A bill to amend part A of title XVIII of the Social Security Act with respect to the payment rates for routine home care and other services included in hospice care.
PL 98-617 (H.R.5386), enacted 11/08/1984

98 STAT. 3294 
PUBLIC LAW 98-617—NOV. 8, 1984 
Nov. 8, 1984 
[H.R. 5386] 
Aged persons. 
Health. 
42 u s e 1395f. 
Report. 
Effective date. 
42 u s e 1395f 
note. 
Public Law 98-617 
98th Congress 
An Act 
To amend part A of title XVIII of the Social Security Act with respect to the pajmient 
r a t ^ for routine home care and other services included in hospice care. 
Be it enacted by the Senate and House of Representatives 
of 
the United States of America in Congress assembled, That (a) sec-
tion 1814(iXl) of the Social Security Act (42 U.S.C. 1395(i)(l)) is 
amended— 
(1) by inserting "(A)" after "(iXD", and 
(2) by adding at the end the following new subparagraphs: 
"(B) Notwithstanding subparagraph (A), the rate of payment per 
day for routine home care furnished during fiscal year 1985 shall be 
$53.17. 
"(C) With respect to care and services furnished on or after 
October 1, 1985, the Secretary shall, not less often than annually, 
review and make appropriate adjustments to the payment rate for 
routine home care and the pa3rment rates for other services included 
in hospice care based on the costs that are reasonable and related to 
the costs of furnishing such care and services. The Secretary shall 
report to Congress on October 1 each year on such review and such 
adjustments and on the adequacy of the rates under this paragraph 
to ensure participation by an adequate number of hospice programs 
under this title.". 
(b) The amendments made by this Act shall apply to routine home 
care and other services included in hospice care furnished on or 
after October 1,1984. 
PUBUC PENSION OFFSET PROVISIONS 
SEC. 2. (aXl) Section 337(b) of the Social Security Amendments of 
97 Stat. 131. 
1983 is amended by striking out "to individuals who initially become 
42 use 402 note, eligible" and all that follows and inserting in lieu thereof "for 
months after June 1983.". 
Effective date. 
(2) The amendments made by this subsection shall apply to bene-
42 use 402 note, fits payable under title II of the Social Security Act for months 
beginning after the month of enactment of this Act. 
(bXD Section 334(gXlXA) of the Social Security Amendments of 
42 use 402 note. 1977 is amended— 
(A) by inserting "(i)" after "(A)"; and 
(B) by inserting before the semicolon at the end thereof the 
following: ", or (ii) who would have been eligible for such a 
monthly periodic benefit (within the meaning of paragraph (2)) 
before the close of such 60-month period, except for a re-
quirement which postponed eligibility (as so defined) for such 
monthly periodic benefit until the month following the month 
in which all other requirements were met". 
(2) Section 334(hXl) of such Amendments (as amended by section 7 
of Public Law 97-455) is amended— 
(A) by inserting "(A)" after "(1)"; and 
PUBLIC LAW 98-617—NOV. 8, 1984 
98 STAT. 3295 
(B) by inserting before the semicolon at the end thereof the 
following: ", or (B) who would have been eligible for such a 
monthly periodic benefit (within the meaning of subsection 
(g)(2)) before the close of June 1983, except for a requirement 
which postponed eligibility (as so defined) for such monthly 
periodic benefit until the month following the month in which 
all other requirements were met". 
(3) The amendments made by this subsection shall apply with 
Effective date. 
respect to benefits payable under title II of the Social Security Act 
^2 use 402 note. 
for months beginning after the month of enactment of this Act. 
TECHNICAL AMENDMENTS 
SEC. 3. (a)(1) Section 2307(a)(1) of the Deficit Reduction Act of 1984 
Ante, p. 1073. 
is amended by striking out "1842(b)(7)(A)" and inserting in lieu 
thereof "1842(b)(7)". 
(2) Section 2326(a) of the Deficit Reduction Act of 1984 is amended 
Ante, p. 1087. 
by striking out "1816(a)(1)" and inserting in lieu thereof "1816(a)". 
(3) Section 2354(b)(1) of the Deficit Reduction Act of 1984 is 
Ante, p. iioo. 
amended by striking out "last sentence of sections 1814(a) and the 
last sentence of section 1835(a)" and inserting in lieu thereof "the 
third sentence of section 1814(a) and the fourth sentence of section 
1835(a)". 
(4) Section 2354(b)(23) of the Deficit Reduction Act of 1984 is 
amended by striking out "1861(v)(lXE)(ii)" and inserting in lieu 
thereof "1861(v)(l)(E)". 
(5) Section 2354(c)(3)(BXi) of the Deficit Reduction Act of 1984 is 
amended by inserting "under" before "section". 
(6) Section 2363(b) of the Deficit Reduction Act of 1984 is amended 
Ante, p. 1105. 
by striking out "1903" and inserting in lieu thereof "1903(g)". 
(7) Section 2373(b) of the Deficit Reduction Act of 1984 is amended 
Ante, p. ilii. 
by striking out paragraph (6). 
(b)(1) Section 1814(kX2) of the Social Security Act, as added by 
section 2321(aX2) of the Deficit Reduction Act of 1984, is amended— 
Ante, p. 1084. 
(A) by inserting after "public home health agency" the follow-
ing: ", or by another home health agency which demonstrates to 
the satisfaction of the Secretary that a significant portion of its 
patients are low-income (and requests that payment be made 
under this paragraph),", and 
(B) by inserting "80 percent of" before "the amount". 
