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SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Expanding Access to Medical Records 
Act''.

SEC. 2. FULL ACCESS TO MEDICARE INFORMATION BY THE AUTHORIZED 
              REPRESENTATIVE OF A DECEASED BENEFICIARY.

    (a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) is amended by adding at the end the following new 
section:

``full access to medicare information by the authorized representative 
                       of a deceased beneficiary

    ``Sec. 1899.  (a) In General.--In the case of the death of an 
individual entitled to, or enrolled for, benefits under part A or 
enrolled for benefits under part B, the Secretary shall--
            ``(1) make available to the authorized representative of 
        the individual all information concerning the individual's 
        benefits under this title, including--
                    ``(A) the coverage and status of such benefits (as 
                of the day before the individual's death); and
                    ``(B) billing, claims, and payment information 
                regarding items and services furnished to the 
                individual under this title (on or before such day); 
                and
            ``(2) provide such authorized representative access to any 
        source of information maintained by the Federal government with 
        respect to such benefits, including online databases, that the 
        individual had access to during his or her lifetime.
    ``(b) Definition of Authorized Representative; Special Rules.--
            ``(1) In general.--In this section, the term `authorized 
        representative' means an executor, administrator, or other 
        individual who has authority to act on the deceased 
        individual's behalf (as determined by the Secretary under 
        paragraph (2)).
            ``(2) Determination of authorized representative.--
                    ``(A) In general.--The Secretary shall establish 
                procedures under which the Secretary determines whether 
                an individual is an authorized representative of the 
                deceased individual. Under such procedures, the 
                individual seeking such determination shall provide 
                evidence (in such form and such manner as specified by 
                the Secretary) of the individual's legal authority to 
                act on behalf of the deceased individual.
                    ``(B) Timeline for determination.--The Secretary 
                shall make a determination under subparagraph (A) not 
                later than 30 days after receipt of the evidence 
                described in such subparagraph.
            ``(3) Notification and access to information.--After making 
        a determination under paragraph (2) with respect to an 
        individual, the Secretary shall--
                    ``(A) notify the individual of the determination 
                not later than 7 days after the date on which the 
                determination is made; and
                    ``(B) in the case where such individual is so 
                determined to be the authorized representative of the 
                deceased individual, as soon as practicable--
                            ``(i) make available to the authorized 
                        representative the information described in 
                        paragraph (1) of subsection (a); and
                            ``(ii) provide the authorized 
                        representative access to the sources described 
                        in paragraph (2) of such subsection.''.
    (b) Effective Date.--The amendment made by this section shall take 
effect on the date that is 60 days after the date of enactment of this 
Act.

SEC. 3. FULL ACCESS TO MEDICAID INFORMATION BY THE AUTHORIZED 
              REPRESENTATIVE OF A DECEASED BENEFICIARY.

    (a) In General.--Title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) is amended by adding at the end the following new 
section:

``full access to medicaid information by the authorized representative 
                       of a deceased beneficiary

    ``Sec. 1943.  (a) In General.--In the case of the death of an 
individual enrolled under the State plan for medical assistance or 
under a waiver of such plan, the State Medicaid agency shall--
            ``(1) make available to the authorized representative of 
        the individual all information concerning the individual's 
        benefits under this title, including--
                    ``(A) the coverage and status of such benefits (as 
                of the day before the individual's death); and
                    ``(B) billing, claims, and payment information 
                regarding items and services furnished to the 
                individual under this title (on or before such day); 
                and
            ``(2) provide such authorized representative access to any 
        source of information maintained by the State with respect to 
        such benefits, including online databases, that the individual 
        had access to during his or her lifetime.
    ``(b) Definition of Authorized Representative; Special Rules.--
            ``(1) In this section, the term `authorized representative' 
        means an executor, administrator, or other individual who has 
        authority to act on the deceased individual's behalf (as 
        determined by the State Medicaid agency under paragraph (2)).
            ``(2) Determination of authorized representative.--
                    ``(A) In general.--The State Medicaid agency shall 
                establish procedures under which such agency determines 
                whether an individual qualifies as an authorized 
                representative of the deceased individual. Under such 
                procedures, the individual seeking such a determination 
                shall provide evidence (in such form and such manner as 
                specified by the State Medicaid Agency) of the 
                individual's legal authority to act on behalf of the 
                deceased individual.
                    ``(B) Timeline for determination.--The State 
                Medicaid agency shall make a determination under 
                subparagraph (A) not later than 30 days after receipt 
                of the evidence described in such subparagraph.
            ``(3) Notification and access to information.--After making 
        a determination under paragraph (2) with respect to an 
        individual, the State Medicaid Agency shall--
                    ``(A) notify the individual of the determination 
                not later than 7 days after the date on which the 
                determination is made; and
                    ``(B) in the case where such individual is so 
                determined to be the authorized representative of the 
                deceased individual, as soon as practicable--
                            ``(i) make available to the authorized 
                        representative the information described in 
                        paragraph (1) of subsection (a); and
                            ``(ii) provide the authorized 
                        representative access to the sources described 
                        in paragraph (2) of such subsection.
    ``(c) Definition of State Medicaid Agency.--The term `State 
Medicaid agency' means the State agency responsible for administering 
the State plan established under this title or any waiver of such 
plan.''.
    (b) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendment made by this section shall take effect on the date 
        that is 60 days after the date of enactment of this Act.
            (2) Extension of effective date for state law amendment.--
        In the case of a State plan under this title which the 
        Secretary of Health and Human Services determines requires 
        State legislation in order for the plan to meet the additional 
        requirements imposed by the amendment made by subsection (a), 
        the State plan shall not be regarded as failing to comply with 
        the requirements of such title solely on the basis of its 
        failure to meet these additional requirements before the first 
        day of the first calendar quarter beginning after the close of 
        the first regular session of the State legislature that begins 
        after the date of the enactment of this Act. For purposes of 
        the previous sentence, in the case of a State that has a 2-year 
        legislative session, each year of the session is considered to 
        be a separate regular session of the State legislature.
Expanding Access to Medical Records Act - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require the Secretary of Health and Human Services (HHS) grant the authorized representative of a deceased beneficiary full access to information with respect to the deceased beneficiary's benefits under the Medicare and Medicaid programs.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Provo River Project Transfer Act''.

