Medicare Amendments of 1979

Summary

Medicare Amendments of 1979 - Amends title XVIII (Medicare) of the Social Security Act with respect to home health care services to eliminate: (1) the 100 visit limitation presently applicable to such services; (2) prior hospitalization as a condition of eligibility for such services; and (3) the $60 deductible. Directs the Secretary of Health, Education, and Welfare to prescribe regulations which prohibit a physician who has a significant financial relationship with a home health agency from certifying that the services of such agency are required for any individual, and from establishing and reviewing a plan for furnishing such services to such individuals. Requires home health aides to complete a training program approved by the Secretary. Repeals provisions of title XVIII which prohibit the classification, as a home health agency, of a private organization which is not a nonprofit organization unless licensed pursuant to State law. Eliminates the requirement of consecutive months in the 24-month Medicare waiting period for railroad retirement disability beneficiaries, or old-age, survivors and disability insurance beneficiaries who are disabled, to be eligible for Medicare hospital care benefits. Authorizes the President under title XVIII, to enter into agreements establishing reciprocal arrangements between the health insurance program established by such title and the program of any foreign country under which similar services are provided directly to entitled individuals or under which insurance is provided to meet all or part of the expenses of entitled individuals for health services. Requires that any such agreement specify: (1) the nature and extent of payment to be made to or on behalf of individuals entitle to benefits; (2) limitations on the nature and duration of health services and on entitlement of individuals to benefits on a reciprocal basis under an agreement in the United States and in the foreign country;(3) limitations on entitlement of individuals to benefits; and (4) the methods by which the cost of providing health services on a reciprocal basis shall be shared by the United States and the foreign country. Directs the Secretary to make rules and regulations and to establish procedures which are reasonable and necessary to implement and administer any agreement which has been entered into in accordance with this Act. Authorizes the Secretary to enter into interim arrangements with any hospital in a foreign country which is accredited by the Joint Commission on Accreditation of Hospitals, or such other hospitals as the Secretary finds meets specified health and safety standards. Provides Medicare coverage for: (1) all services performed by a dentist which would be covered if performed by a physician; and (2) inpatient hospital services furnished because of the severity of the dental procedure. Authorizes payments under the Medicare program for the cutting or removal of warts on the feet. Allows reimbursement under the Medicare program for services furnished in qualified community mental health centers and comprehensive outpatient rehabilitation centers. Restricts payment for optometrists' services under Medicare to services related to the treatment of aphakia. Directs the Secretary to make recommendations with respect to providing Medicare coverage for the treatment of cataracts and for other services which optometrists may perform. Directs the Secretary to develop and carry out demonstration projects to permit reimbursement under title XVIII for services provided by hospices offering comprehensive health service. Directs the Secretary to study methods for providing Medicare coverage for orthopedic shoes. Authorizes payment under the Medicare program for antigens prepared by a physician. Authorizes the Secretary to make payments of such benefits as are necessary to correct the effect of an unintentional or erroneous transfer of an individual from an approved hospital or skilled nursing facility. Includes rural health facility of 50 beds or less within the definition of the term "hospital, under title XVIII." Makes special provisions with respect to nursing services, health, fire, and safety requirements for such facilities. Recognizes podiatrists as physicians for purposes of physician certification and participation in utilization review, where consistent with State law and policies of the health care institutions involved. Allows a speech pathologist, as well as a physician, to establish the plan of treatment for speech pathology services. States that where services are provided for which payment may be made under the Medicare program to an individual who has died and the persons who provided the services do not agree that the reasonable charge is the full charge for the services, payment shall be made on the basis of an itemized bill. Repeals provisions of the Medicare program concerning the presumed coverage for extended care facilities and home health care in specified circumstances. Repeals the existing provisions under part A (Hospital Insurance) of title XVIII under which payment to a provider of services shall be the lesser of the reasonable cost of such services or the customary charge with respect to such services, and provides that payment to a provider shall now be based upon the reasonable cost of such services. Limits to a maximum of 30 percent the amount by which the premium for voluntary participation in Medicare insurance may be increased due to late enrollment. Repeals the prohibition against enrolling more than twice in the Supplementary Medical Insurance Program (part B of title XVIII). Authorizes Medicare coverage for certain services furnished by: (1) chiropractors; and (2) clinical psychologists to certain hospital inpatients. Directs the Secretary to develop and carry out demonstration projects to determine how to make the services of clinical social workers more generally available under the Medicare program.

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3 official files

• Reported to House amended, Part III

  summary · EN · 18 March 1980

  Open at official source

• Reported to House amended, Part I

  summary · EN · 5 November 1979

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• Introduced in House

  summary · EN · 8 May 1979

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