PUBLIC LAW 108–173—DEC. 8, 2003
117 STAT. 2299
‘‘(A) IN GENERAL.—Subject to subparagraph (B), in the case of a resident of a skilled nursing facility who is afflicted with acquired immune deficiency syndrome (AIDS), the per diem amount of payment otherwise applicable (determined without regard to any increase under section 101 of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999, or under section 314(a) of Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000), shall be increased by 128 percent to reflect increased costs associated with such residents. ‘‘(B) SUNSET.—Subparagraph (A) shall not apply on and after such date as the Secretary certifies that there is an appropriate adjustment in the case mix under paragraph (4)(G)(i) to compensate for the increased costs associated with residents described in such subparagraph.’’. (b) EFFECTIVE DATE.—The amendment made by paragraph (1) shall apply to services furnished on or after October 1, 2004.
42 USC 1395yy note.
SEC. 512. COVERAGE OF HOSPICE CONSULTATION SERVICES.
(a) COVERAGE OF HOSPICE CONSULTATION SERVICES.—Section 1812(a) (42 U.S.C. 1395d(a)) is amended— (1) by striking ‘‘and’’ at the end of paragraph (3); (2) by striking the period at the end of paragraph (4) and inserting ‘‘; and’’; and (3) by inserting after paragraph (4) the following new paragraph: ‘‘(5) for individuals who are terminally ill, have not made an election under subsection (d)(1), and have not previously received services under this paragraph, services that are furnished by a physician (as defined in section 1861(r)(1)) who is either the medical director or an employee of a hospice program and that— ‘‘(A) consist of— ‘‘(i) an evaluation of the individual’s need for pain and symptom management, including the individual’s need for hospice care; and ‘‘(ii) counseling the individual with respect to hospice care and other care options; and ‘‘(B) may include advising the individual regarding advanced care planning.’’. (b) PAYMENT.—Section 1814(i) (42 U.S.C. 1395f(i)) is amended by adding at the end the following new paragraph: ‘‘(4) The amount paid to a hospice program with respect to the services under section 1812(a)(5) for which payment may be made under this part shall be equal to an amount established for an office or other outpatient visit for evaluation and management associated with presenting problems of moderate severity and requiring medical decisionmaking of low complexity under the fee schedule established under section 1848(b), other than the portion of such amount attributable to the practice expense component.’’. (c) CONFORMING AMENDMENT.—Section 1861(dd)(2)(A)(i) (42 U.S.C. 1395x(dd)(2)(A)(i)) is amended by inserting before the comma at the end the following: ‘‘and services described in section 1812(a)(5)’’.
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