A bill to amend the Social Security Act to provide for a general strategy of health care de-institutionalization by broadening coverage of home health services under medicare and medicaid, by providing coverage under medicare of adult ambulatory care services, and by accelerating completion of the study relating to medicare coverage of services furnished by outpatient surgical centers.
Home and Family Services Health Care Act - Title I: Home Health Services - Increases from 100 to 200 the number of allowable home health visits under Medicare. Requires that in case such services are provided to an individual during any one-year period for more than 100 visits, a physician must certify that such visits must prevent or postpone institutionalization of the patient. Limits the cost of such expanded home health benefits to no more than the cost would have the patient been institutionalized. Requires that home health services be offered where the physician certifies that the patient would, without these services, require institutional care.
Title II: Services of Outpatient Surgical Centers - Requires the Department of Health, Education, and Welfare to complete its evaluation of outpatient surgical centers no later than March 1, 1976. Provides that until such study is complete the Secretary is allowed to reimburse such centers for services to Medicare beneficiaries, provided the centers meet standards set by the Department.
Title III: Adult Ambulatory Care Services - Extends coverage under the Medicare program to pay for 100 days of service in adult ambulatory care centers. Requires that such services include nursing care and rehabilitation services on a daily basis.
Provides that in order to qualify for Medicare reimbursement, such center must be governed by both a physician and a registered nurse; must maintain clinical records; and must conduct a review of the appropriateness and necessity of patient care.
Limits payment for services offered in such a center to no more than the cost of institutional care that would have been provided had these services not been available.
Introduced in Senate
Referred to Senate Committee on Finance.
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