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42 U.S.C. 1395d: Scope of benefits

Created in 1965 by Public Law 89-97. Changed by 13 later laws. No bill we track in this Congress changes it.

9 other sections of the Code cite this one, including 10 U.S.C. 1074j, 42 U.S.C. 1395e, 42 U.S.C. 1395f, 42 U.S.C. 1395m, 42 U.S.C. 1395w–23.

1 part of federal rules cite it as their authority, written by Centers for Medicare & Medicaid Services, Department of Health and Human Services (1).

This Congress

No bill we track in the 119th Congress changes this section.

    How it got here

    2003

    • Pub. L. 108–173, §736(c)(1), substituted "in the case of individuals not" for "for individuals not" and "in the case of individuals so" for "for individuals so". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (a)
    • Pub. L. 108–173, §512(a), added par. (5). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (a)

    1999

    • Pub. L. 106–113 inserted "during" after "100 visits" in concluding provisions. (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (b)

    1997

    • Pub. L. 105–33, §4201(c)(1), substituted "critical access" for "rural primary care". (Balanced Budget Act of 1997) Law text · (a)
    • Pub. L. 105–33, §4611(a)(1), substituted "for individuals not enrolled in part B, home health services, and for individuals so enrolled, post-institutional home health services furnished during a home health spell of illness for up to 100 visits during such spell of illness" for "ho… (Balanced Budget Act of 1997) Law text · (a)
    • Pub. L. 105–33, §4443(a), substituted "and an unlimited number of subsequent periods of 60 days each" for ", a subsequent period of 30 days, and a subsequent extension period". (Balanced Budget Act of 1997) Law text · (a)
    • Pub. L. 105–33, §4611(a)(2), inserted closing provisions. (Balanced Budget Act of 1997) Law text · (b)
    • Pub. L. 105–33, §4443(a), substituted "and an unlimited number of subsequent periods of 60 days each" for ", a subsequent period of 30 days, and a subsequent extension period". (Balanced Budget Act of 1997) Law text · (d)
    • Pub. L. 105–33, §4443(b)(1), substituted "90-day period or a subsequent 60-day period" for "90- or 30-day period or a subsequent extension period". (Balanced Budget Act of 1997) Law text · (d)

    1994

    • Pub. L. 103–432 substituted "inpatient hospital services or inpatient rural primary care hospital services" for "inpatient hospital services" before "for up to 150 days" and "such services" for "inpatient hospital services" before "in excess of 90" and struck out "and inpatient rura… · (a)

    1990

    • Pub. L. 101–508, §4006(a)(1), substituted "90 days each, a subsequent period of 30 days, and a subsequent extension period" for "90 days each and one subsequent period of 30 days". · (a)
    • Pub. L. 101–508, §4006(a)(2)(A), substituted "90 days each, a subsequent period of 30 days, and a subsequent extension period during the individual's lifetime" for "90 days each and one subsequent period of 30 days during the individual's lifetime". · (d)
    • Pub. L. 101–508, §4006(a)(2)(B), substituted "a 90- or 30-day period or a subsequent extension period" for "a 90- or 30-day period". · (d)

    1989

    • Pub. L. 101–234 repealed Pub. L. 100–360, §101(1), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below. · (a)
    • Pub. L. 101–239 inserted "and inpatient rural primary care hospital services" before semicolon at end. · (a)
    • Pub. L. 101–234 repealed Pub. L. 100–360, §101(2)–(6), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment notes below. · (b), (c), (d)

    1988

    • Pub. L. 100–360, §101(1), struck out former pars. (1) to (4) and added new pars. (1) to (4) which read as follows: · (a)
    • Pub. L. 100–360, §101(2), amended subsec. (b) generally, striking out par. (1) and renumbering and amending pars. (2) and (3) as (1) and (2), respectively. · (b)
    • Pub. L. 100–360, §101(3), amended subsec. (c) generally, substituting pars. (1) to (4) limiting periods for inpatients of psychiatric hospitals for former single paragraph. · (c)
    • Pub. L. 100–360, §101(4)(A), substituted ", a subsequent period of 30 days, and a subsequent extension period" for "and one subsequent period of 30 days". · (d)
    • Pub. L. 100–360, §101(4)(B), inserted "or a subsequent extension period" after "30-day period" in introductory provisions. · (d)
    • Pub. L. 100–360, §101(5), struck out "post-hospital" before "extended care services". · (e)
    • Pub. L. 100–360, §101(6), struck out subsec. (f) which provided coverage of extended care services without regard to three-day prior hospitalization requirement. · (f)
    • Pub. L. 100–360, §101(6), struck out subsec. (g) which cross-referenced section 1395x of this title for definitions of "spell of illness" and other terms used in this part. · (g)

    1983

    • Pub. L. 97–448 substituted "or to services" for "or to other than services" after "(if not an employee of the hospice program)". · (d)

    1982

    • Pub. L. 97–248, §123(a), redesignated existing provisions as subpar. (A) and added subpar. (B). · (a)
    • Pub. L. 97–248, §122(b)(1), added par. (4). · (a)
    • Pub. L. 97–248, §122(b)(2), added subsec. (d). · (d)
    • Pub. L. 97–248, §123(b), added subsec. (f) and redesignated former subsec. (f) as (g). · (f), (g)

    1981

    • Pub. L. 97–35 struck out par. (4) which related to alcohol detoxification facility services. · (a)

    1980

    • Pub. L. 96–499, §930(b), substituted "home health services" for "post-hospital home health services for up to 100 visits (during the one-year period described in section 1395x(n) of this title) after the beginning of one spell of illness and before the beginning of the next". · (a)
    • Pub. L. 96–499, §931(a), added par. (4). · (a)
    • Pub. L. 96–499, §930(c), struck out subsec. (d) which authorized payment for post-hospital home health services furnished an individual only during the one year period described in section 1395x(n) of this title following his most recent hospital discharge which met the requirements of… · (d)
    • Pub. L. 96–499, §930(d), substituted "subsections (b) and (c)" for "subsections (b), (c), and (d)" and "and post-hospital extended care services" for "post-hospital extended care services, and post-hospital home health services". · (e)

    1968

    • Pub. L. 90–248, §143(b), inserted "or, in the case of payments referred to in section 1395f(d)(2) of this title to him" after "on his behalf" in text preceding par. (1). · (a)
    • Pub. L. 90–248, §137(a)(1), increased the maximum duration of benefits from 90 to 150 days 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 u… · (a)
    • Pub. L. 90–248, §129(c)(2), struck out par. (4) which provided for payment for outpatient hospital diagnostic services. · (a)
    • Pub. L. 90–248, §137(a)(2), changed the limitation on payments from 90 to 150 days 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 thi… · (b)
    • Pub. L. 90–248, §138(a), increased the limit from 90 to 150 days so that if an individual was an inpatient of a psychiatric or tuberculosis hospital on the first day of the first month for which he is entitled to benefits, the days he was an inpatient in the 150-day period immediately … · (c)
    • Pub. L. 90–248, §146(a), provided that the limitation of allowable days of inpatient hospital services will not apply to services provided to an inpatient of a tuberculosis hospital. · (c)

    Text, outline and history from the official U.S. Code (2024 edition) on GovInfo, published by the Office of the Law Revision Counsel. Changes made after that edition appear under This Congress.