SEC. 2. DEFINITIONS.

    In this Act:
        (1) Agreement.--The term ``Agreement'' means the contract 
    numbered 04-WC-40-8950 and entitled ``Agreement Among the United 
    States, the Provo River Water Users Association, and the 
    Metropolitan Water District of Salt Lake & Sandy to Transfer Title 
    to Certain Lands and Facilities of the Provo River Project'' and 
    shall include maps of the land and features to be conveyed under 
    the Agreement.
        (2) Association.--The term ``Association'' means the Provo 
    River Water Users Association, a nonprofit corporation organized 
    under the laws of the State.
        (3) District.--The term ``District'' means the Metropolitan 
    Water District of Salt Lake & Sandy, a political subdivision of the 
    State.
        (4) Pleasant grove property.--
            (A) In general.--The term ``Pleasant Grove Property'' means 
        the 3.79-acre parcel of land acquired by the United States for 
        the Provo River Project, Deer Creek Division, located at 
        approximately 285 West 1100 North, Pleasant Grove, Utah, as in 
        existence on the date of enactment of this Act.
            (B) Inclusions.--The term ``Pleasant Grove Property'' 
        includes the office building and shop complex constructed by 
        the Association on the parcel of land described in subparagraph 
        (A).
        (5) Provo reservoir canal.--The term ``Provo Reservoir Canal'' 
    means the canal, and any associated land, rights-of-way, and 
    facilities acquired, constructed, or improved by the United States 
    as part of the Provo River Project, Deer Creek Division, extending 
    from, and including, the Murdock Diversion Dam at the mouth of 
    Provo Canyon, Utah, to and including the Provo Reservoir Canal 
    Siphon and Penstock, as in existence on the date of enactment of 
    this Act.
        (6) Salt lake aqueduct.--The term ``Salt Lake Aqueduct'' means 
    the aqueduct and associated land, rights-of-way, and facilities 
    acquired, constructed or improved by the United States as part of 
    the Provo River Project, Aqueduct Division, extending from, and 
    including, the Salt Lake Aqueduct Intake at the base of Deer Creek 
    Dam to and including the Terminal Reservoirs located at 3300 South 
    St. and Interstate Route 215 in Salt Lake City, Utah, as in 
    existence on the date of enactment of this Act.
        (7) Secretary.--The term ``Secretary'' means the Secretary of 
    the Interior or a designee of the Secretary.
        (8) State.--The term ``State'' means the State of Utah.

SEC. 3. CONVEYANCE OF LAND AND FACILITIES.

