Page:United States Statutes at Large Volume 100 Part 3.djvu/230

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PUBLIC LAW 99-000—MMMM. DD, 1986

100 STAT. 2038 \::'X

PUBLIC LAW 99-509—OCT. 21, 1986

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(D) by adding at the end the following new paragraphs: "(3) Review of any national coverage determination under section 42 USC 1395y. 1862(a)(1) respecting whether or not a particular type or class of items or services is covered under this title shall be subject to the 3 '.., iii following limitations: "(A) Such a determination shall not be reviewed by any administrative law judge. "(B) Such a determination shall not be held unlawful or set aside on the ground that a requirement of chapter 5 of title 5, 5 USC 500 et seq; United States Code, or section 1871(b), relating to publication in ante, p. 2017. the Federal Register or opportunity for public comment, was i r j not satisfied. Records. "(C) In any case in which a court determines that the record is

, ' incomplete or otherwise lacks adequate information to support

the validity of the determination, it shall remand the matter to ithe Secretary for additional proceedings to supplement the vi record and the court may not determine that an item or service q a*nK is Covered except upon review of the supplemented record. "(4) A regulation or instruction which relates to a method for determining the amount of payment under part B and which was initially issued before January 1, 1981, shall not be subject to judicial review.". (2) Section 1842(b)(3)(C) of such Act (42 U.S.C. 1395u(b)(3)(C)) is amended by striking "$100 or more" and inserting "at least $100, but not more than $500". (3) Section 1879(d) of such Act (42 U.S.C. 1395pp(d)) is amended by striking "section 1869(b)" and all that follows through "part B)" and 42 USC 1395ff. inserting "sections 1869(b) and 1842(b)(3)(C) (as may be applicable)". 42 USC 1395ff (b) EFFECTIVE DATE.—The amendments made by subsection (a) note. shall apply to items and services furnished on or after January 1, 1987. ,... 42 USC 1395b-l note.

SEC. 9342. ALZHEIMER'S DISEASE DEMONSTRATION PROJECTS. (a) DEMONSTRATION PROJECTS.—The Secretary of Health and

Human Services (in this section referred to as the "Secretary") shall conduct at least 5 (and not more than 10) demonstration projects to determine the effectiveness, cost, and impact on health status and functioning of providing comprehensive services for individuals entitled to benefits under title XVIII of the Social Security Act (in this 42 USC 1395. section referred to as "medicare beneficiaries") who are victims of Alzheimer's disease or related disorders. (b) SERVICES UNDER DEMONSTRATION PROJECTS.—The services provided under demonstration projects must be designed to meet the specific needs of Alzheimer s disease patients and may include— (1) case management services, (2) home and community-based services, (3) mental health services, ^^ (4) outpatient drug therapy, (5) respite care and other supportive services and counseling

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for family, r:: (6) adult day care services, and i'^ j? ? (7) other in-home services. •^iii (c) CONDUCT OF PROJECTS.—The demonstration projects shall— e! > (1) each be conducted over a period of 3 years; (2) provide each medicare beneficiary with a comprehensive Si. medical and mental status evaluation upon entering the project and at discharge;