Ill STAT. 422 PUBLIC LAW 105-33 —AUG. 5, 1997 (i) in the opening paragraph, by striking "paragraphs (3) and (6)" and inserting "paragraphs (3), (6), and (7)", and (ii) in paragraph (7), after "skilled nursing facilities", by inserting ", or by others under arrangements with them made by the facility". (E) Section 1861(v)(7)(D) (42 U.S.C. 1395x(v)(7)(D)) is amended by inserting "subsections (a) through (c) of before "section 1888.". (F) Section 1866(a)(1)(H) (42 U.S.C. 1395cc(a)(l)(H)) is amended— (i) by redesignating clauses (i) and (ii) as subclauses (I) and (II) respectively, (ii) by inserting "(i)" after "(H)", and. (iii) by adding after clause (i), as so redesignated, the following new clause: "(ii) in the case of skilled nursing facilities which provide covered skilled nursing facility services— "(I) that are furnished to an individual who is a resident of the skilled nursing facility, and "(II) for which the individual is entitled to have pay- ment made under this title, to have items and services (other than services described in section 1888(e)(2)(A)(ii)) furnished by the skilled nursing facility or otherwise under arrangements (as defined in section 1861(w)(l)) made by the skilled nursing facility,". (G) Section 1883(a)(2)(B)(ii)(II) (42 U.S.C. 1395tt(a)(2)(B)(ii)(II)) is amended by inserting "subsections (a) through (d) of before "section 1888". (H) Section 1888(d)(1) (42 U.S.C. 1395yy(d)(l)) is amended by striking "Any skilled nursing facility" and inserting "Subject to subsection (e), any skilled nursing facility". 42 USC I395yy (c) MEDICAL REVIEW PROCESS.— In order to ensure that medinote. care beneficiaries are furnished appropriate services in skilled nursing facilities, the Secretary of Health and Human Services shall establish and implement a thorough medical review process to examine the effects of the amendments made by this section on the quality of covered skilled nursing facility services furnished to medicare beneficiaries. In developing such a medical review process, the Secretary shall place a particular emphasis on the quality of non-routine covered services and physicians' services for which payment is made under title XVIII of the Social Security Act. 42 USC l395i-3 (d) EFFECTIVE DATE. —The amendments made by this section note. are effective for cost reporting periods beginning on or after July 1, 1998; except that the amendments made by subsection (b) shall apply to items and services furnished on or after July 1, 1998. CHAPTER 4—PROVISIONS RELATED TO HOSPICE SERVICES SEC. 4441. PAYMENTS FOR HOSPICE SERVICES. (a) PAYMENT UPDATE.—Section 1814(i)(l)(C)(ii) (42 U.S.C. 1395f(i)(l)(C)(ii)) is amended— (1) in subclause (V), by striking "and" at the end; (2) by redesignating subclause (VI) as subclause (VII); and
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