I
104TH CONGRESS
2D SESSION
H. R. 3714
To amend title XVIII of the Social Security Act to make certain changes
to hospice care under the Medicare program.
IN THE HOUSE OF REPRESENTATIVES
JUNE 25, 1996
Mr. CARDIN (for himself, Mr. PORTMAN, Mr. ENGLISH of Pennsylvania, Mr.
JACOBS, and Mr. MCNULTY) introduced the following bill; which was re-
ferred 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 provisions as fall with-
in the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to make
certain changes to hospice care under the Medicare program.
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 ‘‘Medicare Hospice Ben-
efit Amendments of 1996’’.
SEC. 2. HOSPICE CARE BENEFIT PERIODS.
(a) RESTRUCTURING OF BENEFIT PERIOD.—Section
1812 of the Social Security Act (42 U.S.C. 1395d) is
amended in subsections (a)(4) and (d)(1), by striking ‘‘,
a subsequent period of 30 days, and a subsequent exten-
sion period’’ and inserting ‘‘and an unlimited number of
subsequent periods of 60 days each’’.
(b) CONFORMING AMENDMENTS.—(1) Section 1812
of such Act (42 U.S.C. 1395d) is amended in subsection
(d)(2)(B) by striking ‘‘90- or 30-day period or a subse-
quent extension period’’ and inserting ‘‘90-day period or
a subsequent 60-day period’’.
(2) Section 1814(a)(7)(A) of such Act (42 U.S.C.
1395f(a)(7)(A)) is amended—
(A) in clause (i), by inserting ‘‘and’’ at the end;
(B) in clause (ii)—
(i) by striking ‘‘30-day’’ and inserting ‘‘60-
day’’; and
(ii) by striking ‘‘and’’ at the end and in-
serting a period; and
(C) by striking clause (iii).
SEC. 3. AMBULANCE SERVICES, DIAGNOSTIC TESTS, CHEM-
OTHERAPY SERVICES, AND RADIATION THER-
APY SERVICES INCLUDED IN HOSPICE CARE.
Section 1861(dd)(1) of the Social Security Act (42
U.S.C. 1395x(dd)(1)) is amended—
(1) 
in 
subparagraph 
(E), 
by 
inserting
‘‘anticancer chemotherapeutic agents and other’’ be-
fore ‘‘drugs’’;
(2) in subparagraph (G), by striking ‘‘and’’ at
the end;
(3) in subparagraph (H), by striking the period
at the end and inserting a comma; and
(4) by inserting after subparagraph (H) the fol-
lowing:
‘‘(I) ambulance services,
‘‘(J) diagnostic tests, and
‘‘(K) radiation therapy services.’’.
SEC. 4. CONTRACTING WITH INDEPENDENT PHYSICIANS
OR PHYSICIAN GROUPS FOR HOSPICE CARE
SERVICES PERMITTED.
Section 1861(dd)(2) of the Social Security Act (42
U.S.C. 1395x(dd)(2)) is amended—
(1) in subparagraph (A)(ii)(I), by striking
‘‘(F),’’; and
(2) in subparagraph (B)(i), by inserting ‘‘or
under contract with’’ after ‘‘employed by’’.
SEC. 5. WAIVER OF CERTAIN STAFFING REQUIREMENTS
FOR HOSPICE CARE PROGRAMS IN NON-UR-
BANIZED AREAS.
Section 1861(dd)(5) of the Social Security Act (42
U.S.C. 1395x(dd)(5)) is amended—
(1) in subparagraph (B), by inserting ‘‘or (C)’’
after ‘‘subparagraph (A)’’ each place it appears; and
(2) by adding at the end the following:
‘‘(C) The Secretary may waive the requirements of
paragraph (2)(A)(i) and (2)(A)(ii) for an agency or orga-
nization with respect to the services described in para-
graph (1)(B) and, with respect to dietary counseling,
paragraph (1)(H), if such agency or organization—
‘‘(i) is located in an area which is not an urban-
ized area (as defined by the Bureau of Census), and
‘‘(ii) demonstrates to the satisfaction of the
Secretary that the agency or organization has been
unable, despite diligent efforts, to recruit appro-
priate personnel.’’.
SEC. 6. LIMITATION ON LIABILITY OF BENEFICIARIES AND
PROVIDERS FOR CERTAIN HOSPICE COV-
ERAGE DENIALS.
(a) IN GENERAL.—Section 1879(g) of the Social Se-
curity Act (42 U.S.C. 1395pp(g)) is amended—
(1) by redesignating paragraphs (1) and (2) as
subparagraphs (A) and (B), respectively, and mov-
ing such subparagraphs 2 ems to the right;
(2) by striking ‘‘is,’’ and inserting ‘‘is—’’;
(3) by making the remaining text of subsection
(g), as amended, that follows ‘‘is—’’ a new para-
graph (1) and indenting such paragraph 2 ems to
the right;
(4) by striking the period at the end and insert-
ing ‘‘; and’’; and
(5) by adding at the end the following new
paragraph:
‘‘(2) with respect to the provision of hospice
care to an individual, a determination that the indi-
vidual is not terminally ill.’’.
(b) 
WAIVER
PERIOD
EXTENDED.—Section
9305(f)(2) of the Omnibus Budget Reconciliation Act of
1986 is amended by striking ‘‘and before December 31,
1995.’’.
(c) EFFECTIVE DATE.—The amendments made by
this section take effect December 31, 1995.