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

Q: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Living Independently for Extended
Time Act'' or the ''LIFETIME Act''.

SEC. 2. FINDINGS.

Congress finds the following:
(1) The number of Americans over age 65 or living with a
disability is growing, and over 70 percent of these individuals
will need some form of long-term services and supports, with a
majority of individuals preferring home and community-based
care.
(2) This is a major demographic shift and provides an
opportunity for innovative solutions in long-term services and
supports.
(3) Developing programs to facilitate high-quality
independent community-based living, create and improve jobs,
and address and improve upon gaps in existing systems will be
essential to providing necessary services and supports to these
individuals and families.
(4) It is imperative that Congress act to address the
looming long-term services and supports crisis.

SEC. 3. PURPOSE.

It is the purpose of this Act to establish a grant program to
provide incentives to States for the development of solutions to the
increased need of individuals for long-term services and supports and
to increase State support and systems in long-term care.

SEC. 4. ESTABLISHMENT OF LONG-TERM SERVICES AND SUPPORTS INNOVATION
GRANT PROGRAM.

(a) State Planning Grants.--
(1) In general.--Not later than 90 days after the date on
which grant announcements are made under subsection (d), the
Secretary of Health and Human Services (referred to in this Act
as the ''Secretary'') shall award grants to eligible States to
enable such States to develop innovative programs to meet the
unique need for long-term services and supports in the State.
(2) Eligibility.--To be eligible to receive a grant under
paragraph (1), a State shall--
(A) submit to the Secretary an application, at such
time, in such manner, and containing such information
as the Secretary may require;
(B) demonstrate to the Secretary that the State
will work in conjunction with both public and private
long-term services and supports stakeholder groups
described in paragraph (3) to develop a coordinated
statewide long-term services and supports program for
the State that is not duplicative of other programs
providing such services and supports in the State; and
(C) provide assurances that the State will, not
later than 1 year after the date on which the grant is
awarded, submit to the Secretary a comprehensive plan
for the implementation of innovative long-term services
and supports program in the State, which shall include
the utilization of existing State or local frameworks.
(3) Stakeholder groups.--Stakeholder groups described in
this paragraph shall be groups that--
(A) represent the interests of--
(i) consumers of long-term services and
supports and related insurance products, as
well as their representatives;
(ii) older adults;
(iii) individuals with cognitive or
functional limitations;
(iv) family caregivers for individuals
described in clause (i), (ii), or (iii);
(v) the health care workforce who directly
provide long-term services and supports;
(vi) private long-term services and
supports insurance providers;
(vii) employers;
(viii) State insurance departments;
(ix) area agency on aging or State agency
on aging;
(x) direct care workforce; and
(xi) State Medicaid agencies;
(B) have demonstrated experience in dealing with
issues related to long-term services and supports,
health care policy, and public and private insurance;
and
(C) represent the health care interests and needs
of a variety of geographic areas and demographic
groups.
(b) State Implementation Grants.--
(1) In general.--The Secretary shall award grants to
eligible States to enable such States to implement the
comprehensive plans submitted under subsection (a)(2)(C) to
meet the long-term services and supports needs of such States.
(2) Eligibility.--To be eligible to receive a grant under
paragraph (1), a State shall--
(A) submit to the Secretary an application, at such
