Page:United States Statutes at Large Volume 100 Part 1.djvu/217

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PUBLIC LAW 99-000—MMMM. DD, 1986

PUBLIC LAW 99-272—APR. 7, 1986

100 STAT. 181

(1) There have been more than 600 liver transplants since 1963 and the one year survival rate at qualified institutions is now greater than 70 percent. (2) There are 4,000 to 4,700 potential candidates in the United States each year who require a liver transplant, but only a small percentage would be eligible for Medicare coverage. (3) There are currently individuals on waiting lists for liver transplants who will die without Medicare coverage. (4) After extensive review and consideration of all the avail,pj j'«, able data, an National Institutes of Health expert panel concluded liver transplantation is "a therapeutic modality for end-stage liver disease that deserves broader application" in a limited number of centers where they can be carried out under optimal conditions. (5) National Institutes of Health further recommended that liver transplants be done in individuals under 18 years of age. (6) The CHAMPUS program, after considering all relevant data, determined that there was no scientific basis for limiting liver transplants to children under 18 years of age. (7) The Department of Health and Human Services has determined that liver transplantation is no longer an experimental procedure only for children under 18. (b) Based upon the above findings, it is the sense of the Senate that: (1) For the purposes of title XVIII of the Social Security Act, 42 USC 1395. the Secretary immediately reconsider the Medicare liver transplant coverage decision and implement a policy under which a liver transplant shall not be considered to be an experimental procedure for Medicare beneficiaries solely because an individual is over 18 years of age. . j >j; (2) A liver transplant shall be covered under such title when -'^o.i reasonable and medically necessary. (3) The Secretary shall place appropriate limiting criteria on coverage, including those relating to the patient's condition, the .^ -^^^., disease state, and the institution providing the care, so as to ' ^ >.j ensure the highest quality of medical care demonstrated to be consistent with successful outcomes. SEC. 9218. STUDIES RELATING TO PHYSICAL THERAPISTS AND OTHER PROFESSIONALS. (a) SUPERVISION OF HOME HEALTH SERVICES.—The Secretary of

Health and Human Services shall conduct a study of the advisability of changing the requirements of title XVIII of the Social Security Act to allow home health services to be provided under the supervision of a physical therapist or other health care professional, rather than requiring the supervision of a physician or registered nurse. Cb) OFFICE REQUIREMENT.—The Secretary of Health and Human Services shall conduct a study on the advisability of deleting the requirement under such title that a physical therapist must have an office equipped with specified equipment, even if such therapist provides all such services in patients' homes. (c) REPORTS.—The Secretary shall report the results of the studies to the Congress prior to October 1, 1986. SEC. 9219. TECHNICAL CORRECTIONS. (a) WORKING AGED TECHNICAL CORRECTIONS.—