MISCELLANEOUS MEDICAID TECHNICAL AMENDMENTS.

SEC. 6411. MISCELLANEOUS MEDICAID TECHNICAL AMENDMENTS. (a) Technical Correction to Medicare Buy-in for the Elderly.— (1) Clarification with respect to “section 209 (b)” states.—The first sentence of section 1902(f) of the Social Security Act (42 U.S.C. 1396a(f)) is amended by inserting “and except with respect to qualified medicare beneficiaries, qualified severely impaired individuals, and individuals described in subsection (m)(1)” before “, no State”. (2) Effective date.—The amendment made by paragraph (1) shall apply as if it had been included in the enactment of the Medicare Catastrophic Coverage Act of 1988. (b) Extension of Delay in Issuance of Certain Final Regulations.—Section 8431 of the Technical and Miscellaneous Revenue Act of 1988 is amended by striking “May 1, 1989” and inserting “December 31, 1990”. (c) Disproportionate Share Hospitals.— (1) Special rule for new jersey uncompensated care trust fund.—Section 1923(e)(1) of the Social Security Act (42 U.S.C. 1396r–4(e)(1)) is amended— (A) by inserting “(A)(i)” after “without regard to the requirement of subsection (a) if”, and (B) by striking “and if” and inserting “or (ii) the plan as of January 1, 1987, provided for payment adjustments based on a statewide pooling arrangement involving all acute care hospitals and the arrangement provides for reimbursement of the total amount of uncompensated care provided by each participating hospital, and (B)”. (2) Conforming amendment.—Section 1915(b)(4) of such Act (42 U.S.C. 1396n(b)(4)) is amended by inserting “shall be consistent with the requirements of section 1923 and” after “which standards”. (3) Transition rule.—The State of Missouri shall be treated as having met the requirement of section 1902(a)(13)(A) of the Social Security Act (insofar as it requires payments to hospitals to take into account the situation of hospitals that serve, a disproportionate number of low-income patients with special needs) for the period beginning with July 1, 1988, and ending with (and including) June 30, 1990, if the total amount of such payments for such period is not less than the total of such payments otherwise required by law for such period. (4) Effective date.—The amendment made by paragraph (2) shall be effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1987, (d) Fraud and Abuse Technical Amendments.— (1) Treatment of loss of right to renew license.—Section 1128(b)(4)(A) of the Social Security Act (42 U.S.C. 1396a–7(b)(4)(A)) is amended by inserting “or the right to apply for or renew such a license” after “lost such a license”. 103 STAT. 2271 (2) Clarification with respect to emergency treatment.—Sections 1862(e)(1) and 1903(i)(2) of such Act (42 U.S.C. 1395y(e)(1), 1396b(i)(2)) are each amended by inserting “, not including items or services furnished in an emergency room of a hospital” after “emergency item or service”. (3) Clarification of exclusion with respect to employment by health maintenance organizations.—(A) Section 1876(i)(6)(A) of the Social Security Act (42 U.S.C. 1395mm(i)(6)(A)) is amended— (i) by striking “or” at the end of clause (v), (ii) by adding “or” at the end of clause (vi), and (iii) by inserting after clause (vi) the following new clause: “(vii) in the case of a risk-sharing contract, employs or contracts with any individual or entity that is excluded from participation under this title under section 1128 or 1128A for the provision of health care, utilization review, medical social work, or administrative services or employs or contracts with any entity for the provision (directly or indirectly) through such an excluded individual or entity of such services;”. (B) Section 1902(p)(2) of such Act (42 U.S.C. 1396a(p)(2)) is amended— (i) by striking “or” at the end of subparagraph (A), (ii) by striking the period at the end of subparagraph (B) and inserting “, or”, and (iii) by adding at the end the following new subparagraph: “(C) employs or contracts with any individual or entity that is excluded from participation under this title under section 1128 or 1128A for the provision of health care, utilization review, medical social work, or administrative services or employs or contracts with any entity for the provision (directly or indirectly) through such an excluded individual or entity of such services.”. (4) Effective dates.—The amendments made by paragraphs (1) and (2) shall take effect on the date of the enactment of this Act. (B) The amendments made by paragraph (3) shall apply to employment and contracts as of 90 days after the date of the enactment of this Act. (e) Spousal Impoverishment.— (1) Equal treatment of transfers by community spouse before institutionalization.