time, in such manner, and containing such information
as the Secretary may require;
(B) have submitted a comprehensive plan under
subsection (a)(2)(C) that has been approved by the
Secretary or, if the State has not applied for a grant
under subsection (a), submit a plan (that is similar to
the plans required under subsection (a)(2)(C)) to the
Secretary for the implementation of new, or continued
operation of existing, long-term services and supports
activities;
(C) provide assurances that the State will provide
long-term services and supports under the grant to
individuals who demonstrate a need for such services
regardless of age;
(D) provide assurances that the State will provide
matching funds in accordance with paragraph (3); and
(E) submit to the Secretary progress and outcomes
reports containing uniform data as determined
appropriate by the Secretary.
(3) Matching requirement.--To be eligible to receive a
grant under paragraph (1), a State shall agree, with respect to
the costs to be incurred by the State in implementing the
comprehensive plan under subsection (a)(2)(C), to make
available non-Federal contributions (in cash or in-kind) toward
such costs in an amount equal to not less than $1 for each $4
of Federal funds provided under the grant. Such contributions
may be made directly or through donations from public or
private entities.
(4) Preference.--In awarding grants under paragraph (1),
the Secretary shall give preference to States that
demonstrate--
(A) the activities to be carried out under the
grant will enhances access to quality, affordable long-
term services and supports for consumers; and
(B) the sustainability and scalability of the
program to be carried out under the grant beyond the
grant period.
(5) Limitation.--A State shall not use in excess of 5
percent of the amount awarded under a grant under paragraph (1)
for the administrative expenses associated with carrying out
activities under the grant.
(c) Technical Assistance and Outcomes Data.--The Secretary may use
not to exceed 5 percent of the amount appropriated for each fiscal year
under subsection (f) to--
(1) provide technical assistance to States in carrying out
programs under this section; and
(2) collect and disseminate data, including from the
reports submitted by the States under subsection (b)(2)(D), on
improvements to long-term services and supports provided in the
States and the effect that grants under this section had on the
availability of such services and supports.
(d) Grant Announcements.--Not later than 1 year after the date of
enactment of this Act, the Secretary shall announce the opportunity to
apply for the initial series of grants under this section. Not later
than 2 years after such date, the Secretary shall announce the
opportunity to apply for the remaining grants under this section.
(e) Report.--Not later than 1 year after the date on which grants
are awarded under subsection (b), and annually thereafter, the
Secretary shall submit to Congress a report on the activities carried
out under grants under this section, including a description of
improvements to long-term services and supports provided in the States
and the effect that grants under this section had on the availability
of such services and supports.
(f) Appropriations.--
(1) In general.--There is authorized to be appropriated--
(A) to award grants under subsection (a),
$50,000,000, to be used during the first fiscal year
for which such grants are awarded; and
(B) to award grants under subsection (b),
$250,000,000, to be available until expended.
(2) Additional amounts.--In addition to amounts
appropriated under paragraph (1)(B) for a fiscal year, the
Secretary may use any amounts appropriated under paragraph
(1)(A) and remaining unexpended after fiscal year 2015 to award
grants under subsection (b).
(g) Definition.--In this Act, the term ''long-term services and
supports'' means the services and supports described in section 321(a)
of the Older Americans Act of (42 U.S.C. 3030d(a) et seq.).

