H.R. 3165 — Catastrophic Coverage Repeal Act of 1989

 
HR 3165 IH
101st CONGRESS
1st Session
 H. R. 3165
To repeal titles I and II of the Medicare Catastrophic Coverage Act of 1988,
and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
August 4, 1989
Mr. DONNELLY (for himself, Mr. ARCHER, Mr. RUSSO, Mr. BROWN of Colorado,
Mr. GIBBONS, Mrs. KENNELLY, Mr. JACOBS, Mr. CRANE, Mr. CHANDLER, Mr. SUNDQUIST,
Mr. FAWELL, Mr. ANNUNZIO, Ms. SLAUGHTER of New York, Mr. RAVENEL, Mr. KOLBE,
Mr. BARTON of Texas, Mr. SMITH of New Hampshire, Mr. MCCRERY, Mr. SMITH
of Mississippi, Mr. BEREUTER, Mr. IRELAND, Mr. ROTH, Mr. ARMEY, Mr. NEAL
of Massachusetts, Mr. KYL, Mr. SHAYS, Mr. BLILEY, Mr. ROBERTS, Mr. LEWIS
of Florida, Mr. RITTER, Mr. MCNULTY, Mr. COMBEST, Mr. HORTON, Mr. HERGER,
Mr. COX, Mr. WELDON, and Mr. GEJDENSON) introduced the following bill;
which was referred to the Committees on Ways and Means, and Energy and Commerce
A BILL
To repeal titles I and II of the Medicare Catastrophic Coverage Act of 1988,
and for other purposes.
  Be it enacted by the Senate and House of Representatives of the United
  States of America in Congress assembled,
SECTION 1. SHORT TITLE.
  This Act may be cited as the `Catastrophic Coverage Repeal Act of 1989'.
SEC. 2. REPEAL OF TITLES I AND II OF THE MEDICARE CATASTROPHIC COVERAGE ACT
OF 1988.
  (a) GENERAL RULE- Titles I and II of the Medicare Catastrophic Coverage Act
  of 1988 (Public Law 100-360) (hereafter in this Act referred to as `MCCA'),
  other than the provisions described in subsection (b), are repealed,
  and any provision of law amended or repealed by such titles is restored
  or revived, and shall be effective as if MCCA had not been enacted.
  (b) PROVISIONS OF MCCA NOT REPEALED- The provisions described in this
  subsection (which are not repealed by subsection (a)) are as follows:
  (1) Section 102(1) (relating to deductibles and coinsurance under part A),
  but only insofar as such section amended paragraph (2) of section 1813(a)
  of the Social Security Act (relating to a deduction for blood).
  (2) Section 103 (relating to the part A premium for medicare buy-ins).
  (3) Section 113 (relating to a study of tax incentives for purchase of
  coverage for long-term care).
  (4) Section 208 (relating to a study of adult day care services).
  (5) Subsection (b) of section 211 (relating to extension of hold-harmless
  provision).
  (6) Section 221 (relating to voluntary certification of medicare supplemental
  health insurance policies).
  (7) Subsections (a) and (d)(1) of section 223 (relating to the distribution
  of notices of medicare benefits).
  (8) Section 224 (relating to civil money penalties for certain practices
  of health maintenance organizations and competitive medical plans).
  (c) REPEAL OF CERTAIN ADDITIONAL SECTIONS IN MCCA- The following sections
  of MCCA are repealed:
  (1) Section 421 (relating to maintenance of effort).
  (2) Section 422 (relating to rate reduction for medicare eligible Federal
  annuitants).
  (3) Section 425 (relating to case management demonstration projects).
  (d) CONFORMING AND MISCELLANEOUS AMENDMENTS-
  (1) REINSTITUTION OF MEDIGAP REGULATIONS- Section 1882 of the Social
  Security Act (42 U.S.C. 1395ss), as amended by section 221(d) of the
  Medicare Catastrophic Coverage Act of 1988, is amended--
  (A) in the third sentence of subsection (a) and in subsection (b), by
  striking `subsection (k)(3)' and inserting `subsections (k)(3), (k)(4),
  and (m)';
  (B) in subsection (k)--
  (i) in paragraph (3), by inserting `and in paragraph (4)' after `subsection
  (l)', and
  (ii) by adding at the end the following new paragraph:
  `(4)(A) The preceding provisions of this subsection shall not apply to
  the application of standards, effective on and after the date specified
  in subparagraph (B).