—Section 1917(c) of the Social Security Act (42 U.S.C. 1396p(c)) is amended— (A) in paragraph (1), by inserting “or whose spouse,” after “an institutionalized individual (as defined in paragraph (3)) who,”, and (B) in paragraph (2)(B)— (i) by amending clause (i) to read as follows: “(i) to or from (or to another for the sole benefit of) the individual’s spouse, or”, and (ii) by striking “, or (iii)” and all that follows through “fair market value”. (2) Clarifying application to “section 209(b)” states.—Section 1902(0 of such Act (42 U.S.C. 1396a(f)) is amended by inserting “and section 1924” after “1619(b)(3)”. (3) Clarification of application of income rules to redeterminations—Subsections (b)(2) and (d)(1) of section 1924 103 STAT. 2272of such Act (42 U.S.C. 1396r–5) are amended by inserting “or redetermined” after “determined”. (4) Effective dates.— (A) Spousal transfers.—The amendments made by paragraph (1) shall apply to transfers occurring after the date of the enactment of this Act. (B) Other amendments.—Except as provided in subparagraph (A), the amendments made by this subsection shall apply as if included in the enactment of section 303 of the Medicare Catastrophic Coverage Act of 1988. (f) Extension of Waiver for Health Insuring Organization.—The Secretary of Health and Human Services shall continue to waive, through June 30, 1992, the application of section 1903(m)(2)(A)(ii) of the Social Security Act to the Tennessee Primary Care Network, Inc., under the same terms and conditions as applied to such waiver as of July 1, 1989. (g) Day Habilitation and Related Services.— (1) Prohibition of disallowance pending issuance of regulations.—Except as specifically permitted under paragraph (3), the Secretary of Health and Human Services may not— (A) withhold, suspend, disallow, or deny Federal financial participation under section 1903(a) of the Social Security Act for day habilitation and related services under paragraph (9) or (13) of section 1905(a) of such Act on behalf of persons with mental retardation or with related conditions pursuant to a provision of its State plan as approved on or before June 30, 1989, or (B) withdraw Federal approval of any such State plan provision. (2) Requirements for regulation.—A final regulation described in this paragraph is a regulation, promulgated after a notice of proposed rule-making and a period of at least 60 days for public comment, that— (A) specifies the types of day habilitation and related services that a State may cover under paragraph (9) or (13) of section 1905(a) of the Social Security Act on behalf of persons with mental retardation or with related conditions, and (B) any requirements respecting such coverage. (3) Prospective application of regulation.—If the Secretary promulgates a final regulation described in paragraph (2) and the Secretary determines that a State plan under title XIX of the Social Security Act does not comply with such regulation, the Secretary shall notify the State of the determination and its basis, and such determination shall not apply to day habilitation and related services furnished before the first day of the first calendar quarter beginning after the date of the notice to the State. (h) Moratorium on Issuance of Final Regulation on Medically Needy Income Levels for Certain 1-Member Families.—The Secretary of Health and Human Services may not issue in final form, before December 31, 1990, any regulation implementing the proposed regulation published on September 26, 1989 (54 Federal Register 39421) insofar as such regulation changes the method for establishing the medically needy income level for single individuals in any State (including the proposed change to section 435.1007(a)(1) of title 42, Code of Federal Regulations). 103 STAT. 2273 (i) Technical Corrections Concerning Transitional Coverage.— (1) Clarification of termination when no child in household.—Subsections (a)(3)(A) and (b)(3)(A)(i) of section 1925 of the Social Security Act (42 U.S.C. 1396r–6) are each amended by striking “who is” and inserting “, whether or not the child is”. (2) Effective date for termination of current 9-month extension.—Section 303(f)(2)(A) of the Family Support Act of 1988 is amended by inserting before the period at the end the following: “, but such amendment shall not apply with respect to families that cease to be eligible for aid under part A of title IV of the Social Security Act before such date”. (3) Correction of references.—Subsections (a)(3)(C) and (b)(3)(C)(i) of section 1925 of the Social Security Act (42 U.S.C. 1396r–6) are each amended by striking “or (v) of section 1905(a)” and inserting “of section 1905(a) or clause (i)(IV), (i)(VI), or (ii)(IX) of section 1902(a)(10)(A)”. (4) Effective date.—The amendments made by this subsection shall be effective as if included in the enactment of the Family Support Act of 1988. (j) Minnesota Prepaid Medicaid Demonstration Project Extension.—Section 507 of the Family Support Act of 1988 is amended by striking “1990” and inserting “1991”.