; (B) by striking , for not less than 24 months ; and (C) by striking could have been entitled for 24 calendar months, and . (c) Effective date The amendments made by this section shall apply to insurance benefits under title XVIII of the Social Security Act with respect to items and services furnished in months beginning after December 1 following the date of enactment of this Act, and before January 1 of the year that is 4 years after such date of enactment. XI Miscellaneous 1101. Definitions In this Act— (1) the term Secretary means the Secretary of Health and Human Services; (2) the term State means a State, the District of Columbia, or a territory of the United States; and (3) the term United States shall include the States, the District of Columbia, and the territories of the United States.