A: Living Independently for Extended Time Act or the LIFETIME Act This bill requires the Department of Health and Human Services to award grants to enable eligible states to develop innovative programs to meet the unique need for long-term services and supports in the state.
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Q: SECTION 1. ESTABLISHMENT OF NEW FASHION MODEL NONIMMIGRANT
CLASSIFICATION.

(a) In General.--
(1) New classification.--Section 101(a)(15)(P) of the
Immigration and Nationality Act (8 U.S.C. 1101(a)(15)(P)) is
amended--
(A) in clause (iii), by striking ''or'' at the end;
(B) in clause (iv), by striking ''clause (i), (ii),
or (iii)'' and inserting ''clause (i), (ii), (iii), or
(iv)'';
(C) by redesignating clause (iv) as clause (v); and
(D) by inserting after clause (iii) the following:
''(iv) is a fashion model who is of distinguished
merit and ability and who is seeking to enter the
United States temporarily to perform fashion modeling
services that involve events or productions which have
a distinguished reputation or that are performed for an
organization or establishment that has a distinguished
reputation for, or a record of, utilizing prominent
modeling talent; or''.
(2) Authorized period of stay.--Section 214(a)(2)(B) of the
Immigration and Nationality Act (8 U.S.C. 1184(a)(2)(B)) is
amended in the second sentence--
(A) by inserting ''or fashion models'' after
''athletes''; and
(B) by inserting ''or fashion model'' after
''athlete''.
(3) Numerical limitation.--Section 214(c)(4) of the
Immigration and Nationality Act (8 U.S.C. 1184(c)(4)) is
amended by adding at the end the following:
''(I)(i) The total number of aliens who may be issued visas or
otherwise provided nonimmigrant status during any fiscal year under
section 101(a)(15)(P)(iv) may not exceed 1,000.
''(ii) The numerical limitation established by clause (i) shall
only apply to principal aliens and not to the spouses or children of
such aliens.
''(iii) An alien who has already been counted toward the limitation
established by clause (i) shall not be counted again during the same
period of stay or authorized extension under subsection (a)(2)(B),
irrespective of whether there is a change in petitioner under
subparagraph (C).''.
(4) Consultation.--
(A) In general.--Section 214(c)(4)(D) of the
Immigration and Nationality Act (8 U.S.C.
1184(c)(4)(D)) is amended by striking ''clause (i) or
(iii)'' and inserting ''clause (i), (iii), or (iv)''.
(B) Advisory opinion.--Section 214(c)(6)(A)(iii) of
the Immigration and Nationality Act (8 U.S.C.
1184(c)(6)(A)(iii)) is amended--
(i) by striking ''section 101(a)(15)(P)(i)
or 101(a)(15)(P)(iii),'' and inserting ''clause
(i), (iii), or (iv) of section
101(a)(15)(P),''; and
(ii) by striking ''of athletics or
entertainment''.
(C) Expedited procedures.--Section 214(c)(6)(E)(i)
of the Immigration and Nationality Act (8 U.S.C.
1184(c)(6)(E)(i)) is amended by striking ''artists or
entertainers'' and inserting ''artists, entertainers,
or fashion models''.
(b) Elimination of H-1B Classification for Fashion Models.--Section
101(a)(15)(H)(i)(b) of the Immigration and Nationality Act (8 U.S.C.
1101(a)(15)(H)(i)(b)) is amended--
(1) by striking ''or as a fashion model''; and
(2) by striking ''or, in the case of a fashion model, is of
distinguished merit and ability''.
(c) Effective Date and Implementation.--
(1) In general.--The amendments made by this section shall
take effect on the date of the enactment of this Act.
(2) Regulations, guidelines, and precedents.--The
regulations, guidelines and precedents in effect on the date of
the enactment of this Act for the adjudication of petitions for
fashion models under section 101(a)(15)(H)(i)(b) of the
Immigration and Nationality Act (8 U.S.C.
1101(a)(15)(H)(i)(b)), shall be applied to petitions for
fashion models under section 101(a)(15)(P)(iv) of the
Immigration and Nationality Act (8 U.S.C. 1101(a)(15)(P)(iv)),
as added by this Act, except to the extent modified by the
Secretary of Homeland Security through final regulations (not
through interim regulations) promulgated in accordance with
subchapter II of chapter 5, and chapter 7, of title 5, United
States Code (commonly known as the ''Administrative Procedure
Act'').
(3) Construction.--Nothing in this section shall be
construed as preventing an alien who is a fashion model from
obtaining nonimmigrant status under section 101(a)(15)(O)(i) of
the Immigration and Nationality Act (8 U.S.C.
1101(a)(15)(O)(i)) if such alien is otherwise qualified for
such status.
(4) Treatment of pending petitions.--Petitions filed on
behalf of fashion models under section 101(a)(15)(H)(i)(b) of
the Immigration and Nationality Act (8 U.S.C.
1101(a)(15)(H)(i)(b)) that are pending on the date of the
enactment of this Act shall be treated as if they had been
filed under section 101(a)(15)(P)(iv) of the Immigration and
Nationality Act (8 U.S.C. 1101(a)(15)(P)(iv)), as added by this
Act.

A: Amends the Immigration and Nationality Act to replace the current nonimmigrant (H-1B) visa category for fashion models with a new (P-4) visa category.

Defines such category as a fashion model who is of distinguished merit and ability and who is seeking to enter the United States temporarily to perform fashion modeling services that involve events or productions which have a distinguished reputation or that are performed for an organization or establishment that has a distinguished reputation for, or a record of, utilizing prominent modeling talent.

Provides that such entrants may not: (1) exceed 1,000 in any fiscal year, not including accompanying spouses or children; and (2) stay in the United States for more than 10 years (initial five-year period with one five-year extension).

Makes an employer petition for such alien models eligible for expedited consultation procedures.

States that applicable H-1B regulations, guidelines, and precedents in effect on the date of the enactment of this Act for the adjudication of fashion model petitions shall be applied to P-4 petitions, except to the extent modified by the Secretary of Homeland Security.
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Q: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Medicare Home Health Access
Restoration Act of 1999''.

SEC. 2. ADJUSTMENT TO PER BENEFICIARY LIMITS.

