number shall be reduced by one, and a quarter shall not be counted as part of any period if any part of such quarter was included in a prior period of disability unless such quarter was a quarter of coverage.” "
(b)Section 223(c)(1) of such Act is amended by striking out subparagraph [70 Stat. 815](/us/stat/70/815).[42 USC 423](/us/usc/t42/s423).(B) and inserting in lieu thereof the following: " “(B)
(i)he had not less than 20 quarters of coverage during the 40-quarter period which ends with the quarter in which such month occurred, or “(ii) if such month ends before he attains (or would attain) age 31 and he is under a disability by reason of blindness (as defined in section 216(i)(1)), not less than one-half (and not [68 Stat. 1080](/us/stat/68/1080).[42 USC 416](/us/usc/t42/s416).less than 6) of the quarters during the period ending with the quarter in which such month occurred and beginning after he attained the age of 21 were quarters of coverage, or (if the number of quarters in such period is less than 12) not less than 6 of the quarters in the 12-quarter period ending with such quarter were quarters of coverage. For purposes of subparagraph
(B)of this paragraph, when the number of quarters in any period is an odd number, such number shall be reduced by one, and a quarter shall not be counted as part of any period if any part of such quarter was included in a period of disability unless such quarter was a quarter of coverage.” "
(c)Section 223(a)(1) of such Act (as amended by section 303 of this Act) is further amended by adding the following sentence*Ante*, p. 367. at the end thereof: “No payment under this paragraph may be made to an individual who would not meet the definition of disability in subsection (c)(2) except for subparagraph
(B)thereof for any month in which he engages in substantial gainful activity, and no payment may be made for such month under subsection (b), (c), or
(d)of section 202 to any person on the basis of the wages and self-employment *Ante*, pp. 370, 375, 397; [64 Stat. 482](/us/stat/64/482).[42 USC 402](/us/usc/t42/s402).income of such individual.”
(d)The first sentence of section 223(c)(2) of such Act (as amended by section 303 of this Act) is further amended by adding after subparagraph
(A)the following new subparagraph: " “(B) in the case of an individual who has attained the age of 55 and is blind (within the meaning of ‘blindness’ as defined in section 216(i)(1)), inability by reason of such blindness to engage in substantial gainful activity requiring skills or abilities comparable to those of any gainful activity in which he has previously engaged with some regularity and over a substantial period of time.” "
(e)The amendments made by this section shall apply only with respect to monthly benefits under title II of the Social Security Act [42 USC 401](/us/usc/t42/s401).for months after the first month following the month in which this Act is enacted, on the basis of applications for such benefits filed in or after the month in which this Act is enacted. 79 Stat. 414 TITLE IV— PUBLIC ASSISTANCE AMENDMENTS increased federal payments under public assistance titles of the social security act Sec. 401. [76 Stat. 193](/us/stat/76/193).[41 USC 303](/us/usc/t41/s303).
(a)Section 3(a)(1) of the Social Security Act is amended
(1)by striking out, in so much thereof as precedes clause (A), “during such quarter” and inserting in lieu thereof “during each month of such quarter”;
(2)by striking out, in clause (A), “29/35”, “any month”, and “$35” and inserting in lieu thereof “31/37”, “such month”, and “$3 7”, respectively; and
(3)by striking out clauses
(B)and
(C)and inserting in lieu thereof the following: " “(B) the larger of the following: “(i)(I) [72 Stat. 1050](/us/stat/72/1050).[42 USC 1301](/us/usc/t42/s1301). the Federal percentage (as defined in section 1101(a)(8)) of the amount by which such expenditures exceed the amount which may be counted under clause (A), not counting so much of such excess with respect to such month as exceeds the product of $38 multiplied by the total number of recipients of old-age assistance for such month, plus
(II)15 per centum of the total expended during such month as old-age assistance under the State plan in the form of medical or any other type of remedial care, not counting so much of such expenditure with respect to such month as exceeds the product of $15 multiplied by the total number of recipients of old-age assistance for such month, or “(ii)(I) [74 Stat. 991](/us/stat/74/991).[42 USC 306](/us/usc/t42/s306). the Federal medical percentage (as defined in section 6(c)) of the amount by which such expenditures exceed the maximum which may be counted under clause (A), not counting so much of any expenditures with respect to such month as exceeds
