Title IV, SEC. 4221. TREATMENT OF ITEMS AND SERVICES NOT COVERED UNDER THE COMPREHENSIVE BENEFIT PACKAGE. (a) Continuation of Eligibility for Assistance for AFDC and SSI Recipients. With respect to an individual who is described in section 1933(b) of the Social Security Act (as added by subsection (b)(1)), nothing in this Act shall be construed as (1) changing the eligibility of the individual for medical assistance under title XIX of the Social Security Act for items and services not covered under the comprehensive benefit package, or (2) subject to the amendments made by this subtitle, changing the amount, duration, or scope of medical assistance required (or permitted) to be provided to the individual under such title. (b) Limitation on Scope of Assistance for Other Medicaid Beneficiaries. (1) In general. Title XIX, as amended by sections 4201 and 4213, is amended by redesignating section 1933 as section 1934 and by inserting after section 1932 the following new section: ``limitation on scope of assistance for most non-cash beneficiaries ``Sec 1933. (a) Limitation. Notwithstanding any other provision of this title, the medical assistance made available under section 1902(a) to an individual not described in subsection (b) shall be limited to medical assistance for ``(1) long-term care services (as defined in subsection (c)); and ``(2) medicare cost-sharing (as defined in section 1905(p)(3)), in accordance with the requirements of section 1902(a)(10)(E). ``(b) Individuals Exempt from Limitation. The individuals described in this subsection are the following: ``(1) AFDC recipients (as defined in section 1902(3) of the Health Security Act) 18 years of age or older. ``(2) SSI recipients (as defined in section 1902(33) of the Health Security Act) 18 years of age or older. ``(3) Individuals entitled to benefits under title XVIII. ``(c) Long-Term Care Services Defined. In subsection (a), the term `long-term care services' means the following items and services, but only to the extent they are not included as an item or service under the comprehensive benefit package under the Health Security Act: ``(1) Nursing facility services and intermediate care facility services for the mentally retarded (including items and services that may be included in such services pursuant to regulations in effect as of October 26, 1993). ``(2) Personal care services. ``(3) Home or community-based services provided under a waiver granted under subsection (c), (d), or (e) of section 1915. ``(4) Home and community care provided to functionally disabled elderly individuals under section 1929. ``(5) Community supported living arrangements services provided under section 1930. ``(6) Case-management services (as described in section 1915(g)(2)). ``(7) Home health care services, clinic services, and rehabilitation services that are furnished to an individual who has a condition or disability that qualifies the individual to receive any of the services described in paragraphs (1) through (6). ``(8) Hospice care.''. (2) Conforming amendment. Section 1902(a)(10) of such Act (42 U.S.C. 1396a(a)(10)), as amended by section 13603(c)(1) of OBRA 1993 and section 4211(b), is amended in the matter following subparagraph (G) (as inserted by section 4212(a)) (A) by striking ``and (XIV)'' and inserting ``(XIV)''; and (B) by inserting before the semicolon at the end the following: ``, and (XV) the medical assistance made available to an individual who is not described in section 1933(b) shall be limited in accordance with section 1933''. (c) Conforming Amendments Relating to Secondary Payer. (1) Section 1902(a)(25)(A) (42 U.S.C. 1396a(a)(25)(A)), as amended by section 13622(a) of OBRA 1993, is amended by inserting ``health plans (as defined in section 1400 of the Health Security Act),'' after ``of 1974),''. (2) Section 1903(o) (42 U.S.C. 1396b(o)), as so amended, is amended by inserting ``and a health plan (as defined in section 1400 of the Health Security Act)'' after ``of 1974)''. (d) Effective Date. The amendments made by this section shall apply to items and services furnished in a State on or after January 1 of the first year for which the State is a participating State under the Health Security Act.