(a) Increase in Payment Amount to Agencies With Limits Under the
National Average.--Section 1861(v)(1)(L) of the Social Security Act (42
U.S.C. 1395x(v)(1)(L)), as amended by section 5101(a) of the Tax and
Trade Relief Extension Act of 1998 (Public Law 105-277), is amended--
(1) in clause (v)(I), by inserting '', clause (ix)'' after
''subject to clause (viii)(I)'';
(2) in clause (viii)(I), by striking ''during or after
fiscal year 1999'' and inserting ''during fiscal year 1999'';
(3) by redesignating clause (ix) as clause (xii); and
(4) by inserting after clause (viii) the following new
clause:
''(ix) In the case of a provider with a 12-month cost reporting
period ending in fiscal year 1994, if the limit imposed under clause
(v) (determined without regard to this subclause) for a cost reporting
period beginning after fiscal year 1999 is less than the median
described in clause (vi)(I) (but determined as if any reference in
clause (v) to '98 percent' were a reference to '100 percent'), the
payment limit for such provider and period shall be equal to--
''(I) for cost reporting periods beginning during fiscal
year 2000, 90 percent of such median;
''(II) for cost reporting periods beginning during fiscal
year 2001, 95 percent of such median; and
''(III) for cost reporting periods beginning during or
after fiscal year 2002, such median.
Each of the amounts specified in subclauses (I) through (III) are such
amounts as adjusted under clause (iii) to reflect variations in wages
among different areas.''.
(b) Establishment of Per Beneficiary Cap; Waiver.--
(1) In general.--Section 1861(v)(1)(L) of such Act (42
U.S.C. 1395x(v)(1)(L)), as amended in subsection (a), is
further amended--
(A) in clause (v)(I), by inserting '', and clause
(x)'' after ''clause (ix)''; and
(B) by inserting after clause (ix), the following
new clause:
''(x) In the case of a provider with a 12-month cost reporting
period ending in fiscal year 1994, if the limit imposed under clause
(v) (determined without regard to this subclause) for a cost reporting
period beginning after fiscal year 1999 exceeds the median described in
clause (vi)(I) (but determined as if any reference in clause (v) to '98
percent' were a reference to '100 percent'), the payment limit for such
provider and period may not exceed--
''(I) for cost reporting periods beginning during fiscal
year 2000, an amount equal to 250 percent of such median;
''(II) for cost reporting periods beginning during fiscal
year 2001, an amount equal to 225 percent of such median; and
''(III) for cost reporting periods beginning during or
after fiscal year 2002, an amount equal to 200 percent of such
median.
Notwithstanding the previous sentence, in the case of such a provider
that demonstrates to the Secretary (in such form and using such data as
the Secretary requires) that, for a cost reporting period, the
provider, or a unit of the provider, specializes in the treatment of
individuals who, because of age, diagnosis, or other criteria specified
by the Secretary are substantially more costly-than-average to treat,
the amount of payment to that provider or unit for such an individual
for that period is the limitation determined under clause (v).''.
(2) Consultation.--The Secretary of Health and Human
Services shall consult with appropriate organizations,
including such organizations representing providers of home
health services, physicians, and patients in determining the
criteria required for special payment provisions under the
second sentence of clause (x) and under clause (xi) of section
1861(v)(1)(L) of the Social Security Act (42 U.S.C.
1395x(v)(1)(L)), including descriptions of the type of patient,
patient condition, unusual variations, and home health service
that qualifies for such payment.
(c) Waiver of Per Beneficiary Limit for Outliers.--
(1) In general.--Section 1861(v)(1)(L) of such Act (42
U.S.C. 1395x(v)(1)(L)), as amended in subsections (a) and (b),
is further amended by inserting after clause (x), the following
new clause:
''(xi)(I) Notwithstanding the applicable limit under clause (v),
(vi), (viii), (ix), or (x), in the case of a provider that demonstrates
to the Secretary that with respect to an individual to whom the
provider furnishes home health services that are appropriate to the
individual's condition (as determined by the Secretary) at a reasonable
cost (as determined by the Secretary), and that such reasonable cost
significantly exceeded such applicable limit because of unusual
variations in the type or amount of medically necessary care (outliers)
required to treat the individual, the Secretary, upon application by
the provider, shall pay to such provider for such individual such
reasonable cost.
''(II) The Secretary shall establish such criteria as is required
for payment under this clause, including a description of the type of
patient, patient condition, unusual variations, and home health service
that qualifies for such payment.
''(III) In making determinations under subclause (I), the Secretary
shall use data from the cost report, or from other data collected by
the Secretary, of the provider for such year.
''(IV) A provider may make an application for payment under this
clause for a fiscal year no earlier than the end of the provider's cost
reporting period beginning in such fiscal year.
''(V) In the case of an application for payment under this clause
that is approved by the Secretary, a provider may elect to receive
payment on a quarterly basis.''.
(2) Effective date.--The amendment made by subsection (a)
takes effect six months after the date of the enactment of this
Act, and applies with respect to applications by home health
agencies for payment of reasonable costs for outliers for cost
reporting periods ending on or after such date.
(d) Reports to Congress.--
(1) Initial report.--Not later than one year after the date
of the enactment of this Act, the Secretary of Health and Human
Services shall submit to Congress a report describing the
effect of the special payment provisions provided for under the
second sentence of clause (x) and under clause (xi) of section
1861(v)(1)(L) of the Social Security Act (42 U.S.C.
1395x(v)(1)(L)). Such report shall include information with
respect to the number of home health agencies that requested
payment under such provisions and the number of such agencies
that received payment under such provisions.
(2) Final report.--Not later than three years after the
date of the enactment of this Act, the Secretary shall submit
to Congress a report that updates the report submitted under
paragraph (1), including additional information with respect to
the illnesses, and the characteristics of such illnesses, of
the patients for whom payment under such special provisions was
requested, and the characteristics of the home health agencies
furnishing home health services to such patients for such
illnesses.

