I
106TH CONGRESS
1ST SESSION
H. R. 3004
To amend title XVIII of the Social Security Act to permit a Medicare
beneficiary enrolled in a Medicare+Choice plan to elect to receive covered
skilled nursing facility services at the skilled nursing facility in which
the beneficiary or spouse resides or which is part of the continuing
care retirement community in which the beneficiary resides.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 4, 1999
Mr. BROWN of Ohio (for himself, Mr. WAXMAN, Mr. STARK, Mr. FROST, Mr.
FRANK of Massachusetts, and Mr. BRADY of Pennsylvania) 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 consider-
ation of such provisions as fall within the jurisdiction of the committee
concerned
A BILL
To amend title XVIII of the Social Security Act to permit
a Medicare beneficiary enrolled in a Medicare+Choice
plan to elect to receive covered skilled nursing facility
services at the skilled nursing facility in which the bene-
ficiary or spouse resides or which is part of the con-
tinuing care retirement community in which the bene-
ficiary resides.
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 Return To
Home Act of 1999’’.
SEC. 2. PERMITTING MEDICARE+CHOICE BENEFICIARIES
TO RETURN TO NURSING HOME FOR RECEIPT
OF COVERED SKILLED NURSING FACILITY
SERVICES.
(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) PERMITTING RETURN
TO CERTAIN SKILLED
NURSING FACILITIES FOR THE RECEIPT OF COVERED
POST-HOSPITAL EXTENDED CARE SERVICES.—
‘‘(1) 
IN
GENERAL.—Insofar 
as 
a
Medicare+Choice plan provides for coverage of post-
hospital extended care services, the plan shall pro-
vide such coverage through a home skilled nursing
facility described in paragraph (2) and consistent
with paragraph (3) if the enrollee elects to receive
such coverage through such facility and the
facility—
‘‘(A) 
has 
a 
contract 
with 
the
Medicare+Choice organization for the provision
of such services; or
‘‘(B) agrees to accept substantially similar
payment under the same terms and conditions
that apply to similarly situated skilled nursing
facilities that are under contract with the
Medicare+Choice organization for the provision
of such services and through which the enrollee
would otherwise receive such services.
The organization shall provide payment to the home
skilled nursing facility consistent with the contract
described in subparagraph (A) or the agreement de-
scribed in subparagraph (B), as the case may be.
‘‘(2) HOME SKILLED NURSING FACILITY.—For
purposes of this subsection, a home skilled nursing
facility described in this paragraph, with respect to
an enrollee who is entitled to receive post-hospital
extended care services under a Medicare+Choice
plan, is any of the following skilled nursing facilities:
‘‘(A) SNF RESIDENCE AT TIME OF ADMIS-
SION.—The skilled nursing facility in which the
enrollee resided at the time of admission to the
hospital preceding the receipt of such post-hos-
pital extended care services.
‘‘(B) SNF IN CONTINUING CARE RETIRE-
MENT COMMUNITY.—A skilled nursing facility
that is providing such services through a con-
tinuing care retirement community (as defined
in paragraph (5)) which provided residence to
the enrollee at the time of such admission.
‘‘(C) 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.
‘‘(3) NO LESS FAVORABLE TERMS AND CONDI-
TIONS OF COVERAGE.—The coverage provided under
this subsection (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 enrollee with respect to a
skilled nursing facility the post-hospital extended
care services of which are otherwise covered under
the Medicare+Choice plan.
‘‘(4) CONSTRUCTION.—Nothing in this sub-
section shall be construed—
‘‘(A) as requiring 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; and
‘‘(B) as preventing a skilled nursing facil-
ity from refusing to accept, or imposing condi-
tions upon the acceptance of, an enrollee for the
receipt of post-hospital extended care services.
‘‘(5) CONTINUING CARE RETIREMENT COMMU-
NITY
DEFINED.—For purposes of this subsection,
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 amendments made by
this section shall apply with respect to contracts entered
into or renewed on or after the date of enactment of this
Act.
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