I
106TH CONGRESS
2D SESSION
H. R. 5042
To amend title XVIII of the Social Security Act to protect the right of
a Medicare beneficiary enrolled in a Medicare+Choice plan to receive
services at a skilled nursing facility selected by that individual.
IN THE HOUSE OF REPRESENTATIVES
JULY 27, 2000
Mr. HOBSON (for himself and Ms. PRYCE of Ohio) introduced the following
bill; which was referred to the Committee on Ways and Means, and in
addition to the Committee on Commerce, for a period to be subsequently
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to protect
the right of a Medicare beneficiary enrolled in a
Medicare+Choice plan to receive services at a skilled
nursing facility selected by that individual.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Seniors Healing at
Home Act of 2000’’.
SEC. 2. PROVIDING CHOICE FOR SKILLED NURSING FACIL-
ITY 
SERVICES 
UNDER 
THE
MEDICARE+CHOICE PROGRAM.
(a) IN GENERAL.—Section 1852 of the Social Secu-
rity Act (42 U.S.C. 1395w–22) is amended by adding at
the end the following new subsection:
‘‘(l) RETURN TO HOME SKILLED NURSING FACILI-
TIES FOR COVERED POST-HOSPITAL EXTENDED CARE
SERVICES.—
‘‘(1) ENSURING RETURN TO HOME SNF.—
‘‘(A) IN
GENERAL.—A Medicare+Choice
organization offering a Medicare+Choice plan
that provides for coverage of post-hospital ex-
tended care services shall provide for such cov-
erage through a home skilled nursing facility if
the following conditions are met:
‘‘(i) ENROLLEE ELECTION.—The en-
rollee elects to receive such coverage
through such facility.
‘‘(ii) SNF AGREEMENT.—The facility
has a contract with the Medicare+Choice
organization for the provision of such serv-
ices, or the facility agrees to accept sub-
stantially similar payment under the same
terms and conditions that apply to simi-
larly situated skilled nursing facilities that
are 
under 
contract 
with 
the
Medicare+Choice organization for the pro-
vision of such services and through which
the enrollee would otherwise receive such
services.
‘‘(B) MANNER
OF
PAYMENT
TO
HOME
SNF.—The organization shall provide payment
to the home skilled nursing facility consistent
with the contract or the agreement described in
subparagraph (A)(ii), as the case may be.
‘‘(2) NO
LESS
FAVORABLE
COVERAGE.—The
coverage provided under paragraph (1) (including
scope of services, cost-sharing, and other criteria of
coverage) shall be no less favorable to the enrollee
than the coverage that would be provided to the en-
rollee with respect to a skilled nursing facility the
post-hospital extended care services of which are
otherwise covered under the Medicare+Choice plan.
‘‘(3) RULE
OF
CONSTRUCTION.—Nothing in
this subsection shall be construed to do the fol-
lowing:
‘‘(A) To require coverage through a skilled
nursing facility that is not otherwise qualified
to provide benefits under part A for medicare
beneficiaries not enrolled in a Medicare+Choice
plan.
‘‘(B) To prevent a skilled nursing facility
from refusing to accept, or imposing conditions
upon the acceptance of, an enrollee for the re-
ceipt of post-hospital extended care services.
‘‘(4) DEFINITIONS.—In this subsection:
‘‘(A) HOME
SKILLED
NURSING
FACIL-
ITY.—The term ‘home skilled nursing facility’
means, with respect to an enrollee who is enti-
tled to receive post-hospital extended care serv-
ices under a Medicare+Choice plan, any of the
following skilled nursing facilities:
‘‘(i) SNF RESIDENCE AT TIME OF AD-
MISSION.—The skilled nursing facility in
which the enrollee resided at the time of
admission to the hospital preceding the re-
ceipt of such post-hospital extended care
services.
‘‘(ii) SNF IN CONTINUING CARE RE-
TIREMENT COMMUNITY.—A skilled nursing
facility that is providing such services
through a continuing care retirement com-
munity (as defined in subparagraph (B))
which provided residence to the enrollee at
the time of such admission.
‘‘(iii) SNF RESIDENCE OF SPOUSE AT
TIME OF DISCHARGE.—The skilled nursing
facility in which the spouse of the enrollee
is residing at the time of discharge from
such hospital.
‘‘(B) 
CONTINUING
CARE
RETIREMENT
COMMUNITY
DEFINED.—The term ‘continuing
care retirement community’ means, with respect
to an enrollee in a Medicare+Choice plan, an
arrangement under which housing and health-
related services are provided (or arranged)
through an organization for the enrollee under
an agreement that is effective for the life of the
enrollee or for a specified period.’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) applies with respect to contracts entered
into or renewed on or after the date of enactment of this
Act.
Æ