SEC. 3. REVISION OF PER VISIT LIMITS.

Section 1861(v)(1)(L)(i) of the Social Security Act (42 U.S.C.
1395x(v)(1)(L)(i)), as amended by section 5101(b) of the Tax and Trade
Relief Extension Act of 1998 (Public Law 105-277), is amended--
(1) in subclause (IV), by striking ''or'';
(2) in subclause (V)--
(A) by inserting ''and before October 1, 1999,''
after ''October 1, 1998,''; and
(B) by striking the period at the end and inserting
'', or''; and
(3) by adding at the end the following new subclause:
''(V) October 1, 1999, 110 percent of such median.''.

SEC. 4. ELIMINATION OF CONTINGENT 15 PERCENT REDUCTION IN PAYMENT
LIMITS UNDER THE INTERIM PAYMENT SYSTEM.

Section 4603 of the Balanced Budget Act of 1997 (Public Law 105-
33), as amended by section 5101(c)(3) of the Tax and Trade Relief
Extension Act of 1998 (Public Law 105-277) (111 Stat. 471), is amended
by striking subsection (e).

SEC. 5. INFORMATIONAL MATERIALS FOR MEDICARE BENEFICIARIES WITH RESPECT
TO HOME HEALTH SERVICES.

(a) In General.--The Secretary shall prepare a notice of the rights
of individuals entitled to benefits under the medicare program (under
title XVIII of the Social Security Act) to appeal a coverage
determination with respect to items and services furnished to such
individual under the program. In the case of such items and services
consisting of home health services furnished by a home health agency,
the home health agency shall furnish such notice to such an individual
upon discharge by the agency of such individual from such services.
(b) Information for Physicians.--The Secretary shall provide
guidance for physicians contacted by affected individuals to assist
such individuals, including specific guidance in the case of such
individuals for whom home health services are discontinued before the
recommended treatment is complete, but on behalf of whom payment under
the limits established under section 1861(v)(1)(L) of the Social
Security Act (42 U.S.C. 1395x(v)(1)(L)) has been made in full by the
Secretary to the home health agency. The materials shall include
telephone numbers and such other information to enable the physician to
seek further assistance or clarification from individuals within the
Health Care Financing Administration with appropriate expertise.
(c) Requests for Additional Resources.--The Secretary may submit to
Congress an estimate of additional resources required by the Health
Care Financing Administration to comply with the provisions of the
section. Any such estimate shall be included in the report required
under paragraph (1) of section 2(d).
(d) Effective Date.--By not later than six months after the date of
the enactment of this Act, the Secretary shall begin distributing to
home health agencies furnishing home health services under the medicare
program (under title XVIII of the Social Security Act), and to
physicians furnishing services under such program, the information
prepared under this section.

SEC. 6. COMPTROLLER GENERAL STUDY ON MEDICARE HOME HEALTH BENEFIT.

(a) Study.--
(1) Cost of services.--The Comptroller General of the
United States shall conduct a study on the relationship between
the costs to the medicare program (under title XVIII of the
Social Security Act) for home health services furnished by home
health agencies under the program, and the costs to State and
Federal government programs (including the medicare program and
the medicaid program (under title XIX of such Act)) for
services furnished by rehabilitation agencies, public health
agencies, clinics, comprehensive outpatient rehabilitation
facilities, skilled nursing facilities under the medicare
program, and for long-term care services furnished under the
medicaid program (under title XIX of such Act).
(2) Determination of saving overall to medicare program.--
The Comptroller General shall also determine whether providing
home health services as a benefit under the medicare program
has resulted in lower costs overall to the Federal government.
(b) Report.--Not later than 18 months after the date of the
enactment of this Act, the Comptroller General shall submit to Congress
a report describing the results of the study conducted under subsection
(a).

A:
Amends the Balanced Budget Act of 1997 to eliminate the 15 percent contingent reduction in payment amounts under the interim prospective payment system (PPS) for home health services.
Directs: (1) the Secretary to prepare specified informational materials for assisting Medicare beneficiaries with regard to home health services; and (2) the Comptroller General to study and report to Congress on certain aspects of the Medicare home health benefit, including whether it has resulted in overall lower costs to the Federal Government.
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