TECHNICAL AND MISCELLANEOUS AMENDMENTS.

SEC. 4118. TECHNICAL AND MISCELLANEOUS AMENDMENTS. (a) Section 2176 Waiver Technicals.— (1) Section 1915(c)(3) of the Social Security Act (42 U.S.C. 1396n(c)(3)) is amended by striking “and section 1902(a)(10)(B) (relating to comparability)” and inserting “, section 1902(a)(10)(B) (relating to comparability), and section101 STAT. 1330–155 1902(a)(10)(C)(i)(III) (relating to income and resource rules applicable in the community)”. (2) The amendment made by paragraph (1) shall be effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1986. (b) Increase in Number of Individuals Who May 5454Copy read “who may”. be Served Under Model Home and Community-Based Services Waivers.— Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)) is amended by adding at the end the following new paragraph: “(10) No waiver under this subsection shall limit by an amount less than 200 the number of individuals in the State who may receive home and community-based services under such waiver.”. (c) Katie Beckett Technical.— (1) Section 1902(e)(3)(C) of such Act (42 U.S.C. 1396a(e)(3)(C)) is amended by striking “to have a supplemental security income (or State supplemental) payment made with respect to him under title XVI” and inserting “for medical assistance under the State plan under this title”. (2) The amendment made by paragraph (1) shall be effective as if it were included in section 134 of the Tax Equity and Fiscal Responsibility Act of 1982. (d) Organ Transplant Technical.— (1) Section 1903(i) of the Social Security Act (42 U.S.C. 1396b(i)) is amended— (A) in paragraph (1), by striking the period at the end and inserting “; or”, and (B) by adding at the end the following new sentence: “Nothing in paragraph (1) shall be construed as permitting a State to provide services under its plan under this title that are not reasonable in amount, duration, and scope to achieve their purpose.”. (2) The amendments made by paragraph (1) shall be effective as if included in the enactment of section 9507 of the Consolidated Omnibus Budget Reconciliation Act of 1985. (e) Civil Money Penalty and Exclusion Clarifications.— (1) Section 1128A(a)(1) of the Social Security Act (42 U.S.C. 1320a–7(a)(1)), as amended by section 3(a)(1) of the Medicare and Medicaid Patient and Program Protection Act of 1987 (Public Law 100–93), is amended by striking “or has reason to know” each place it appears and inserting “or should know”. (2) Section 1128(d)(3)(B) of the such Act (42 U.S.C. 1320a–6(d)(3)(B)), as amended by section 2 of the Medicare and Medicaid Patient and Program Protection Act of 1987 (Public Law 100–93), is amended— (A) by inserting “(i)” after “(B)”, and (B) by adding at the end the following new clause: “(ii) A State health care program may provide for a period of exclusion which is longer than the period of exclusion under a program under title XVIII.”. (3) The amendment made by paragraph (1) shall apply to activities occurring before, on, or after the date of the enactment of this Act. (f) Incorporation of Certain Provisions Relating to Indian Health Service Facilities.— 101 STAT. 1330–156 (1) Section 1911 of the Social Security Act (42 U.S.C. 1396j), as amended by section 4111(g)(8) of this title, is amended— (A) by striking “or nursing facility” each place it appears and inserting “, nursing facility, or any other type of facility which provides services of a type otherwise covered under the State plan”; and (B) by adding at the end the following new subsection: “(c) The Secretary is authorized to enter into agreements with the State agency for the purpose of reimbursing such agency for health care and services provided in Indian Health Service facilities to Indians who are eligible for medical assistance under the State plan.”. 5555Subparagraph “ “(c)” indented incorrectly. (2) The amendments made by paragraph (1) shall apply to health care services performed on or after the date of the enactment of this Act. (g) Frail Elderly Demonstration Project Waivers.— (1) Section 9412(b)(2) of the Omnibus Budget Reconciliation Act of 1986 is amended— (A) in subparagraph (A), by inserting before the period at the end the following: “, including permitting the organization to assume progressively (over the initial 3-year period of the waiver) the full financial risk”, and (B) in subparagraph (B), by striking “be awarded a grant from the Robert Wood Johnson Foundation” and insert “participate in an organized initiative to replicate the findings of the On Lok long-term care demonstration project (described in section 603(c)(1) of the Social Security Amendments of 1983)”. (2) The amendments made by paragraph (1) shall take effect as though it were included in the Omnibus Budget Reconciliation Act of 1986. (h) Medically Needy Incurred Expenses. (1) Section 1902(a)(17) of the Social Security Act (42 U.S.C. 1396a(a)(17)) is amended by striking “(whether in the form of insurance premiums or otherwise)” and inserting “(whether in the form of insurance premiums or otherwise and regardless of whether such costs are reimbursed under another public program of the State or political subdivision thereof)”. (2) The amendment made by paragraph (1) shall apply to costs incurred after the date of the enactment of this Act. (i) Qualifications for Case Managers for Individuals With Development Disabilities and Chronic Mental Illness.