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(ii) by striking out "(including determination of whether an individual received inpatient hospital services for purposes of such section)" and inserting in lieu thereof "and 1835(b) (including determination of whether an individual received inpatient hospital services or diagnostic services for purposes of such sections)". (10) Section 1861(p) of such Act is repealed. (11) Section 1861(y)(3) of such Act is amended by striking out "1813 (a)(4) " and inserting in lieu thereof "1813 (a)(3)". (12)(A) Section 1866(a)(2)(A) of such Act is amended— (i) by striking out ", (a)(2), or (a)(4) " and inserting in lieu thereof "or (a)(3) "; and (ii) by striking out "or, in the case of outpatient hospital diagnostic services, for which payment is made under part A". (B) Section 1866(a)(2)(C) of such Act is amended by striking out "1813(a)(3) " and inserting in lieu thereof "1813(a)(2)". (13) Section 21(a) of the Railroad Retirement Act of 1937 is amended by striking out "post-hospital home health services, and outpatient hospital diagnostic services" and inserting in lieu thereof "and post-hospital home health services". (d) The amendments made by this section shall apply with respect to services furnished after March 31, 1968, except that subsection (c) (5) of such section shall become effective with respect to services furnished after the date of enactment of this Act.

849

Repeal. 79 Stat. 321. 42 USd 1395x. 42 USC 1395CC.

79 Stat. 340. 45 USC 228 s-2.

BILLING BY HOSPITAL FOR SERVICES F U R N I S H E D TO OUTPATIENTS

SEC. 130. (a) Section 1835(a) of the Social Security Act (as amended by section 129(c)(9)(A) of this Act) is further amended by striking out "Except as provided in subsection (b), " and inserting in lieu thereof "Except as provided in subsections (b) and (c),". (b) Section 1835 of such Act (as amended by section 129(c)(9) (B) of this Act) is amended by redesignating subsection (c) (as redesignated) as subsection (d), and by inserting after subsection (b) the following new subsection: "(c) Notwithstanding the provisions of this section and sections 1832, 1833, and 1866(a)(1)(A), a hospital may, subject to such limitations as may be prescribed by regulations, collect from an individual the customary charges for services specified in section 1861(s) and furnished to him by such hospital as an outpatient, but only if such charges for such services do not exceed $50, and such customary charges shall be regarded as expenses incurred by such individual with respect to which benefits are payable in accordance with section 1833 (a)(1). Payments under this title to hospitals which have elected to make collections from individuals in accordance with the preceding sentence shall be adjusted periodically to place the hospital in the same position it would have been had it instead been reimbursed in accordance with section 1833(a)(2)." (c) The amendments made by this section shall apply with respect to services furnished after March 31, 1968.

Ante,

p. 848.

42 USC 1395k, 1395Z, 1395CC. 42 USC 1395X. Ante, p. 847.

Intra-

P A Y M E N To r REASONABLE CHARGES FOR RADIOLOGICAL OR PATHOLOGICAL SERVICES F U R N I S H E D BY CERTAIN P H Y S I C I A N S TO HOSPITAL I N P A T I E N T S

SEC. 131. (a) Section 1833(a)(1) of the Social Security Act is amended— (1) by striking out "except that" and inserting in lieu thereof "except that (A) ", and (2) by striking out "of subsection (b) " and inserting in lieu thereof "of subsection (b), and (B) with respect to expenses

H^^^^l302. i. 395

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Page:United States Statutes at Large Volume 81.djvu/884

 850

Ante,

PUBLIC LAW 90-248-JAN. 2, 1968

p. 848.

incurred for radiological or pathological services for which payment may be made under this part, furnished to an inpatient of a hospital by a physician in the field of radiology or pathology, the amounts paid shall be equal to 100 percent of the reasonable charges for such services". (b) Section 1833(b) of such Act (as amended by section 129(c)(7) of this Act) is amended by inserting before the period at the end thereof the following: ", and (2) such total amount shall not include expenses incurred for radiological or pathological services furnished to such individual as an inpatient of a hospital by a physician in the field of radiology or pathology". (c) The amendments made by this section shall apply with respect to services furnished after March 31, 1968. P A Y M E N T FOR P U R C H A S E OF DURABLE M E D I C A L

r2 USC?395x

42 USC 1395/.

[81 STAT.

EQUIPMENT

^^^' ^^^' (^) Section 1861(s)(6) of the Social Security Act is amended by striking out "rental of", and by inserting before the semicolon at the end thereof the following: ", whether furnished on a rental basis or purchased". Qy-j Section 1833 of such Act is amended by adding at the end thereof the following new subsection: " (f) I n the case of the purchase of durable medical equipment included under section 1861(s)(6), by or on behalf of an individual, payment shall be made in such amounts as the Secretary determines to be equivalent to payments that would have been made under this part had such equipment been rented and over such period of time as the Secretary finds such equipment would be used for such individual's medical treatment, except that with respect to purchases of inexpensive equipment (as determined by the Secretary) payment may be made in a lump sum if the Secretary finds that such method of payment is less costly or more practical than periodic payments." (c) The amendments made by this section shall apply only with respect to items purchased after December 31, 1967. P A Y M E N T FOR P H Y S I C A L THE R A P Y SERVICES F U R N I S H E D TO O U T P A T I E N T S

Ante,

p. 847.

Ante,

p. 849.

SEC. 133. (a) Section 1861(s)(2) of the Social Security Act (as amended by section 129(a)(2) of this Act) is amended by— (1) striking out "and" at the end of subparagraph (B); (2) inserting "and" at the end of subparagraph (C); and (3) adding at the end thereof the following: " (D) outpatient physical therapy services;" (b) Section 1861 of such Act is amended by inserting after subsection (o) the following new subsection (in lieu of subsection (p) repealed by section 129(c) (10) of this Act): "Outpatient Physical Therapy Services " (p) The term 'outpatient physical therapy services' means physical therapy services furnished by a provider of services, a clinic, rehabilitation agency, or a public health agency, or by others under an arrangement with, and under the supervision of, such provider, clinic, rehabilitation agency, or public health agency to an individual as an outpatient— "(1) who is under the care of a physician (as defined in section 1861 (r)(l)), and " (2) with respect to whom a plan prescribing the type, amount, and duration of physical therapy services that are to be fur-

�

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/


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PUBLIC LAW 00-248-JAN. 2, 1968

nished such individual has been established, and is periodically reviewed, by a physician (as so defined); excluding, however— "(3) any item or service if it would not be included under subsection (b) if furnished to an inpatient of a hospital; and " (4) any such service— " (A) if furnished by a clinic or rehabilitation agency, or by others under arrangements with such clinic or agency, unless such clinic or rehabilitation agency— " (i) provides an adequate program of physical therapy services for outpatients and has the facilities and personnel required for such program or required for the supervision of such a program, in accordance with such requirements as the Secretary may specify, "(ii) has policies, established by a group of professional personnel, including one or more physicians (associated with the clinic or rehabilitation agency) and one or more qualified physical therapists, to govern the services (referred to in clause (i)) it provides, "(iii) maintains clinical records on all patients, "(iv) if such clinic or agency is situated in a State in which State or applicable local law provides for the licensing of institutions of this nature, (I) is licensed pursuant to such law, or ( II) is approved by the agency of such State or locality responsible for licensing institutions of this nature, as meeting the standards established for such licensing; and " (v) meets such other conditions relating to the health and safety of individuals who are furnished services by such clinic or agency on an outpatient basis, as the Secretary may find necessary, or " (B) if furnished by a public health agency, unless such agency meets such other conditions relating to health and safety of individuals who are furnished services by such agency on an outpatient basis, as the Secretary may find necessary." (c) Section 1866 of such Act is amended by adding at the end thereof the following new subsection: "(e) For purposes of this section, the term 'provider of services' shall include a clinic, rehabilitation agency, or public health agency if, in the case of a clinic or rehabilitation agency, such clinic or agency meets the requirements of section 1861(p)(4)(A), or if, in the case of a public health agency, such agency meets the requirements of section 1861 (p)(4)(B), but only with respect to the furnishing of outpatient physical therapy services (as therein defined)." (d) Section 1832(a) of such Act is amended by— (1) deleting "and" at the end of paragraph (2)(A) thereof; (2) striking out the period at the end and inserting in lieu thereof the following: "; and"; and (3) adding at the end thereof the following new subparagraph: " (C) outpatient physical therapy services." (e^ Section 1835(a)(2) of such Act (as amended by section 126(b^ of this Act) is amended by— (1) striking out "and" at the end of subparagraph (A); (2) striking out the period at the end and inserting in lieu thereof the following:"; and"; (3) adding at the end thereof the following new subparagraph: " (C) m the case of outpatient physical therapy services, (i) such services are or were required because the mdividual

851

79 Stat. 327. 42 USC 1395CC. " P r o v i d e r of services."

Supra.

79 Stat. 302. 42 USC 1395k.

Ante,

p. 846.

�


text:
Page:United States Statutes at Large Volume 81.djvu/886

 852

Ante. p. 850. ^.''°^^^,t^ °^

services.

Ante. p. 851.

79 Stat. 326. 42 USC 1395aa.

PUBLIC LAW 90-248-.1AN. 2, 1968

[81 STAT.

needed physical therapy services on an outpatient basis, (ii) a plan for furnishing such services has been established, and is periodically reviewed, by a physician, and (iii) such services are or were furnished wiile the individual is or was under the care of a physician."; (4) striking out " (B) and (C) of section 1861(s)(2)" and inserting in lieu thereof " (B), (C), and (D) of section 1861 (s)(2) "; aud (5) adding at the end thereof the following new sentence: "For purposes of this section, the term 'provider of services' shall include a clinic, rehabilitation agency, or public health agency if, in the case of a clinic or rehabilitation agency, such clinic or agency meets the requirements of section 1861(p)(4)(A), or if, in the case of a public health agency, such agency meets the requirements of section 1861(p)(4)(B), but only with respect to the furnishing of outpatient physical therapy services (as therein defined)." (f) The first sentence of section 1864(a) of such Act is amended by inserting before the period the following: ", or whether a clinic, rehabilitation agency or public health agency meets the requirements of subparagraph (A) or (B), as the case may be, of section 1861(p)(4)". (g) The amendments made by the preceding subsections of this section shall apply to services furnished after June 30, 1968. PAYMENT FOR CERTAIN PORTABLE X-RAY SERVICES

42 USC 1395X.

SEC. 134, (a) Section 1861(s)(3) of the Social Security Act is amended by striking out "diagnostic X-ray tests," and inserting in lieu thereof the following: "diagnostic X-ray tests (including tests under the supervision of a physician, furnished in a place of residence used as the patient's home, if the performance of such tests meets such conditions relating to health and safety as the Secretary may find necessary),". (b) The amendment made by subsection (a) shall apply with respect to services furnished after December 31, 1967. BLOOD D E D U C T I B L E S

Ante, p. 847.