(a)the product of $52 multiplied by the total number of such recipients of old-age assistance for such month, or
(b)if smaller, the total expended as old-age assistance in the form of medical or any other type of remedial care with respect to such month plus the product of $37 multiplied by such total number of such recipients, plus
(II)the Federal percentage of the amount by which the total expended during such month as old-age assistance under the State plan exceeds the amount which may be counted under clause
(A)and the preceding provisions of this clause (B)(ii), not counting so much of such excess with respect to such month as exceeds the product of $38 multiplied by the total number of such recipients of old-age assistance for such month;”. "
(b)[76 Stat. 200](/us/stat/76/200).[42 USC 1383](/us/usc/t42/s1383). Section 1603(a)(1) of such Act is amended
(1)by striking out, in so much thereof as precedes clause (A), “during such quarter” and inserting in lieu thereof “during each month of such quarter”;
(2)by striking out, in clause (A), “29/35”, “any month”, and “$35” and inserting in lieu thereof “31/37”, “such month”, and “$37”, respectively; and
(3)by striking out clauses
(B)and
(C)and inserting in lieu thereof the following: " “(B) the larger of the following: “(i)(I) the Federal percentage (as defined in section 1101(a)(8)) of the amount by which such expenditures exceed the amount which may be counted under clause (A), not counting so much of such excess with respect to such month as exceeds the product of $38 multiplied by the total number of recipients of aid to the aged, blind, or disabled for such month, plus
(II)15 per centum of the total expended during such month as aid to the aged, blind, or disabled under 79 Stat. 415the State plan in the form of medical or any other type of remedial care, not counting so much of such expenditure with respect to such month as exceeds the product of $15 multiplied by the total number of recipients of aid to the aged,blind, or disabled for such month, or “(ii)(I) the Federal medical percentage (as defined in section 6(c)) of the amount by which such expenditures [74 Stat. 991](/us/stat/74/991).[42 USC 306](/us/usc/t42/s306).exceed the maximum which may be counted under clause (A), not counting so much of any expenditures with respect to such month as exceeds
(a)the product of $52 multiplied by the total number of such recipients of aid to the aged, blind, or disabled for such month, or
(b)if smaller, the total expended as aid to the aged, blind, or disabled in the form of medical or any other type of remedial care with respect to such month plus the product of $37 multiplied by such total number of such recipients, plus
(II)the Federal percentage of the amount by which the total expended during such month as aid to the aged, blind, or disabled under the State plan exceeds the amount which may be counted under clause
(A)and the preceding provisions of this clause (B)(ii), not counting so much of such excess with respect to such month as exceeds the product of $38 multiplied by the total number of such recipients of aid to the aged, Wind, or disabled for such month;”. "
(c)Section 403(a)(1) of such Act is amended
(1)by striking [76 Stat. 174](/us/stat/76/174).[42 USC 603](/us/usc/t42/s603).out “fourteen-seventeenths” and “$17” in clause
(A)and inserting in lieu thereof “five-sixths” and “$18”, respectively; and
(2)by striking out “$30” in clause
(B)and inserting in lieu thereof “$32”.
(d)Section 1003(a)(1) of such Act is amended
(1)by striking[42 USC 1203](/us/usc/t42/s1203). out, in clause (A), “29/35” and “$35” and inserting in lieu thereof “31/37” and “$37”, respectively; and
(2)by striking out, in clause (B), “$70” and inserting in lieu thereof “$75”.
(e)Section 1403(a)(1) of such Act is amended
(1)by striking [42 USC 1353](/us/usc/t42/s1353).out, in clause (A), “29/35” and “$35” and inserting in lieu thereof “31/37” and “$37”, respectively; and
(2)by striking out, in clause (BL “$70” and inserting in lieu thereof “$75”.
(f)The amendments made by this section shall apply in the case of expenditures made after December 31, 1965, under a State plan approved under title I, IV, X, XIV, or XVI of the Social Security Act.[42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381). protective payments Sec. 402.