  `(B) The date specified in this subparagraph for a State is the date the
  State readopts the 1979 NAIC Model Standards or January 1, 1990, whichever
  is earlier.
  `(C) This paragraph shall not affect the implementation of subsections
  (b)(1)(C) or (c)(4) of this section.'; and
  (C) by adding at the end the following new subsection:
  `(m)(1) Until the date specified in paragraph (3), in the case of a
  qualifying medicare supplemental policy described in paragraph (2) issued
  in a State--
  `(A) before January 1, 1990, the policy is deemed to remain in compliance
  with the standards described in subsection (b)(1)(A) if the insurer issuing
  the policy complies with such transition provision which the Secretary
  shall promulgate (in consultation with the National Association of Insurance
  Commissioners) to provide for a transition similar to that provided under
  the NAIC Model Transition Regulation (described in subsection (l)), or
  `(B) on or after January 1, 1990, the policy is deemed to be in compliance
  with the standards described in subsection (b)(1)(A) if the insurer issuing
  the policy complies with the 1979 NAIC Model Standards before the date of
  the sale of the policy.
  `(2) In paragraph (1), the term `qualifying medicare supplemental policy'
  means a medicare supplemental policy which has been issued in compliance
  with this section as in effect on the date before the date of the enactment
  of this subsection.
  `(3)(A) The date specified in this paragraph for a policy issued in a
  State is--
  `(i) the first date a State readopts, after the date of the enactment of
  this subsection, standards equal to or more stringent than the 1979 NAIC
  Model Standards, or
  `(ii) the date specified in subparagraph (B),
whichever is earlier.
  `(B) In the case of a State which the Secretary identifies as--
  `(i) requiring State legislation (other than legislation appropriating
  funds) in order for medicare supplemental policies to meet standards
  described in subparagraph (A)(i), but
  `(ii) having a legislature which is not scheduled to meet in 1990 in a
  legislative session in which such legislation may be considered,
the date specified in this subparagraph is the first day of the first calendar
quarter beginning after the close of the first legislative session of the
State legislature that begins on or after January 1, 1990. For purposes of
the previous sentence, in the case of a State that has a 2-year legislative
session, each year of such session shall be deemed to be a separate regular
session of the State legislature.
  `(4) In this subsection and subsection (l)(4), the term `1979 NAIC Model
  Standards' means the NAIC Model Regulation, adopted on June 6, 1979,
  described in subsection (g)(2)(A).'.
  (2) MEDICARE COST-SHARING REQUIREMENTS UNDER MEDICAID- Section 1905(p)
  of the Social Security Act (42 U.S.C. 1396d(p)) is amended--
  (A) in paragraph (3)(C)--
  (i) by striking `Subject to paragraph (4), deductibles' and inserting
  `Deductibles', and
  (ii) by striking `1813, section 1833(b)' and all that follows and inserting
  `1813 and section 1833(b)).'; and
  (B) by striking paragraph (4) and redesignating paragraph (5) as paragraph
  (4).
  (3) DELAY IN DEADLINE- Section 113(c) of MCCA is amended by striking
  `November 30, 1988' and inserting `May 31, 1990'.
