In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

Example Input: SECTION 1. EXPENSES FOR HOUSEHOLD AND ELDER CARE SERVICES NECESSARY FOR
GAINFUL EMPLOYMENT.

(a) In General.--Subpart A of part IV of subchapter A of chapter 1
of the Internal Revenue Code of 1986 is amended by adding at the end
the following new section:

''SEC. 25E. EXPENSES FOR HOUSEHOLD AND ELDER CARE SERVICES NECESSARY
FOR GAINFUL EMPLOYMENT.

''(a) Allowance of Credit.--
''(1) In general.--In the case of an individual for which
there are 1 or more qualifying individuals (as defined in
subsection (b)(1)) with respect to such individual, there shall
be allowed as a credit against the tax imposed by this chapter
for the taxable year an amount equal to the applicable
percentage of the employment-related expenses (as defined in
subsection (b)(2)) paid by such individual during the taxable
year.
''(2) Applicable percentage defined.--For purposes of
paragraph (1), the term 'applicable percentage' means 35
percent reduced (but not below 20 percent) by 1 percentage
point for each $2,000 (or fraction thereof) by which the
taxpayer's adjusted gross income for the taxable year exceeds
$15,000.
''(b) Definitions of Qualifying Individual and Employment-Related
Expenses.--For purposes of this section--
''(1) Qualifying individual.--The term 'qualifying
individual' means an individual who--
''(A) has attained age 50, and
''(B) is one of the following:
''(i) An individual who bears a
relationship to the taxpayer described in
subparagraph (C) or (D) of section 152(d)(2)
(relating to fathers, mothers, and ancestors).
''(ii) An individual would be a dependent
of the taxpayer (as defined in section 152,
determined without regard to subsections (b)(1)
and (b)(2)) as a qualifying relative described
in section 152(d)(1) if--
''(I) in lieu of subparagraphs (B)
and (C) thereof the following applied
with respect to the individual:
''(aa) the taxpayer has
provided over one-half of the
individual's support for the
calendar year in which such
taxable year begins and each of
the preceding 4 taxable years,
and
''(bb) the individual's
modified adjusted gross income
for the calendar year in which
such taxable year begins is
less than the exemption amount
(as defined in section 151(d)),
''(II) the individual is physically
or mentally incapable of caring for
himself or herself, and
''(III) who has the same principal
place of abode as the taxpayer for more
than one-half of such taxable year.
''(iii) The spouse of the taxpayer who is
physically or mentally incapable of caring for
himself or herself.
''(2) Modified adjusted gross income.--The term 'modified
adjusted gross income' means adjusted gross income determined
without regard to section 86.
''(3) Employment-related expenses.--
''(A) In general.--The term 'employment-related
expenses' means amounts paid for the following
expenses, but only if such expenses are incurred to
enable the taxpayer to be gainfully employed for any
period for which there are 1 or more qualifying
individuals with respect to the taxpayer:
''(i) expenses for household services, and
''(ii) expenses for the care of a
qualifying individual, including expenses for
respite care and hospice care.
''(B) Exception.--Employment-related expenses
described in subparagraph (A) which are incurred for
services outside the taxpayer's household shall be
taken into account only if incurred for the care of--
''(i) a qualifying individual described in
paragraph (1)(A), or
''(ii) a qualifying individual (not
described in paragraph (1)(A)) who regularly
spends at least 8 hours each day in the
taxpayer's household.
''(C) Dependent care centers.--Employment-related
expenses described in subparagraph (A) which are
incurred for services provided outside the taxpayer's
household by a dependent care center (as defined in
subparagraph (D)) shall be taken into account only if--
''(i) such center complies with all
applicable laws and regulations of a State or
unit of local government, and
''(ii) the requirements of subparagraph (B)
are met.
''(D) Dependent care center defined.--For purposes
of this paragraph, the term 'dependent care center'
means any facility which--
''(i) provides care for more than six
individuals (other than individuals who reside
at the facility), and
''(ii) receives a fee, payment, or grant
for providing services for any of the
individuals (regardless of whether such
facility is operated for profit).
''(c) Dollar Limit on Amount Creditable.--The amount of the
employment-related expenses incurred during any taxable year which may
be taken into account under subsection (a) shall not exceed--
''(1) $3,000 if there is 1 qualifying individual with
