Amends the Medicare program to require that payments for blood clotting factors administered to inpatient hemophiliacs be made on the basis of a predetermined price per unit consumed.
Allows individuals under age 65 whose entitlement to OASDI disability benefits ended due to their employment earnings to enroll in part A (Hospital Insurance) of the Medicare program.
Requires the Secretary, at the request of a State, to permit qualified Medicare beneficiaries in the State (enrolled under part B of the Medicare program) to enroll in the Hospital Insurance program.
Requires studies into the appropriateness of an adjustment to the methodology of determining payment amounts for hospitals serving a disproportionate share of Medicare beneficiaries and on methods of compensating hospices for high-cost care.
Authorizes the Secretary to assign a new base period to a hospital in determining Medicare hospital payment amounts when such hospital's costs are skewed by events beyond the hospital's control or extraordinary circumstances.
Imposes obligations on hospitals regarding the treatment of emergency medical conditions and indigent care.
Provides for the release of hospital accreditation surveys to the Secretary and the Secretary's release of survey information which relates to an enforcement action.
Permits the Secretary to withdraw a hospital's Medicare-approved status on the basis of information other than accreditation surveys.
Establishes intermediate sanctions for psychiatric hospitals.
Permits certain merged or consolidated hospitals to receive Medicare periodic interim payments.
Alters the basis for judging the effectiveness of a waiver of Medicare hospital reimbursement mechanisms in favor of a State hospital reimbursement control system.
Prohibits the Secretary from requiring a hospital to change its bad debt recognition policy approved as of August 1, 1987.
Requires the Secretary to determine a nursing facilities routine service costs using data collected no earlier than October 1985.
Permits dentists to serve as hospital medical directors.
Directs the Comptroller General to conduct a study of the differences in costs and case-mix between hospital-based and freestanding skilled nursing facilities.
Prohibits the Secretary from collecting overpayments from hospitals in Massachusetts prior to May 1990 occurring during a specified statewide hospital reimbursement demonstration project.
Permits nurse practitioners and clinical nurse specialists to certify an individual's need for Medicare extended care and hospice services.
Provides for the future annual recalibration of diagnosis-related group (DRG) weights on a budget-neutral basis.
Establishes a demonstration program under which the Secretary makes grants to no more than seven States for use in:
(1) planning and implementing a rural health care plan and rural health networks;
(2) designating hospitals or facilities as essential access community hospitals or rural primary care hospitals; and
(3) developing and supporting communication and emergency transportation systems.
Authorizes hospitals and facilities in grant States to apply, subject to the State's approval, to the Secretary for a grant to finance the costs it incurs in converting itself to a primary care hospital or in becoming part of a rural health network in the State in which it is located.
Requires that hospitals designated as essential access community hospitals be isolated rural hospitals that have at least 75 inpatient beds and provide emergency and medical backup services to rural primary care hospitals in their rural health network and throughout their service area.
Requires that rural primary care hospitals provide 24-hour emergency care and no more than 72 hours of inpatient care for no more than six inpatients.
Requires States, in designating facilities as rural primary care hospitals, to give preference to facilities participating in the rural health network.
Defines a "rural health network" as an organization consisting of at least one essential access community hospital, rural referral center, or urban regional referral center and at least one rural primary care hospital which cooperate in the deliverance of health care.
Authorizes appropriations for FY 1990 through 1992 for such demonstration program.
Amends the Omnibus Budget Reconciliation Act of 1987 to extend the Rural Health Care Transition Grant Program through FY 1992, and permit hospitals to use grants received under such Program to provide instruction and consultation via telecommunications to physicians in rural health manpower shortage areas, to develop a plan for converting to rural primary care hospitals or to develop a rural health network, if located in a State participating in the preceding demonstration program.
Amends the Medicare program to treat essential access community hospitals as sole community hospitals.
Covers inpatient rural primary care hospital services.
Establishes the Medicare Geographical Classification Review Board which shall consider hospital requests for changes in their geographical classification pursuant to guidelines to be issued by the Secretary. Directs the Secretary to fashion a legislative proposal eliminating the system of determining separate average standardized payment amounts for hospitals located in large urban, other urban, or rural areas.
Requires the Prospective Payment Assessment Commission to conduct a study regarding Medicare reimbursement of small rural hospitals and rural sole community hospitals.