Medicare and Medicaid Amendments of 1979

Medicare and Medicaid Amendments of 1979 - Title I: Medicare Provisions - Amends the Internal Revenue Code to prohibit the deduction as a trade or business expense of the expenses of an employer with respect to inpatient hospital services health benefits provided to his or her employees if benefits are not offered to employees between the ages of 65 and 70 which are at least equal to benefits offered at the same cost to employees under 65. Prohibits payments, under title XVIII (Medicare) of the Social Security Act, for inpatient hospital services for cases in which payment has been made or will be made as health benefits provided by an employer. Authorizes the Secretary of Health, Education, and Welfare to enter into contracts with public and private entities to provide for the administration of Medicare benefits. Limits the 100 percent reimbursement for physicians in the fields of radiology or pathology to physicians who agree to accept assignment for all physicians' services furnished by such physicians to hospital inpatients. Eliminates Medicare coverage of chiropractors' services. Increases the amount considered as incurred expenses for the outpatient treatment of mental, psychoneurotic, and personality disorders. Repeals the restriction against enrolling more than twice under part B (Supplementary Medical Insurance) of title XVIII. Repeals provisions of presumptive eligibility for post-hospital extended care and post-hospital home health services under Medicare for conditions prescribed in regulations by the Secretary. Authorizes payment under the Medicare program for: (1) cutting or removal of warts on the feet; and (2) antigens furnished by a physician for administration by or under the supervision of another physician. Provides for the settlement of the claim for payment of a person who furnished services to an individual who has died when the person who provided the services does not agree that the reasonable charge is the full charge for the services. Repeals the 12 month limitation on agreements governing payment for services between a skilled nursing facility and the Secretary. Requires a skilled nursing facility participating in Medicare which is located in a State which also has a Medicaid plan to participate in the Medicaid plan. Authorizes the Secretary, in certain instances, to apply sanctions less severe than decertification of a skilled nursing facility in the case of a facility which no longer meets the requirements for participation in the Medicare program. Title II: Medicaid Provisions - Repeals the requirement that a member of a family receiving aid to families with dependent children (title IV of the Act, part A) must remain employed during the four months of Medicaid coverage permitted to such family which loses its AFDC assistance because of increased earnings from employment. Eliminates Medicaid coverage of chiropractors' services. Requires a skilled nursing facility participating in Medicaid to participate in Medicare. Permits a skilled nursing facility or intermediate care facility to participate in the Medicaid program only when the Secretary determines that such facility is qualified as required under the program. Authorizes the Secretary, in certain instances, to apply sanctions less severe than decertification of a skilled nursing facility or intermediate care facility in the case of a facility which no longer meets the requirements for participation in the Medicaid program. Requires a State Medicaid plan with respect to skilled nursing facilities, or if it includes medical assistance for inpatient mental hospital services or for intermediate care facility services, to provide: (1) a regular program of review for each patient receiving assistance; (2) for periodic inspections of the care being provided to each individual receiving assistance in mental hospitals within the State; (3) for full reports to the State of the findings of each inspection; and (4) that, if required by the Secretary, the review will be performed jointly with the review of the appropriateness and quality of care and services furnished to recipients of medical assistance under Medicaid. Requires that State Medicaid plans provided for common audits under Medicare and Medicaid of hospitals, skilled nursing facilities, and home health agencies participating in both programs. Amends part A (General Provisions) of title XI of the Act to increase federal Medicaid funding for Puerto Rico, the Virgin Islands, and Guam. Provides for federal Medicaid funding to the Northern Mariana Islands. Title III: Professional Standards Review Provisions - Amends part B (Professional Standards Review) of title XI of the Act to eliminate the requirement that a Professional Standards Review Organization (PSRO) must, review ambulatory care services, if capable of performing such a review, within two years of being designated a PSRO. Authorizes the Secretary to enter an agreement with an organization other than a PSRO to conduct the reviews for which the PSRO is responsible, if the PSRO originally selected by the Secretary has not assumed its responsibilities. Requires a qualified PSRO to include health care practitioners, other than physicians, who have been invited to become members and who hold independent hospital admitting privileges. Stipulates that a PSRO shall be considered neither an agency of the Federal Government nor an "advisory committee" for purposes of the Federal Advisory Committee Act. Abolishes statewide professional standards review councils. Adds one dentist, one registered nurse, and one health care practitioner not a physician to the National Professional Standards Review Council. Requires a PSRO to consult with representatives of health care practitioners other than physicians. Title IV: Miscellaneous Provisions - Authorizes the Secretary to waive compliance with the requirements of titles X (Aid to the Blind), XVIII, and XIX of the Act to the extent necessary to conduct specified experiments or demonstration projects.

Written by analysts at the Congressional Research Service and published on Congress.gov, not by Civibrief. Summarized at the "Introduced in House" stage on June 14, 1979. It describes the bill, it is not the legal text.

Every answer above is assembled from this measure's own record on Congress.gov and from published counts of what Congress has passed before. Civibrief does not predict outcomes and takes no position on any measure.