article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Medicare and Medicaid Hospital Self- Referral Amendments of 1996''. SEC. 2. NOTIFICATION OF AVAILABILITY OF PROVIDERS AS PART OF DISCHARGE PLANNING PROCESS. (a) Medicare Requirement.--Section 1861(ee)(2) of the Social Security Act (42 U.S.C. 1395x(ee)(2)) is amended-- (1) in subparagraph (D), by inserting before the period the following: ``, including the availability of those services through individuals and entities that participate in the program under this title and that serve the area in which the patient resides and that request to be listed by the hospital as available''; and (2) by adding at the end the following: ``(H) Consistent with section 1802, the discharge plan shall-- ``(i) not specify or otherwise limit the qualified provider which may provide post-hospital care, and ``(ii) identify (in a form and manner specified by the Secretary) any provider (to whom the individual is referred) in which the hospital has a disclosable financial interest (as specified by the Secretary consistent with section 1866(a)(1)(R)) or which has such an interest in the hospital.''. (b) Requirement for Medicaid Funding.--Section 1903(i) of such Act (42 U.S.C. 1396b(i)) is amended-- (1) by striking ``or'' at the end of paragraph (14), (2) by striking the period at the end of paragraph (15) and inserting ``; or'', and (3) by inserting after paragraph (15) the following new paragraph: ``(16) with respect to any amount expended for inpatient hospital services of a hospital unless the hospital has in place a discharge planning process that meets the requirements of section 1861(ee) with respect to individuals entitled to medical assistance under this title in the same manner as such requirements otherwise apply to individuals entitled to benefits under title XVIII.''. (c) Effective Dates.--The amendments made by subsection (a) shall apply to discharges occurring on or after 90 days after the date of the enactment of this Act. The amendments made by subsection (b) shall apply to expenditures for inpatient hospital services with respect to discharges occurring on or after 90 days after the date of the enactment of this Act. SEC. 3. MAINTENANCE AND DISCLOSURE OF INFORMATION ON POST-HOSPITAL SERVICE PROVIDERS. (a) Medicare Requirement.--Section 1866(a)(1) of the Social Security Act (42 U.S.C. 1395cc(a)(1)) is amended-- (1) by striking ``and'' at the end of subparagraph (P), (2) by striking the period at the end of subparagraph (Q), and (3) by adding at the end the following: ``(R) in the case of a hospital that has a financial interest (as specified by the Secretary in regulations) in a provider of post-hospital services (including an entity that furnishes durable medical equipment), or in which such a provider has such a financial interest, or in which another entity has such a financial interest (directly or indirectly) with such hospital and such a provider, to maintain and disclose to the Secretary (in a form and manner specified by the Secretary) information on-- ``(i) the nature of such financial interest, ``(ii) the number of individuals who were discharged from the hospital and who were identified as requiring the type of post-hospital services provided by such provider, and ``(iii) the percentage of such individuals who received such services from such provider (or another such provider).''. (b) Requirement for Medicaid Funding.--Section 1903(i)(16) of such Act (42 U.S.C. 1396b(i)), as inserted by section 2(b), is amended-- (1) by striking ``(A)'' after ``unless'', and (2) by inserting before the period at the end the following: ``, and (B) the hospital is complying with the requirements of section 1866(a)(1)(R)''. (c) Disclosure of Information to the Public.--Title XI of such Act is amended by inserting after section 1145 the following new section: ``public disclosure of certain information on hospital financial interest and referral patterns ``Sec. 1146. The Secretary shall make available to the public, in a form and manner specified by the Secretary, information disclosed to the Secretary pursuant to section 1866(a)(1)(R) or section 1903(i)(16).''. (d) Effective Date.--The Secretary of Health and Human Services shall issue regulations by not later than 1 year after the date of the enactment of this Act to carry out the amendments made by this section and such amendments shall take effect as of such date (on or after the issuance of such regulations) as the Secretary specifies in such regulations.
summary: Medicare and Medicaid Hospital Self-Referral Amendments of 1996 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act (SSA) to require hospitals participating in the Medicare or Medicaid programs to: (1) give notice of availability of providers as part of the discharge planning process; and (2) maintain and disclose information on certain referrals. Amends SSA title XI to provide for public disclosure of certain information on hospital financial interest and referral patterns by the Secretary of Health and Human Services.