respect to the taxpayer for such taxable year, or
''(2) $6,000 if there are 2 or more qualifying individuals
with respect to the taxpayer for such taxable year.
The amount determined under paragraph (1) or (2) (whichever is
applicable) shall be reduced by the aggregate amount excludable from
gross income under section 129 for the taxable year.
''(d) Earned Income Limitation.--Except as otherwise provided in
this subsection, the amount of the employment-related expenses incurred
during any taxable year which may be taken into account under
subsection (a) shall not exceed--
''(1) in the case of an individual who is not married at
the close of such year, such individual's earned income for
such year, or
''(2) in the case of an individual who is married at the
close of such year, the lesser of such individual's earned
income or the earned income of his spouse for such year.
''(e) Special Rules.--For purposes of this section--
''(1) Place of abode.--An individual shall not be treated
as having the same principal place of abode of the taxpayer if
at any time during the taxable year of the taxpayer the
relationship between the individual and the taxpayer is in
violation of local law.
''(2) Married couples must file joint return.--If the
taxpayer is married at the close of the taxable year, the
credit shall be allowed under subsection (a) only if the
taxpayer and his spouse file a joint return for the taxable
year.
''(3) Marital status.--An individual legally separated from
his spouse under a decree of divorce or of separate maintenance
shall not be considered as married.
''(4) Certain married individuals living apart.--If--
''(A) an individual who is married and who files a
separate return--
''(i) maintains as his home a household
which constitutes for more than one-half of the
taxable year the principal place of abode of a
qualifying individual, and
''(ii) furnishes over half of the cost of
maintaining such household during the taxable
year, and
''(B) during the last 6 months of such taxable year
such individual's spouse is not a member of such
household, such individual shall not be considered as
married.
''(5) Payments to related individuals.--No credit shall be
allowed under subsection (a) for any amount paid by the
taxpayer to an individual--
''(A) with respect to whom, for the taxable year, a
deduction under section 151(c) (relating to deduction
for personal exemptions for dependents) is allowable
either to the taxpayer or his spouse, or
''(B) who is a child of the taxpayer (within the
meaning of section 152(f)(1)) who has not attained the
age of 19 at the close of the taxable year. For
purposes of this paragraph, the term 'taxable year'
means the taxable year of the taxpayer in which the
service is performed.
''(6) Identifying information required with respect to
service provider.--No credit shall be allowed under subsection
(a) for any amount paid to any person unless--
''(A) the name, address, and taxpayer
identification number of such person are included on
the return claiming the credit, or
''(B) if such person is an organization described
in section 501(c)(3) and exempt from tax under section
501(a), the name and address of such person are
included on the return claiming the credit.
In the case of a failure to provide the information required
under the preceding sentence, the preceding sentence shall not
apply if it is shown that the taxpayer exercised due diligence
in attempting to provide the information so required.
''(7) Identifying information required with respect to
qualifying individuals.--No credit shall be allowed under this
section with respect to any qualifying individual unless the
TIN of such individual is included on the return claiming the
credit.
''(f) Regulations.--The Secretary shall prescribe such regulations
as may be necessary to carry out the purposes of this section.''.
(b) Clerical Amendment.--The table of sections for subpart A of
part IV of subchapter A of chapter 1 of the Internal Revenue Code of
1986 is amended by adding at the end the following new item:

''Sec. 25E. Expenses for household and elder care services necessary
for gainful employment.''.
(c) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after the date of the enactment of
this Act.
Example Output: Amends the Internal Revenue Code to allow a new tax credit for employment-related expenses necessary to care for a dependent of a taxpayer who has attained age 50, including expenses for household services and for the care of the dependent, including respite care and hospice care. Limits the amount of such credit to $3,000 for the care of one dependent and $6,000 for the care of two or more dependents of the taxpayer in a taxable year.

