Page:United States Statutes at Large Volume 100 Part 3.djvu/252

This page needs to be proofread.

PUBLIC LAW 99-000—MMMM. DD, 1986

100 STAT. 2060

42 USC 1396b.

Ante, p. 2058. 42 USC 1396a note.

PUBLIC LAW 99-509—OCT. 21, 1986

"(d) Notwithstanding any other provision of this title, ambulatory prenatal care that— "(1) is furnished to a pregnant woman— "(A) during a presumptive eligibility period, "(B) by a qualified provider; and "(2) is included in the care and services covered by a State plan; shall be treated as medical assistance provided by such plan for purposes of section 1903.". (c) CONFORMING CHANGE.—Section 1903(u)(l)(D) of such Act (42 U.S.C. 1396b(u)(l)(D)) is amended by adding at the end the following: "(v) In determining the amount of erroneous excess payments, there shall not be included any erroneous payments made for ambulatory prenatal care provided during a presumptive eligibility period (as defined in section 1920(b)(1)).". (d) EFFECTIVE DATE.—The amendments made by this section shall apply to ambulatory prenatal care furnished in calendar quarters beginning on or after April 1, 1987, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date. SEC. 9408. RESPIRATORY CARE SERVICES FOR VENTILATOR-DEPENDENT INDIVIDUALS.

42 USC 1396a. State and local governments.

Health care facilities.

(a) REQUIRED SERVICES.—Section 1902(e) of the Social Security Act (42 U.S.C. 1396b(e)), as amended by sections 9401(d) and 9403(f) of this subtitle, is further amended by adding at the end the following new paragraph: "(9)(A) At the option of the State, the plan may include as medical assistance respiratory care services for any individual who— "(i) is medically dependent on a ventilator for life support ^' at least six hours per day; iax<., "(ii) has been so dependent for at least 30 consecutive days (or the maximum number of days authorized under the State plan, whichever is less) as an inpatient; — f< "(iii) but for the availability of respiratory care services, would require respiratory care as an inpatient in a hospital, skilled nursing facility, or intermediate care facility, and would be eligible to have payment made for such inpatient

u^'

care under the State plan; "(iv) has adequate social support services to be cared for >- • ' ' ' at home; and "(v) wishes to be cared for at home. "(B) The requirements of subparagraph (A)(ii) may be satisfied by a continuous stay in one or more hospitals, skilled ,- nursing facilities, or intermediate care facilities. "(C) For purposes of this paragraph, respiratory care services means services provided on a part-time basis in the home of the individual by a respiratory therapist or other health care professional trained in respiratory therapy (as determined by the State), payment for which is not otherwise included within other items and services furnished to such individual as medical assistance under the plan.". (b) WAIVER OF COMPARABILITY.—Section 1902(a)(10) of such Act (42 U.S.C. 1396a(a)(10)), as amended by sections 9401(c), 9403(a), and