(2) Section 1833(a)(2XA) of the Social Security Act is amended by 
42 use 1395/. 
inserting after "public provider of services" the following: ", or by 
another provider which demonstrates to the satisfaction of the 
Secretary that a significant portion of its patients are low-income 
(and requests that payment be made under this provision),". 
(3) Section 1833(hX5XC) of the Social Securitv Act, as amended by 
section 2303(d) of the Deficit Reduction Act of 1984, is amended by 
Ante, p. 1064. 
inserting a comma after "1842(bX6)(B)". 
(4) Section 1839(f)(2)(A) of the Social Security Act, as added by 
section 2302(b) of the Deficit Reduction Act of 1984, is amended— 
Ante, p. 1063. 
(A) by striking out "for that January after the deduction" and 
inserting in lieu thereof "for that December after the deduc-
tion"; and 
(B) by striking out "for that November" and inserting in lieu 
thereof "for that December". 
(5) Section 1842(bX7XA) of the Social Security Act, as amended by 
section 2307 of the Deficit Reduction Act of 1984, is amended— 
Ante, p. 1073. 
98 STAT. 3296 
PUBLIC LAW 98-617—NOV. 8, 1984 
Ante, p. 1073. 
Hospitals. 
Ante, p. 1094. 
Ante, p. 1086. 
Ante, p. 1076. 
Ante, p. 1109. 
Effective date. 
42 u s e 1395f 
note. 
Ante, p. 494. 
42 u s e 674. 
(A) in clause (ii), by striking out "the amount of the payment 
exceeds the reasonable charge for the services (with the custom-
ary charge determined consistent with subparagraph (B))" and 
inserting in lieu thereof "the payment is based upon a reason-
able charge for the services in excess of the customary charge as 
determined in accordance v^dth subparagraph (B)"; and 
(B) by striking out the last sentence thereof. 
(6) Section 1842(bX7XB) of such Act, as amended by section 2307 of 
the Deficit Reduction Act of 1984, is amended by adding at the end 
thereof the following new clause: 
"(iii) If all the teaching physicians in a hospital agree to 
have payment made for all of their physicians' services 
under this part furnished to patients in such hospital on the 
beisis of an assignment described in paragraph (3)(B)(ii) or 
under the procedure described in section 1870(f)(1), the 
customary charge for such services shall be equal to 90 
percent of the prevailing charges paid for similar services 
in the same locality.". 
(7) Section 1861(rX3) of the Social Security Act, as amended by 
section 2341 of the Deficit Reduction Act of 1984, is amended by 
striking out "under subsections (k) and (m) and sections 1814(a) and 
1835" and inserting in lieu thereof "under subsections (k), (m), and 
(pXD of this section and sections 1814(a), 1832(aX2XFXii), and 1835". 
(8) Paragraph (11) of section 1881(b) of the Social Security Act, 
added by section 2323(c) of the Deficit Reduction Act of 1984, is 
amended by aligning its left mai^n flush so as to align its left 
margin with that of paragraph (10). 
(9) Section 1886(dX5XCXi) of the Social Security Act, as amended 
by section 2311(a) of the Dieficit Reduction Act of 1984, is amended 
by striking out "30 days after the date of the enactment of this Act" 
and inserting in lieu thereof "August 17,1984". 
(10) Section 1902(aX26) of the Social Security Act, as amended by 
section 2368(b) of the Deficit Reduction Act of 1984, is amended by 
indenting subpar^aph (C) two additional ems to the right so as to 
align its left margin with the left margin of subparagraph (A) of that 
section. 
(c) The amendments made by this section shall be effective as if 
they had been originally included in the Deficit Reduction Act of 
1984. 
FOSTER CARE PROVISIONS 
SEC. 4. (a) Section 474(b) of the Social Security Act is amended— 
(1) in paragraphs (1), (2XB), and (4XB), by striking out "1981 
through 1984" and inserting in lieu thereof "1981 through 
1985"; 
(2) in paragraph (2XA)— 
(A) by striking out "and" at the end of clause (iii), 
(B) by striking out the period at the end of clause (iv) and 
inserting in lieu thereof "; and", and 
(C) by adding after clause (iv) the following new clause: 
"(v) with respect to fiscal year 1985, only if the amount 
appropriated under section 420 for such fiscal year is equal to 
$266,000,000."; and 
(3) in paragraph (5XA)— 
(A) by striking out "October 1,1984" and inserting in lieu 
thereof "October 1,1985", and 
PUBLIC LAW 98-617—NOV. 8, 1984 
98 STAT. 3297 
(B) by striking out "fiscal year 1984" in clause (ii) and 
inserting in lieu thereof "each of fiscal years 1984 and 
1985". 
(b) Section 474(c) of such Act is amended in paragraphs (1) and (2) 
42 use 674. 
by striking out "1981 through 1984" and inserting in lieu thereof 
"1981 through 1985". 
(c)(1) Section 102(aXl) of the Adoption Assistance and Child Wel-
fare Act of 1980 (Public Law 96-272) is amended by striking out 
9
7 Stat. 803. 
"October 1, 1984" and inserting in lieu thereof "October 1, 1985". 42 use 672 
(2) Section 102(c) of such Act is amended by striking out 
97*stat 803 
"October 1,1984" each place it appears and inserting in lieu thereof 
42 use 672 
"October 1,1985". 
note. 
Approved November 8, 1984. 
LEGISLATIVE HISTORY—H.R. 5386: 
HOUSE REPORT No. 98-1100 (Comm. on Ways and Means). 
eONGRESSIONAL RECORD, Vol. 130 (1984): 
Oct. 1, considered and passed House. 
Oct. 11, considered and passed Senate, amended; House concurred in Senate 
amendments.