Ante. p. 849.

SEC. 135. (a)(1) Section 1813(a)(2) of the Social Security Act (as redesignated by section 129(c)(3) of this Act) is amended to read as follows: "(2) The amount payable to any provider of services under this part for services furnished an individual during any spell of illness shall be further reduced by a deduction equal to the cost of the first three pints of whole blood (or equivalent quantities of packed red blood cells, as defined under regulations) furnished to him as part of such services during such spell of illness." (b) Section 1866(a)(2)(C) of such Act (as amended by section 129(c) (12)(B) of this Act) is amended— (1) by striking out "may also charge" and inserting in lieu thereof "may in accordance with its customary practice also appropriately charge"; (2) by inserting after "whole blood" the following: " ( o r equivalent quantities of packed red blood cells, as defined under regulations)"; (3) by inserting after "blood" where it appears in clauses (i), (ii), and (iii) the following: "(or equivalent quantities of packed red blood cells, as so defined)"; and (4) by adding at the end thereof the following new sentence: " For purposes of clause (iii) of the preceding sentence, whole

�


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 81 STAT. ]

PUBLIC LAW 90-248-JAN. 2, 1968

853

blood (or equivalent quantities of packed red blood cells, as so defined) furnished an individual shall be deemed replaced when the provider of services is given one pint of blood for each pint of blood (or equivalent quantities of packed red blood cells, as so defined) furnished such individual with respect to which a deduction is imposed under section 1813(a)(2)." ^"'^' P- ^^2(c) Section 1833(b) of such Act (as amended by sections 129(c)(7) and 131(b) of this Act) is amended by adding at the end thereof the g^"^^- ^^' ^'*^' following new sentence: "The total amount of the expenses incurred by an individual as determined under the preceding sentence shall, after the reduction specified in such sentence, be further reduced by an amount equal to the expenses incurred for the first three pints of whole blood (or equivalent quantities of packed red blood cells, as defined under regulations) furnished to the mdividual during the calendar year, except that such deductible for such blood shall in accordance with regulations be appropriately reduced to the extent that there has been a replacement of such blood (or equivalent quantities of packed red blood cells, as so defined); and for such purposes blood (or equivalent quantities of packed red blood cells, as so defined) furnished such individual shall be deemed replaced when the institution or other person furnishing such blood (or such equivalent quantities of packed red blood cells, as so defined) is given one pint of blood for each pint of blood (or equivalent quantities of packed red blood cells, as so defined) furnished such individual with respect to which a deduction is made under this sentence." (d) The amendments made by this section shall apply with respect to payment for blood (or packed red blood cells) furnished an individual after December 31, 1967. E N R O L L M E N T U N D E R S U P P L E M E N T A R Y MEDICAL INSURANCE BASED O N ALLEGED DATE OF A T T A I N I N G AGE 6 5

PROGRAM

SEC. 136. (a) Section 1837(d) of the Social Security Act is amended goltaJr^ioS'^' by adding at the end thereof the following new sentence: "Where the 42 USC 1395p. Secretary finds that an individual who has attained age 65 failed to enroll under this part during his initial enrollment period (based on a determination by the Secretary of the month in which such individual attained age 65), because such individual (relying on documentary evidence) was mistaken as to his correct date of birth, the Secretary shall establish for such individual an initial enrollment period based on his attaining age 65 at the time shown in such documentary evidence (wuth a coverage period determined under section 1838 as though he had attained such age at that time)." (b) The amendment made by subsection (a) shall apply to individuals enrolling under part B of title X VIII in months beginning 1395^^^ ^^^^' after the date of the enactment of this Act. E X T E N S I O N BY 6 0 DAYS D U R I N G I N D IV I D U A L ' S L I F E T I M E O F MAXIMUM DURATION OF B E N E F I T S FOR I N P A T I E N T H O S P I T A L SERVICES

SEC. 137. (a)(1) Section 1812(a)(1) of the Social Security Act is amended by striking out "up to 90 days during any spell of illness" and inserting in lieu thereof "up to 150 days during any spell of illness minus 1 day for each day of inpatient hospital services in excess of 90 received during any preceding spell of illness (if such individual was entitled to have payment for such services made under this part unless he specifies in accordance with regulations of the Secretary that he does not desire to have such payment made)". (2) Section 1812(b)(1) of such Act is amended by striking out "for 90 days during such spell" and inserting in lieu thereof "for 150 days

42 USC 1395d.

�


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 854

PUBLIC LAW 90-248-JAN. 2, 1968

79 Stat. 29 2. 42 USC 1395e,

[81 STAT.

during such spell minus 1 day for each day of inpatient hospital services in excess of 90 received during any preceding spell of illness (if such individual was entitled to have payment for such services made under this part unless he specifies in accordance with regulations of the Secretary that he does not desire to have such payment made)". (b) The second sentence of section 1813(a)(1) of such Act is amended to read as follows: "Such amount shall be further reduced by a coinsurance amount equal to— " (A) one-fourth of the inpatient hospital deductible for each day (before the 91st day) on which such individual is furnished such services during such spell of illness after such services have been furnished to him for 60 days during such spell; and " (B) one-half of the inpatient hospital deductible for each day (before the day following the last day for which such individual is entitled under section 1812(a)(1) to have payment made on his behalf for inpatient hospital services during such spell of illness) on which such individual is furnished such services during such spell of illness after such services have been furnished tc him for 90 days during such spell; except that the reduction under this sentence for any day shall not exceed the charges imposed for that day with respect to such individual for such services (and for this purpose, if the customary charges for such services are greater than the charges so imposed, such customary charges shall be considered to be the charges so imposed)." (c) The amendments made by subsections (a) and (b) shall apply with respect to services furnished after December 31, 1967. L I M I T A T I O N O N SPECIAL REDUCTION I N ALLOWABLE DAYS OF I N P A T I E N T H O S P I T A L SERVICES

42 USC i395d.

Ante,

p. 853.

g-Ec. 138. (a) Section 1812(c) of the Social Security Act is amended by striking out "in the 90-day period immediately before such first day shall be included in determining the 90-day limit under subsection (b)(1) (but not in determining the 190-day limit under subsection (b)(3)) " and inserting in lieu thereof "in the 150-day period immediately before such first day shall be included in determining the number of days limit under subsection (b)(1) insofar as such limit applies to (1) inpatient psychiatric hospital services and inpatient tuberculosis hospital services, or (2) inpatient hospital services for an individual who is an inpatient primarily for the diagnosis or treatment of mental illness or tuberculosis (but shall not be included in determining such number of days limit insofar as it applies to other inpatient hospital services or in determining the 190-day limit under subsection (b) (3))". (b) The amendment made by subsection (a) shall apply with respect to payment for services furnished after December 31, 1967. T R A N S I T I O N A L PROVISION ON E L I G I B I L I T Y OF P R E S E N T L Y U N I N S U R E D I N D IV I D U A L S FOR H O S P I T A L INSURANCE B E N E F I T S

^o flin Ao^' 42 USC 4203.

SEC. 139. Section 103(a)(2) of the Social Security Amendments of 1965 is amended by striking out "1965" in clause (B) and inserting in //^ „„««•«

^

lieu thereof "1966". ADVISORY C O U N C I L TO STUDY COVERAGE OF THE DISABLED U N D E R TITLE X VIII O F THE SOCIAL S E C U R I T Y ACT

42 USC S s 1395^.

SEC. 140. (a) The Secretary of Health, Education, and Welfare shall appoint an Advisory Council to study the need for coverage of the disabled under the health insurance program of title X VIII of the Social Security Act.

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 81 STAT.]

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PUBLIC LAW 90-248-JAN. 2, 1968

(b) The Council shall be appointed by the Secretary during 1968 without regard to the provisions of title 5, United States Code, governing appointments in the competitive service and shall consist of 12 persons who shall, to the extent possible, represent organizations of employers and employees in equal numbers, and represent self-employed persons and the public. (c) The Council is authorized to engage such technical assistance, including actuarial services, as may be required to carry out its functions, and the Secretary shall, in addition, make available to such Council such secretarial, clerical, and other assistance and such actuarial and other pertinent data prepared by the Department of Health, Education, and Welfare as it may require to carry out such functions. (d) Members of the Council, while serving on the business of the Council (inclusive of travel time), shall receive compensation at rates fixed by the Secretary, but not exceeding $100 per day and, while so serving away from their homes or regular places of business, they may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section 5703 of title 5, United States Code, for persons in the Government employed intermittently. (e) The Council shall make findings on the unmet need of the disabled for health insurance, on the costs involved in providing the disabled with insurance protection to cover the cost'of hospital and medical services, and on the ways of financing this insurance. The Council shall submit a report of its findings to the Secretary not later than January 1, 1969, together with recommendations on how such protection should be financed and, if such financing is to be accomplished through the trust funds established under title X VIII of the Social Security Act, on the extent to which each of such trust funds should bear the cost of such financing. Such report shall thereupon be transmitted to the Congress and to the Boards of Trustees created by sections 1817(b) and 1841(b) of the Social Security Act. After the date of transmittal to the Congress of the report, the Council shall cease to exist.

80 Stat. 417. 5 USC 3301 et seq.

Compensation, trdvel e x p e n s e s.

