A bill to amend title XVIII of the Social Security Act to expand the definition of homebound for purposes of receiving home health services under the Medicare program to allow Medicare beneficiaries to attend adult day care programs for treatment of Alzhe

4 Pages·2000·0.17 MB·English

by  United States. Congress. House

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106thcongress H. R. 4028
2dSession
To amend title XVIUofthe Social SecurityAct to ex})and the definition
of homebound for purposes of receiAing home health serxices under
the medicare pro-am to allow medicare beneficiaries to attend adult
daycareprogramsfortreatmentofAlzheimer'sdiseaseandothercondi-
tions.
IN THE HOUSE OF REPRESENTATIVES
March16,2000
Mr.SmithofNewJersey(forhimselfandMr.Maricey)introducedthefol-
lowingbill;whichwasreferredtotheCommitteeonWaysand Means,
andinadditiontotheCommitteeonCommeree,foraperiodtobesubse-
quentlydeterminedbytheSpeaker,ineacheaseforconsiderationofsuch
provisionsasfallwithinthejurisdictionofthecommitteeconcerned
•IV
A
BILL
To amend title XVIII of the Social Security Act to expand
the definition of homebound for purposes of receiving
home health services under the medicare program to
allow medicare beneficiaries to attend adult day care
programsfortreatmentofAlzheimer's disease and other
conditions.
1 BeitenactedhytheSenateandHouseofRepresenta-
2 tivesoftheUnitedStatesofAmericainCongressassembled,
4
2
1 SECTION1.SHORTTITLE.
2 This Act maybe cited as the "Alzheimer's Disease
3 Medicare Home Health Care Benefit ClarificationAct of f
4 2000".
5 SEC.^.FINDINGS.
—
6 (a)Findings. Confessfindsthefollowing:
7 (1) Homehealth services are a\italcomponent
8 of the benefits that are furnished to beneficiaries
9 underthemedicareprogramundertitleXVIIIofthe
10 SocialSecurityAct.
11 (2) Home health sendees under the medicare
12 program enable homebound individuals who are at
13 greatriskforcostlyinstitutionalized care to stayin
14 theirownhomesandcommunities.
15 (3) Existingmedicare regulations andpractices
16 inadvertentlypenalizemedicarebeneficiaries (includ-
17 ingthosewithAlzheimer'sdisease, arelateddemen-
18 tia, or both) who participate in an adult day care
19 program. Under those regulations, if a medicare
20 beneficiaryattendsaprivatelyfundedadultdaycare
21 program as part oftheirAlzheimer's treatment re-
22 gime, including an Alzheimer's treatment regime,
23 they may lose ehgibility for the medicare home
24 healthbenefitbecausetheabsencesoftheindividual »
25 fromhomearenotinfrequentandshortduration.
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1 (4) Adultdaycare programs can be avaluable
2 and medically beneficial part ofa treatment regime
3 for a person \y\th Alzheimer's disease or a related
4 dementia. These programs can pro\ide structured
5 acti\ities and health monitoring to maintain func-
6 tion, manage behavioral symptoms, and prevent
7 healthcarecrisesandprematureinstitutionalization.
8 (5) The Health Care FinancingAdministration
9 anditsvariousmedicarecontractorsandfiscalinter-
10 mediarieshavemisinterpretedtheintentofCongress
11 with respect to eligibility for home health services.
12 Participation by medicare beneficiaries in privately
13 funded adult day care programs is not intended to
14 precludeeligiblityforhomehealth servicesforthose
15 medicare beneficiaries under the medicare program.
16 SEC. 3. CLARIFICATION OF THE DEFINITION OF HOME-
17 BOUND.
—
18 (a) In General. The last sentence of sections
19 1814(a)and1835(a)oftheSocialSecurityAct(42U.S.C.
20 1395f(a); 1395n(a))areeachamendedbystrikingthepe-
21 riodandinserting"includingparticipatinginanadultday
22 careprogramlicensedbyaStatetofurnishadultdaycare
23 servicesintheState,forthepurposeoftherapeutictreat-
24 mentforAlzheimer'sdiseaseorarelateddementia,orfor
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4 3 flDTS DOOICi5llEIIItIIIillfl
1 medical treatment furnished in an adult day care pro-
2 ^am.".
—
3 (b) Effective Date. The amendments made by
4 subsection (a) shall applyto items and services provided
5 onorafterthedateofenactmentofthisAct.
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