Medicare, Unemployment Compensation, and Public Assistance Amendments of 1982

Medicare, Unemployment Compensation, and Public Assistance Amendments of 1982 - Title I: Medicare Changes - Subtitle A: Changes in Benefits and Coverage - Amends title XVIII (Medicare) of the Social Security Act to permit an individual to elect hospice care, in lieu of certain other benefits, during two periods of 90 days each and one period of 45 days during the individual's lifetime.

Provides for full reimbursement of reasonable costs to a hospice program, subject to a ceiling. Directs the Secretary to conduct a study of the hospice reimbursement method.

Defines hospice care as including certain items and services furnished to the terminally ill in their homes, on an outpatient basis, and on a short term inpatient basis.

Directs the Secretary to provide coverage of extended care services which are not post-hospital extended care services under such conditions as the Secretary finds appropriate so long as the inclusion of such services will not increase the total payments made under Medicare and will not alter the acute care nature of such services.

Provides for Medicare coverage of, and application of the hospital insurance tax (through amendments to the Internal Revenue Code) to, Federal employees.

Subtitle B: Reimbursement and Payment Changes - Prohibits the Secretary from recognizing as reasonable a hospital's costs for inpatient services if the costs exceed 120 percent of the costs of all hospitals in the same group. Authorizes the Secretary to establish percentages of less than 120 for stated periods prior to October 1, 1985, under certain conditions, except that the Secretary may not establish a percentage prior to October 1, 1983, pursuant to such authority. Directs the Secretary to develop a plan to pay hospitals and skilled nursing facilities under a methodology under which rates or amounts paid for inpatient hospital services and extended care services are established prior to the defined rate period. Authorizes the Secretary to provide for payment, with respect to services provided by a hospital in a State, to be made in accordance with an approved State hospital reimbursement control system.

Permits an eligible individual to have the right to receive benefits under an Optional Alternative Medicare Program rather than under part A (Hospital Insurance) and part B (Supplementary Medical Insurance) of title XVIII. Defines an "eligible individual" as an individual who is an aged individual or a disabled individual and who is not a Medicaid (title XIX of the Act) eligible individual.

Sets forth formulas for determining the amount of benefits provided. Provides for the assignment of an eligible individual's benefits to a qualified plan in the case of an individual who elects the Alternative Program and enrolls in a qualified plan.

Directs the Secretary to annually determine the actuarial adjustments to be made for the succeeding plan year in amounts of benefits paid with respect to different classes of eligible individuals. Directs the Secretary to delineate the United States into health care areas. Permits an entity wanting to offer a health plan to apply to the Secretary for certification in one or more health care areas. Requires the Secretary to act upon each health plan's application for certification as a qualified plan within 45 days of receiving the application.

Requires a plan, in order to be qualified, to: (1) provide at least the services covered under parts A and B of title XVIII; and (2) accept all eligible individuals residing in the health care area in which the plan is offered and who apply for membership, subject to certain exceptions.

Requires a plan to establish for each health care area in which it is offered an annual premium for all members who are eligible individuals.

Sets forth reporting requirements for entities offering qualified plans.

Excludes, under the Internal Revenue Code, the amount of any benefits received by an individual under the Optional Alternative Medicare Program.

Revises provisions relating to payments to and contractual arrangements with health maintenance organizations (HMOs) on behalf of individuals eligible for Medicare.

Directs the Secretary to annually determine a per capita rate of payment for each class of individuals: (1) enrolled with an HMO pursuant to this Act and entitled to benefits under part A (Hospital Insurance) of title XVIII and enrolled under part B (Supplementary Medical Insurance) of title XVIII; and (2) enrolled with an HMO under part B only. Provides a rate for each class equal to 95 percent of the adjusted average per capital cost for that class. Defines the term "adjusted average per capita cost" to mean the average per capita amount that the Secretary estimates would be payable for services furnished under the Medicare program, if the services were to be furnished by other than an HMO.

Directs the Secretary in establishing classes of individuals to take into consideration such factors as age, sex, institutional status, disability status, place of residence, and other factors which the Secretary determines to be appropriate.