80 Stat. 499.

79 Stat. 291. 42 USC 1395\395ll. Report to Congress. 42 USC 13951, 1395t. Expiration date.

STUDY TO DETERMINE F E A S I B I L I T Y OF I N C L U S I O N OF CERTAIN ADDITIONAL SERVICES U N D E R PART B OF TITLE X VIII OF THE SOCIAL SECURITY ACT

SEC. 141. The Secretary shall make a study relating to the inchision under the supplementary medical insurance program (part B of title X VIII of the Social Security Act) of services of additional types of licensed practitioners performing health services in independent practice. The Secretary shall make a report to the Congress prior to January 1, 1969, of his finding with respect to the need for covering, under the supplementary medical insurance program, any of the various types of services such practitioners perform and the costs to such program of covering such additional services, and shall make recommendations as to the priority and method for covering these services and the measures that should be adopted to protect the health and safety of the individuals to whom such services would be furnished.

42 USC 139i5j1395w. Report to Congress.

PROVISIONS FOR B E N E F I T S U N D E R PART A OF TITLE X VIII OF THE SOCIAL SECURITY ACT FOR SERVICES TO P A T I E N T S ADMITTED PRIOR TO 1968 TO CERTAIN HOSPITALS

SEC. 142. (a) Notwithstanding any provision of title X VIII of the Social Security Act, an individual who is entitled to hospital insurance benefits under section 226 of such Act may, subject to subsections (b) and (c), receive, on the basis of an itemized bill, reimbursement for charges to him i o r inpatient hospital services (as defined in section

79 Stat. 290. 42 USC 426.

�


text:
Page:United States Statutes at Large Volume 81.djvu/890

 856 79 Stat. 313. 42 USC 1395X.

42 USC 1395CC. 42 USC 1395c1395i.

42 USC 1395f.

" R o u t i n e serv-

PUBLIC LAW 90-248-JAN. 2, 1968

[81 STAT.

1861 of such Act, but without regard to subsection (e) of such section) furnished by, or under arrangements (as defined in section 1861 (w) of such Act) with, a hospital if— (1) the hospital did not have an agreement in effect under section 1866 of such Act but would have been eligible for payment under part A of title X VIII of such Act with respect to such services if at the time such services were furnished the hospital had such an agreement in effect; (2) the hospital (A) meets the requirements of paragraphs (5) and (7) of section 1861(e) of such Act, (B) is not primarily engaged in providing the services described in section 1861(j) (1)(A) of such Act, and (C) is primarily engaged in providing, by or under the supervision of individuals referred to in paragraph (1) of section 1861(r) of such Act, to inpatients (i) diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons, or (ii) rehabilitation services for the rehabilitation of injured, disabled, or sick persons; (3) the hospital did not meet the requirements that must be met to permit payment to the hospital under part A of title X VIII of such Act; and (4) an application is filed (submitted in such form and manner and by such person, and containing and supported by such information, as the Secretary shall by regulations prescribe) for reimbursement before January 1, 1969. (b) Payments under this section may not be made for inpatient hospital services (as described in subsection (a)) furnished to an individual— (1) prior to July 1, 1966, (2) after December 31, 1967, unless furnished with respect to an admission to the hospital prior to January 1, 1968, and (3) for more than— (A) 90 days in any spell of illness, but only if (i) prior to January 1, 1969, the hospital furnishing such services entered into an agreement under section 1866 of the Social Security Act and (ii) the hospital's plan for utilization review, as provided for in section 1861(k) of such Act, has, in accordance with section 1814 of such Act, been applied to the services furnished such individual, or (B) 20 days in any spell of illness, if the hospital did not meet the conditions of clauses (i) and (ii) of subparagraph (A). . . . (c)(1) The amounts payable in accordance with subsection (a) with respect to inpatient hospital services shall, subject to paragraph (2) of this subsection, be paid from the Federal Hospital Insurance Trust Fund in amounts equal to 60 percent of the hospital's reasonable charges for routine services furnished in the accommodations occupied by the individual or in semi-private accommodations (as defined in section 1861(v)(4) of the Social Security Act) whichever is less, plus 80 percent of the hospital's reasonable charges for ancillary services. If separate charges for routine and ancillary services are not made by the hospital, reimbursement may be based on two-thirds of the hospital's reasonable charges for the services received but not to exceed the charges which would have been made if the patient had occupied semi-private accommodations (as so defined). For purposes of the preceding provisions of this paragraph, the term "routine services" shall mean the regular room, dietary, and nursing services, minor medical

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 81 STAT. ]

PUBLIC LAW 90-248-JAN. 2, 1968

and surgical supplies and the use of equipment and facilities for which a separate charge is not customarily made; the term "ancillary services" shall mean those special services for which charges are customarily made in addition to routine services. (2) Before applying paragraph (1), payments made under this section shall be reduced to the extent provided for under section 1813 of the Social Security Act in the case of benefits payable to providers of services under part A of title X VIII of such Act. (d) For the purposes of this section— (1) the 90-day period, referred to in subsection (b)(3)(A), shall be reduced by the number of days of inpatient hospital services furnished to such individual during the spell of illness, referred to therein, and with respect to which he was entitled to have payment made under part A of title X VIII of the Social Security Act; (2) the 20-day period, referred to in subsection (b)(3)(B) shall be reduced by the number of days in excess of 70 days of inpatient hospital services furnished during the spell of illness, referred to therein, and with respect to which such individual was entitled to have payment made under such part A; (3) the term "spell of illness" shall have the meaning assigned to it by subsection (a) of section 1861 of such Act except that the term "inpatient hospital services" as it appears in such subsection shall have the meaning assigned to it by subsection (a) of this section.

857 id's^"'''"^*"^

serv-

79 Stat. 29:;. ^^ u s e ^^^^^ ^^^ 1395e. 42 42 USC 1395013951.

"speii of inhospit"i'srr''v^-^'^"* ices." '^^ ^^^ i395x.

P A Y M E N T S FOR E M E R G E N C Y H O S P I T A L SERVICES

SEC. 143. (a) The second sentence following paragraph (8) of section 1861(e) of the Social Security Act is amended by striking out "which meets the requirement of paragraphs (1), (2), (3), (4), (5) and (7) of this subsection" and inserting in lieu thereof "which (i) meets the retjuirements of paragraphs (5) and (7) of this subsection, (ii) is not primarily engaged in providing the services described in section 1861 (]) (1)(A) and (iii) is primarily engaged in providing, by or under the supervision of individuals referred to in paragraph (1) of section 1861(r), to inpatients diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons, or rehabilitation services for the rehabilitation of injured, disabled, or sick persons." (b) That portion of section 1812(a) of such Act that precedes paragraph (1) thereof is amended by inserting "or, in the case of payments referred to in section 1814(d)(2) to him" after "on his behalf". (c) Section 1814(d) of such Act is amended by— (1) striking out "Payments" and inserting in lieu thereof "(1) Payments"; (2) deleting "furnished" and inserting "furnished in a calendar year"; (3) deleting "and" at the end of clause (A) and inserting a comma in lieu thereof; (4) inserting before the period at the end of the first sentence the following: ", and (C) such hospital has elected to claim payments for all such inpatient emergency services and for the emergency outpatient services referred to in section 1835(b) furnished during such year"; and (5) adding at the end of such section 1814(d) the following new paragraphs:

42 USC i395d. ^°s'' p- sss. 79 st^a^. 296^^ •^^ u c i395f.

'^"'®' ^- *•**•

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text:
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 858 79 Stat. 290. 42 USC 426.

42 USC 1395e.

42 USC 1395X.

"Routine serv-

"Ancillary services."

PUBLIC LAW 90-248-JAN. 2, 1968

[81 STAT

"(2) Payment nuiy be made on the basis of an itemized bill to an individual entitled to hospital insurance benefits under section 226 for services described in paragraph (1) which are emergency services if (A) payment cannot be made under paragraph (1) solely beca.use the hospital does not elect to claim such payment, and (B) such individual files application (submitted within such time and in such form and manner and by such person, and containing and supported by such information as the Secretary shall by regulations prescribe) for reimbursement, "(3) The amounts payable under the preceding paragraph with respect to services described therein shall, subject to the provisions of section 1813, be equal to 60 percent of the hospital's reasonable charges for routine services furnished in the accommodations occupied by the individual or in semiprivate accommodations (as defined in section 1861 (v)(4)), whichever is less, plus 80 percent of the hospital's reasonable charges for ancillary services. If separate charges for routine and ancillary services are not made by the hospital, reimbursement may be based on two-thirds of the hospital's reasonable charges for the services received but not to exceed the charges which would have been made if the patient had occupied semiprivate accommodations. For purposes of the preceding provisions of this paragraph, the term 'routine services' shall mean the regular room, dietary, and nursing services, minor medical and surgical supplies and the use of equipment and facilities for which a separate charge is not customarily made; the term 'ancillary services' shall mean those special services for which charges are customarily made in addition to routine services." (d) The provisions made by subsection (a) of this section shall become effective as of July 1, 1966, and the provisions made by subsections (b) and (c) of this section shall apply to services furnished with respect to admissions occurring after December 31, 1967, and to outpatient hospital diagnostic services furnished after December 31, 1967, and before April 1, 1968. PAYMENT I NDER SUPPLEMENTARY MEDICAL INSURANCE PRO(iRAM FOR CERTAIN INPATIENT ANCILLARY SERVICES

79 Stat. 321. 42 USC 1395x.

Ante, p. 847. 42 USC 1395f.