    (a) Conveyances to Association.--
        (1) Provo reservoir canal.--
            (A) In general.--In accordance with the terms and 
        conditions of the Agreement and subject to subparagraph (B), 
        the Secretary shall convey to the Association, all right, 
        title, and interest of the United States in and to the Provo 
        Reservoir Canal.
            (B) Condition.--The conveyance under subparagraph (A) shall 
        not be completed until the Secretary executes the Agreement and 
        accepts future arrangements entered into by the Association, 
        the District, the Central Utah Water Conservancy District, and 
        the Jordan Valley Water Conservancy District providing for the 
        operation, ownership, financing, and improvement of the Provo 
        Reservoir Canal.
        (2) Pleasant grove property.--In accordance with the terms and 
    conditions of the Agreement, the Secretary shall convey to the 
    Association, all right, title, and interest of the United States in 
    and to the Pleasant Grove Property.
    (b) Conveyance to District.--
        (1) In general.--In accordance with the terms and conditions of 
    the Agreement, and subject to the execution of the Agreement by the 
    Secretary, the Secretary shall convey to the District, all right, 
    title, and interest of the United States in and to Salt Lake 
    Aqueduct.
        (2) Easements.--
            (A) In general.--As part of the conveyance under paragraph 
        (1), the Secretary shall grant to the District permanent 
        easements to--
                (i) the National Forest System land on which the Salt 
            Lake Aqueduct is located; and
                (ii) land of the Aqueduct Division of the Provo River 
            Project that intersects the parcel of non-Federal land 
            authorized to be conveyed to the United States under 
            section 104(a) of Public Law 107-329 (116 Stat. 2816).
            (B) Purpose.--The easements conveyed under subparagraph (A) 
        shall be for the use, operation, maintenance, repair, 
        improvement, or replacement of the Salt Lake Aqueduct by the 
        District.
            (C) Limitation.--The United States shall not carry out any 
        activity on the land subject to the easements conveyed under 
        subparagraph (A) that would materially interfere with the use, 
        operation, maintenance, repair, improvement, or replacement of 
        the Salt Lake Aqueduct by the District.
            (D) Boundaries.--The boundaries of the easements conveyed 
        under subparagraph (A) shall be determined by the Secretary, in 
        consultation with the District and the Secretary of 
        Agriculture.
            (E) Transfer of administrative jurisdiction.--
                (i) In general.--On conveyance of the easement to the 
            land described in subparagraph (A)(ii), the Secretary, 
            subject to the easement, shall transfer to the Secretary of 
            Agriculture administrative jurisdiction over the land.
                (ii) Administrative site.--The land transferred under 
            clause (i) shall be administered by the Secretary of 
            Agriculture as an administrative site.
            (F) Administration.--The easements conveyed under 
        subparagraph (A) shall be administered by the Secretary of 
        Agriculture in accordance with section 501(b)(3) of the Federal 
        Land Policy and Management Act of 1976 (43 U.S.C. 1761(b)(3)).
    (c) Consideration.--
        (1) Association.--
            (A) In general.--In exchange for the conveyance under 
        subsection (a)(1), the Association shall pay the Secretary an 
        amount that is equal to the sum of--
                (i) the net present value of any remaining debt 
            obligation of the United States with respect to the Provo 
            Reservoir Canal; and
                (ii) the net present value of any revenues from the 
            Provo Reservoir Canal that, based on past history--

                    (I) would be available to the United States but for 
                the conveyance of the Provo Reservoir Canal under 
                subsection (a)(1); and
                    (II) would be deposited in the reclamation fund 
                established under the first section of the Act of June 
                17, 1902 (43 U.S.C. 391), and credited under the terms 
                of Reclamation Manual/Directives and Standards PEC 03-
                01.

            (B) Deduction.--In determining the net present values under 
        clauses (i) and (ii) of subparagraph (A), the Association may 
        deduct from the net present value such sums as are required for 
        the reimbursement described in the Agreement.
        (2) District.--
            (A) In general.--In exchange for the conveyance under 
        subsection (b)(1), the District shall pay the Secretary an 
        amount that is equal to the sum of--
                (i) the net present value of any remaining debt 
            obligation of the United States with respect to the Salt 
            Lake Aqueduct; and
                (ii) the net present value of any revenues from the 
            Salt Lake Aqueduct that, based on past history--

                    (I) would have been available to the United States 
                but for the conveyance of the Salt Lake Aqueduct under 
                subsection (b)(1); and
                    (II) would be deposited in the reclamation fund 
                established under the first section of the Act of June 
                17, 1902 (43 U.S.C. 391), and credited under the terms 
                of Reclamation Manual/Directives and Standards PEC 03-
                01.