Example Input: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Housing Opportunities and Mitigating
Emergencies Act of 2005''.

SEC. 2. FINDINGS.

Congress finds the following:
(1) The Gulf Coast region of the United States was recently
decimated by twin natural disasters: Hurricanes Katrina and
Rita.
(2) Hurricane Katrina crashed into the Gulf Coast on August
29, 2005, as a category 4 storm.
(3) At the time of its landing, Hurricane Katrina was
recorded as the third strongest hurricane to ever make landfall
on the United States, with sustained winds over 140 miles per
hour.
(4) The damage and destruction caused by Hurricane Katrina
along the coastal regions of Louisiana, Mississippi, and
Alabama were unmatched in their breadth and scope.
(5) A 10- to 30-foot storm surge came ashore on over 200
continuous miles of coastline from southeast Louisiana,
including Mississippi and Alabama, through to the Florida
panhandle.
(6) The 30-foot storm surge recorded at Biloxi,
Mississippi, is the highest ever observed in the United States.
(7) Hurricane Katrina's storm surge quickly breached the
levee system that protected the city of New Orleans from Lake
Pontchartrain and the Mississippi River, subsequently flooding
at least 80 percent of the city.
(8) The magnitude of Hurricane Katrina was of such an
unprecedented scale that the Federal disaster declarations
which followed its destructive path blanketed over 90,000
square miles of the United States, an area almost as large as
the United Kingdom, displacing more than 1,000,000 people--a
humanitarian crisis on a scale unseen in the United States
since the Great Depression.
(9) The storm has now become the most destructive and
costliest natural disaster in the history of the United States,
resulting in over 1,300 deaths and estimated damage between
$70,000,000,000 and $130,000,000,000.
(10) Less than one month later, on September 24, 2005, the
region was battered again, this time by the strongest-measured
hurricane to ever have entered the Gulf of Mexico--Hurricane
Rita.
(11) Hurricane Rita came ashore between Texas and Louisiana
as a category 3 hurricane, packing winds up to 120 miles per
hour and a storm surge of 10 feet.
(12) A day prior to landfall, the resultant storm surge
also reopened some of the levee breaches caused by Hurricane
Katrina a month earlier and re-flooded parts of New Orleans.
(13) Local storm surges of 15 to 20 feet in southwestern
Louisiana were reported, and damage was extensive in coastal
parishes.
(14) Thousands of residents and families in the effected
States, who lived outside the 100-year flood plain and were
told they did not need flood insurance, suffered significant
damage to their homes and in many cases total losses.
(15) These families are currently without any type of
permanent shelter or any means by which to acquire such shelter
or otherwise make themselves whole, thus crippling the Gulf
Coast region and its economy.
(16) Because of the unprecedented magnitude of the storm
and the impact that the devastation of such a large region will
have on the United States as a whole, the Federal Government
should play a role in providing emergency assistance to these
families to help them rebuild and get on with their lives.

SEC. 3. TEMPORARY EMERGENCY ASSISTANCE FOR PRIMARY RESIDENCES DAMAGED
OR DESTROYED BY HURRICANES KATRINA AND RITA.

Title IV of the Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. 5170 et seq.) is amended by adding at the end
the following:

''SEC. 425. TEMPORARY EMERGENCY ASSISTANCE FOR PRIMARY RESIDENCES
DAMAGED OR DESTROYED BY HURRICANES KATRINA AND RITA.