SEC. 144. (a) So much of section 1861(s) of the Social Security Act which precedes paragraph (1) is amended by striking out "(unless they would otherwise constitute inpatient hospital services, extended care services, or home health services)". (b) The sentence immediately following paragraph (9) of section 1861 (s) of such Act is amended by inserting after "hospital" the following: " (which, for purposes of this sentence, means an institution considered a hospital for purposes of section 1814(d))". (c) Section 1861(s) of such Act is amended by adding at the end thereof (after and below paragraph (13) as added to such section by section 129(b) of this Act) the following new sentence: "None of the items and services referred to in the preceding paragraphs (other than paragraphs (1) and (2)(A)) of this subsection which are furnished to a patient of an institution which meets the definition of a hospital for purposes of section 1814(d) shall be included unless such other conditions are met as the Secretary may find necessary relating to health and safety of individuals with respect to whom such items and services are furnished." (d) Section 1861(s)(6) of such Act is amended by striking out "as his home" and inserting in lieu thereof "as his home other than an

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institution that meets the requirements of subsection (e)(1) or (j)(l) of this section". (e) The amendments made by this section shall apply with respect to services furnished after March 31, 1968. GENERAL E N R O L L M E N T PERIOD U N D E R TITLE

XVIII

SEC. 145. (a) Section 1837(b)(1) of the Social Security Act is amended to read as follows: "(1) No individual may enroll for the first time under this part unless he does so in a general enrollment period (as provided in subsection (e)) which begins within 3 years after the close of the first enrollment period during which he could have enrolled under this part." (b) Section 1837(e) of such Act is amended to read as follows: "(e) There shall be a general enrollment period, after the period described in subsection (c), during the period beginning on January 1 and ending on March 31 of each year beginning with 1969." (c) Section 1838(b) of such Act is amended by— (1) striking out in paragraph (1) the following: ", during a general enrollment period described in section 1837(e),"; and (2) striking out "December 31 of the year" and inserting in lieu thereof "the calendar quarter following the calendar quarter". (d) Section 1839(b)(2) of such Act is amended to read as follows: "(2) The Secretary shall, during December 1968 and of each year thereafter, determine and promulgate the dollar amount (whether or not such dollar amount was applicable for premiums for any prior month) which shall be applicable for premiums for months occurring in the 12-month period commencing July 1 in each succeeding year. Such dollar amount shall be such amount as the Secretary estimates to be necessary so that the aggregate premiums for such 12-month period will equal one-half of the total of the benefits and administrative costs which he estimates will be payable from the Federal Supplementary Medical Insurance Trust Fund for such 12-month period. In estimating aggregate benefits payable for any period, the Secretary shall include an appropriate amount for a contingency margin. Whenever the Secretary, pursuant to the preceding sentence, promulgates the dollar amount which shall be applicable for premiums for any period, he shall, at the time such promulgation is announced, issue a public statement setting forth the actuarial assumptions and bases employed by him in arriving at the amount of premiums so promulgated." (e) The amendments made by subsections (a), (b), and (c) shall become effective April 1, 1968. Notwithstanding the provisions of section 2 of Public Law 90-97, the amendments made by subsection (d) shall become effective December 1, 1968.

79 Stat. 304. 42 USC 1395p.

^2 USC i395q

^2 USC i395r.

^"'®' P- 249-

E L I M I N A T I O N OF SPECIAL REDUCTION I N ALLOWABLE DAYS OF I N P A T I E N T H O S P I T A L SERVICES FOR P A T I E N T S I N TUBERCULOSIS H O S P I T A L S

S E C 146. (a) Section 1812(c) of the Social Security Act (as amended by section 138 of this Act) is further amended— (1) by striking out "a psychiatric hospital or a tuberculosis hospital" and inserting in lieu thereof "a psychiatric hospital", (2) by striking out "and inpatient tuberculosis hospital services", and (3) by striking out "or tuberculosis". (b) The amendments made by subsection (a) shall apply with respect to payment for services furnished after December 31, 1967.

'^"'°' P- ^54.

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[81 STAT.

PART 4—^MISCW.LANEOUS AND TECHNICAL AMENDMENTS ELKiiBiLrn:

O F ADOP'TED

CHILD

FOR M O N T H L Y

BENEFITS

SEC. 150. (a) The second sentence of section 216(e) of the Social 72 Stat. 1028. Security Act is amended by striking out "before the end of two years after the day on which such individual died or the date of enactment of this Act" and inserting in lieu thereof "only if (A) proceedings for the adoption of the child had been instituted by such individual before his death, or (B) such child was adopted by such individual's surviving spouse before the end of two years after (i) the day on which such individual died or (ii) the date of enactment of the Social 42 USC 30 2 Security Amendments of 1958. note. (b) The amendment made by subsection (a) shall apply with respect to monthly benefits payable under title II of the Social Security '^L^^'^AV^^^' -^^^ ^^^' i^oiiths after January 1968, but only on the basis of an Ante, p. 833. application filed in or after the month in which this Act is enacted. CRITERIA FOR DETERMINING CHILD S DEPENDENCY ON MOTHER 64 Stat. 484. 42 USC 40 2.

SEC. 151. (a) Section 202(d)(3) of the Social Security Act is amended— (1) by inserting "or his mother or adopting mother" after "his father or adopting father" in the first sentence; and 74 Stat. 952. (2) by striking out ", if such individual is the child's father,'' in the second sentence. (b) Section 202(d)(4) of such Act is amended by inserting "or stepmother'' after "stepfather" each place it appears. 72^stat^'io3o^' ^^^ Section 202(d) of such Act is further amended by striking out 79 Stat." 371,397. paragraph (5), and by redesignating paragraphs (6) through (10) as paragraphs (5) through (9), respectively. (d)(1) The paragraph of section 202(d) of such Act redesignated as paragraph (9) by subsection (c) of this section is amended by striking out "under paragraph (9) " and inserting in lieu thereof "under paragraph (8)''. 79 Stat. 372. ^2) Paragraphs (2) and (3) of section 202(s) of such Act are each amended by striking out " (d)(6). " and inserting in lieu thereof "(d)(5),". 65 Stat. 689. (8) Section (5)(1)(1) of the Railroad Retirement Act of 1937 is 45 USC 228e. amended— (A) by striking out " (3), (4), or (5) " in the third sentence and inserting in lieu thereof " (3) or (4) "; and 80 Stat. 1084. ^g) jjy striking out "paragraph (8) " in the ninth sentence and inserting in lieu thereof "paragraph (7)". (e) The amendments made by this section shall apply with respect to monthly benefits payable under title II of the Social Security Act 45 us^c 2^28^3- (si'Tid aiinuities accruing under the Railroad Retirement Act of 1937) 228 s-2. for months after January 1968, but only on the basis of applications filed in or after the month in which this Act is enacted. R E C O V E R Y O F OVERPAYMENTS

42 USC io\^.^'

SEC. 152. (a) Section 204(a) of the Social Security Act is amended to read as follows: " (a) Whenever the Secretary finds that more or less than the correct amount of payment has been made to any person under this title, proper adjustment or recovery shall be made, under regulations prescribed by the Secretary, as follows:

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"(1) With respect to payment to a person of more than the correct amount, the Secretary shall decrease any payment under this title to which such overpaid person is entitled, or shall require such overpaid person or his estate to refund the amount in excess of the correct amount, or shall decrease any payment under this title payable to his estate or to any other person on the basis of the wages and self-employment income which were the basis of the payments to such overpaid person, or shall apply any combination of the foregoing. "(2) With respect to payment to a person of less than the correct amount, the Secretary shall make payment of the balance of the amount due such underpaid person, or, if such person dies before payments are completed or before negotiating one or more checks representing correct payments, disposition of the amount due shall be made in accordance with subsection (d). " (b) Section 204(b) of such Act is amended to read as follows: "(b) I n any case in which more than the correct amount of payment has been made, there shall be no adjustment of payments to, or recovery by the United States from, any person who is without fault if such adjustment or recovery would defeat the purpose of this title or would be against equity and good conscience."

861

^3 Jt^^^-^i^aes.

B E N E F I T S PAID O X BASIS OF ERRONEOUS REPORTS OP D E A T H I N M I L I T A R Y SERVICE

SEC. 153. (a) Section 204(a)(1) of the Social Security Act (as amended by section 152 of this Act) is further amended by adding at ^Ante, p. seo. the end the following sentence: "A payment made under this title on the basis of an erroneous report of death by the Department of Defense of an individual in the line of duty while he is a member of the uniformed services (as defined in section 210(m)) on active duty (as defined in section 210(1)) shall not be considered an incorrect pay- 42 USC 410. ment for any month prior to the month such Department notifies the Secretary that such individual is alive." (b) The amendment made by this section shall apply with respect to benefits under title II of the Social Security Act if the individual 42 USC 4oito whom such benefits were paid would have been entitled to such •*28;>i"<e. p..833. benefits in or after the month in which this Act was enacted if the report mentioned in the amendment made by subsection (a) of this section had been correct (but without regard to the provisions of section 202(j)(1) of such Act). 42 USC 402. UNDERPAYMENTS

SEC. 154. (a) Section 204(d) of the Social Security Act is amended read as follows: " (d) If an individual dies before any payment due him under this title is completed, payment of the amount due (including the amount of any unnegotiated checks) shall be made— "(1) to the person, if any, who is determined by the Secretary to be the surviving spouse of the deceased individual and who either (i) was living m the same household with the deceased at the time of his death or (ii) was, for the month in which the deceased individual died, entitled to a monthly benefit on the basis of the same wages and self-employment income as Avas the deceased individual; "(2) if there is no person who meets the requirements of paragraph (1), or if the person who meets such requirements dies before the payment due him under this title is completed, to the child or children, if any, of the deceased individual who were, for

^ f'^'- IV

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79 Stat. 331. 42 USC 1395gg.