Redefines an HMO. Requires an HMO to meet certain requirements, including limits on premiums, deductibles, coinsurance, and copayments.

Provides that individuals enrolled in the Medicare program shall be eligible under this Act for enrollment with any HMO with which the Secretary has contracted.

Prohibits premiums, deductibles, coinsurance, and copayments of an HMO for services in addition to those available to Medicare enrollees from exceeding, for such individuals, the adjusted community rate for such services. Defines the adjusted community rate.

Authorizes the Secretary to provide for the reimbursement of an HMO on a reasonable cost basis, if: (1) the Secretary is not satisfied that an HMO can bear the risk of potential losses under an risk-sharing contract; or (2) the HMO elects reasonable cost reimbursement.

Provides for the coverage of the services of a physician assistant or nurse practitioner furnished pursuant to a contract under title XVIII to a member of an HMO.

Directs the Secretary to conduct a study and report to Congress concerning: (1) additional benefits offered by HMOs; and (2) the extent of, and reasons for, the termination by Medicare beneficiaries of their HMO memberships.

Prohibits, in the case of a provider of services which is paid on a reasonable cost basis and which has entered into a contract for the purpose of having services furnished for or on behalf of itself, the Secretary from including any cost incurred by the provider under the contract if the amount payable under the contract by the provider for that cost is determined on the basis of a percentage (or other proportion) of the provider's reimbursement or claim for reimbursement for services furnished by the provider. Provides that the provisions of the preceding sentence shall not apply where the amount involved under the percentage contract is reasonable and the contract: (1) is a customary commercial business practice; or (2) provides incentives for the efficient and economical operation of the provider of services.

Prohibits reimbursement for an assistant at surgery if the hospital has a training program relating to the medical specialty of the surgical procedure and a qualified individual is on the hospital staff to provide such services, except that payment may be made if: (1) there are exceptional medical circumstances; (2) a team of physicians is needed for complex procedures; or (3) a physician of another specialty is required during surgery.

Provides for the imposition of interest charges on overpayments and underpayments to a provider.

Prohibits including as reasonable costs: (1) the costs of care by a provider of services pursuant to an assurance, under the Public Health Service Act, that such provider will make available a reasonable volume of services to persons unable to pay for such services; and (2) the cost incurred for activities directly related to influencing employees respecting proposed unionization.

Directs the Secretary, with respect to the last 21 days of FY 1983 and 1984, in the case of a hospital which is paid periodic interim payments, to defer such payments until FY 1984 and 1985 respectively.

Subtitle C: Miscellaneous Changes - Transfers from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Fund $45,000,000 for each of the FY 1983, 1984, and 1985 for payments to Medicare intermediaries and carriers, to be used exclusively to carry out audits and claims reviews.

Extends until December 31, 1983, the period during which the Secretary shall conduct a program which determines the proficiency of health care personnel who do not meet formal educational requirements.

Provides that unless regulations relating to access of the books and records of certain subcontractors are published by a certain date, such regulations shall not be retroactive.

Makes technical corrections to the Omnibus Budget Reconciliation Act of 1981.

Title II: Unemployment Compensation - Subtitle A: Federal Supplemental Unemployment Compensation Program - Federal Supplemental Unemployment Compensation Act of 1982 - Permits States to enter into and participate in agreements with the Secretary of Labor under this Act and to terminate such agreements upon providing 30 days' written notice to the Secretary.

Requires that such agreements provide that the State agency will make Federal supplemental compensation payments: (1) to individuals who have exhausted all rights to regular and extended compensation under State law, have no rights to unemployment compensation with respect to a week under State or Federal law, and are not receiving Canadian unemployment compensation with respect to such week; and (2) for any week of unemployment which begins in an extended benefit period and the individual's period of eligibility. Prohibits any Federal supplemental compensation payment to any individual for any week of unemployment which begins more than two years after the end of the benefit year for which rights to regular compensation were exhausted.

Makes the amount of Federal supplemental compensation payable to any individual for any week of total unemployment equal to the amount of the regular compensation (including dependents' allowances) payable during the benefit year under the State law.

