Ill STAT. 424 PUBLIC LAW 105-33—AUG. 5, 1997 SEC. 4445. CONTRACTING WITH INDEPENDENT PHYSICIANS OR PHYSI- CIAN GROUPS FOR HOSPICE CARE SERVICES PER- MITTED. Section 1861(dd)(2) (42 U.S.C. 1395x(dd)(2)) is amended— (1) in subparagraph (A)(ii)(I), by striking "(F),"; and (2) in subparagraph (B)(i), by inserting "or, in the case of a physician described in subclause (I), under contract with" after "employed b/'. SEC. 4446. WAIVER OF CERTAIN STAFFING REQUIREMENTS FOR HOS- PICE CARE PROGRAMS IN NONURBANIZED AREAS. Section 1861(dd)(5) (42 U.S.C. 1395x(dd)(5)) is amended— (1) in subparagraph (B), by inserting "or (C)" after "subparagraph (A)" each place it appears; and (2) by adding at the end the following: "(C) The Secretary may waive the requirements of paragraph (2)(A)(i) and (2)(A)(ii) for an agency or organization with respect to the services described in paragraph (1)(B) and, with respect to dietary counseling, paragraph (1)(H), if such agency or organization— "(i) is located in an area which is not an urbanized area (as defined by the Bureau of Census), and "(ii) demonstrates to the satisfaction of the Secretary that the agency or organization has been unable, despite diligent efforts, to recruit appropriate personnel.". SEC. 4447. LIMITATION ON LIABILITY OF BENEFICIARIES FOR CERTAIN HOSPICE COVERAGE DENIALS. Section 1879(g) (42 U.S.C. 1395pp(g)) is amended— (1) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and moving such subparagraphs 2 ems to the right; (2) by striking "is," and inserting "is—"; (3) by making the remaining text of subsection (g), as amended, that follows "is—" a new paragraph (1) and indenting such paragraph 2 ems to the right; (4) by striking the period at the end and inserting "; and"; and (5) by adding at the end the following new paragraph: "(2) with respect to the provision of hospice care to an individual, a determination that the individual is not terminally ill.". SEC. 4448. EXTENDING THE PERIOD FOR PHYSICIAN CERTIFICATION OF AN INDIVIDUAL'S TERMINAL ILLNESS. Section 1814(a)(7)(A)(i) (42 U.S.C. 1395f:a)(7)(A)(i)) is amended in the matter following subclause (II) by striking ", not later thsin 2 days after hospice care is initiated (or, if each certify verbally not later than 2 days after hospice care is initiated, not later than 8 days after such care is initiated)" and inserting "at the beginning of the period". 42 USC 1395d SEC. 4449. EFFECTIVE DATE. Except as otherwise provided in this chapter, the amendments made by this chapter apply to benefits provided on or after the date of the enactment of this chapter, regardless of whether or not an individual has made an election under section 1812(d) of the Social Security Act (42 U.S.C. 1395d(d)) before such date.
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