97 STAT. 168 PUBLIC LAW 98-21—APR. 20, 1983 42 USC 1395. 42 USC 1395b-l. 42 USC 1395b-l note. 42 USC 1315. 42 USC 1396. 42 USC 1395b-l note. 42 USC 1395WW note. Ante, p. 163. Ante, p. 152. Publication in Federal Register. (2) The Secretary shall provide that, upon the request of a State which has a demonstration project, for payment of hospitals under title XVIII of the Social Security Act approved under section 402(a) of the Social Security Amendments of 1967 or section 222(a) of the Social Security Amendments of 1972, which (A) is in effect as of March 1, 1983, and (B) was entered into after August 1982 (or upon the request of another party to demonstration project agreement), the terms of the demonstration agreement shall be modified so that the demonstration project is not required to maintain the rate of increase in medicare hospital costs in that State below the national rate of increase in medicare hospital costs. (c) The Secretary shall approve, with appropriate terms and condi- tions as defined by the Secretary, within 30 days after the date of enactment of this Act— (1) the risk-sharing application of On Lok Senior Health Services (according to terms and conditions as specified by the Secretary), dated July 2, 1982, for waivers, pursuant to section 222 of the Social Security Amendments of 1972 and section 402(a) of the Social Security Amendments of 1967, of certain requirements of title XVIII of the Social Security Act over a period of 36 months in order to carry out a long-term care demonstration project, and (2) the application of the Department of Health Services, State of California, dated November 1, 1982, pursuant to section 1115 of the Social Security Act, for the waiver of certain requirements of title XIX of such Act over a period of 36 months in order to carry out a demonstration project for capitated reimbursement for comprehensive long-term care services involving On Lok Senior Health Services. (d) The Secretary shall conduct demonstrations with hospitals in areas with critical shortages of skilled nursing facilities to study the feasibility of providing alternative systems of care or methods of payment. EFFECTIVE DATES SEC. 604. (a)(1) Except as provided in section 602(1) and in para- graph (2), the amendments made by the preceding provisions of this title apply to items and services furnished by or under arrange- ments with a hospital beginning with its first cost reporting period that begins on or after October 1, 1983. A change in a hospital s cost reporting period that has been made after November 1982 shall be recognized for purposes of this section only if the Secretary finds good cause for that change. (2) Section 1866(a)(1)(F) of the Social Security Act (as added by section 602(f)(1)(C) of this title), section 1862(a)(14) (as added by section 602(e)(3) of this title) and sections 1886(a)(1)(G) and (H) of such Act (as added by section 602(f)(l)(C) of this title) take effect on October 1, 1983. (b) The Secretary shall make an appropriate reduction in the payment amount under section 1886(d) of the Social Security Act {as amended by this title) for any discharge, if the admission has occurred before a hospital's first cost reporting period that begins after September 1983, to take into account amounts payable under title XVIII of that Act (as in effect before the date of the enactment of this Act) for items and services furnished before that period. (c)(1) The Secretary shall cause to be published in the Federal Register a notice of the interim final DRG prospective payment
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