— (1) Section 1915(g)(1) of such Act (42 U.S.C. 1396n(g)(l)) is amended by adding at the end the following new sentence: “The State may limit the case managers available with respect to case management services for eligible individuals with developmental disabilities or with chronic mental illness in order to ensure that the case managers for such individuals are capable of ensuring that such individuals receive needed services.”. (2) The amendment made by paragraph (1) shall take effect as though it were included in the enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985. (j) Habilitation Services Effective Date.— Effective as if included in the enactment of section 9502 of the Consolidated Omni-101 STAT. 1330–157bus Budget Reconciliation Act of 1985, subsection (j)(1) of such section is amended by inserting before the period at the end the following: “to individuals eligible for services under a waiver granted under section 1915(c) of the Social Security Act, without regard to whether such individuals were receiving institutional services before their participation in the waiver”. (k) Section 2176 Waiver for Institutionalized Developmentally Disabled.— Section 1915(c)(7) of the Social Security Act (42 U.S.C. 1396n(c)(7)) is amended by inserting “(A)” after “(7)” and adding at the end the following new subparagraph: “(B) In making estimates under paragraph (2)(D) in the case of a waiver that applies only to individuals with developmental disabilities who are inpatients in a skilled nursing facility or intermediate care facility and whom the State has determined, on the basis of an evaluation under paragraph (2)(B), to need the level of services provided by an intermediate care facility for the mentally retarded, the State may determine the average per capita expenditures that would have been made in a fiscal year for those individuals under the State plan on the basis of the average per capita expenditures under the State plan for services to individuals who are inpatients in an intermediate care facility for the mentally retarded.”. (l) Renewal of Freedom-Of-Choice Waivers.— (1) Section 1915(h) of such Act (42 U.S.C. 1396n(h)) is amended by striking “denies such request in writing within 90 days after the date of its submission to the Secretary.” and inserting “, within 90 days after the date of its submission to the Secretary, either denies such request in writing or informs the State agency in writing with respect to any additional information which is needed in order to make a final determination with respect to the request. After the date the Secretary receives such additional information, the request shall be deemed granted unless the Secretary, within 90 day of such date, denies such request.”. (2) The amendment made by paragraph (1) shall apply to requests for continuation of waivers received after the date of the enactment of this Act. (m) Repeal of Coordinated Audit Requirement.— (1) (A) Section 1129 of such Act (42 U.S.C. 1320a–8) is repealed. (B) Section 1902(a)(42) of such Act (42 U.S.C. 1396a(a)(42)) is amended— (i) by striking “(A)”, and (ii) by striking “, (B)” and all that follows up to the semicolon at the end. (2) The amendments made by paragraph (1) shall apply to audits conducted after the date of the enactment of this Act. (n) Temporary Technical Error Definition.— For purposes of section 1903(u)(1)(E)(ii) of the Social Security Act, effective for the period beginning on the date of enactment of this Act and ending December 31, 1988, a “technical error” 5656Copy read “ ‘technical error’ ”. is an error in eligibility condition (such as assignment of social security numbers and assignment of rights to third-party benefits as a condition of eligibility) that, if corrected, would not result in a difference in the amount of medical assistance paid. 101 STAT. 1330–158 (o) Technical Amendments Relating to New Jersey Respite Care Pilot Project.— (1) Section 9414(b) of the Omnibus Budget Reconciliation Act of 1986 is amended— (A) by redesignating paragraphs (2), (3), and (4), as paragraphs (3), (4), and (5), respectively, (B) by inserting after paragraph (1) the following new paragraph: “(2) provide that the State may submit a detailed proposal describing the project (in lieu of a formal request for the waiver of applicable provisions of title XIX of the Social Security Act) and that submission of such a description by the State will be treated as such a request for purposes of subsection (g),”, and (C) in paragraph (3), as redesignated by 56a56aCopy read “by by”. paragraph (1) of this subsection, by striking “if the project” and all that follows through “Act” the second place it appears and inserting “the State shall utilize a post-eligibility cost-sharing formula based on the available income of participants with income in excess of the nonfarm income official poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981)”. (2) (A) Section 9414(a) of the Omnibus Budget Reconciliation Act of 1986 is amended by striking “elderly and disabled individuals” and inserting “eligible individuals”. (B) Section 941(c) of the Omnibus Budget Reconciliation Act of 1986 is amended to read as follows: “(C) Definitions.