''(a) In General.--The Director shall provide emergency assistance
to owners of eligible structures in accordance with this section.
''(b) Application.--The Director shall provide for owners of
eligible structures to submit applications for assistance under this
section in such form, containing such information, and in accordance
with such procedures, as the Director may require.
''(c) Use of Funds; Scope of Coverage.--
''(1) In general.--The amount of any assistance under this
section provided to an owner of an eligible structure in a
covered disaster area of a State may be used only for paying--
''(A) the costs of repair, reconstruction, or
replacement of such structure or construction or
purchase of any other structure (including a
manufactured home) to be used as the primary residence
of the owner in the covered disaster area of such
State; or
''(B) the amount remaining to be paid by the owner
on the mortgage of the eligible structure.
''(2) Replacement cost.--
''(A) In general.--Subject to subsection (d), the
amount of any assistance provided under this section
shall be based on the replacement cost necessary for
repair, reconstruction, or replacement of the eligible
structure to its original specifications and standards
prior to--
''(i) August 29, 2005, in the case of a
structure damaged by flooding resulting from
Hurricane Katrina; or
''(ii) September 23, 2005, in the case of a
structure damaged by flooding resulting from
Hurricane Rita.
Such costs shall include adjustments as necessary for
compliance with the requirements of subsection
(e)(1)(B).
''(B) Documentation.--An owner of an eligible
structure applying for assistance under paragraph (1)
shall submit to the Director documentation and such
other evidence (including a report completed by a
State-licensed, nationally-certified home inspector) as
the Director may require to establish the replacement
cost of the eligible structure under subparagraph (A).
''(d) Cost Sharing.--
''(1) Federal share.--Subject to subsection (f) and
paragraph (2), the Federal share of the cost of assistance
provided under this section for an eligible structure that the
Director shall pay to the owner of the eligible structure shall
be 80 percent of the replacement cost of the eligible structure
as determined under subsection (c)(2).
''(2) Maximum amount.--The maximum amount of assistance
that may be provided to an owner of an eligible structure under
this section for such structure may not exceed $150,000.
''(3) Optional state share.--If the owner of an eligible
structure in a State is provided assistance under this section,
the State may provide to the owner 10 percent of the
replacement cost of the eligible structure as determined under
subsection (c)(2), but not to exceed $15,000.
''(e) Requirements Regarding Future Flood Insurance Coverage and
Mitigation Actions.--
''(1) In general.--The Director may not provide assistance
under this section for an eligible structure unless--
''(A) the owner of the property upon which the
eligible structure is located has entered into a
legally binding agreement with the Director, including
such deed restrictions as the Director considers
appropriate, to ensure that such owner, and any future
owners, will at all times after such assistance is
provided under this section with respect to the
property, purchase and maintain flood insurance, in
perpetuity, for any structures located at any time on
the same property on which, at the time of purchase,
such eligible structure is located, in an amount at
least equal to the lesser of--
''(i) the value of the structure, as
determined by the Director; or
''(ii) the maximum limit of coverage made
available with respect to the particular type
of property under the National Flood Insurance
Program, if such coverage is available; and
''(B) the owner of the property certifies to the
Director that any structure constructed, repaired, or
reconstructed with such assistance will be constructed,
repaired, or reconstructed in accordance with--
''(i) standards established by the
International Code Council in effect at the
time the building permit is issued by the local
government to the owner of the eligible
structure; and
''(ii) any final flood elevations or flood
maps in effect for purposes of the National
Flood Insurance Program at the time the
building permit is issued by the local
government to the owner of the eligible
structure and any advisory flood elevations or
advisory flood insurance rate maps issued by
the Director for purposes of such program
before such building permit is issued.
''(2) Waiver authority.--The Director may waive the