(a)Section 6(a) of the Social Security Act (as amended by section 221 of this Act) is amended by adding at the end thereof *Ante*, p. 356.the following new sentence: “Such term also includes payments which are not included within the meaning of such term under the preceding sentence, but which would be so included except that they are made on behalf of such a needy individual to another individual who (as determined in accordance with standards prescribed by the Secretary) is interested in or concerned with the welfare of such needy individual, but only with respect to a State whose State plan approved under section 2 includes provision for—[42 USC 302](/us/usc/t42/s302). “(1) determination by the State agency that such needy individual has, by reason of his physical or mental condition, such inability to manage funds that making payments to him would be contrary to his welfare and. therefore, it is necessary to provide such assistance through payments described in this sentence; 79 Stat. 416 “(2) making such payments only in cases in which such payments will, under the rules otherwise applicable under the State plan for determining need and the amount of old-age assistance to be paid (and in conjunction with other income and resources), meet all the need of the individuals with respect to whom such payments are made; “(3) undertaking and continuing special efforts to protect the welfare of such individual and to improve, to the extent possible, his capacity for self-care and to manage funds; “(4) periodic review by such State agency of the determination under paragraph
(1)to ascertain whether conditions justifying such determination still exist, with provision for termination of such payments if they do not and for seeking judicial appointment of a guardian or other legal representative, as described in section[72 Stat. 1052](/us/stat/72/1052).[42 USC 1311](/us/usc/t42/s1311). 1111, if and when it appears that such action will best serve the interests of such needy individual; and “(5) opportunity for a fair hearing before the State agency on the determination referred to in paragraph
(1)for any individual with respect to whom it is made.”
(b)Section 1605(a) of such Act (as amended by section 221 of *Ante*, p. 358.this Act) is amended by adding at the end thereof (after and below paragraph (2)) the following new sentence: " “Such term also includes payments which are not included within the meaning of such term under the preceding sentence, but which would be so included except that they are made on behalf of such a needy individual to another individual who (as determined in accordance with standards prescribed by the Secretary) is interested in or concerned with the welfare of such needy individual, but only with [76 Stat. 198](/us/stat/76/198).[42 USC 1382](/us/usc/t42/s1382).respect to a State whose State plan approved under section 1602 includes provision for— “(A) determination by the State agency that such needy individual has, by reason of his physical or mental condition, such inability to manage funds that making payments to him would be contrary to his welfare and, therefore, it is necessary to provide such aid through payments described in this sentence; “(B) making such payments only in cases in which such payments will, under the rules otherwise applicable under the State plan for determining need and the amount of aid to the aged, blind, or disabled to be paid (and in conjunction with other income and resources), meet all the need of the individuals with respect to whom such payments are made; “(C) undertaking and continuing special efforts to protect the welfare of such individual and to improve, to the extent possible, his capacity for self-care and to manage funds; “(D) periodic review by such State agency of the determination under clause
(A)to ascertain whether conditions justifying such determination still exist, with provision for termination of such payments if they do not and for seeking judicial appointment of a guardian or other legal representative, as described in section 1111, if and when it appears that such action will best serve the interests of such needy individual; and “(E) opportunity for a fair hearing before the State agency on the determination referred to in clause
(A)for any individual with respect to whom it is made.” "
(c)*Ante*, p. 358. Section 1006 of the Social Security Act (as amended by section 221 of this Act) is amended by adding at the end thereof the following new sentence: “Such term also includes payments which are not in-79 Stat. 417cluded within the meaning of such term under the preceding sentence, but which would be so included except that they are made on behalf of such a needy individual to another individual who (as determined in accordance with standards prescribed by the Secretary) is interested in or concerned with the welfare of such needy individual, but only with respect to a State whose State plan approved under section 1002 [49 Stat. 645](/us/stat/49/645).[42 USC 1202](/us/usc/t42/s1202).includes provision for— “(1) determination by the State agency that such needy individual has, by reason of his physical or mental condition, such inability to manage funds that making payments to him would be contrary to his welfare and, therefore? it is necessary to provide such aid through payments described in this sentence; “(2) making such payments only in cases in which such payments will, under the rules otherwise applicable under the State plan for determining need and the amount of aid to the blind to be paid (and in conjunction with other income and resources), meet all the need of the individuals with respect to whom such payments are made; “(3) undertaking and continuing special efforts to protect the welfare of such individual and to improve, to the extent possible, his capacity for self-care and to manage funds; “(4) periodic review by such State agency of the determination under paragraph
(1)to ascertain whether conditions justifying such determination still exist, with provision for termination of such payments if they do not and for seeking judicial appointment of a guardian or other legal representative, as described in section 1111, if and when it appears that such action [72 Stat. 1052](/us/stat/72/1052).[42 USC 1311](/us/usc/t42/s1311).will best serve the interests of such needy individual; and “(5) opportunity for a fair hearing before the State agency on the determination referred to in paragraph
(1)for any individual with respect, to whom it is made.”
