I 

108TH CONGRESS 

1ST SESSION H. R. 754

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 HOUSE OF REPRESENTATIVES 

FEBRUARY 12, 2003

Mr. WICKER introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy 

and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

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.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Rural Communities 

5 Hospice Care Access Improvement Act of 2003’’.
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1 SEC. 2. EXCEPTION TO MEDICARE 20 PERCENT INPATIENT 

2 CARE LIMITATION FOR CERTAIN RURAL HOS3 PICE PROGRAMS. 

4 (a) IN GENERAL.—Section 1861(dd) of the Social Se5 curity Act (42 U.S.C. 1395x(dd)) is amended—

6 (1) in paragraph (2)(A)(iii), by inserting ‘‘sub7 ject to paragraph (6),’’ after ‘‘(iii)’’; and 

8 (2) by adding at the end the following new 

9 paragraph: 

10 ‘‘(6) The requirement of paragraph (2)(A)(iii) (relat11 ing to a limitation on proportion of hospice care provided 

12 in an inpatient setting) shall not apply in the case of a 

13 hospice program that meets the following requirements: 

14 ‘‘(A) The hospice program is a non-profit orga15 nization, provides a residence for inidividuals who do 

16 not have a primary caregiver available at home, is 

17 located in a rural area (as defined in section 

18 1886(d)(2)(D)), is not certified for purposes of this 

19 title to provide other than hospice care, and is not 

20 affiliated with any organization that provides a type 

21 of care other than hospice care. 

22 ‘‘(B) The residence has not more than 20 beds. 

23 ‘‘(C) The residence offers all other categories of 

24 hospice care, including continuous home care, respite 

25 care, and general patient care, for individuals who 

26 qualify to receive such care.’’. 
3

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1 (b) MAINTAINING PAYMENT RATES FOR ROUTINE

2 CARE.—Section 1814(a) of such Act (42 U.S.C. 1395f(a)) 

3 is amended—

4 (1) by redesignating paragraph (3) as para5 graph (4); and 

6 (2) by inserting after paragraph (2) the fol7 lowing new paragraph: 

8 ‘‘(3)(A) With respect to a care provided under a hos9 pice program described in section 1861(dd)(6) that meets 

10 the requirements of that section, payment for routine care 

11 and other services included in hospice care furnished 

12 under such program shall be made at the rate applicable 

13 under this subsection for routine home care and other 

14 services included in hospice care. 

15 ‘‘(B) For purposes of determining payment amounts 

16 under subparagraph (A) with respect to routine and 

17 conitnuous care, the residence described in section 

18 1861(dd)(6) is deemed to be the home of the individual 

19 receiving hospice care.’’. 

20 (c) EFFECTIVE DATE.—The amendments made by 

21 this section shall apply to hospice care provided on or after 

22 the date of the enactment of this Act.

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