requirements of paragraph (1)(B) with respect to the repair of
an eligible structure if the Director determines that the cost
of compliance with such requirements by the owner in repairing
the eligible structure outweigh the benefit derived from such
compliance pursuant to a substantial damage analysis.
''(f) Prohibition on Duplicative Benefits in Excess of Replacement
Costs.--Notwithstanding section 312, the Director shall assure that no
owner of an eligible structure will receive assistance under this
section that, when combined with other financial assistance received by
the owner under any program, including section 404 or 408, or from
insurance or any other source for the purpose of repair,
reconstruction, or replacement of the eligible structure, is in excess
of the replacement cost of the eligible structure as determined under
subsection (c)(2). Before receipt of any assistance for which an owner
is eligible under this section for an eligible structure, the owner
shall enter into a legally binding agreement with the Director to repay
any and all of such assistance that is in excess of the replacement
cost of the eligible structure as determined under subsection (c)(2).
''(g) Verification of Use of Funds and Compliance.--
''(1) Documentation; reports.--Within 6 months after the
date on which an owner of an eligible structure receives
assistance under this section, and every 6 months thereafter
until all such assistance is accounted for, the owner shall
submit to the Director--
''(A) all receipts and documentation verifying the
use of such assistance for the purpose for which it was
provided; and
''(B) reports completed by a State-licensed,
nationally-certified home inspector verifying
compliance by the owner with the requirements of
subsection (e)(1)(B) if such requirements are not
waived by the Director.
''(2) Enforcement.--The Director may suspend assistance
under this section, and take any additional action which the
Director deems appropriate, with respect to an owner of an
eligible structure if the Director determines that the owner is
not complying with paragraph (1).
''(h) Definitions.--In this section, the following definitions
apply:
''(1) Covered disaster area.--The term 'covered disaster
area' means an area--
''(A) for which a major disaster was declared by
the Director pursuant to title IV of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act
as a result of Hurricane Katrina or Hurricane Rita in
2005; and
''(B) in which the sale of flood insurance coverage
was available under the National Flood Insurance Act of
1968 (42 U.S.C. 4001 et seq.) as of--
''(i) August 29, 2005, in the case of an
area for which a declaration referred to in
subparagraph (A) was made as a result of
Hurricane Katrina; or
''(ii) September 23, 2005, in the case of
an area for which a declaration referred to in
subparagraph (A) was made as a result of
Hurricane Rita.
''(2) Eligible structure.--The term 'eligible structure'
means a structure (including a manufactured home) that--
''(A) sustained damage or losses from flooding
resulting from Hurricane Katrina or Hurricane Rita in
2005;
''(B) is located in a covered disaster area;
''(C) is a residential structure that was used as
the primary residence of the owner of the structure as
of--
''(i) August 29, 2005, in the case of a
structure damaged by flooding resulting from
Hurricane Katrina; and
''(ii) September 23, 2005, in the case of a
structure damaged by flooding resulting from
Hurricane Rita;
''(D) was covered by an insurance policy for losses
caused by wind or windstorm as of--
''(i) August 29, 2005, in the case of a
structure damaged by flooding resulting from
Hurricane Katrina; and
''(ii) September 23, 2005, in the case of a
structure damaged by flooding resulting from
Hurricane Rita;
''(E) is of a type for which coverage was generally
made available under the National Flood Insurance
Program as of August 29, 2005; and
''(F) is not located in an area that has been
identified by the Director as an area having special
flood hazards (as such term is used for purposes of
section 102 of the Flood Disaster Protection Act of
1973 (42 U.S.C. 4012a)) as of August 29, 2005.
''(3) Director.--The term 'Director' means the Director of
the Federal Emergency Management Agency.
''(i) Termination.--The Director may not provide any assistance
under this section except pursuant to an application for such
assistance submitted to the Director before the expiration of the 180-
day period beginning on the date of the enactment of this section.
''(j) Regulations.--The Director may issue any regulations
necessary to carry out this section.''.