(d)Section 1405 of the Social Security Act (as amended by section 221 of this Act) is amended by adding at the end thereof the following *Ante*, p. 358.new sentence: “Such term also includes payments which are not included within the meaning of such term under the preceding sentence, but which would be so included except that they are made on behalf of such a needy individual to another individual who (as determined in accordance with standards prescribed by the Secretary) is interested in or concerned with the welfare of such needy individual, but only with respect to a State whose State plan approved under section 1402 includes provision for—[64 Stat. 555](/us/stat/64/555).[42 USC 1352](/us/usc/t42/s1352). “(1) determination by the State agency that such needy individual has, by reason of his physical or mental condition, such inability to manage funds that making payments to him would be contrary to his welfare and, therefore, it is necessary to provide such aid through payments described in this sentence; “(2) making such payments only in cases in which such payments will, under the rules otherwise applicable under the State plan for determining need and the amount of aid to the permanently and totally disabled to be paid (and in conjunction with other income and resources), meet all the need of the individuals with respect to whom such payments are made: “(3) undertaking and continuing special efforts to protect the welfare of such individual and to improve, to the extent possible, his capacity for self-care and to manage funds; “(4) periodic review by such State agency of the determination underparagraph
(1)to ascertain whether conditions justifying 79 Stat. 418such determination still exist, with provision for termination of such payments if they do not and for seeking judicial appointment of a guardian or other legal representative, as described in section [72 Stat. 1052](/us/stat/72/1052).[42 USC 1311](/us/usc/t42/s1311).1111, if and when it appears that such action will best serve the interests of such needy individual; and “(5) opportunity for a fair hearing before the State agency on the determination referred to in paragraph
(1)for any individual with respect to whom it is made.”
(e)The amendments made by this section shall apply in the case of expenditures made after December 31, 1965, under a State plan [42 USC 301, 1201, 1351, 1381](/us/usc/t42/s301/1201/1351/1381).approved under title I, X, XIV, or XVI of the Social Security Act. disregarding certain earnings in determining need under assistance programs for the aged, blind, and disabled Sec. 403. [74 Stat. 988](/us/stat/74/988).[42 USC 302](/us/usc/t42/s302).
(a)Effective October 1, 1965, section 2(a)(10)(A) of the Social Security Act is amended by striking out “; except that, in making such determination, of the first $50 per month of earned income the State agency may disregard, after December 31, 1962, not more than the first $10 thereof plus one-half of the remainder” and inserting in lieu thereof the following: “; except that, in making such determination,
(i)the State agency may disregard not more than $5 per month of any income and
(h)of the first $80 per month of additional income which is earned the State agency may disregard not more than the first $20 thereof plus one-half of the remainder”.
(b)*Post*, p. 423. Effective October 1, 1965, section 402(a)(7) of the Social Security Act (as amended by section 410 of this Act) is further amended by inserting before the semicolon at the end thereof the following: “, and
(C)the State agency may, before disregarding the amounts referred to in clauses
(A)and (B), disregard not more than $5 of any income”.
(c)[78 Stat. 1078](/us/stat/78/1078).[42 USC 1202](/us/usc/t42/s1202). Effective October 1, 1965, section 1002(a)(8) of the Social Security Act is amended by inserting before the semicolon at the end thereof the following: “, and
(C)may, before disregarding the amounts referred to in clauses
(A)and (B), disregard not more than $5 of any income”.
(d)[64 Stat. 555](/us/stat/64/555).[42 USC 1352](/us/usc/t42/s1352). Effective October 1, 1965, section 1402(a)(8) of such Act is amended by inserting after the semicolon at the end thereof the following: “except that, in making such determination,
(A)the State agency may disregard not more than $5 of any income,
(B)of the first $80 per month of additional income which is earned the State agency may disregard not more than the first $20 thereof plus one-half of the remainder, and
(C)the State agency may, for a period not in excess of 36 months, disregard such additional amounts of other income and resources, in the case of an individual who has a plan for achieving self-support approved by the State agency, as may be necessary for the fulfillment of such plan, but only with respect to the part or parts of such period during substantially all of which he is actually undergoing vocational rehabilitation;”.