            (B) Deduction.--In determining the net present values under 
        clauses (i) and (ii) of subparagraph (A), the District may 
        deduct from the net present value such sums as are required for 
        the reimbursement described in the Agreement.
    (d) Payment of Costs.--In addition to amounts paid to the Secretary 
under subsection (c), the Association and the District shall, in 
accordance with the Agreement, pay the Secretary--
        (1) any necessary and reasonable administrative and real estate 
    transfer costs incurred by the Secretary in carrying out the 
    conveyance; and
        (2) one-half of any necessary and reasonable costs associated 
    with complying with--
            (A) the National Environmental Policy Act of 1969 (42 
        U.S.C. 4321 et seq.);
            (B) the Endangered Species Act of 1973 (16 U.S.C. 1531 et 
        seq.); and
            (C)(i) the National Historic Preservation Act (16 U.S.C. 
        470 et seq.); and
            (ii) any other Federal cultural resource laws.
    (e) Compliance With Environmental Laws.--
        (1) In general.--Before conveying land and facilities under 
    subsections (a) and (b), the Secretary shall comply with all 
    applicable requirements under--
            (A) the National Environmental Policy Act of 1969 (42 
        U.S.C. 4321 et seq.);
            (B) the Endangered Species Act of 1973 (16 U.S.C. 1531 et 
        seq.); and
            (C) any other law applicable to the land and facilities.
        (2) Effect.--Nothing in this Act modifies or alters any 
    obligations under--
            (A) the National Environmental Policy Act of 1969 (42 
        U.S.C. 4321 et seq.); or
            (B) the Endangered Species Act of 1973 (16 U.S.C. 1531 et 
        seq.).

SEC. 4. EXISTING CONTRACTS.

    (a) Deer Creek Division Construction Contract.--Notwithstanding the 
conveyances under subsections (a) and (b)(1) of section 3, and subject 
to the terms of the Agreement, any portion of the Deer Creek Division, 
Provo River Project, Utah, that is not conveyed under that section 
shall continue to be operated and maintained by the Association, in 
accordance with the contract numbered I1r-874, dated June 27, 1936, and 
entitled the ``Contract Between the United States and Provo River Water 
Users Association Providing for the Construction of the Deer Creek 
Division of the Provo River Project, Utah''.
    (b) Provo River Project and Jordan Aqueduct System Contracts.--
Subject to the terms of the Agreement, any written contract of the 
United States in existence on the date of enactment of this Act 
relating to the operation and maintenance of any division or facility 
of the Provo River Project or the Jordan Aqueduct System is confirmed 
and declared to be a valid contract of the United States that is 
enforceable in accordance with the express terms of the contract.
    (c) Use of Central Utah Project Water.--
        (1) In general.--Subject to paragraph (2), any entity with 
    contractual Provo Reservoir Canal or Salt Lake Aqueduct capacity 
    rights in existence on the date of enactment of this Act may, in 
    addition to the uses described in the existing contracts, use the 
    capacity rights, without additional charge or further approval from 
    the Secretary, to transport Central Utah Project water on behalf of 
    the entity or others.
        (2) Limitations.--An entity shall not use the capacity rights 
    to transport Central Utah Project water under paragraph (1) 
    unless--
            (A) the transport of the water is expressly authorized by 
        the Central Utah Water Conservancy District;
            (B) the use of the water facility to transport the Central 
        Utah Project water is expressly authorized by the entity 
        responsible for operation and maintenance of the facility; and
            (C) carrying Central Utah Project water through Provo River 
        Project facilities would not--
                (i) materially impair the ability of the Central Utah 
            Water Conservancy District or the Secretary to meet 
            existing express environmental commitments for the 
            Bonneville Unit; or
                (ii) require the release of additional Central Utah 
            Project water to meet those environmental commitments.
    (d) Authorized Modifications.--The Agreement may provide for--
        (1) the modification of the 1936 Repayment Contract for the 
    Deer Creek Division of the Provo River Project to reflect the 
    partial prepayment, the adjustment of the annual repayment amount, 
    and the transfer of the Provo Reservoir Canal and the Pleasant 
    Grove Property; and
        (2) the modification or termination of the 1938 Repayment 
    Contract for the Aqueduct Division of the Provo River Project to 
    reflect the complete payout and transfer of all facilities of the 
    Aqueduct Division.
    (e) Effect of Act.--Nothing in this Act impairs any contract 
(including subscription contracts) in effect on the date of enactment 
of this Act that allows for or creates a right to convey water through 
the Provo Reservoir Canal.

SEC. 5. EFFECT OF CONVEYANCE.

    On conveyance of any land or facility under subsection (a) or 
(b)(1) of section 3--
        (1) the land and facilities shall no longer be part of a 
    Federal reclamation project;
        (2) the Association and the District shall not be entitled to 
    receive any future reclamation benefits with respect to the land 
    and facilities, except for benefits that would be available to 
    other nonreclamation facilities; and
        (3) the United States shall not be liable for damages arising 
    out of any act, omission, or occurrence relating to the land and 
    facilities, but shall continue to be liable for damages caused by 
    acts of negligence committed by the United States or by any 
    employee or agent of the United States before the date of 
    conveyance, consistent with chapter 171 of title 28, United States 
    Code.

SEC. 6. REPORT.