— For purposes of this section— “(1) the term ‘eligible individual’ means an individual— “(A) who is elderly or disabled, “(B) (i) whose income (not including the income of the spouse or family of the individual) does not exceed 300 percent of the amount in effect under section 1611(a)(1)(A) of the Social Security Act (as increased pursuant to section 1617 of such Act), or “(ii) in the case of an individual and spouse who are both dependent on a caregiver, whose combined incomes do not exceed such amount, “(C) whose liquid resources (as declared by the individual) do not exceed $40,000, “(D) who is at risk of institutionalization unless the individual’s caregiver is provided with respite care, and “(E) who has been determined to meet the requirements of subparagraphs (A) through (D) in accordance with an application process designed by the State; and “(2) the term ‘respite care services’ shall include— “(A) short-term and intermittent— “(i) companion or sitter services (paid as well as volunteer), “(ii) homemaker and personal care-services, “(iii) adult day care, and “(iv) inpatient care in a hospital, a skilled nursing facility, or an intermediate care facility (not to exceed a total of 14 days for any individual), and “(B) peer support and training for family caregivers (using informal support groups and organized counseling).”. 101 STAT. 1330–159 (3) Section 9414(g) of the Omnibus Budget Reconciliation Act of 1986 is amended by inserting “section 1902(a)(10)(C)(i)(III),” after “section 1902(a)(10)(B),”. (4) The amendments made by this subsection shall be effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1986. (p) Miscellaneous Technical Corrections.— (1) Subclause (IX) of section 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended by moving it 4 ems to the right so as to align its left margin with that of subclause (VIII) of that section. (2) Subclause (X) of section 1902(a)(10)(A)(ii) of such Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended by moving it 2 ems to the right so as to align its left margin with that of subclause (VIII) of that section. (3) Section 1902(a)(17) of such Act (42 U.S.C. 1396a(a)(17)) is amended by striking “subsection (1)(3)” and inserting “subsections (1)(3), (m)(4), and (m)(5)”. (4) Section 1902(a)(30)(C) of such Act (42 U.S.C. 1396(a)(30)(C)) is amended by striking “provide” and inserting “use”. (5) Section 1903(f)(4) of such Act (42 U.S.C. 1396b(f)(4)) is amended by inserting “, 1902(a)(10)(A)(ii)(X), or 1905(p)(1)” after “1902(a)(10)(A)(ii)(IX)”. (6) Paragraph (9) of section 1902(e) of such Act (42 U.S.C. 1396a(e)) is amended by moving the paragraph 2 ems to the left so as to align the left margin of subparagraph (A) (before clause (i)) and subparagraphs (B) and (C) with the left margin of paragraph (8). (7) Section 1902(1)(1) of such Act (42 U.S.C. 1396a(1)(1)) is amended— (A) by striking “(1)(1) Individuals” and inserting “(1)(1) Individuals”, (B) by moving the matter before subparagraph (A) 2 ems to the left so it is indented only once, and (C) by striking “, whose” and inserting “and whose”. (8) Sections 1902(1)(2), 1902(m)(2)(A), 1905(p)(2)(A), and 501(b)(2) of such Act (42 U.S.C. 1396a(1)(2), 1396a(m)(2)(A), 1396d(p)(2)(A), 701(b)(2)) are each amended by striking “nonfarm”. (9) Paragraphs (1) and (2) of section 1925(a), as redesignated by section (4111(a)) of this title, are amended to read as follows: “(1) AFDC.— (A) Section 402(a)(32) of this Act (relating to individuals who are deemed recipients of aid but for whom a payment is not made). “(B) Section 402(a)(37) of this Act (relating to individuals who lose AFDC eligibility due to increased earnings). “(C) Section 406(h) of this Act (relating to individuals who lose AFDC eligibility due to increased collection of child or spousal support). “(D) Section 414(g) of this Act (relating to certain individuals participating in work supplementation programs). “(2) SSI.— (A) Section 1611(e) of this Act (relating to treatment of couples sharing an accommodation in a facility). “(B) Section 1619 of this Act (relating to benefits for individuals who perform substantial gainful activity despite severe medical impairment). “(C) Section 1634(b) of this Act (relating to preservation of benefit status for disabled widows and widowers who lost SSI101 STAT. 1330–160 benefits because of 1983 changes in actuarial reduction formula). “(D) Section 1634(c) of this Act (relating to individuals who lose eligibility for SSI benefits due to entitlement to child’s insurance benefits under section 202(d) of this Act).”. (10) Effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1986, section 9411(a)(2)(B) of such Act is amended by inserting “such” after “need for”.