(e)[78 Stat. 1078](/us/stat/78/1078).[42 USC 1382](/us/usc/t42/s1382). Effective October 1, 1965, section 1602(a)(14) of such Act is amended to read as follows: " “(14) provide that the State agency shall, in determining need for aid to the aged, blind, or disabled, take into consideration any other income and resources of an individual claiming such aid, as well as any expenses reasonably attributable to the earning of any such income; except that, in making such determination with respect to any individual— 79 Stat. 419 “(A) if such individual is blind, the State agency
(i)shall disregard the first $85 per month of earned income plus one-half of earned income in excess of $85 per month, and
(ii)shall, for a period not in excess of 12 months, and may, for a period not in excess of 36 months, disregard such additional amounts of other income and resources, in the case of any such individual who has a plan for achieving self-support approved by the State agency, as may be necessary for the fulfillment of such plan, “(B) if such individual is not blind but is permanently and totally disabled,
(i)of the first $80 per month of earned income, the State agency may disregard not more than the first $20 thereof plus one-hair of the remainder, and
(ii)the State agency may, for a period not in excess of 36 months, disregard such additional amounts of other income and resources, in the case of any such individual who has a plan for achieving self-support approved by the State agency, as may be necessary for the fulfillment of such plan, but only with respect to the part or parts of such period during substantially ail of which he is actually undergoing vocational rehabilitation, “(C) if such individual has attained age 65 and is neither blind nor permanently and totally disabled, of the first $80 per month of earned income the State agency may disregard not more than the first $20 thereof plus one-half of the remainder, and “(D) the State agency may, before disregarding the amounts referred to above in this paragraph (14), disregard not more than $5 of any income; and”. " administrative and judicial review of public assistance determinations Sec. 404.
(a)Title XI of the Social Security Act is amended by [42 USC 1301](/us/usc/t42/s1301).adding at the end thereof the following new section: " “administrative and judicial review of certain administrative determinations “Sec. 1116.
(1)Whenever a State plan is submitted to the Secretary by a State for approval under title I, IV, X, XIV, XVI, or XIX, he shall, not later than 90 days after the date the plan is submitted [42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381).*Ante*, p. 343.to him, make a determination as to whether it conforms to the requirements for approval under such title. The 90-day period provided herein may be extended by written agreement of the Secretary and the affected State. “(2) Any State dissatisfied with a determination of the Secretary under paragraph
(1)with respect to any plan may, within 60 days after it has been notified of such determination, file a petition with the Secretary for reconsideration of the issue of whether such plan conforms to the requirements for approval under such title. Within 30 days after receipt of such a petition, the Secretary shall notify the State of the time and place at which a hearing will be held for the purpose of reconsidering such issue. Such hearing shall be held not less than 20 days nor more than 60 days after the date notice of such hearing is furnished to such State, unless the Secretary and such 79 Stat. 420State agree in writing to holding the hearing at another time. The Secretary shall affirm, modify, or reverse his original determination within 60 days of the conclusion of the hearing. “(3) Any State Which is dissatisfied with a final determination made by the Secretary on such a reconsideration or a final determination of the Secretary under section 4, 404, 1004, 1404, 1604j or 1904 may, within 60 days after it has been notified of such determination, file with the United States court of appeals for the circuit in which such State is located a petition for review of such determination. A copy of the petition shall be forthwith transmitted by the clerk of the court to the Secretary. The Secretary thereupon shall file in the court the record of the proceedings on which he based his determination as provided in section 2112 of title 28, United States Code. “(4) [72 Stat. 941](/us/stat/72/941). The