Requires that the amount established in an individual's Federal supplemental compensation account equal the lesser of: (1) 50 percent of the total amount of regular compensation (including dependents' allowances) payable with respect to the benefit year on the basis of which regular compensation was most recently received; or (2) 13 times the individual's average weekly benefit amount for the benefit year.

Prohibits payment of Federal supplemental compensation to any individual under an agreement entered into under this Act for any week beginning: (1) before the first week beginning after enactment of this Act or the week following the week in which such agreement is entered into, whichever is later; or (2) after September 30, 1983.

Provides for Federal payments to States having agreements for the payment of Federal supplemental compensation.

Directs the Secretary to certify from time to time to the Secretary of the Treasury, for payment to each State, the sums payable under this Act. Directs the Secretary of the Treasury, to make such payments by transfers from funds appropriated pursuant to this Act to the account of the State in the Unemployment Trust Fund. Authorizes appropriations from the general fund of the Treasury, without fiscal year limitation, as necessary to carry out this Act.

Sets forth provisions relating to fraud and overpayments.

Subtitle B: Taxation of Unemployment Compensation - Amends the Internal Revenue Code to reduce the income thresholds limiting the inclusion of unemployment benefits in adjusted gross income for Federal income tax purposes to $12,000 (currently $20,000) for single taxpayers and to $18,000 (currently $25,000) for married taxpayers filing jointly.

Increases the wage base for purposes of the Federal unemployment tax from $6,000 to $7,000, effective in 1983. Increases the unemployment tax rate from 3.4 to 3.5 percent, effective in 1983, and to 6.2 percent (a permanent tax of 6.0 percent and an extended benefit tax of 0.2 percent), effective in 1985. Increases the credit which employers receive against such tax to 5.4 percent, effective in 1985.

Allows States to make Federal unemployment loan repayments from State trust fund accounts in lieu of further reductions in the credit against unemployment taxes, provided certain requirements are met. Eliminates the additional credit reduction that begins in the fifth year a State is subject to reductions because of outstanding Federal unemployment loans.

Amends title IX (Miscellaneous Provisions Relating to Employment Security) of the Social Security Act to direct the Secretary of the Treasury to transfer from the general fund of the Treasury to the extended unemployment compensation account an amount equal to the aggregate interest paid on specified accounts under title XII of such Act (Advances to State Unemployment Funds) received in the Treasury during the preceding calendar month.

Permits States with high unemployment to defer interest on Federal unemployment loans. Specifies when repayments should be made from extended unemployment compensation accounts.

Amends the Internal Revenue Code to permit the payment of retroactive unemployment compensation benefits to nonteaching, nonresearch, or nonadministrative employees of institutions of higher education who were reasonably assured of employment between school terms (and therefore denied benefits for such period) but upon the commencement of the subsequent term were not offered a position with the institution.

Subtitle C: Short-Time Compensation - Short-Time Compensation Act of 1982 - Directs the Secretary of Labor to: (1) develop legislation which may be used by States as a model in developing and enacting short-time compensation programs; (2) provide technical assistance to States to develop, enact, and implement such programs; and (3) study and evaluate the operation, costs, effect on the State insured rate of unemployment, and other effects of such programs.

Terminates the guideline and grant provisions of this Act after a three-year experimental period. Encourages States to experiment, but to consider requiring specified provisions to assure minimum uniformity.

Defines a "short-time compensation program" as one under which: (1) individuals whose workweek has been reduced by at least ten percent, pursuant to a qualified employer plan, will be eligible for at least a pro rata portion of the unemployment benefits payable if such individual were totally unemployed; (2) eligible employees may apply for and collect short-time compensation or regular unemployment compensation benefits, as needed, but shall not collect more than the maximum unemployment compensation benefit for full-time unemployment or be eligible for short-time compensation for more than 26 weeks in any 12-month period; and (3) eligible employees will not be expected to meet the availability for work or work search test requirement while collecting short-time compensation, but must be available for their normal workweek.