    If a conveyance required under subsection (a) or (b)(1) of section 
3 is not completed by the date that is 18 months after the date of 
enactment of this Act, the Secretary shall submit to Congress a report 
that--
        (1) describes the status of the conveyance;
        (2) describes any obstacles to completing the conveyance; and
        (3) specifies an anticipated date for completion of the 
    conveyance.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
Provo River Project Transfer Act - (Sec. 3) Directs the Secretary of the Interior to convey to the Provo River Water Users Association (Association) all right, title, and interest of the United States in and to the Provo Reservoir Canal in the State of Utah. Conditions such conveyance upon the execution by the Secretary of the Agreement entitled "Agreement Among the United States, the Provo River Waters Users Association, and the Metropolitan Water District of Salt Lake & Sandy to Transfer Title to Certain Lands and Facilities of the Provo River Project (Agreement)," and upon the Secretary's acceptance of future arrangements governing the operation, ownership, financing, and improvement of the Provo Reservoir Canal.

Directs the Secretary to convey to the Association all right, title, and interest of the United States in and to the Pleasant Grove Property in the State of Utah.

Directs the Secretary to: (1) convey to the Metropolitan Water District of Salt Lake & Sandy (District) in the State of Utah, all right, title, and interest of the United States in and to Salt Lake Aqueduct; (2) grant permanent easements to the District for the use, operation, maintenance, repair, improvement, or replacement of the Salt Lake Aqueduct by the District; (3) determine the boundaries of such easements; and (4) transfer administrative jurisdiction over certain land of the Aqueduct Division of the Provo River Project to the Secretary of Agriculture. Directs the Secretary of Agriculture to administer such land as an administrative site subject to provisions of the Federal Land Policy and Management Act of 1976.

Prohibits the United States from carrying out any activities on the lands covered by the Salt Lake Aqueduct easements that would materially interfere with the operation, maintenance, repair, improvement, or replacement of the Salt Lake Aqueduct by the District.

Sets forth a formula for for payments by the Association and the District for the land conveyances under this Act. Requires the Association and the District to pay certain additional costs relating to the land conveyances.

Requires the Secretary to comply with certain environmental and other laws prior to making land conveyances under this Act.

(Sec. 4) Confirms that: (1) certain existing contracts covering lands of the Provo River Project not conveyed by this Act remain in effect; and (2) entities with existing contractual capacity rights to either the Provo Reservoir Canal or Salt Lake Aqueduct may transport Central Utah Project water.

Authorizes the Agreement to provide for modifications to repayment contracts for the Deer Creek and Aqueduct Divisions of the Provo River Project.

Provides that nothing in this Act impairs any existing contract (including subscription contracts) regarding the conveyance of water through the Provo Reservoir Canal.

(Sec. 5) Provides that: (1) lands and facilities conveyed under this Act are no longer part of a Federal reclamation project; (2) the Association and the District are no longer entitled to reclamation benefits for conveyed lands, except for benefits available to other nonreclamation facilities; and (3) the United States shall not be liable for damages for acts, omissions, or occurrences relating to conveyances under this Act, except for negligent acts committed prior to the date of conveyance.

(Sec. 6) Requires the Secretary to report to Congress on the status of any land conveyances not completed within 18 months after the enactment of this Act.

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Medicare Home 
Health Refinement Act of 2000''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
    TITLE I--EMERGENCY CASH-FLOW ASSISTANCE FOR HOME HEALTH AGENCIES

Sec. 101. Home Health Transitional Loan Program.
Sec. 102. Establishment of split-payment percentages under the PPS for 
                            home health services.
Sec. 103. Prompt payment from medicare trust funds under the IPS and 
                            the PPS for home health services.
   TITLE II--REIMBURSEMENT OF HOME HEALTH AGENCIES FOR UNFUNDED PPS 
                             RELATED COSTS

Sec. 201. Adjustment to reflect administrative costs not included in 
                            the PPS for home health services.
 TITLE III--REIMBURSEMENT OF HOME HEALTH AGENCIES FOR OASIS LABOR COSTS

Sec. 301. Reimbursement for OASIS labor costs under the IPS and PPS for 
                            home health services.
TITLE IV--NONROUTINE MEDICAL SUPPLIES FURNISHED BY HOME HEALTH AGENCIES

Sec. 401. Exclusion of nonroutine medical supplies under the PPS for 
                            home health services.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Home health care is a vital component of the medicare 
        program under title XVIII of the Social Security Act.
            (2) Home health services provided under the medicare 
        program enable medicare beneficiaries who are homebound and 
        greatly risk costly institutionalized care to continue to live 
        in their own homes and communities.
            (3) The Balanced Budget Act of 1997 reformed Medicare home 
        health care spending by instructing the Health Care Financing 
        Administration (in this section referred to as ``HCFA'') to 
        implement a prospective payment system.
            (4) A number of HCFA's regulations to implement the 
        prospective payment system are administratively burdensome and 
        divert funds away from needed beneficiary care.
            (5) The vast majority of home health agencies are small 
        businesses or nonprofit institutions that cannot operate with 
        significant cash flow problems.
            (6) The prospective payment system should not penalize home 
        health agencies that treat medicare beneficiaries with higher-
        than-average medical needs.