PUBLIC LAW 90-248-JAN. 2, 1968

[81 STAT.

the month in which the deceased individual died, entitled to monthly benefits on the basis of the same wages and self-employment income as was the deceased individual (and, in case there is more than one such child, in equal parts to each such child); "(3) if there is no person who meets the requirements of paragraph (1) or (2), or if each person who meets such requirements dies before the payment due him under this title is completed, to the parent or parents, if any, of the deceased individual who were, for the month in which the deceased individual died, entitled to monthly benefits on the basis of the same wages and self-employment income as was the deceased individual (and, in case there is more than one such parent, in equal parts to each such p a r e n t); "(4) if there is no person who meets the requirements of paragraph (1), (2), or (3), or if each person who meets such requirements dies before the payment due him under this title is completed, to the person, if any, determined by the Secretary to be the surviving spouse of the deceased individual; "(5) if there is no person who meets the requirements of paragraph (1), (2), (3), or (4), or if each person who meets such requirements dies before the payment due him under this title is completed, to the person or persons, if any, determined by the Secretary to be the child or children of the deceased individual (and, in case there is more than one such child, in equal parts to each such child); "(6) if there is no person who meets the requirements of paragraph (1), (2), (3), (4), or (5), or if each person who meets such requirements dies before the payment due him under this title is completed, to the parent or parents, if any, of the deceased individual (and, in case there is more than one such parent, in equal parts to each such p a r e n t); or "(7) if there is no person who meets the requirements of paragraph (1), (2), (3), (4), (5), or (6), or if each person who meets such requirements dies before the payment due him under this title is completed, to the legal representative of the estate of the deceased individual, if any." (b) The heading of section 1870 of such Act is amended by adding at the end thereof "AND SETTLEMENT OF C L A I M S FOR B E N E F I T S ON B E H A L F OF D E C E A S E D I N D IV I D U A L S ". (c) Section 1870 of such Act is amended by adding after subsection (d) the following new subsections: "(e) If an individual, who received services for which payment may be made to such individual under this title, dies, and payment for such services was made (other than under this title), and the individual died before any payment due him under this title with respect to such services Avas completed, payment of the amount due (including the amount of any unnegotiated checks) shall be made— " (1) if the payment for such services was made (before or after such individual's death) by a person other than the deceased individual, to the person or persons determined by the Secretary under regulations to have paid for such services, or if the payment for such services was made by the deceased individual before his death, to the legal representative of the estate of such deceased individual, if any; "(2) if there is no person who meets the requirements of paragraph (1), to the person, if any, who is determined by the Secretary to be the surviving spouse of the deceased individual and who was either living in the same household with the deceased at the time of his death or was, for the month in which the deceased individual died, entitled to a monthly benefit on the

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863

basis of the same wages and self-employment income as was the deceased individual; "(3) if there is no person who meets the requirements of paragraph (1) or (2), or if the person who meets such requirements dies before the payment due him under this title is completed, to the child or children, if any, of the deceased individual who were, for the month in which the deceased individual died, entitled to monthly benefits on the basis of the same wages and self-employment income as was the deceased individual (and, in case there is more than one such child, in equal parts to each such child); " (4) if there is no person who meets the requirements of paragraph (1), (2), or (3), or if each person who meets such requirements dies before the payment due him under this title is completed, to the parent or parents, if any, of the deceased individual who were, for the month in which the deceased individual died, entitled to monthly benefits on the basis of the same wages and self-employment income as was the deceased individual (and, in case there is more than one such parent, in equal parts to each such p a r e n t); "(5) if there is no person who meets the requirements of paragraph (1), (2), (3), or (4), or if each person who meets such requirements dies before the payment due him under this title is completed, to the person, if any, determined by the Secretary to be the surviving spouse of the deceased individual; " (6) if there is no person who meets the requirements of paragraph (1), (2), (3), (4), or (5), or if each person who meets such requirements dies before the payment due him under this title is completed, to the person or persons, if any, determined by the Secretary to be the child or children of the deceased individual (and, in case there is more than one such child, in equal parts to each such child); "(7) if there is no person who meets the requirements of paragraph (1), (2), (3), (4), (5), or (6), or if each person who meets such requirements dies before the payment due him under this title is completed, to the parent or parents, if any, of the deceased individual (and, in case there is more than one such parent, in equal parts to each such p a r e n t); or "(8) if there is no person who meets the requirements of paragraph (1), (2), (3), (4), (5), (6), or (7), or if each person who meets such requirements dies before the payment due him under this title is completed, to the legal representatives of the estate of the deceased individual, if any. "(f) If an individual who received medical and other health services for which payment may be made under section 1832(a)(1) dies, ^ ^^^^ ^^^;^ and— " (1) no assignment of the right to payments was made by such individual before his death, and " (2) payment for such services has not been made, payment for such services shall be made to the physician or other person who provided such services, but payment shall be made under this subsection only in such amount and subject to such conditions as would have been applicable if the individual who received the services had not died, and only if the person or persons who provided the services agrees that the reasonable charge is the full charge for the services." (d) Section 1842(b)(3)(B) of such Act (as amended by section 125(a) of this Act) is amended by striking out "and such payment Ante, p. 845. will be made" and inserting in lieu thereof "and such payment will (except as otherwise provided in section 1870(f)) be made". 85-622 0-68—57

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PUBLIC LAW 90-248-JAN. 2, 1968

[81 STAT.

S I M P L I F I C A T I O N OF C O M P U T A T I O N OF P R I M A K Y INSURANCE A M O U N T AND QUARTERS OF COVERAGE I N CASE OF 1937 - 1 0 5 0 WAGES

72 Stat. 1016.

SEC. 155. (a)(1) Section 215(d)(1) of the Social Security Act is amended to read as follows: "Primary Insurance Benefit Under 1939 Act

Ante,

p. 824.

• To t a l wages prior to 1951. "

42 USC 417. 50 Stat. 30 7. 45 USC 228 a-

228"'s-2."" """"

42 USC 40 2,

Post, p. 865.

" (d)(1) For purposes of column I of the table appearing in subsection (a) of this section, an individual's primary insurance benefit shall be computed as follows: " (A) The individuaFs average monthly wage shall be determined as provided in subsection (b) (but without regard to paragraph (4) thereof) of this section, except that for purposes of paragraph (2)(C) and (3) of such subsection, 1936 shall be used instead of 1950. " (B) For purposes of subparagraphs (B) and (C) of subsection (b)(2), an individual whose total wages prior to 1951 (as defined in subparagraph (C) of this subsection) — "(i) do not exceed $27,000 shall be deemed to have been paid such wages in equal parts in nine calendar years after 1936 and prior to 1951; "(ii) exceed $27,000 and are less than $42,000 shall be deemed to have been paid (I) $3,000 in each of such number of calendar years after 1936 and prior to 1951 as is equal to the integer derived by dividing such total wages by $3,000, and ( II) the excess of such total wages over the product of $3,000 times such integer, in an additional calendar year in such period; or "(ill) are at least $42,000 shall be deemed to have been paid $3,000 in each of the fourteen calendar years after 1936 and prior to 1951. " (C) For the purposes of subparagraph (B), 'total wages prior to 1951' with respect to an individual means the sum of (i) remuneration credited to such individual prior to 1951 on the records of the Secretary, (ii) wages deemed paid prior to 1951 to such individual under section 217, and (iii) compensation under the Railroad Retirement Act of 1937 prior to 1951 creditable to him pursuant to this title. " (D) The individual's primary insurance benefit shall be 45.6 per centum of the first $50 of his average monthly wage as computed under this subsection, plus 11.4 per centum of the next $200 of such average monthly wage." (2) Section 215(d)(2) of such Act is amended to read as follows: "(2) The provisions of this subsection shall be applicable only in the case of an individual— " (A) with respect to whom at least one of the quarters elapsing prior to 1951 is a quarter of coverage; " (B) except as provided in paragraph (3), who attained age 22 after 1950 and with respect to whom less than six of the quarters elapsing after 1950 are quarters of coverage, or who attained such age before 1951; and " (C)(i) who becomes entitled to benefits under section 202(a) or 223 after the date of the enactment of the Social Security Amendments of 1967, or "(ii) who dies after such date without being entitled to benefits under section 202(a) or 223, or "(iii) whose primary insurance amount is required to be recomputed under section 215(f)(2)."

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(3) Section 215(d)(3) of such Act is amended to read as follows: ^ vicTis: "(3) The provisions of this subsection as in effect prior to the enactment of the Social Security Amendments of 1967 shall be applicable in the case of an individual— " (A) who attained age 21 after 1936 and prior to 1951, or " (B) who had a period of disability which began prior to 1951, but only if the primary insurance amount resulting therefrom is higher than the primary insurance amount resulting from the application of this section (as amended by the Social Security Amendments of 1967) and section 220.". ^^ use 42o. (4) So much of section 215(f)(2) of such Act as precedes subparagraph (E) is amended to read as follows: ^^ s*^'- ^^'S. "(2) If an individual has wages or self-employment income for a year after 1965 for any part or which he is entitled to old-age insurance benefits, the Secretary shall, at such time or times and within such period as he may by regulations prescribe, recompute such individual's primary insurance amount with respect to each such year. Such recomputation shall be made as provided in subsection (a)(1) and (3) as though the year with respect to which such recomputation is made is the last year of the period specified in subsection (b)(2) (C). A recomputation under this paragraph with respect to any year shall be effective—" (5) Subparagraphs (E) and (F) of such section 215(f)(2) are redesignated as subparagraphs (A) and (B), respectively. (6) Section 215(f) of such Act is further amended by adding at the y/stat^^aes"^' end thereof the following new paragraph: "(5) I n the case of a man who became entitled to old-age insurance benefits and died before the month in which he attained age 65, the Secretary shall recompute his primary insurance amount as provided in subsection (a) as though he became entitled to old-age insurance benefits in the month in which he died; except that (i) his computation base years referred to in subsection (b)(2) shall include the year in which he died, and (ii) his elapsed years referred to in subsection (b)(3) shall not include the year in which he died or any year thereafter. Such recomputation of such primary insurance amount shall be effective for and after the month in which he died." (7)(A) The amendments made by paragraphs (4) and (5) shall apply with respect to recomputations made under section 215(f)(2) of the Social Security Act after the date of the enactment of this Act. (B) The amendment made by paragraph (6) shall apply with respect to individuals who die after the date of enactment of this Act. (8) I n any case in which— (A) any person became entitled to a monthly benefit under section 202 or 223 of the Social Security Act after the date of ^/g^ use 402, enactment of this Act and before February 1968, and (B) the primary insurance amount on which the amount of such benefit is based was determined by applying section 215(d) of the Social Security Act as amended by this Act, ^"'^' P- ^^'^^ such primary insurance amount shall, for purposes of section 215(c) of the Social Security Act, as amended by this Act, be deemed to have Ante, p. 827. been computed on the basis of the Social Security Act in effect prior to the enactment of this Act. (9) The amendment made by paragraphs (1) and (2) shall not apply with respect to monthly benefits for any month prior to January 1967. (b)(1) Section 213 of the Social Security Act is amended by add- J^ us^c 4?^?" ing at the end thereof the following new subsection:

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PUBLIC LAW 90-248-JAN. 2, 1968

[81 STAT.

