Page:United States Statutes at Large Volume 98 Part 1.djvu/1153

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PUBLIC LAW 98-000—MMMM. DD, 1984

PUBLIC LAW 98-369—JULY 18, 1984

98 STAT. 1105

CLARIFICATION OF MEDICAID ENTITLEMENT FOR CERTAIN NEWBORNS

SEC. 2362. (a) Section 1902(e) of the Social Security Act is amended 42 USC I396a. by adding at the end the following new paragraph: "(4) A child born to a woman eligible for and receiving medical assistance under a State plan on the date of the child's birth shall be deemed to have applied for medical assistance and to have been found eligible for such assistance under such plan on the date of such birth and to remain eligible for such assistance for a period of one year so long as the child is a member of the woman's household and the woman remains eligible for such gissistance.". (b) The amendment made by subsection (a) shall apply to children 42 USC 1396a note. born on or after October 1, 1984. RECERTIFICATION OF SNF AND ICF PATIENTS

SEC. 2363. (a)(1) Section 1902(a) of the Social Security Act, as amended by section 2303(g) of this title, is amended— (A) in paragraph (30)— (i) by inserting "(A)" after "(30)", and (ii) by adding at the end the following new subparagraph: "(B) provide, under the program described in subparagraph (A), that— "(i) each admission to a hospital, skilled nursing facility, intermediate care facility, or hospital for mental diseases is reviewed or screened in accordance with criteria established by medical and other professional personnel who are not themselves directly responsible for the care of the patient involved, and who do not have a significant financial interest in any such institution and are not, except in the case of a hospital, employed by the institution providing the care involved, and "(ii) the information developed from such review or screening, along with the data obtained from prior reviews of the necessity for admission and continued stay of patients by such professional personnel, shall be used as the basis for establishing the size and composition of the sample of admissions to be subject to review and evaluation by such personnel, and any such sample may be of any size up to 100 percent of all admissions and must be of sufficient size to serve the purpose of (I) identifying the patterns of care being provided and the changes occurring over time in such patterns so that the need for modification may be ascertained, and (II) subjecting admissions to early or more extensive review where information indicates that such consideration is warranted to a hospital, skilled nursing facility, intermediate care facility, or hospital for mental diseases;"; and (B) by striking out "and" at the end of paragraph (42), by striking out the period at the end of paragraph (43) and inserting in lieu thereof "; and", and by inserting after paragraph (43) the following new paragraph: "(44) in each case for which payment for inpatient hospital services, skilled nursing facility services, intermediate care fa cility services, or inpatient mental hospital services is made under the State plan—

31-194 0 - 86 - 37: QL. 3 Part 1

42 USC 1396a. Ante, p. 1064.