I
106TH CONGRESS
2D SESSION
H. R. 4028
To amend title XVIII of the Social Security Act to expand the definition
of homebound for purposes of receiving home health services under
the medicare program to allow medicare beneficiaries to attend adult
day care programs for treatment of Alzheimer’s disease and other condi-
tions.
IN THE HOUSE OF REPRESENTATIVES
MARCH 16, 2000
Mr. SMITH of New Jersey (for himself and Mr. MARKEY) introduced the fol-
lowing bill; which was referred to the Committee on Ways and Means,
and in addition to the Committee on Commerce, for a period to be subse-
quently 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 expand
the definition of homebound for purposes of receiving
home health services under the medicare program to
allow medicare beneficiaries to attend adult day care
programs for treatment of Alzheimer’s disease and other
conditions.
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 ‘‘Alzheimer’s Disease
Medicare Home Health Care Benefit Clarification Act of
2000’’.
SEC. 2. FINDINGS.
(a) FINDINGS.—Congress finds the following:
(1) Home health services are a vital component
of the benefits that are furnished to beneficiaries
under the medicare program under title XVIII of the
Social Security Act.
(2) Home health services under the medicare
program enable homebound individuals who are at
great risk for costly institutionalized care to stay in
their own homes and communities.
(3) Existing medicare regulations and practices
inadvertently penalize medicare beneficiaries (includ-
ing those with Alzheimer’s disease, a related demen-
tia, or both) who participate in an adult day care
program. Under those regulations, if a medicare
beneficiary attends a privately funded adult day care
program as part of their Alzheimer’s treatment re-
gime, including an Alzheimer’s treatment regime,
they may lose eligibility for the medicare home
health benefit because the absences of the individual
from home are not infrequent and short duration.
(4) Adult day care programs can be a valuable
and medically beneficial part of a treatment regime
for a person with Alzheimer’s disease or a related
dementia. These programs can provide structured
activities and health monitoring to maintain func-
tion, manage behavioral symptoms, and prevent
health care crises and premature institutionalization.
(5) The Health Care Financing Administration
and its various medicare contractors and fiscal inter-
mediaries have misinterpreted the intent of Congress
with respect to eligibility for home health services.
Participation by medicare beneficiaries in privately
funded adult day care programs is not intended to
preclude eligiblity for home health services for those
medicare beneficiaries under the medicare program.
SEC. 3. CLARIFICATION OF THE DEFINITION OF HOME-
BOUND.
(a) IN GENERAL.—The last sentence of sections
1814(a) and 1835(a) of the Social Security Act (42 U.S.C.
1395f(a); 1395n(a)) are each amended by striking the pe-
riod and inserting ‘‘including participating in an adult day
care program licensed by a State to furnish adult day care
services in the State, for the purpose of therapeutic treat-
ment for Alzheimer’s disease or a related dementia, or for
medical treatment furnished in an adult day care pro-
gram.’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) shall apply to items and services provided
on or after the date of enactment of this Act.
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