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108th CONGRESS
  1st Session
                                 S. 114

   To amend title XVIII of the Social Security Act to remove the 20 
    percent inpatient limitation under the medicare program on the 
  proportion of hospice care that certain rural hospice programs may 
                                provide.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 9, 2003

  Mr. Cochran introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
   To amend title XVIII of the Social Security Act to remove the 20 
    percent inpatient limitation under the medicare program on the 
  proportion of hospice care that certain rural hospice programs may 
                                provide.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Communities Hospice Care 
Access Improvement Act of 2003''.

SEC. 2. EXCEPTION TO MEDICARE 20 PERCENT INPATIENT CARE LIMITATION FOR 
              CERTAIN RURAL HOSPICE PROGRAMS.

    (a) In General.--Section 1861(dd) of the Social Security Act (42 
U.S.C. 1395x(dd)) is amended--
            (1) in paragraph (2)(A)(iii), by inserting ``subject to 
        paragraph (6),'' after ``(iii)''; and
            (2) by adding at the end the following new paragraph:
    ``(6) The requirement of paragraph (2)(A)(iii) (relating to a 
limitation on the proportion of hospice care provided in an inpatient 
setting) shall not apply in the case of a hospice program that meets 
the following requirements:
            ``(A) The hospice program is a non-profit organization, 
        provides a residence for individuals who do not have a primary 
        caregiver available at home, is located in a rural area (as 
        defined in section 1886(d)(2)(D)), is not certified for 
        purposes of this title to provide other than hospice care, and 
        is not affiliated with any organization that provides a type of 
        care other than hospice care.
            ``(B) The residence has not more than 20 beds.
            ``(C) The residence offers all other categories of hospice 
        care, including continuous home care, respite care, and general 
        patient care, for individuals who qualify to receive such 
        care.''.
    (b) Maintaining Payment Rates for Routine Care.--Section 1814(i) of 
such Act (42 U.S.C. 1395f(i)) is amended--
            (1) by redesignating paragraph (3) as paragraph (4); and
            (2) by inserting after paragraph (2) the following new 
        paragraph:
    ``(3)(A) With respect to a care provided under a hospice program 
described in section 1861(dd)(6) that meets the requirements of that 
section, payment for routine care and other services included in 
hospice care furnished under such program shall be made at the rate 
applicable under this subsection for routine home care and other 
services included in hospice care.
    ``(B) For purposes of determining payment amounts under 
subparagraph (A) with respect to routine and continuous care, the 
residence described in section 1861(dd)(6) is deemed to be the home of 
the individual receiving hospice care.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to hospice care provided on or after the date of the enactment of 
this Act.
                                 <all>

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