MEDICAID CERTIFICATIONS AND RECERTIFICATIONS FOR CERTAIN SERVICES.

SEC. 4218. MEDICAID CERTIFICATIONS AND RECERTIFICATIONS FOR CERTAIN SERVICES. (a) In General.— Section 1902(a)(44) of the Social Security Act (42 U.S.C. 1396a(a)(44)) is amended— (1) in subparagraph (A)— (A) by striking “physician certifies” and inserting “physician (or, in the case of skilled nursing facility services or intermediate care facility services, a physician, or a nurse practitioner or clinical nurse specialist who is not an employee of the facility but is working in collaboration with a physician) certifies”, and (B) by striking “the physician, or a physician assistant or nurse practitioner under the supervision of a physician,” and inserting “a physician, a physician assistant under the supervision of a physician, or, in the case of skilled nursing facility services or intermediate care facility services, a physician, or a nurse practitioner or clinical nurse specialist who is not an employee of the facility but is working in collaboration with a physician,”; and (2) in subparagraph (B), by striking “a physician;” and inserting “a physician, or, in the case of skilled nursing facility101 STAT. 1330–221 services or intermediate care facility services, a physician, or a nurse practitioner or clinical nurse specialist who is not an employee of the facility but is working in collaboration with a physician;”. (b) Effective Date.— The amendments made by subsection (a) shall apply with respect to certifications or recertifications during the period beginning on July 1, 1988, and ending on October 1, 1990.