SEC. 4. HAZARD MITIGATION.

(a) In General.--Section 404(a) of the Robert T. Stafford Disaster
Relief and Emergency Assistance Act (42 U.S.C. 5170c(a)) is amended--
(1) in the first sentence by striking ''75'' and inserting
''90''; and
(2) in the last sentence by striking ''7.5'' and inserting
''15''.
(b) Property Acquisition and Relocation Assistance.--Section 404(b)
of such Act (42 U.S.C. 5170c(b)) is amended by adding at the end the
following:
''(4) Reduction.--The amount of any assistance that would
otherwise be provided to an owner of an eligible structure
under section 425(c)(1)(B) shall be reduced by the amount of
assistance the owner receives for such structure under such
section.''.
(c) Applicability.--The amendments made by subsections (a) and (b)
shall apply with respect to a major disaster declared by the President
on or after August 24, 2005.
Example Output: Housing Opportunities and Mitigating Emergencies Act of 2005 - Amernds the Robert T. Stafford Disaster Relief and Emergency Assistance Act to require the Director of the Federal Emergency Management Agency (FEMA) to provide temporary emergency assistance for primary residences damaged or destroyed by Hurricanes Katrina and Rita.

Increases from 75% to 90% the amount the President may contribute toward the cost of cost-effective hazard mitigation measures which substantially reduce the risk of future damage, hardship, loss, or suffering in any area affected by a major disaster. Doubles from 7.5% to 15% of the estimated aggregate federal disaster relief grants to an area the limit on the total amount of such presidential contributions.

Example Input: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Medicare Substitute Adult Day Care
Services Act of 1998''.

SEC. 2. COVERAGE OF SUBSTITUTE ADULT DAY CARE SERVICES UNDER MEDICARE.

(a) Substitute Adult Day Care Services Benefit.--
(1) In general.--Section 1861(m) of the Social Security Act
(42 U.S.C. 1395x(m)) is amended--
(A) in the matter preceding paragraph (1), by
inserting ''or paragraph (8)'' after ''paragraph (7)'';
(B) in paragraph (6), by striking ''and'' at the
end;
(C) in paragraph (7), by adding ''and'' at the end;
and
(D) by inserting after paragraph (7), the following
new paragraph:
''(8) substitute adult day care services (as defined in
subsection (uu));''.
(2) Substitute adult day care services defined.--Section
1861 of such Act (42 U.S.C. 1395x) is amended by adding at the
end the following new subsection:

''Substitute Adult Day Care Services; Adult Day Care Facility

''(uu)(1)(A) The term 'substitute adult day care services' means
the items and services described in subparagraph (B) furnished to an
individual by an adult day care facility as a part of a plan under
subsection (m) substituting such services for a portion of the items
and services described in subparagraph (B)(i) furnished by a home
health agency under the plan, as determined by the physician
establishing the plan.
''(B) The items and services described in this subparagraph are the
following items and services:
''(i) Items and services described in paragraphs (1)
through (7) of subsection (m).
''(ii) Transportation of the individual to and from the
adult day care facility in connection with any such item or
service.
''(iii) Meals.
''(iv) A program of supervised activities designed to
promote physical and mental health and furnished to the
individual by the adult day care facility in a group setting
for a period of not fewer than four and not greater than twelve
hours per day.
''(2)(A) Except as provided in subparagraph (B), the term 'adult
day care facility' means a public agency or private organization, or a
subdivision of such an agency or organization, that--
''(i) is engaged in providing skilled nursing services and
other therapeutic services; and
''(ii) meets the requirements of paragraphs (2) through (8)
of subsection (o).
''(B) The Secretary may waive the requirement of a surety bond
under paragraph (7) of subsection (o) in the case of an agency or
organization that provides a comparable surety bond under State law.
''(C) For purposes of payment for home health services consisting
of substitute adult day care services furnished under this title, any
reference to a home health agency is deemed to be a reference to an
adult day care facility.''.
(3) Conforming amendments.--Sections 1814(a)(2)(C) and
1835(a)(2)(A)(i) of such Act (42 U.S.C. 1395f(a)(2)(C) and 42
U.S.C. 1395f(a)(2)(C)) are each amended by striking ''section
1861(m)(7)'' and inserting ''paragraph (7) or (8) of section
1861(m)''.
(b) Payment for Substitute Adult Day Care Services.--
(1) Reasonable cost.--Section 1861(v)(1)(L) of such Act (42
U.S.C. 1395x(v)(1)(L)) is amended by adding at the end the
following new clause:
''(viii) In the case home health services consisting of substitute
adult day care services, the following rules apply:
''(I) The Secretary shall determine each component (as
defined by the Secretary) of substitute adult day care services
(under subsection (uu)(1)(B)(i)) furnished to an individual
under the plan of care established under subsection (m) with
respect to such services.
''(II) The Secretary shall estimate the amount that would
otherwise be payable under this subparagraph for all home
health services under that plan of care other than substitute
adult day care services for a week or other period specified by
the Secretary.
''(III) The total amount payable for home health services
consisting of substitute adult day care services may not exceed
95 percent of the amount estimated to be payable under
subclause (II) furnished under the plan by a home health
agency.
''(IV) No payment may be made under this title for home
health services consisting of substitute adult day care
services described in clauses (ii), (iii), and (iv) of
subsection (uu)(1)(B).''.
(2) Prospective payment system.--Section 1895 of such Act
(42 U.S.C. 1395fff) is amended by adding at the end the
following new subsection:
''(e) Payment Rate for Substitue Adult Day Care Services.--In the
case home health services consisting of substitute adult day care
services, the following rules apply:
''(1) The Secretary shall determine each component (as
defined by the Secretary) of substitute adult day care services
(under section 1861(uu)(1)(B)(i)) furnished to an individual
under the plan of care established under section 1861(m) with
respect to such services.
''(2) The Secretary shall estimate the amount that would
otherwise be payable under this section for all home health
services under that plan of care other than substitute adult
day care services for a week or other period specified by the
Secretary.
''(3) The total amount payable for home health services
consisting of substitute adult day care services may not exceed
95 percent of the amount estimated to be payable under
paragraph (2) furnished under the plan by a home health agency.
''(4) No payment may be made under this title for home
health services consisting of substitute adult day care
services described in clauses (ii), (iii), and (iv) of section
1861(uu)(1)(B).''.
(c) Adjustment in Case of Overutilization of Substitute Adult Day
Care Services.--
(1) Monitoring expenditures.--The Secretary of Health and
Human Services shall monitor the expenditures made under the
Medicare Program under title XVIII of the Social Security Act
for home health services furnished under section 1861(m) of
such Act for a fiscal year beginning with fiscal year 2000,
including substitute adult day care services under paragraph
(8) of such section (as added by subsection (a)), and compare
such expenditures to expenditures that the Secretary estimates
would have been made for home health services for that fiscal
year if subsection (a) had not been enacted.
(2) Required reduction in payment rate.--If the Secretary
determines, after making the comparison under paragraph (1) and
making such adjustments for changes in demographics and age of
the Medicare beneficiary population as the Secretary determines
appropriate, that expenditures for home health services
including such substitute adult day care services exceed
expenditures that would have been made for home health services
furnished under section 1861(m) of such Act for a year if
subsection (a) had not been enacted, then the Secretary shall
adjust the rate of payment so that total expenditures for home
health services furnished under such section in a fiscal year
does not exceed the Secretary's estimate of such expenditures
if subsection (a) had not been enacted.
(d) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after January 1, 1999.
Example Output:
Medicare Substitute Adult Day Care Services Act of 1998 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of substitute adult day care services.
Directs the Secretary of Health and Human Services to monitor Medicare expenditures for home health services for a fiscal year, including substitute adult day care services, and compare them to expenditures that the Secretary estimates would have been made for home health services for that fiscal year if there had been no coverage of substitute adult day care services. Requires the Secretary, if home health service expenditures exceed such estimates, to adjust the rate of payment for home health services so that total expenditures do not exceed such estimates.