Medicare Hospice Reform and Savings Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act to revise payments and coverage for hospice care under the Medicare program.
Prescribes conditions for recovery by the Secretary of Health and Human Services (HHS) of repayment demands from a hospice program for any accounting year during the four-year period ending on October 31, 2009.
Requires the Secretary to issue evidence-based national coverage determinations for life expectancies covering at least each of those terminal medical diagnoses currently covered by Local Coverage Determinations promulgated by Medicare's fiscal intermediaries.
Directs the Secretary to restore the application (and reduce the phase out) of the budget neutrality adjustment factor in the Medicare hospice wage index for FY2010-FY2013 in a manner that will result in an aggregate increase in Medicare expenditures equivalent to the aggregate reductions in expenditures resulting from the issuance of the national coverage determinations.
[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3454 Introduced in House (IH)]
111th CONGRESS
1st Session
H. R. 3454
To amend title XVIII of the Social Security Act to reform payments and
coverage for hospice care under the Medicare Program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 31, 2009
Mr. Sullivan (for himself, Mr. Boren, Mr. Cole, Mr. Lucas, and Ms.
Fallin) introduced the following bill; which was referred to the
Committee on Ways and Means, and in addition to the Committee on Energy
and Commerce, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to reform payments and
coverage for hospice care under the Medicare Program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare Hospice Reform and Savings
Act of 2009''.
SEC. 2. HOSPICE CARE PAYMENT AND COVERAGE REFORMS.
(a) Relief From Demand Payments.--Section 1814(i)(2) of the Social
Security Act (42 U.S.C. 1395f(i)(2)) is amended--
(1) in subparagraph (A), by inserting ``(ending before
November 1, 2009)'' after ``for an account year;''; and
(2) by adding at the end the following new subparagraph:
``(E) With respect to repayment demands based upon the application
of this paragraph for an accounting year ending during the 4-year
period ending on October 31, 2009, recovery by the Secretary of such
demands from a hospice program shall be subject to the following:
``(i)(I) Subject to subclause (II), no such demand to any
hospice program shall exceed 10 percent of the payments under
this part to the program for the same time period covered by
the demand.
``(II) The aggregate reduction in repayment demands under
subclause (I) shall not exceed $400,000,000 and the Secretary
shall reduce, in a pro-rata manner, the application of
reductions under such subclause to the extent such reductions
would otherwise exceed such limit.
``(III) Subclause (I) shall be applied taking into account
principal amounts made on or before the date of the enactment
of this subparagraph.
``(ii) Upon request of a hospice program subject to the
maximum demand under the limitation specified in clause (i),
the Secretary shall allow the program a period of 60 months
from the date of demand to repay such demand in installments.
``(iii) The interest rate charged on any demand during the
period specified in this clause may not exceed the effective
rate established by the Secretary of the Treasury pursuant to
section 3717(a) of title 31, United States Code, as of the date
of the demand.
Nothing in this subparagraph shall be construed to require the
Secretary to return funds collected or repaid before the date of the
enactment of this subparagraph.''.
(b) Realignment of Payment Amounts.--Section 1814(i)(1) of such Act
(42 U.S.C. 1395f(i)(1)) is amended--
(1) in subparagraph (B), by inserting ``subject to
subparagraph (D),'' after ``subparagraph (A)'';
(2) in subparagraph (C), by inserting ``subject to
subparagraph (D),'' after ``for a subsequent fiscal year,'';
and
(3) by adding at the end the following new subparagraph:
``(D)(i) In the case of hospice care (other than short-term
inpatient care) furnished on or after November 1, 2009, with respect to
an individual in a hospice election period (other than one of the first
two 90-day periods for such individual under section 1812(d)(1)), the
amount of payment otherwise established for such care shall be reduced
by 12\1/2\ percent.
``(ii) In the case of routine home hospice care furnished on or
after November 1, 2009, during the first 5 days of hospice care in an
individual's initial 90-day hospice election period under section
1812(d)(1) and during the last 5 days of hospice care preceding (and
including) the date of the beneficiary's death, the amount of payment
otherwise established for such care shall be increased by 20
percent.''.
(c) Listing of Terminal Illnesses.--By not later than January 31,
2010, and for purposes of applying section 1861(dd)(3)(A) of the Social
Security Act (42 U.S.C. 1395x(dd)(3)(A)), the Secretary of Health and
Human Services shall issue evidence-based national coverage
determinations for life expectancies covering at least each of those
terminal medical diagnoses currently covered by Local Coverage
Determinations promulgated by Medicare's fiscal intermediaries.
(d) Delay in Phase Out of Medicare Hospice Budget Neutrality
Adjustment Factor During Fiscal Years 2010-2013 Based Upon Savings From
National Coverage Determinations.--
(1) Determination of savings.--The Secretary of Health and
Human Services shall annually determine, and report to
Congress, the amount of the reductions in expenditures under
title XVIII of the Social Security Act during fiscal years 2010
through 2013 that results from the issuance of the national
coverage determinations described in subsection (c) for hospice
care.
(2) Restoration of medicare hospice budget neutrality
adjustment factor.--Notwithstanding any other provision of law,
including the final rule published on August 10, 2008, 73
Federal Register 46464 et seq., relating to Medicare Program;
Hospice Wage Index for Fiscal Year 2009, the Secretary shall
restore the application (and reduce the phase out) of the
budget neutrality adjustment factor in the Medicare hospice
wage index for the fiscal years 2010 through 2013 in such
manner as the Secretary estimates will result in an aggregate
increase in expenditures under title XVIII of the Social
Security Act equivalent to the aggregate reductions in
expenditures determined under paragraph (1) for such period.
<all>
Introduced in House
Introduced in House
Referred to House Ways and Means
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to House Energy and Commerce
Referred to the Subcommittee on Health.
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