Defines "qualified employer plan" as one under which there is a reduction in the number of hours worked by employees rather than total layoffs if: (1) such plan is approved by the State agency; (2) the employer or employers' association which is party to a collective bargaining agreement certifies that the aggregate reduction in work hours pursuant to such plan is in lieu of total layoffs which would result in an equivalent reduction of work hours; (3) the employer continues to provide health and pension benefits to employees whose workweek is reduced under such plan at the same level provided before such reduction; (4) the exclusive bargaining representative (if there is one) of the employees has consented to the plan; and (5) during the previous four months, the work force in the affected unit or units has not been reduced by temporary layoffs of more than ten percent.

Requires a State to review, at least annually, any plan put into effect to assure that it continues to meet the requirements of this Act and of any applicable State law.

Requires that such short-time compensation benefits be charged in a manner consistent with State law.

Directs the Secretary to study State short-time compensation programs and to consult with employee and employer representatives in developing guidelines to measure specified factors.

Directs the Secretary to submit a final report to the Congress and the President on the implementation of the short-time compensation program with a program evaluation and recommendations.

Title III: Aid to Families With Dependent Children and Child Support Enforcement Programs - Amends part A (Aid to Families with Dependent Children) of title IV of the Social Security Act to increase the "earned income disregards" in the AFDC program. Requires States to disregard the following amounts in determining a family's monthly AFDC benefit: (1) the first $50 of earnings; (2) 20 percent of gross earnings up to $175; (3) child care costs up to $160 per child; and (4) one-third of remaining earnings. (Retains the earned income disregard for earnings of full-or-part-time students who are not full-time employees). Requires States to disregard the earnings of a child in an AFDC family derived from participation in a youth program under the Comprehensive Employment and Training Act (CETA).

Repeals the requirement that limits AFDC eligibility to families with income below 150 percent of the State standard of need.

Requires that States consider as earned income for AFDC purposes the amount of earned income tax credit received by the person.

Requires that States continue to exclude, for purposes of such AFDC earned income determinations, certain State-financed payments to meet certain needs of AFDC children.

Requires that Federal AFDC payments to a State shall be made, if a State requests, at such times so as to assure that the amount paid will actually be available before the State makes it expenditures.

Permits a State to require that, as a condition of eligibility for AFDC, an individual required to register for the WIN program (Work Incentive Program, part C of title IV) must participate in a program of employment search beginning at the time application for aid is made. Provides that any individual required to look for employment will be furnished with transportation as necessary to participate in an employment search program. Subjects an individual who fails to comply with the search requirements to the same sanctions as are applied under the WIN program.

Authorizes a State to charge an application fee under part D (Child Support and Establishment of Paternity) of title IV of the Social Security Act to non-AFDC families in cases where the State provides services relating to the collection of support. Permits any costs in excess of any collection fee imposed to be collected: (1) from such individual by deducting such costs from the recovery; or (2) from the parent who owes the support. Reduces Federal funding for States under part D.

Requires a member of the uniformed services on active duty to make allotments from his or her pay as support payments whenever such individual has failed to make periodic payments under a support order. Prohibits the making of such allotments until such member has had an opportunity for consultation with a judge advocate or a law specialist.

Provides that child support payments collected which would make an AFDC family ineligible shall be paid to the family (instead of the State) in the month following the first month of ineligibility (currently such payments are made to the family beginning with the first month of ineligibility).

Title IV: Supplemental Security Income Program - Amends title XVI (Supplemental Security Income) of the Act to provide that an individual's monthly eligibility shall be determined on the basis of the individual's income, resources, and other relevant characteristics in such month. Authorizes the Secretary to redetermine eligibility for and amount of benefits at other times.

Phases out "hold harmless" provisions applicable to State SSI supplementary benefits so that by FY 1985 a hold harmless State would be paying for the entire cost of supplementary payments.

Adds the value of a burial plot to the items excludable from an individual's resources in determining SSI eligibility.

Provides that a State has met the requirement that it pass through Federal SSI cost of living increases if the State does not decrease the State supplementation payment below the level of the previous December.