    TITLE I--EMERGENCY CASH-FLOW ASSISTANCE FOR HOME HEALTH AGENCIES

SEC. 101. HOME HEALTH TRANSITIONAL LOAN PROGRAM.

    (a) Establishment of Home Health Transitional Loan Program.--There 
is established a Home Health Transitional Loan Program under which the 
Secretary of Health and Human Services (in this section referred to as 
the ``Secretary'') shall make loans from the Federal Hospital Insurance 
Trust Fund to any qualified home health agency (as defined in 
subsection (c)) in accordance with the terms and conditions described 
in subsection (b) before the termination of the authority of the 
Secretary to make such loans under subsection (d).
    (b) Terms and Conditions.--
            (1) In general.--Subject to paragraph (2), the Secretary 
        shall make loans on such terms and conditions as the Secretary 
        may specify.
            (2) Specific terms and conditions.--The terms and 
        conditions of each loan shall include the following:
                    (A) Application.--The Secretary shall approve each 
                application for a loan under this section submitted by 
                a qualified home health agency not later than 10 days 
                after the Secretary receives such application.
                    (B) Amount.--The total amount of a loan made to a 
                qualified home health agency under this section may not 
                exceed the average total costs incurred by such a home 
                health agency during a 3-month period as reported on 
                such home health agency's most recently settled 
                medicare cost report.
                    (C) Interest rate.--The interest rate of the loans 
                made under this section shall be zero percent.
                    (D) Duration.--The home health agency shall repay 
                any loan made under this section not later than 12 
                months after the date on which such loan is made.
    (c) Qualified Home Health Agency Defined.--The term ``qualified 
home health agency'' means a home health agency (as defined in section 
1861(o) of the Social Security Act (42 U.S.C. 1395x(o))) that the 
Secretary determines does not have sufficient cash reserves to 
transition from the interim payment system for home health services 
under section 1861(v)(1)(L) of such Act (42 U.S.C. 1395x(v)(1)(L)) (in 
this section referred to as the ``IPS'' to the prospective payment 
system for such services under section 1895 of such Act (42 U.S.C. 
1395fff) (in this section referred to as the ``PPS'') because of--
            (1) the repayment by the home health agency of overpayments 
        made under the IPS;
            (2) the discontinuation of the periodic interim payment for 
        home health agencies by section 4603(b) of the Balanced Budget 
        Act of 1997 (Public Law 105-133; 111 Stat. 470); or
            (3) the payment amounts under the PPS being less than the 
        payment amounts under the IPS.
    (d) Termination of Authority.--The Secretary may not make any loan 
under this section after the date that is 6 months after the date of 
enactment of this Act.
    (e) Effective Date.--This section shall take effect on the later 
of--
            (1) the date of enactment of this Act; or
            (2) the date on which the Secretary implements the 
        prospective payment system under section 1895 of the Social 
        Security Act (42 U.S.C. 1395fff).

SEC. 102. ESTABLISHMENT OF SPLIT-PAYMENT PERCENTAGES UNDER THE PPS FOR 
              HOME HEALTH SERVICES.

     (a) Establishment.--Section 1895(b) of the Social Security Act (42 
U.S.C. 1395fff) is amended by adding at the end the following new 
paragraph:
            ``(7) Establishment of split-payment percentages.--In 
        making payments under this section, the Secretary shall pay to 
        the agency 80 percent of the prospective payment amount upon 
        the transmittal of the notice of patient admission and 20 
        percent of such amount upon transmittal of the final episode 
        claim.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect on the date of enactment of this Act.

SEC. 103. PROMPT PAYMENT FROM MEDICARE TRUST FUNDS UNDER THE IPS AND 
              THE PPS FOR HOME HEALTH SERVICES.