"Alternative Method for Determining Quarters of Coverage With Respect to Wages in the Period from 1937 to 1950 75 Stat. 137. 42 USC 414. Ante. p. 864.

^42 USC 402, 74 Stat. 964; 79 Stat. 366. ^^42 USC 415

"(g) For purposes of section 214(a), an individual shall be deemed ^^ have one quarter of coverage for each $400 of his total wages prior to 1951 (as defined in section 215(d)(1)(C)), except where— "(1) such individual is not a fully insured individual on the basis of the number of quarters of coverage so derived plus the number of quarters of coverage derived from the wages and selfemployment income credited to him for periods after 1950, or "(2) such individual's elapsed years (for purposes of section 214 (a)(1)) are less than 7." (2) The amendment made by paragraph (1) shall apply only in the case of an individual who applies for benefits under section 202(a) of the Social Security Act after the date of the enactment of this Act, or who dies after such date without being entitled to benefits under section 202(a) or 223 of the Social Security Act. (c) SectioR 303(g)(1) of the Social Security Amendments of 1960 ig amended— ^-^^ ^y striking out "section 302 of" and by striking out "Amendments of 1965 and inserting in lieu thereof "Amendments of 1965 and 1967 in the first sentence; and (2) by striking out "after 1965, or dies after 1965" and inserting in lieu thereof "after the date of the enactment of the Social Security Amendments of 1967, or dies after such date", and by striking out "Amendments of 1965" and inserting in lieu thereof "Amendments of 1967", in the second sentence. DEFINITIONS

42 us^c 416^^'

74^stat^99V°'

OF W I D O W, WIDOWER, A N D

STEPCHILD

^^^- ^^^- (^) Section 216(c) of the Social Security Act is amended by striking out "not less than one year" in clause (5) and inserting in lieu thereof "not less than nine months". (b) The first sentence of section 216(e) of such Act is amended by striking out "the day on which such individual died" and inserting in lieu thereof "not less than nine months immediately preceding the day on which such individual died". ^^^ SectioR 216 (g) of such Act is amended by striking out "not less than one year" in clause (5) and inserting in lieu thereof "not less than nine months". (d) Section 216 of such Act is further amended by adding at the end thereof the following new subsection: "Waiver of Nine-Month Requirement for Widow, Stepchild, or Widower in Case of Accidental Death or in Case of Serviceman Dying in Line of Duty

^"P'-^-

" (k) The requirement in clause (5) of subsection (c) or clause (5) of subsection (g) that the surviving spouse of an individual have been married to such individual for a period of not less than nine months immediately prior to the day on which such individual died in order to qualify as such individual's widow or widower, and the requirement in subsection (e) that the stepchild of a deceased individual have been such stepchild for not less than nine months immediately preceding the day on which such individual died in order to qualify as such individual's child, shall be deemed to be satisfied, where such individual dies within the applicable nine-month period, if his death— "(1) is accidental, or

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867

" (2) occurs in line of duty while he is a member of a uniformed service serving on active duty (as defined in section 210(1)(2)), '*2 USC 410. and he would satisfy such requirement if a three-month period were substituted for the nine-month period; except that this subsection shall not apply if the Secretary determines that at the time of the marriage involved the individual could not have reasonably been expected to live for nine months. For purposes of paragraph (1) of the preceding sentence, the death of an individual is accidental if he receives bodily injuries solely through violent, external, and accidental means and, as a direct result of the bodily injuries and independently of all other causes, loses his life not later than three months after the day on which he receives such bodily injuries." (e) The amendments made by this section shall apply with respect to monthly benefits under title II of the Social Security Act for ^4^. ^^^^'^°„^' months after January 1968, but only on the basis of applications filed 428; Ante, p. 833. in or after the month in which this Act is enacted. HUSBAND'S AND WIDOWER'S INSURANCE BENEFITS WITHOUT REQUIREMENT OF WIFE'S CURRENTLY INSURED STATUS

SEC. 157. (a)(1) Section 202(c)(1) of the Social Security Act is amended by striking out "a currently insured individual (as defined in section 2 1 4 (b)) " in the matter preceding subparagraph (A) and inserting in lieu thereof "an individual". (2) Section 202(c)(2) of such Act is amended by striking out ""The requirement in paragraph (1) that the individual entitled to old-age or disability insurance benefits be a currently insured individual, and the provisions of subparagraph (C) of such paragraph," and inserting in lieu thereof "The provisions of subparagraph (C) of paragraph (1)". (b)(1) Section 2q2(f)(1) of such Act is amended— (A) by striking out "and currently" in the matter preceding subparagraph (A), and (B) by striking out ". and she was a currently insured individual," in subparagraph (D) (ii). (2) Section 202(f)(2) of such Act is amended by striking out "The requirement in paragraph (1) that the deceased fully insured individual also be a currently insured individual, and the provisions of subparagraph (D) of such paragraph," and inserting in lieu thereof "The provisions of subparagraph (D) of paragraph (1)". (c) In the case of any husband who would not be entitled to husband's insurance benefits under section 202(c) of the Social Security Act or any widower who would not be entitled to widower's insurance benefits under section 202(f) of such Act except for the enactment of this section, the requirement in section 202(c)(1)(C) or 202(f)(1)(D) of such Act relating to the time within which proof of support must be filed shall not apply if such proof of support is filed within two years after the month following the month in which this Act is enacted. (d) The amendments made by this section shall apply with respect to monthly benefits payable under title II of the Social Security Act for months after January 1968, but only on the basis of applications filed in or after the month in which this Act is enacted.

I'^^lTc}^^'

^2 Stat. 1026.

^^ Stat. 485.

72 Stat. 1023.

DEFINITION OF DISABILITY

SEC. 158. (a) Section 223(c) of the Social Security Act is amended— (1) by inserting "of Insured Status and Waiting Period" after "Definitions" in the heading;

lH'i'c

HI

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 868

7/Stat.^367!^4i3. 42 USC 423.

PUBLIC LAW 90-248-JAN. 2, 1968

[81 STAT.

(2) b j Striking out paragraph (2); and (3) by redesignating paragraph (3) as paragraph (2). (b) Section 223 of such Act is further amended by adding at the end thereof the following new subsection: "Definition of Disability

42 USC 416.

42 USC 402.

,,p mentai^imp^air"'^ ment."

42 USC 422.

79 Stat. 370. 42 USC 402.

" (d)(1) The term 'disability' means— " (A) inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months; or " (B) in the case of an individual who has attained the age of 55 and is blind ^within the meaning of 'blindness' as defined in section 2 1 6 (i)(l)), inability by reason of such blindness to engage in substantial gainful activity rec|uiring skills or abilities comparable to those of any gainful activity in which he has previously engaged with some regularity and over a substantial period of time. "(2) For purposes of paragraph (1)(A) — " (A) an individual (except a widow, surviving divorced wife, or widower for purposes of section 202(e) or (f)) shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work. For purposes of the preceding sentence (with respect to any individual), 'work which exists in the national economy' means work which exists in significant numbers either in the region where such individual lives or in several regions of the country. " (B) A widow, surviving divorced wife, or widower shall not be determined to be under a disability (for purposes of section 202 (e) or (f)) unless his or her physical or mental impairment or impairments are of a level of severity which under regulations prescribed by the Secretary is deemed to be sufficient to preclude an individual from engaging in any gainful activity. " ( ^) F'or purposes of t h i s subsection, a 'physical o r m e n t a l i m p a i r m e n t ' is a n i m p a i r m e n t that results from a n a to m i c a l, physiological, or psychological a b n o r m a l i t i e s which a r e d e m o n s t r a b l e by medically acceptable clinical and laboratory diagnostic techniques.

"(4) The Secretary shall by regulations prescribe the criteria for determining when services performed or earnings derived from services demonstrate an individual's ability to engage in substantial gainful activity. Notwithstanding the provisions of paragraph (2), an individual whose services or earnings meet such criteria shall, except for purposes of section 222(c), be found not to be disabled. "(5) An individual shall not be considered to be under a disability unless he furnishes such medical and other evidence of the existence thereof as the Secretary may require." (c)(1) Section 202(d)(1)(B) of such Act is amended by striking out "section 223(c)" and inserting in lieu thereof "section 223(d)". (2) Paragraphs (1), (2), and (3) of section 202(s) of such Act are each amended by striking out "section 223(c)" and inserting in lieu thereof "section 223(d) ".

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 81 STAT. ]

PUBLIC LAW 90-248-JAN. 2, 1968

(3) Section 221(a) of such Act is amended by striking out "or 223 (c) " and inserting in lieu thereof "or 223 (d) ". (4) Section 221(c) of such Act is amended by striking out "or 223 (c) " and inserting in lieu thereof "or 223 (d) ". (5) Section 222(c)(4)(B) of such Act is amended by striking out "section 223(c)(2) " and inserting in lieu thereof "section 223(d)". (6) Section 223(a)(1)(D) of such Act is amended by striking out "subsection (c)(2) " and inserting in lieu thereof "subsection (d) ". (7) The first sentence of section 223(a)(1) of such Act is further amended by striking out "subsection (c)(3) " and inserting in lieu thereof "subsection (c)(2)". (8) The last sentence of section 223(a)(1) is amended by striking out "subsection (c)(2) except for subparagraph (B) thereof" and inserting in lieu thereof "subsection (d) except for paragraph (1)(B) thereof". (9) Section 225 of such Act is amended by striking out "section 223(c)(2) " and inserting in lieu thereof "section 223(d)". (d) Section 216(i)(1) of such Act is amended by striking out the third sentence and inserting in lieu thereof the following: "The provisions of paragraphs (2)(A), (3), (4), and (5) of section 223(d) shall be applied for purposes of determining whether an individual is under a disability within the meaning of the first sentence of this paragraph in the same manner as they are applied for purposes of paragraph (1) of such section." (e) The amendments made by this section shall be effective with respect to applications for disability insurance benefits under section 223 of the Social Security Act, and for disability determinations under section 216(i) of such Act, filed— (1) in or after the month in which this Act is enacted, or (2) before the month in which this Act is enacted if the applicant has not died before such month and if— (A) notice of the final decision of the Secretary of Health, Education, and Welfare has not been given to the applicant before such month; or (B) the notice referred to in subparagraph (A) has been so given before such month but a civil action with respect to such final decision is commenced under section 205(g) of the Social Security Act (whether before, in, or after such month) and the decision in such civil action has not become final before such month.

