institutional planning under medicare

institutional planning under medicare Sec. 234. (a) The first sentence of section 1861(e) of the Social Security Act is amended— (1) by striking out “and” at the end of paragraph (7); (2) by redesignating paragraph (8) as paragraph (9); and (3) by inserting after paragraph (7) the following new paragraph: “(8) has in effect an overall plan and budget that meets the requirements of subsection (z); and”. (b) Section 1861(f) (2) of such Act is amended to read as follows: “(2) satisfies the requirements of paragraphs (3) through (9) of subsection (e);”. (c) Section 1861(g) (2) of such Act is amended to read as follows: “(2) satisfies the requirements of paragraphs (3) through (9) of subsection (e);”. (d) The first sentence of section 1861 (j) of such Act is amended— (1) by striking out “and” at the end of paragraph (9); (2) by redesignating paragraph (10) as paragraph (11); and 86 Stat. 1413 (3) by inserting after paragraph (9) the following new paragraph: “(10) has in effect an overall plan and budget that meets the requirements of subsection (z); and”. (e) Section 1861 (o) of such Act is amended— (1) by striking out “and” at the end of paragraph (4); (2) by redesignating paragraph (5) as paragraph (6); and (3) by inserting after paragraph (4) the following new paragraph: “(5) has in effect an overall plan and budget that meets the requirements of subsection (z); and”. (f) Section 1861 of such Act is further amended by adding at the end thereof the following new subsection: “Institutional Planning “(z) An overall plan and budget of a hospital, extended care facility, or home health agency shall be considered sufficient if it— “(1) provides for an annual operating budget which includes all anticipated income and expenses related to items which would, under generally accepted accounting principles, be considered income and expense items (except that nothing in this paragraph shall require that there be prepared, in connection with any budget, an item-by-item identification of the components of each type of anticipated expenditure or income); “(2) provides for a capital expenditures plan for at least a 3-year period (including the year to which the operating budget described in subparagraph (1) is applicable) which includes and identifies in detail the anticipated sources of financing for, and the objectives of, each anticipated expenditure in excess of $100,000 related to the acquisition of land, the improvement of land, buildings, and equipment, and the replacement, modernization, and expansion of the buildings and equipment which would, under generally accepted accounting principles, be considered capital items; “(3) provides for review and updating at least annually; and “(4) is prepared, under the direction of the governing body of the institution or agency, by a committee consisting of representatives of the governing body, the administrative, staff, and the medical staff (if any) of the institution or agency.” (g) (1) Section 1814(a) (2) (C) and section 1814(a) (2) (D) of such Act are each amended by striking out “and (8)” and inserting in lieu thereof “and (9)”. (2) Section 1863 of such Act is amended by striking out “subsections (c)(8), (f)(4), (g)(4), (j)(10), and (o)(5)” and inserting in lieu thereof “subsections (e)(9), (f)(4), (g)(4), (j)(11), and (o)(6)”. (h) Section 1865 of such Act is amended— (1) by striking out “(except paragraph (6) thereof)” in the first sentence and inserting in lieu thereof “(except paragraphs (6) and (8) thereof)”, and (2) by striking out the second sentence and inserting in lieu thereof the following: “If such Commission, as a condition for accreditation of a hospital, (1) requires a utilization review plan as defined in section 1861 (k) or imposes another requirement which serves substantially the same purpose, or (2) requires institutional plans as defined in section 1861 (z) or imposes another requirement which serves substantially the same purpose, the 86 Stat. 1414Secretary is authorized to find that all institutions so accredited by the Commission comply also with section 1861(e) (6) or 1861(e) (8), as the case may be.” (i) The amendments made by this section shall apply with respect to any provider of services for fiscal years (of such provider) beginning after the fifth month following the month in which this Act is enacted.