findings of fact by the Secretary, if supported by substantial evidence, shall be conclusive; but the court, for good cause shown, may remand the case to the Secretary to take further evidence, and the Secretary may thereupon make new or modified findings of fact and may modify his previous action, and shall certify to the court the transcript and record of the further proceedings. Such new or modified findings of fact shall likewise be conclusive if supported by substantial evidence. “(5) The court shall have jurisdiction to affirm the action of the Secretary or to set it aside, in whole or in part. The judgment of the court shall be subject to review by the Supreme Court of the United States upon certiorari or certification as provided in section 1254 of [62 Stat. 928](/us/stat/62/928).title 28, United States Code. “(b) [42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381).*Ante*, p. 343. For the purposes of subsection (a), any amendment of a State plan approved under title I, IV, X, XIV, XVI, or XIX may, at the option of the State, be treated as the submission of a new State plan. “(c) Action pursuant to an initial determination of the Secretary described in subsection
(a)shall not be stayed pending reconsideration, but in the event that the Secretary subsequently determines that his initial determination was incorrect he shall certify restitution forthwith in a lump sum of any funds incorrectly withheld or otherwise denied. “(d) Whenever the Secretary determines that any item or class of items on account of which Federal financial participation is claimed under title I, IV, X, XIV, XVI, or XIX shall be disallowed for such participation, the State shall be entitled to and upon request shall receive a reconsideration of the disallowance.” "
(b)The amendment made by subsection
(a)shall apply only with respect to determinations made after December 31, 1965. maintenance of state public assistance expenditures Sec. 405. [42 USC 1301](/us/usc/t42/s1301). Title XI of the Social Security Act is amended by adding at the end thereof (after the new section 1116 added by section 404 of *Ante*, p. 419.this Act) the following new section: " “maintenance of state effort “Sec. 1117.
(a)The total of the amounts determined under sections 3, 403, 1003, 1403, 1603, and 1903 for any State for any quarter beginning after December 31, 1965, and ending before July 1, 1969, shall be reduced to the extent that.— “(1) the excess of
(A)the total of the amounts determined for the State under sections 3, 403, 1003, 1403, 1603, and 1903 for such quarter over
(B)the total of the amounts determined for 79 Stat. 421the State under sections 3, 403, 1003, 1403, and 1603 for the same quarter of the fiscal year ending June 30, 1965, is greater than “(2) the excess of
(A)the total of the expenditures for such quarter (for which the determination is being made) under the plans of the State approved under titles I, IV, X, XIV, XVI, and XIX over
(B)the total of the expenditures under the State [42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381).*Ante*, p. 343.plans of the State approved under titles I, IV, X, XIV, and XVI for the same quarter of the fiscal year ending June 30, 1965; except that, at the option of the State, any of the following may be substituted (with respect to the quarters of any fiscal year) for the amount determined as provided in paragraph (1)(B)— “(3) the total of the amounts determined for the Stale under sections 3, 403, 1003, 1403, and 1603 for the same quarter in the fiscal year ending June 30, 1964; or “(4) the average of the totals determined for the State under sections 3, 403, 1003, 1403, and 1603 for each quarter in the fiscal year ending June 30, 1964, or June 30, 1965. If the substitution of the total referred to in paragraph
(3)is chosen by the State, there shall be substituted for the amount determined under clause
(B)of paragraph
(2)the total of the expenditures under the plans of the State approved under titles I, IV, X, XIV, and XVI for the quarter referred to in such paragraph (3). If the substitution of the average for either of the years referred to in paragraph
(4)is chosen by the State, there shall be substituted for the amount determined under clause
(B)of paragraph