869 70 Stat. 818. 42 USC 421.

42 JS'42^^' ^o st^a^. MS.

^^ us^c 42^^'

70 Stat. 817. 42 USC 425. 68 Stat. 1080. 42 USC 416. Ante,

p. 868.

H ^^^^ ^Q'^^'

DISABILITY B E N E F I T S AFFECTED BY RECEIPT OF W O R K M E N ' S C O M P E N S A T I O N

SEC. 159. (a)(1) The last sentence of section 224(a) of the Social Security Act is amended by inserting after "his wages and self- ^^ ^*^*- '^°^employment income" where it first appears in clause (B) the follow- "^^^^ '^24a. ing: " (computed without regard to the limitations specified in sections 209(a) and 211(b)(1)) ". ^^\2 USC 409, (2) Section 224(a) of such Act is further amended by adding at the end thereof the following: "In any case where an individual's wages and self-employment income reported to the Secretary for a calendar year reach the limitations specified in sections 209(a) and 211(b)(1), the Secretary under regulations shall estimate the total of such wages and self-employment income for purposes of clause (B) of the preceding sentence on the basis of such information as may be available to him indicating the extent (if any) by which such wages and self-employment income exceed such limitations." (b)(1) The amendments made by subsection (a) shall apply only with respect to monthly benefits under title II of the Social Security Act for months after January 1968. 42 USC 4o 1''

428; Ante,

p. 833.

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 870 79 Stat. 407. 42 USC 424a.

PUBLIC LAW 90-248-JAN. 2, 1968

[81 STAT.

(2) For purposes of any redetermination which is made mider section 224(f) of the Social Security Act in the case of benefits subject to reduction under section 224 of such Act, where such reduction as first computed was effective with respect to benefits for the month in which this Act is enacted or a prior month, the amendments made by subsection (a) of this section shall also be deemed to have applied in the initial determination of the "average current earnings" of the individual whose wages and self-employment income are involved. EXTENSION OF T I M E FOR FILING REPORTS OF EARNINGS

74ltar955°^^' 42 USC 403.

68 Stat. 1076; 74 Stat. 955.

SEC. 160. (a) Section 203(h)(1)(A) of the Social Security Act is amended by adding at the end thereof the following new sentence: "The Secretary may grant a reasonable extension of time for making the report of earnings required in this paragraph if he finds that there is valid reason for a delay, but in no case may the period be extended more than three months." (b) Section 203(h)(2) of such Act is amended by striking out 'within the time prescribed therein" and inserting in lieu thereof "within the time prescribed by or in accordance with such paragraph" PENALTIES FOR FAILURE TO FILE TIMELY REPORTS OF EARNINGS AND OTHER EVENTS

42 USC 40 2.

"Period for which there 16 a

SEC. 161. (a) Section 203(h)(2)(A) of the Social Security Act is amended by inserting before the semicolon at the end thereof the following: ", except that if the deduction imposed under subsection (b) by reason of his earnings for such year is less than the amount of his benefit (or benefits) for the last month of such year for which he was entitled to a benefit under section 202, the additional deduction shall be equal to the amount of the deduction imposed under subsection (b) but not less than $10". (b) Section 203(g) of such Act is amended by striking out all that follows "shall suffer" and inserting in lieu thereof the following: "deductions in addition to those imposed under subsection (c) as follows: "(1) if such failure is the first one with respect to which an additional deduction is imposed by this subsection, such additional deduction shall be equal to his benefit or benents for the first month of the period for which there is a failure to report even though such failure is with respect to more than one month; "(2) if such failure is the second one with respect to which an additional deduction is imposed by this subsection, such additional deduction shall be equal to two times his benefit or benefits for the first month of the period for which there is a failure to report even though such failure is with respect to more than two months; and "(3) if such failure is the third or a subsequent one for which an additional deduction is imposed under this subsection, such additional deduction shall be equal to three times his benefit or benefits for the first month of the period for which there is a failure to report even though the failure to report is with respect to more than three months; except that the number of additional deductions required by this subsection shall not exceed the number of months in the period for which there is a failure to report. As used in this subsection, the term 'period „

i • i

1

•

e •^

•

• i

•

-i- • -i

failure to report." lor which there IS a failure to report with respect to any individual means the period for which such individual received and accepted 42 USC 40 2. insurance benefits under section 202 without making a timely report and for which deductions are required under subsection (c)."

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Page:United States Statutes at Large Volume 81.djvu/905

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PUBLIC LAW 90-248-JAN. 2, 1968

871

(c) The amendnieiits made by this section shall apply with respect to any deductions imposed on or after the date of the enactment of this Act under snbsecti(ms (g) and (h) of section 203 of the Social Security Act on account of failure to make a report required thereby. IJIMITATION ON P A Y M E N T OF B E N E F I T S TO ALIENS THE UNITED STATES

'^^ '^^^ '*°^"

OUTSIDE

SEC. 162. (a)(1) Section 2 0 2 (t)(l) of the Social Security Act is ^°usc'402." amended by adding at the end thereof (after and below subparagraph (B)) the following new sentence: " For purposes of the preceding sentence, after an individual has been outside the United States for any period of thirty consecutive days he shall be treated as remaining outside the United States until he has been in the United States for a period of thirty consecutive days." (2) The amendment made by paragraph (1) shall apply only with respect to six-month periods (within the irieaning of section 202(t) (1)(A) of the Social Security Act) which begin after the date of the enactment of this Act. (b)(1) Section 202(t)(4) of such Act is amended— ya^staS.^^iy^a!' (A) by striking out the period at the end of subparagraph (E) and inserting in lieu thereof a semicolon; and (B) by adding at the end thereof (after and below subparagraph (E)) the following: "except that subparagraphs (A) and (B) of this paragraph shall not apply in the case of any individual who is a citizen of a foreign country that has in eifect a social insurance or pension system which is of general application in such country and which satisfies subparagraph (A) but not subparagraph (B) of paragraph (2), or who is a citizen of a foreign country that has no social insurance or pension system of general application if at any time within five years prior to the month in which the Social Security Amendments of 1967 are enacted (or the first month thereafter for which his benefits are subject to suspension under paragraph (1)) payments to individuals residing in such country were withheld by the Treasury Department under the first section of the Act of October 9, 1940 (31 U.S.C. 123)." _ 56^st!l^*io2°8'^' (2) The amendment made by paragraph (1) shall apply only with respect to monthly benefits under title II of the Social Security Act ^^ti^^^tV'^^^'' for months beginning after June 30, 1968. 70 Stat. 835; (c)(1) Section 202(t) of such Act is further amended by adding 79 Stat. 334. at the end thereof the following new paragraph: "(10) Notwithstanding any other provision of this title, no monthly benefits shall be paid under this Section or under section 223, for any month beginning after June 30, 1968, to an individual who is not a citizen or national of the United States and who resides during such month in a foreign country if payments for such month to individuals residing in such country are withheld by the Treasury Department under the first section of the Act of October 9, 1940 (31 U.S.C. 123)." (2) Section 202(t)(6) of such Act is amended by striking out "by reason of paragraph (1) " and inserting in lieu thereof "by reason of paragraph (1) or (10)". (3) Whenever benefits which an individual who is not a citizen or national of the United States was entitled to receive under title II of the Social Security Act are, on June 30, 1968, being withheld by the Treasury Department under the first section of the Act of October 9, 1940 (31 U.S.C. 123), any such benefits, payable to such individual

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 872

PUBLIC LAW 90-248-JAN. 2, 1968

[81 STAT.

for months after the month in which the determination by the Treasury Department that the benefits should be so withheld was made, shall not be paid— (A) to any person other than such individual, or, if such individual dies before such benefits can be paid, to any person other than an individual who was entitled for the month in which the deceased individual died (with the application of section 202(j) (1) of the Social Security Act) to a monthly benefit under title 428; Anfi.^p.^ 833. ^ ^^ ^^^^1^ ^ ^ t ou the basis of the same wages and self-employment income as such deceased individual, or (B) in excess of the equivalent of the last twelve months' benefits that would have been payable to such individual. B E N K r i T S FOR CERTAIN C H I L D R E N

42 us^c 40 3^^ ^

42 USC 402. 42 USC 416.

42 USC 423.

SEC. 163. (a)(1) The last sentence of section 203(a) of the Social Security Act is amended to read as follows: "Whenever a reduction is made under this subsection in the total of monthly benefits to which individuals are entitled for any month on the basis of the wages and self-employment income of an insured individual, each such benefit other than the old-age or disability insurance benefit shall be proportionately decreased; except that if such total of benefits for such month includes any benefit or benefits under section 202(d) which are payable solely by reason of section 216(h)(3), the reduction shall be first applied to reduce (proportionately where there is more than one benefit so payable) the benefits so payable (but not below zero)." (2) The amendment made by paragraph (1) shall apply only with respect to monthly benefits payable under title II of the Social Security Act with respect to individuals who become entitled to benefits under section 202(d) of such Act solely by reason of section 216(h)(3) of such Act in or after January 1968 (but without regard to section 2 0 2 (j)(l) of such Act). The provisions of section 170 of this Act shall not apply with respect to any such individual, (b) Where— (1) one or more persons were entitled (without the application of section 202(j)(1) of the Social Security Act) to monthly benefits under section 202 or 223 of such Act for January 1968 on the basis of the wages and self-employment income of an individual, and (2) one or more persons became entitled to monthly benefits before January 1968 under section 202(d) of such Act by reason of section 216(h)(3) of such Act (but without regard to section 202(j)(1)), on the basis of such wages and self-employment income and are so entitled for January 1968, and (3) the total of benefits to which all persons are entitled under such section 202 or 223 of such Act on the basis of such wages and self-employment for January 1968 are reduced by reason of section 203(a) of such Act, as amended by this Act (or would, but for the penultimate sentence of such section 203(a), be so reduced), then the amount of the benefit to which each such person referred to in paragraph (1) above (but not including persons referred to in paragraph (2) above) is entitled for months aiter January 1968 shall be increased, after the application of such section 203(a), to the amount it would have been if the person or persons referred to in paragraph (2) were not entitled to a benefit referred to in.such paragraph (2).

