,i  #aag? ,,congress  #b;d ,session  ,h4
 ,r4 #hhgh  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,septemb] #ai1        
#bjbb,ms4 ,*u 7= h]self1 ,mr4 ,pascrell1
 & ,mr4 ,smi? ( ,nebraska7 introduc$ !  
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce1 & 9    
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xviii ( !     
,social ,security ,act to ensure        
adequate cov]age ( outpati5t m5tal heal?
 s]vices "u ! ,m$ic>e program4  #a4     
,ensur+ adequate cov]age ( outpati5t    
m5tal heal? s]vices "u ! ,m$ic>e program
  7a7 ,modification ( def9ition ( p>tial
 hospitalization s]vices ,section       
#ahfa7;ff77#a7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciex7ff77#a77 is  
am5d$ by ins]t+ = an individual det]m9$ 
7n less frequ5tly ?an mon?ly7 by a      
physician to h a ne$ = su* s]vices = a  

m9imum ( #bj h\rs p] week aft] prescrib$
 by a physician4  7b7 ,cov]age (        
int5sive outpati5t s]vices  7#a7 ,scope 
( b5efits  7,a7 ,community m5tal heal?  
c5t]s ,section #ahcb7;a77#b77;,j7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#aciek7a77#b77;,j77 is am5d$ by ins]t+ &
 int5sive outpati5t s]vices aft] p>tial 
hospitalization s]vices4  7,b7          
,incid5t-to s]vices ,section            
#ahfa7s77#b77;,b7 is am5d$ by ins]t+ or 
int5sive outpati5t s]vices aft] p>tial  
hospitalization s]vices4  7#b7          
,def9ition ,section #ahfa7;ff7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7ff77 is am5d$-- 7,a7 9 ! head]1  
by ins]t+ 2 ,int5sive ,outpati5t        
,s]vices aft] ,p>tial ,hospitalization  
,s]vices2 &  7,b7 by add+ at ! end !    
foll[+ new p>agraph3  7#d7 ,! t]m       
int5sive outpati5t s]vices has ! mean+  
giv5 ! t]m p>tial hospitalization       
s]vices 9 p>agraph 7#a71 except t-- 7,a7
 section #ahce7;a77#b77;,f77i7 %all n   
apply2  7,b7 ! ref]5ce 9 su* p>agraph to

 an individual det]m9$ 7n less frequ5tly
 ?an mon?ly7 by a physician to h a ne$ =
 su* s]vices = a m9imum ( #bj h\rs p]   
week %all be treat$ z a ref]5ce to an   
individual det]m9$ 7n less frequ5tly ?an
 once e o!r mon?7 by a physician to h a 
ne$ = su* s]vices = a m9imum ( #i h\rs  
p] week2 &  7,c7 ! ref]5ce to a         
community m5tal heal? c5t] 7z def9$ 9   
subp>agraph 7,b77 9 p>agraph 7#c7 %all  
be treat$ z a ref]5ce to a community    
m5tal heal? c5t] 7z def9$ 9 subp>agraph 
7,b771 a ,f$]ally qualifi$ heal? c5t]1  
or a rural heal? cl9ic4  4  7#c7        
,exclusion f calculation ( c]ta9        
treatm5t co/s ,section #ahcc7;c77#b7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciel7c77#b77 is am5d$ by ins]t+ or    
int5sive outpati5t s]vices aft] p>tial  
hospitalization s]vices4  7#d7 ,con=m+  
am5dm5ts  7,a7 ,int5sive outpati5t      
s]vices ,section #ahfa7;aa7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciex7aa77 is am5d$-- 7i7 9 p>agraph   
7#a7-- 7,i7 9 subp>agraph 7,b71 by /rik+

 & at ! end2  7,,ii7 9 subp>agraph 7,c71
 by add+ & at ! end2 &  7,,iii7 by      
ins]t+ aft] subp>agraph 7,c7 ! foll[+   
new subp>agraph3  7,d7 int5sive         
outpati5t s]vices 7z def9$ 9 section    
#ahfa7;ff77#d771  2 &  7ii7 9 p>agraph  
7#c71 by /rik+ ?r\gh 7,c7 & ins]t+ ?r\gh
 7,d74  7,b7 ,provid] ( s]vices ,section
 #ahff7;e77#b7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acie;cc7e77#b77 is 
am5d$ by ins]t+ 1 or int5sive outpati5t 
s]vices 7z describ$ 9 section           
#ahfa7;ff77#d77 aft] p>tial             
hospitalization s]vices 7z describ$ 9   
section #ahfa7;ff77#a774  7c7 ,special  
paym5t rule = ,f,q,h,cs & ,r,h,cs       
,section #ahcd ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciem7 is am5d$--  
7#a7 9 subsection 7o71 by add+ at ! end 
! foll[+ new p>agraph3  7#e7 ,special   
paym5t rule = int5sive outpati5t s]vices
  7,a7 ,9 g5]al ,9 ! case ( int5sive    
outpati5t s]vices furni%$ by a ,f$]ally 
qualifi$ heal? c5t]1 ! paym5t am\nt =   
su* s]vices %all be equal to ! am\nt t  

w\ld h be5 paid "u ?is title = su*      
s]vices _h su* s]vices be5 cov]$ ,,opd  
s]vices furni%$ by a hospital4  7,b7    
,exclusion ,co/s associat$ ) int5sive   
outpati5t s]vices %all n be us$ to      
det]m9e ! am\nt ( paym5t = ,f$]ally     
qualifi$ heal? c5t] s]vices "u !        
prospective paym5t sy/em "u ?is         
subsection4  2 &  7#b7 9 subsection     
7y7-- 7,a7 9 ! head]1 by /rik+ to       
hospice pati5ts2 &  7,b7 by add+ at !   
end ! foll[+ new p>agraph3  7#c7        
,special paym5t rule = int5sive         
outpati5t s]vices  7,a7 ,9 g5]al ,9 !   
case ( int5sive outpati5t s]vices       
furni%$ by a rural heal? cl9ic1 ! paym5t
 am\nt = su* s]vices %all be equal to ! 
am\nt t w\ld h be5 paid "u ?is title =  
su* s]vices _h su* s]vices be5 cov]$    
,,opd s]vices furni%$ by a hospital4    
7,b7 ,exclusion ,co/s associat$ )       
int5sive outpati5t s]vices %all n be us$
 to det]m9e ! am\nt ( paym5t = rural    
heal? cl9ic s]vices "u ! me?odology =   
all-inclusive rates 7e/abli%$ by !      

,secret>y7 "u section #ahcc7;a77#c74  4 
7d7 ,effective date ,! am5dm5ts made by 
?is section %all apply ) respect to     
items & s]vices furni%$ on or aft]      
,janu>y #a1 #bjbd4