(2)the average of the total expenditures under the plans of the State approved under titles I, IV, X, XIV, and XVI for each quarter in the same fiscal year. “(b) For purposes of this section, expenditures under the plans of any State approved under titles I, IV, X, XIV, XVI, and XIX and the reduction determined with respect thereto under this section, shall be determined on the basis of data furnished by the State in the quarterly reports submitted by the State to the Secretary pursuant to and in accordance with the requirements of the Secretary under title I, IV, X, XIV, XVI, or XIX; and determinations so made shall be conclusive for purposes of this section. “(c) If a reduction is required under the preceding provisions of this section in the total of the amounts determined for a State under sections 3, 403, 1003, 1403, 1603, and 1903 for any quarter, the Secretary shall determine which of such amounts shall be reduced and the extent thereof in such manner as in his judgment will best carry out the purpose of maintaining State effort under the Federal-State public assistance programs of the State, and with the total of such reductions to be equal to the reduction required under subsections
(a)and
(b)of this section.” " disregarding oasdi benefit increase, and child’s insurance benefit payments beyond age 18, to the extent attributable to retroactive effective date Sec. 406. Notwithstanding the provisions of sections 2(a)(10) and (H)(1)), 402(a)(7), 1002(a)(8), 1402(a)(8), and 1602(a)(13) and
(14)of the Social Security Act, a State may disregard, in determining [74 Stat. 988](/us/stat/74/988); *Post*, p. 423; [78 Stat. 1078](/us/stat/78/1078); [71 Stat. 523](/us/stat/71/523); [76 Stat. 199](/us/stat/76/199).[42 USC 401](/us/usc/t42/s401).need for aid or assistance under a State plan approved under title I, IV, X, XIV, or XVI of such Act, any amount paid to any individual under title II of such Act (or under the Railroad Retirement 79 Stat. 422*Ante*, p. 400.Act of 1937 by reason of section 326(a) of this Act), for any one or more months which occur after December 1964 and before the third month following the month in which this Act is enacted, to the extent that such payment is attributable—
(1)to the increase in monthly insurance benefits under the old-age, survivors, and disability insurance system resulting from the *Ante*, p. 361.enactment of section 301 of this Act, or
(2)to the payment of child’s insurance benefits under such system after attainment of age 18, in the case of individuals attending *Ante*, p. 370.school, resulting from the enactment of section 306 of this Act. extension of grace period for disregarding certain income for states where legislature has not met in regular session Sec. 407. [78 Stat. 534](/us/stat/78/534).[42 USC 2981](/us/usc/t42/s2981).[42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381).*Ante*, p. 343. Notwithstanding the provisions of section 701 of the Economic Opportunity Act of 1964, no funds to which a State is otherwise entitled under title I, IV, X, XIV, XVI, or XIX of the Social Security Act for any period before the first month beginning after the adjournment of a State’s first regular legislative session which adjourns after August 20, 1964 (the date of enactment of the Economic Opportunity Act of 1964), shall be withheld by reason of any action taken pursuant to a State statute which prevents such State from complying with the requirements of subsection
(a)of such section 701. technical amendments relating to public assistance programs Sec. 408. [76 Stat. 206](/us/stat/76/206).[42 USC 1308](/us/usc/t42/s1308).[42 USC 303](/us/usc/t42/s303).[42 USC 1383](/us/usc/t42/s1383).
(a)Section 1108 of the Social Security Act is amended—
(1)by striking out “$9,800,000, of which $625,000 may be used only for payments certified with respect to section 3(a)(2)(B) or 1603(a)(2)(B)” and inserting in lieu thereof “$9,800,000”;
(2)by striking out “$330,000, of which $18,750 may be used only for payments certified with respect to section 3(a)(2)(B) or 1603(a)(2)(B)” and inserting in lieu thereof “$330,000”; and
(3)by striking out “$450,000, of which $25,000 may be used only for payments certified with respect to section 3(a)(2)(B) or 1603(a)(2)(B)” and inserting in lieu thereof “$450,000”.
(b)The amendments made by subsection
(a)shall be effective in the case of Puerto Rico, the Virgin Islands, or Guam with respect to fiscal years beginning on or after the date on which its plan under *Ante*, p. 343.[74 Stat. 995](/us/stat/74/995).[42 USC 1312](/us/usc/t42/s1312).title XIX of the Social Security Act is approved.
(1)Section 1112 of such Act is amended by striking out “for the aged”.