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873

PUBLIC LAW 90-248-JAN. 2, 1968

TRANSFER TO HEALTH INSURANCE BENEFITS ADVISORY COUNCIL NATIONAL MEDICAL REVIEW COMMITTEE FUNCTIONS; INCREASE

OF IN

C O U N C I L ' S MEMBERSHIP

SEC. 164. (a) Section 1867 of the Social Security Act is amended to read as follows:

79 Stat. 329. 42 USC 1395dd.

HEALTH I N S I ^ R A N C E BENEFITS ADVISORY COUNCIL

"SEC. 1867. (a) There is hereby created a Health Insurance Benefits Advisory Council which shall consist of 19 persons, not otherwise in the employ of the United States, appointed by the Secretary without regard to the provisions of title 5, United States Code, governing appointments in the competitive service. The Secretary shall from time to time appoint one of the members to serve as Chairman, The members shall include persons who are outstanding in fields related to hospital, medical, and other health activities, persons who are representative of organizations and associations of professional personnel in the field of medicine, and at least one person who is representative of the general public. Each member shall hold office for a term of 4 years, except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term. A member shall not be eligible to serve continuously for more than 2 terms. The Secretary may, at the request of the Advisory Council or otherwise, appoint such special advisory professional or technical committees as may be useful in carrying out this title. Members of the Advisory Council and members of any such advisory or technical committee, while attending meetings or conferences thereof or otherwise serving on business of the Advisory Council or of such committee, shall be entitled to receive compensation at rates fixed by the Secretary, but not exceeding $100 per day, including travel time, and while so serving away from their homes or regular places of business they may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section 5703 of title 5, United States Code, for persons in the Government service employed intermittently. The Advisory Council shall meet as frequently as the Secretary deems necessary. Upon request of 5 or more members, it shall be the duty of the Secretary to call a meeting of the Advisory Council. "(b) I t shall be the function of the Advisory Council (1) to advise the Secretary on matters of general policy in the administration of this title and in the foririulation of regulations under this title, and (2) to study the utilization of hospital and other medical care and services for which payment may be made under this title with a view to recommending any changes which may seem desirable in the way in which such care and services are utilized or in the administration of the programs established by this title, or in the provisions of this title. The Advisory Council shall make an annual report to the Secretary on the performance of its functions, including any recommendations it may have with respect thereto, and such report shall be transmitted promptly by the Secretary to the Congress. "(c) The Advisory Council is authorized to engage such technical assistance as may be required to carry out its functions, and the Secretary shall, in addition, make available to the Advisory Council such secretarial, clerical, and other assistance and such pertinent data obtained and prepared by the Department of Health, Education, and Welfare as the Advisory Council may require to carry out its functions." (b) The amendment made by subsection (a) shall not be construed as affecting the terms of office of the members of the Health Insurance

Membership.

80 Stat. 417. 5 USC 3301 et seq.

Term of office.

eompensation, travel expenses.

80 Stat. 499.

Duties.

Report to Congress.

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79 s^tS; 329.

PUBLIC LAW 90-248-JAN. 2, 1968

fel

STAT.

Benefits Advisory Council in office on the date of the enactment of this Act or their successors. The terms of office of the three additional members of the Health Insurance Benefits Advisory Council first appointed pursuant to the increase in the membership of such Council provided by such amendment shall expire, as designated by the Secretary at the time of appointment, one at the end of the first year, one at the end of the second year, and one at the end of the third year after the date of appointment. (^) Section 1868 of the Social Security Act is repealed.

42 USC 1395ee. ADVISORY C O U N C I L ON SOCIAL 79 Stat. 339. 42 USC 907.

SECURITY

SEC. 165. (a)(1) Section 706(a) of the Social Security Act is amended by striking out "During 1968 and every fifth year thereafter" and inserting in lieu thereof "During 1969 (but not before February 1, 1969) and every fourth year thereafter (but not before February 1 of such fourth year)". (2) Section 706(d) such Act is amended by striking out "reports of its" and inserting in lieu thereof "reports (including any interim reports such Council may have issued) of its". (b) Section 706(b) of such Act is amended by striking out "shall consist of the Commissioner of Social Security, as Chairman, and 12 other persons, appointed by the Secretary" and inserting in lieu thereof "shall consist of a Chairman and 12 other persons, appointed by the Secretary". REIMBURSEMENT OF CIVIL SERVICE RETIREMENT A N N U I T A N T S FOR CERTAIN P R E M I U M P A Y M E N T S U N D E R S U P P L E M E N T A R Y MEDICAL INSURANCE PROGRAM

42 USC 1395s. 80 Stat. 602.

SEC. 166. Section 1840(e)(1) of the Social Security Act is amended by adding at the end thereof the following new sentence: "A plan dcscHbed in section 8903 of title 5, United States Code, may reimburse each annuitant enrolled in such plan an amount equal to the premiums paid by him under this part if such reimbursement is paid entirely from funds of such plan which are derived from sources other than the contributions described in section 8906 of such title." A P P R O P R I A n O N S TO S U P P L E M E N T A R Y MEDICAL INSURANCE TOUST F U N D

lo fl^n f^o^ 42 USC 1395w.

42 USC 1395t.

SEC. 167. (a) Section 1844(a) of the Social Security Act is amended i

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to read as follows: " (a) There are authorized to be appropriated from time to time, out of any moneys in the Treasury not otherwise appropriated, to the Federal Supplementary Medical Insurance Trust Fund— "(1) a Government contribution equal to the aggregate premiums payable under this part and deposited in the Trust Fund, and "(2) such sums as the Secretary deems necessary to place the Trust Fund, at the end of any fiscal year occurring after June 30, 1967, in the same position in which it would have been at the end of such fiscal year if (A) a Government contribution representing the excess of the premiums deposited in the Trust Fund during the fiscal year ending June 30, 1967, over the Government contribution actually appropriated to the Trust Fund during such fiscal year had been appropriated to it on June 30, 1967, and (B) the Government contribution for premiums deposited in the Trust Fund after June 30, 1967, had been appropriated to it when such premiums were deposited." (b) Section 1844(b) of such Act is amended by striking out "1967" and inserting in lieu thereof "1969".

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PUBLIC LAW 90-248-JAN. 2, 1968

875

DISCLOSURE TO COURTS OF W H E R E A B O U T S OF CERTAIN I N D IV I D U A L S

SEC. 168. (a) Section 1106(c)(1) of the Social Security Act is amended by inserting " (A) " after " (c)(1) ' ', by redesignating subparagraphs (A) through (D) as clauses (i) through (iv), respectively, and by adding at the end thereof the following new subparagraph: " (B) If a request for the most recent address of any individual so included is filed (in accordance with paragraph (2) of this subsection) by a court having jurisdiction to issue orders or entertain petitions against individuals for the support and maintenance of their children, the Secretary shall furnish such address, or the address of the individual's most recent employer, or both, for the use of the court (and for no other purpose) in issuing or determining whether to issue such an order against such individual or in determining (in the event such individual is not within the jurisdiction of the court) the court to which a petition for support and maintenance against such individual should be forwarded under any reciprocal arrangements with other States to obtain or improve court orders for support, if the court certifies that the information is requested for such use." (b)(1) Section 1106(c)(2) of such Act is amended by striking out ", and shall be accompanied" and all that follows and inserting in lieu thereof "(and, in the case of a request under paragraph (1)(A), shall be accompanied by a certified copy of the order referred to in clauses (i) and (iv) thereof)." (2) Section 1106(c)(3) of such Act is amended by striking out "authorized by subparagraph (D) thereof" and inserting in lieu thereof "authorized by subparagraph (A) (iv) or (R) thereof",

79 Stat. 4 1 1. 42 USC 1306.

REPORTS OF BOARDS OF TRUSTEES TO CONORESS

SEC. 169. (a) Sections 201(c)(2), 1817(b)(2), and 1841 (b)(2) of the Social Security Act are each amended by striking out "March" 7970 Stat. 8 21; Stat. 300, 308. and inserting in lieu thereof "April". 42 USC" 4oi (b) Section 201(c) of such Act is amended by inserting immedi- ^395i, i395t ately before the last sentence the following new sentence: "Such report shall also include an actuarial analysis of the benefit disbursements made from the Federal Old-Age and Survivors Insurance Trust Fund with respect to disabled beneficiaries." GENERAL SAVING

PROVISION

SEC. 170. Where— (1) one or more persons were entitled (without the application of section 202(j)(1) of the Social Security Act) to monthly benefits under section 202 or 228 of such Act for January 1968 on the basis of the wages and self-employment income of an individual, and (2) one or more persons (not included in paragraph (1)) become entitled to monthly benefits under such section 202 for February 1968 on the basis of such wages and self-employment by reason of the amendments made to such Act by sections 104, 112,150,151,156, and 157 of this Act, and (3) the total of benefits to which all persons are entitled under such section 202 or 223 on the basis of such wages and self-employment for February 1968 are reduced by reason of section 203(a) of such Act, as amended by this Act (or would, but for the penultimate sentence of such section 203(a), be so reduced), then the amount of the benefit to which each such person referred to in paragraph (1) is entitled for months after January 1968 shall be increased, after the application of such section 203(a), to the amount

^4 stat^. 487 42 USC 402. -"" u""^ 423. 42 s e """

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