    (a) Under the IPS.--Section 1861(v)(1)(L) of the Social Security 
Act (42 U.S.C. 1395x(v)(1)(L)) is amended by adding at the end the 
following new clause:
    ``(xi) To ensure that payment of claims of home health agencies are 
not delayed because the Secretary must determine from which trust fund 
to pay a claim under this subparagraph, the Secretary shall pay the 
full amount of each claim for an episode of care from the Federal 
Supplementary Medical Insurance Trust Fund, and, in the case that any 
amount paid from such Trust Fund should have been paid from the Federal 
Hospital Insurance Trust Fund, the Secretary shall transfer such amount 
from the Federal Hospital Insurance Trust Fund to the Federal 
Supplementary Medical Insurance Trust Fund.''.
    (b) Under the PPS.--Section 1895(b) of the Social Security Act (42 
U.S.C. 1395fff) (as amended by section 102) is amended by adding at the 
end the following new paragraph:
            ``(8) Prompt payments from trust funds.--To ensure that 
        payment of claims of home health agencies are not delayed 
        because the Secretary must determine from which trust fund to 
        pay a claim under this section, the Secretary shall pay the 
        full amount of each claim for an episode of care from the 
        Federal Supplementary Medical Insurance Trust Fund, and, in the 
        case that any amount paid from such Trust Fund should have been 
        paid from the Federal Hospital Insurance Trust Fund, the 
        Secretary shall transfer such amount from the Federal Hospital 
        Insurance Trust Fund to the Federal Supplementary Medical 
        Insurance Trust Fund.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date of enactment of this Act.

   TITLE II--REIMBURSEMENT OF HOME HEALTH AGENCIES FOR UNFUNDED PPS 
                             RELATED COSTS

SEC. 201. ADJUSTMENT TO REFLECT ADMINISTRATIVE COSTS NOT INCLUDED IN 
              THE PPS FOR HOME HEALTH SERVICES.

    (a) Adjustment To Reflect Administrative Costs.--In the case of a 
home health agency that furnishes home health services to a medicare 
beneficiary, for each such beneficiary to whom the agency furnished 
such services during the agency's cost reporting period beginning in 
fiscal year 2000, the Secretary of Health and Human Services shall pay 
the agency, in addition to any amount of payment made under section 
1861(v)(1)(L) of the Social Security Act (42 U.S.C. 1395x(v)(1)(L)) for 
the beneficiary and only for such cost reporting period, an aggregate 
amount of $10 to defray costs incurred by the agency attributable to 
technology costs required for compliance with the prospective payment 
system for home health services under section 1895 of the Social 
Security Act (42 U.S.C. 1395fff), including the acquisition of computer 
hardware and software necessary for classification of patients, and 
accounting, billing, and transmitting data in the manner required under 
such payment system.
    (b) Payment 30 Days After Settled Cost Report.--The Secretary shall 
pay the amounts payable to an agency under this section no later than 
30 days after the later of--
            (1) the date of enactment of this Act; or
            (2) the date on which the cost report submitted by the 
        agency for the cost reporting period beginning in fiscal year 
        2000 is settled.
    (c) Payment From Medicare Trust Funds.--Payments under this section 
shall be made, in appropriate part as specified by the Secretary, from 
the Federal Hospital Insurance Trust Fund and from the Federal 
Supplementary Medical Insurance Trust Fund.
    (d) Definitions.--In this section:
            (1) Home health agency.--The term ``home health agency'' 
        has the meaning given that term under section 1861(o) of the 
        Social Security Act (42 U.S.C. 1395x(o)).
            (2) Home health services.--The term ``home health 
        services'' has the meaning given that term under section 
        1861(m) of such Act (42 U.S.C. 1395x(m)).
            (3) Medicare beneficiary.--The term ``medicare 
        beneficiary'' means a beneficiary described in section 
        1861(v)(1)(L)(vi)(II) of the Social Security Act (42 U.S.C. 
        1395x(v)(1)(L)(vi)(II)).

 TITLE III--REIMBURSEMENT OF HOME HEALTH AGENCIES FOR OASIS LABOR COSTS

SEC. 301. REIMBURSEMENT FOR OASIS LABOR COSTS UNDER THE IPS AND PPS FOR 
              HOME HEALTH SERVICES.

