FLEXIBILITY IN PAYMENT METHODS FOR HOSPITAL, NURSING FACILITY, ICF/MR, AND HOME HEALTH SERVICES.

SEC. 4711. FLEXIBILITY IN PAYMENT METHODS FOR HOSPITAL, NURSING FACILITY, ICF/MR, AND HOME HEALTH SERVICES. (a) Repeal of Boren Requirements.—Section 1902(a)(13) (42 U.S.C. 1396a(a)(13)) is amended— (1) by striking all that precedes subparagraph (D) and inserting the following: “(13) provide— “(A) for a public process for determination of rates of payment under the plan for hospital services, nursing facility services, and services of intermediate care facilities for the mentally retarded under which— “(i) proposed rates, the methodologies underlying the establishment of such rates, and justifications for the proposed rates are published, 111 STAT. 508 “(ii) providers, beneficiaries and their representatives, and other concerned State residents are given a reasonable opportunity for review and comment on the proposed rates, methodologies, and justifications, “(iii) final rates, the methodologies underlying the establishment of such rates, and justifications for such final rates are published, and “(iv) in the case of hospitals, such rates take into account (in a manner consistent with section 1923) the situation of hospitals which serve a disproportionate number of low-income patients with special needs;”; (2) by redesignating subparagraphs (D) and (E) as subparagraphs (B) and (C), respectively; (3) in subparagraph (B), as so redesignated, by adding “and” at the end; (4) in subparagraph (C), as so redesignated, by striking “and” at the end; and (5) by striking subparagraph (F). (b) Study and Report.— (1) Study.—The Secretary of Health and Human Services shall study the effect on access to, and the quality of, services provided to beneficiaries of the rate-setting methods used by States pursuant to section 1902(a)(13)(A) of the Social Security Act (42 U.S.C. 1396a(a)(13)(A)), as amended by subsection (a). (2) Report.—Not later than 4 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit a report to the appropriate committees of Congress on the conclusions of the study conducted under paragraph (1), together with any recommendations for legislation as a result of such conclusions. (c) Conforming Amendments.— (1) Section 1905(o)(3) (42 U.S.C. 1396d(o)(3)) is amended by striking “amount described in section 1902(a)(13)(D)” and inserting “amount determined in section 1902(a)(13)(B)”. (2) Section 1923 (42 U.S.C. 1396r–4) is amended, in subsections (a)(1) and (e)(i), by striking “1902(a)(13)(A)” each place it appears and inserting “1902(a)(13)(A)(iv)”. (d) Effective Date.—This section shall take effect on the date of the enactment of this Act and the amendments made by subsections (a) and (c) shall apply to payment for items and services furnished on or after October 1, 1997.