another individual to perform 3 or more of such
activities of daily living.
‘‘(3) ACTIVITIES OF DAILY LIVING DEFINED.—
The ‘activities of daily living’ referred to in this sub-
section are as follows:
‘‘(A) Eating.
‘‘(B) Bathing.
‘‘(C) Dressing.
‘‘(D) Toileting.
‘‘(E) Transferring in and out of a bed or
in and out of a chair.
‘‘(e) IN-HOME CARE.—
‘‘(1) IN GENERAL.—For purposes of this sec-
tion, the term ‘in-home care’ means the items and
services described in paragraph (2) furnished to an
individual by a home care agency (as defined in sec-
tion 1861(ww)) or by others under arrangements
with them made by the agency provided in a place
of residence used as such individual’s home (other
than services described in paragraph (2)(H)).
‘‘(2) SERVICES
DESCRIBED.—The items and
services described in this paragraph are as follows:
‘‘(A) Nursing care provided by or under
the supervision of a registered professional
nurse.
‘‘(B) Services of a homemaker/home health
aide who has successfully completed a training
and competency evaluation program approved
by the Secretary.
‘‘(C) Personal care services.
‘‘(D) Medical social services.
‘‘(E) Physical, occupational, or respiratory
therapy or speech-language pathology.
‘‘(F) Medical supplies (other than drugs
and biologicals) and durable medical equipment,
while under such a plan.
‘‘(G) Patient and caregiver (including fam-
ily caregiver) education and training to develop
skills necessary to permit the individual to re-
main in the home setting.
‘‘(H) Community care services furnished
outside of the place of residence.
‘‘(I) Such other home-based items and
services (other than room and board) as the
Secretary may approve.
‘‘(f) CASE MANAGEMENT REQUIREMENTS.—
‘‘(1) REQUESTS FOR ASSESSMENT.—Each indi-
vidual entitled to benefits under this title (or an-
other person on such individual’s behalf) may re-
quest a case management agency to conduct an as-
sessment under this section to determine whether
the individual is a dependent individual or a chron-
ically dependent individual.
‘‘(2) DESCRIPTION OF PLANS.—For purposes of
this section, a ‘case management plan’ means, with
respect to an individual, a written plan of care
which—
‘‘(A) is established and periodically re-
viewed and revised by a case management agen-
cy; and
‘‘(B) reflects the individual’s needs identi-
fied in the assessment under paragraph (1).
‘‘(3) CASE MANAGEMENT AGENCY DEFINED.—
In this section, the term ‘case management agency’
means a nonprofit or public agency or organization
(or a nonprofit or public subdivision of such an
agency or organization) certified by the Secretary to
conduct assessments and establish case management
plans under this subsection which—
‘‘(A) is experienced in conducting assess-
ments, in establishing and periodically reviewing
and revising case management plans for nurs-
ing facility services and in-home care, and in
coordinating and reviewing the quality of the
provision of such services and care;
‘‘(B) is capable of efficiently and effectively
performing directly or through contracts under
paragraph (4) such duties; and
‘‘(C) does not provide nursing facility serv-
ices or in-home care and does not have a direct
or indirect ownership or control interest in, or
direct or indirect affiliation or relationship with,
an entity that provides, such services or care.
‘‘(4) 
CONTRACTING
OUT
CERTAIN
FUNC-
TIONS.—The Secretary shall permit a case manage-
ment agency, to the extent necessary to carry out
functions under this section, to provide for assess-
ments and case management plans through con-
tracts with nonprofit or public organizations which
do not provide nursing facility services or in-home
care and do not have a direct or indirect ownership
or control interest in, or direct or indirect affiliation
or relationship with, an entity that provides, such
services or care.’’.
(c) 
CONFORMING
AMENDMENTS.—(1) 
Section
1833(a)(1) of the Social Security Act (42 U.S.C.
1395l(a)(1)), as amended by sections 105(c) and 223(c)
of the Medicare, Medicaid, and SCHIP Benefits Improve-
ment and Protection Act of 2000, as enacted into law by
section 1(a)(6) of Public Law 106–554, is amended—
(A) by striking ‘‘and’’ before ‘‘(U)’’; and
(B) by inserting before the semicolon at the end
the following: ‘‘, and (V) with respect to expenses in-
curred 
for 
services 
described 
in 
section
1861(s)(2)(W), the amounts paid shall be the
amounts determined under section 1889(c);’’.
(2) Section 1861 of the Social Security Act (42
U.S.C. 1395x), as amended by sections 102(b) and 105(b)
of the Medicare, Medicaid, and SCHIP Benefits Improve-
ment and Protection Act of 2000, as enacted into law by
section 1(a)(6) of Public Law 106–554, is amended by
adding at the end the following new subsection:
‘‘HOME CARE AGENCY
‘‘(ww) The term ‘home care agency’ means a public
agency or private organization, or a subdivision of such
an agency or organization, which is a home health agency
(as defined in subsection (o)) or—
‘‘(1) is primarily engaged in providing services
of homemaker/home health aides and personal care
aides;
‘‘(2) maintains clinical records on all patients;
‘‘(3) in the case of an agency or organization in
any State in which State or applicable local law pro-
vides for the licensing of agencies or organizations of
this nature—
‘‘(A) is licensed pursuant to such law, or
‘‘(B) is approved, by the agency of such
State or locality, responsible for licensing agen-
cies or organizations of this nature, as meeting
the standards established for such licensing;
and
‘‘(4) meets such other requirements as the Sec-
retary may find necessary in the interest of the
health and safety of individuals who are furnished
services by such agency or organization and for the
effective and efficient operation of the program.’’.
(d) EFFECTIVE DATE.—The amendments made by
this section shall apply to items and services furnished on
or after January 1, 2002.
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