(2)The heading of section 1112 of such Act is amended by striking out “for the aged”. eligibility of children over age 18 attending school Sec. 409. [78 Stat. 1042](/us/stat/78/1042).[42 USC 606](/us/usc/t42/s606). Clause (2)(B) of section 406(a) of the Social Security Act is amended by striking out “(as determined in accordance with standards prescribed by the Secretary) a student regularly attending a high school in pursuance of a course of study leading to a high school diploma or its equivalent,” and inserting in lieu thereof “(as determined by the State in accordance with standards prescribed by the Secretary) a student regularly attending a school, college, or university,”. 79 Stat. 423 disregarding certain earnings in determining need of certain dependent children Sec. 410. Effective July 1, 1965, so much of clause
(7)of section 402(a) of the Social Security Act as follows the first semicolon is[76 Stat. 188](/us/stat/76/188); *Ante*, p. 418.[42 USC 602](/us/usc/t42/s602). amended by inserting after “except that, in making such determination,” the following: “(A) the State agency may disregard not. more than $50 per month of earned income of each dependent child under the age of 18 but not in excess of $150 per month of earned income of such dependent children in the same home, (B)”. federal share of public assistance expenditures Sec. 411. Title XI of the Social Security Act is amended by adding [42 USC 1301](/us/usc/t42/s1301).at the end thereof (after section 1117, added by section 405 of this Act), the following new section:*Ante*, p. 420. " “alternative federal payment with respect to public assistance expenditures “Sec. 1118. In the case of any State which has in effect a plan approved under title XIX for any calendar quarter, the total of the*Ante*, p. 343. payments to which such State is entitled for such quarter, and for each succeeding quarter in the same fiscal year (which for purposes of this section means the 4 calendar quarters ending with June 30), under paragraphs
(1)and
(2)of sections 3(a), 403(a), 1003(a), 1403(a), and 1603(a) shall, at the option of the State, be determined by application of the Federal medical assistance percentage (as defined in section 1905), instead of the percentages provided under each *Ante*, p. 351.such section, to the expenditures under its State plans approved under titles I, IV, X, XIV, and XVI, which would be included in determining [42 USC 301, 601, 1201, 1351, 1381](/us/usc/t42/s301/601/1201/1351/1381).the amounts of the Federal payments to which such State is entitled under such sections, but without regard to any maximum on the dollar amounts per recipient which may be counted under such sections.” " Approved July 30, 1965, 5:19 p.m. Public Law 89–98: To amend the Revised Organic Act of the Virgin Islands to provide for the payment of legislative salaries and expenses by the government of the Virgin Islands. Public Law 98 Public Law 89–98 79 Stat. 423 1965-07-30 United States Government Publishing Office text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Digitization Vendor 2025-11-05 89 1 public Public Law 89–98 AN ACT To amend the Revised Organic Act of the Virgin Islands to provide for the payment of legislative salaries and expenses by the government of the Virgin Islands. July 30, 1965[[H. R. 8721](/us/bill/89/hr/8721)] *Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled*, That subsection (e)Virgin Islands.Legislators, salaries and expenses. of section 6 of the Revised Organic Act of the Virgin Islands (68 Stat. 497, 499), as amended (73 Stat. 568; 48 U.S.C. 1572(e)), is further amended to read as follows: " “(e) Each member of the legislature shall be paid such compensation and shall receive such additional allowances or benefits as may be fixed under the laws of the Virgin Islands. Such compensation, allowances, or benefits, together with all other legislative expenses, shall be appropriated by, and paid out of funds of, the government of the Virgin Islands.” " Approved July 30, 1965. Public Law 89–99: To exempt oceanographic research vessels from tile application of certain vessel inspection laws, and for other purposes. Public Law 99 Public Law 89–99 79 Stat. 424 1965-07-30 United States Government Publishing Office text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Digitization Vendor 2025-11-05 89 1 public
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  • Pub. L. 89-97
  • 79 Stat. 287
  • 79 Stat. 288
  • 79 Stat. 289
  • 79 Stat. 290
  • 53 Stat. 1362
  • 42 USC 401–425
  • 79 Stat. 292
  • 79 Stat. 294
  • 79 Stat. 295
  • 79 Stat. 296
  • 79 Stat. 297
  • 79 Stat. 298
  • 79 Stat. 299
  • 79 Stat. 300
  • 79 Stat. 301
  • 79 Stat. 302
  • 79 Stat. 304
  • 79 Stat. 306
  • 53 Stat. 1363
  • 70 Stat. 819
  • 45 USC 228o
  • 70 Stat. 743
  • 5 USC 2251
  • 79 Stat. 308
  • 79 Stat. 313
  • 79 Stat. 314
  • 79 Stat. 315
  • 79 Stat. 316
  • 79 Stat. 317
  • 79 Stat. 318
  • 79 Stat. 320
  • 64 Stat. 559
  • 79 Stat. 322
  • 79 Stat. 324
  • 74 Stat. 937
  • 79 Stat. 325
  • 5 USC 73b–2
  • 75 Stat. 339
  • 79 Stat. 331
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Stat.Public Law 553
U.S.C.§ 774
U.S.C.§ 401
U.S.C.§ 5
U.S.C.§ 301
Pub. L.Pub. L. 89-97
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