  (e) TRANSITION PROVISIONS FOR MEDICARE BENEFICIARIES-
  (1) INPATIENT HOSPITAL SERVICES AND POST-HOSPITAL EXTENDED CARE SERVICES-
  In applying sections 1812 and 1813 of the Social Security Act, as restored
  by subsection (a)(1), with respect to inpatient hospital services and
  extended care services provided on or after January 1, 1990--
  (A) no day before January 1, 1990, shall be counted in determining the
  beginning (or period) of a spell of illness;
  (B) with respect to the limitation on such services provided in a spell of
  illness, days of such services before January 1, 1990, shall not be counted,
  except that days of inpatient hospital services before January 1, 1989,
  which were applied with respect to an individual after receiving 90 days of
  services in a spell of illness (commonly known as `lifetime reserve days')
  shall be counted;
  (C) the limitation of coverage of extended care services to post-hospital
  extended care services shall not apply to an individual receiving such
  services from a skilled nursing facility during a continuous period
  beginning before (and including) January 1, 1990, until the end of the
  period of 30-consecutive days in which the individual is not provided
  inpatient hospital services or extended care services; and
  (D) the inpatient hospital deductible under section 1813(a)(1) of such
  Act shall not apply--
  (i) in the case of an individual who is receiving inpatient hospital
  services during a continuous period beginning before (and including)
  January 1, 1990, with respect to the spell of illness beginning on such
  date, if such a deductible was imposed on the individual for a period of
  hospitalization during 1989;
  (ii) for a spell of illness beginning during January 1990, if such a
  deductible was imposed on the individual for a period of hospitalization
  that began in December 1989; and
  (iii) in the case of a spell of illness of an individual that began before
  January 1, 1989, and has not ended as of January 1, 1990.
  (2) HOSPICE CARE- The restoration of section 1812(a)(4) of the Social
  Security Act, effected by subsection (a)(1), shall not apply to hospice
  care provided during the subsequent period (described in such section as
  in effect on December 31, 1989) with respect to which an election has been
  made before January 1, 1990.
  (f) TRANSITIONAL ADJUSTMENTS IN PAYMENTS FOR INPATIENT HOSPITAL SERVICES-
  (1) PPS HOSPITALS- In adjusting DRG prospective payment rates under section
  1886(d) of the Social Security Act, outlier cutoff points under section
  1886(d)(5)(A) of such Act, and weighting factors under section 1886(d)(4)
  of such Act for discharges occurring on or after October 1, 1989, the
  Secretary of Health and Human Services shall, to the extent appropriate,
  take into consideration the increases in payments to hospitals by (or on
  behalf of) medicare beneficiaries resulting from the reimposition of a
  day limitation on medicare inpatient hospital services as a result of the
  enactment of this section.
  (2) PPS-EXEMPT HOSPITALS- In adjusting target amounts under section
  1886(b)(3) of the Social Security Act for portions of cost reporting
  periods occurring on or after January 1, 1990, the Secretary shall, on a
  hospital-specific basis, take into consideration the increases in payments
  to hospitals by (or on behalf of) medicare beneficiaries resulting from the
  reimposition of a day limitation on medicare inpatient hospital services
  as a result of the enactment of this section, without regard to whether
  such a hospital is paid on the basis described in subparagraph (A) or (B)
  of section 1886(b)(1) of such Act.
  (g) EFFECTIVE DATES-
  (1) IN GENERAL- Except as provided in this subsection, the provisions of
  this section shall take effect January 1, 1990.
  (2) REPEAL OF SUPPLEMENTAL MEDICARE PREMIUM- The repeal of section 111 of
  MCCA shall apply to taxable years beginning after the date of enactment.
  (3) REPEAL OF INCREASE IN MEDICARE PART B PREMIUM AS OF JANUARY 1990- The
  repeal of section 211 of MCCA shall apply to premiums for months beginning
  with the month after enactment.
  (4) HOLD-HARMLESS PROVISION FOR REPEAL OF MAINTENANCE OF EFFORT- The
  repeal of section 421 of MCCA, made by subsection (c)(1), shall not apply
  to duplicative part A benefits for periods before January 1, 1990.
  (5) DISPOSAL OF FUNDS IN FEDERAL HOSPITAL INSURANCE CATASTROPHIC COVERAGE
  RESERVE FUND- Any balance in the Federal Hospital Insurance Catastrophic
  Coverage Reserve Fund (created under section 1817A(a) of the Social
  Security Act, as inserted by section 112(a) of MCCA) as of January 1,
  1990, shall be transferred into the Federal Hospital Insurance Trust Fund
  and any amounts payable due to overpayments into such Trust Fund shall be
  payable from the Federal Hospital Insurance Trust Fund.
Catastrophic Coverage Repeal Act of 1989

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