    (a) Adjustment To Reflect Administrative Costs.--
            (1) Under the interim payment system.--Section 301(a) of 
        the Medicare, Medicaid, and SCHIP Balanced Budget Refinement 
        Act of 1999 (42 U.S.C. 1395fff note) is amended--
                    (A) in paragraph (1)--
                            (i) by inserting ``and each subsequent 
                        fiscal year before the implementation of the 
                        prospective payment system under section 1895 
                        of the Social Security Act (42 U.S.C. 
                        1395fff)'' after ``beginning in fiscal year 
                        2000''; and
                            (ii) by striking ``$10'' and inserting 
                        ``$30'';
                    (B) in paragraph (2)--
                            (i) by redesignating subparagraphs (A) and 
                        (B) as clauses (i) and (ii), respectively;
                            (ii) by inserting after the heading the 
                        following:
                    ``(A) For fiscal year 2000.--''; and
                            (iii) by adding at the end the following 
                        new subparagraph:
                    ``(B) For subsequent fiscal years.--For each cost 
                reporting period beginning after fiscal year 2000 and 
                before the implementation of the prospective payment 
                system under section 1895 of the Social Security Act 
                (42 U.S.C. 1395fff), the Secretary shall pay the 
                amounts payable to an agency under this subsection no 
                later than 30 days after the date on which the cost 
                report submitted by the agency for the cost reporting 
                period beginning in such fiscal year is settled.''.
            (2) Under the prospective payment system.--Section 1895(b) 
        of the Social Security Act (42 U.S.C. 1395fff) (as amended by 
        section 103) is amended by adding at the end the following new 
        paragraph:
            ``(9) Adjustment to reflect oasis administrative costs.--In 
        the case of a home health agency that furnishes home health 
        services to a medicare beneficiary, for each such beneficiary 
        to whom the agency furnished such services during the agency's 
        cost reporting period for which payment is made to such agency 
        under this section, the Secretary shall include in such payment 
        an aggregate amount of $30 to defray costs incurred by the 
        agency attributable to data collection and reporting 
        requirements under the Outcome and Assessment Information Set 
        (OASIS) required by reason of section 4602(e) of BBA (42 U.S.C. 
        1395fff note).
    (b) Waiving Budget Neutrality.--Section 1895(b)(3) of such Act (42 
U.S.C. 1395fff(b)(3)) is amended by adding at the end the following new 
subparagraph:
                    ``(D) No adjustment for additional payments for 
                oasis administrative costs.--The Secretary shall not 
                reduce the standard prospective payment amount (or 
                amounts) under this paragraph applicable to home health 
                services furnished during a period to offset the 
                increase in payments resulting from the application of 
                paragraph (9).''.
    (c) Effective Date.--The amendments made by subsection (a) shall 
take effect as if included in the enactment of the Medicare, Medicaid, 
and SCHIP Balanced Budget Refinement Act of 1999 (113 Stat. 1501A-358), 
as enacted into law by section 1000(a)(6) of Public Law (106-113).

TITLE IV--NONROUTINE MEDICAL SUPPLIES FURNISHED BY HOME HEALTH AGENCIES

SEC. 401. EXCLUSION OF NONROUTINE MEDICAL SUPPLIES UNDER THE PPS FOR 
              HOME HEALTH SERVICES.

    (a) In General.--Section 1895 of the Social Security Act (42 U.S.C. 
1395fff) is amended by adding at the end the following new subsection:
    ``(e) Exclusion of Nonroutine Medical Supplies.--
            ``(1) In general.--Notwithstanding the preceding provisions 
        of this section, in the case of all nonroutine medical supplies 
        (as defined by the Secretary) furnished by a home health agency 
        during a year (beginning with 2001) for which payment is 
        otherwise made on the basis of the prospective payment amount 
        under this section, payment under this section shall instead be 
        based on the lesser of--
                    ``(A) the actual charge for the nonroutine medical 
                supply, or
                    ``(B) the amount determined under the fee schedule 
                established by the Secretary for purposes of making 
                payment under this subsection for nonroutine medical 
                supplies furnished during that year.
            ``(2) Budget neutrality adjustment.--The Secretary shall 
        provide for an appropriate proportional reduction in payments 
        under this section so that beginning with fiscal year 2001, the 
        aggregate amount of such reductions is equal to the aggregate 
        increase in payments attributable to the exclusion effected 
        under paragraph (1).''.
    (b) Conforming Amendment.--Section 1895(b)(1) of the Social 
Security Act (42 U.S.C. 1395fff(b)(1)) is amended by striking ``The 
Secretary'' and inserting ``Subject to subsection (e), the Secretary''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date of enactment of this Act.

Title II: Reimbursement of Home Health Agencies for Unfunded PPS Related Costs
 - Provides that in the case of a home health agency that furnishes home health services to a Medicare beneficiary, for each such beneficiary to whom the agency furnished such services during the agency's cost reporting period beginning in FY 2000, the Secretary shall pay the agency a specified amount from the Medicare trust funds to defray costs incurred by it attributable to technology costs required for compliance with the PPS for home health services.
Title III: Reimbursement of Home Health Agencies for OASIS Labor Costs
 - Amends the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 to provide for reimbursement for Outcome and Assessment Information Set (OASIS) labor costs under the IPS and PPS for home health services.
Title IV: Nonroutine Medical Supplies Furnished by Home Health Agencies
 - Amends SSA title XVIII to: (1) exclude nonroutine medical supplies from the PPS for home health services; and (2) require payment of the lesser of the actual charge for such supplies or the amount determined under a fee schedule.