Medicare Home Health Rebasing Relief and Reassessment Act - Amends title XVIII (Medicare) of the Social Security Act, with respect to the system for prospective payments for home health services, to suspend for a 12-month period a specified adjustment to (rebasing of) Medicare home health prospective payment amounts.
Revises the home health outlier adjustment to equal not to exceed 2.25% (currently, 2.5%) for 2015 through 2023.
Directs the Secretary of Health and Human Services (HHS) to study alternative methods for determining the appropriate adjustment for 2014 and subsequent years to the prospective payment for home health services, including methods offered by stakeholders.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4625 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 4625
To amend title XVIII of the Social Security Act to suspend the
application of the rebasing of Medicare home health prospective payment
amounts, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 9, 2014
Mr. Hall 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 suspend the
application of the rebasing of Medicare home health prospective payment
amounts, and for other purposes.
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 Home Health Rebasing Relief
and Reassessment Act''.
SEC. 2. RELIEF AND REASSESSMENT OF THE REBASING OF MEDICARE HOME HEALTH
PROSPECTIVE PAYMENT AMOUNTS.
(a) Suspension of Rebasing.--Section 1895(b)(3)(A)(iii) of the
Social Security Act (42 U.S.C. 1395fff(b)(3)(A)(iii)) is amended--
(1) in subclause (I), in the first sentence, by striking
``subclause (II)'' and inserting ``subclauses (II) and (III)'';
(2) in subclause (II), in the first sentence, by striking
``The Secretary'' and inserting ``Subject to subclause (III),
the Secretary''; and
(3) by adding at the end the following new subclause:
``(III) Special rule.--Subclauses
(I) and (II) shall not apply for the
12-month period beginning on the date
of the enactment of this subclause. For
periods beginning after the period
described in the previous sentence, the
Secretary shall apply such subclauses
as if the previous sentence had not
been enacted.''.
(b) Revision of Home Health Outlier Adjustment.--Section
1895(b)(5)(A) of the Social Security Act (42 U.S.C. 1395fff(b)(5)(A))
is amended, in the second sentence, by inserting ``(or, in the case of
each of the years 2015 through 2023, 2.25 percent)'' after ``2.5
percent''.
(c) Study and Report.--
(1) Study.--
(A) In general.--The Secretary of Health and Human
Services, in consultation with representatives of
Medicare home health agencies and beneficiaries, shall
conduct a study on alternative methods for determining
the appropriate adjustment under section
1895(b)(3)(A)(iii) of the Social Security Act (42
U.S.C. 1395(b)(3)(A)(iii)), including methods offered
by stakeholders. Such study shall include an analysis
of each of the following:
(i) The projected impact on Medicare
beneficiary access to care during each of 2014
through 2017 of applying section 1895(b)(3)
during each of such years without application
of subparagraph (A)(iii) of such section,
compared to the projected impact on such access
during each of such years of applying such
section during each of such years with
application of such subparagraph.
(ii) The number and share of home health
agencies that are projected to experience
negative Medicare margins by 2017, including
the location, size, and type of such agencies.
(iii) With respect to home health agencies
described in clause (ii)--
(I) the total number, average age,
average income, and average number of
activities of daily living of the
Medicare beneficiaries such agencies
serve;
(II) the number of staff such
agencies employ;
(III) the number and location of
counties in which such agencies serve
as the sole provider of Medicare home
health services; and
(IV) to the extent practicable, the
payer mix of such agencies.
(iv) The impact of the adjustment on small
home health agencies, as defined by the United
States Small Business Administration small
business size standards, consistent with the
principles of the Regulatory Flexibility Act,
which requires Federal agencies, including the
Department of Health and Human Services, to
fully consider during the rulemaking process
the economic impact of regulatory provisions,
as well as less burdensome regulatory
alternatives, to small entities.
(v) Any other areas determined appropriate
by the Secretary.
(B) Requirement for alternative methods and other
considerations.--For purposes of the analysis under
subparagraph (A)--
(i) the alternative methods described in
such subparagraph shall cover each of the years
in which the rebasing adjustment under such
section 1895(b)(3)(A)(iii) is to be applied;
and
(ii) the Secretary shall include a
cumulative analysis of other Medicare home
health reimbursement reductions established by
statute or regulation, consistent with the
requirements of Executive Order 13563.
(2) Report.--Not later than 6 months after the date of the
enactment of this Act, the Secretary of Health and Human
Services shall submit to Congress a report on the study
conducted under paragraph (1), together with such
recommendations as the Secretary determines appropriate based
on the findings of such study. Such report shall include--
(A) a determination by the Secretary as to whether,
as a result of the findings of such study, the
Secretary intends to use the authority under section
1871 of the Social Security Act (42 U.S.C. 1395hh) to
modify the adjustment described in paragraph (1)(A) and
the extent of any such modification; and
(B) in the case the Secretary determines not to use
such authority, the rationale for such determination.
<all>
Introduced in House
Introduced in House
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 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 the Subcommittee on Health.
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