Preserving Access to Home Health Act of 2023
This bill repeals certain payment adjustments for home health services under Medicare that are based on behavioral changes. It also requires the Medicare Payment Advisory Commission to incorporate certain information into its evaluations of the financial performance and impact of home health agencies, including trends under Medicare Advantage, Medicaid, and other payers with respect to home health services.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5159 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 5159
To amend title XVIII of the Social Security Act to ensure stability in
payments to home health agencies under the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
August 4, 2023
Ms. Sewell (for herself and Mr. Smith of Nebraska) 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 ensure stability in
payments to home health agencies 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 ``Preserving Access to Home Health Act
of 2023''.
SEC. 2. ENSURING STABILITY IN PAYMENTS TO HOME HEALTH AGENCIES.
(a) Repeal of Permanent and Temporary Adjustments.--Section
1895(b)(3) of the Social Security Act (42 U.S.C. 1395fff(b)(3)) is
amended by striking subparagraph (D).
(b) Effective Date; Implementation.--
(1) Effective date.--The amendment made by subsection (a)
shall take effect as if included in the enactment of the
Bipartisan Budget Act of 2018 (Public Law 115-123).
(2) Implementation.--The Secretary of Health and Human
Services (in this section referred to as the ``Secretary'')
shall implement such section 1895(b)(3) for 2024 and subsequent
years as if the amendment made by section 51001(a)(2)(B) of
division E of the Bipartisan Budget Act of 2018 (Public Law
115-123) (adding such subparagraph (D)) had not been made.
(c) Construction.--Nothing in this section shall be construed as
signifying congressional approval or disapproval of the methodology
promulgated by the Secretary to implement section 1895(b)(3)(D) of the
Social Security Act in the final rule entitled, ``Medicare Program;
Calendar Year (CY) 2023 Home Health Prospective Payment System Rate
Update; Home Health Quality Reporting Program Requirements; Home Health
Value-Based Purchasing Expanded Model Requirements; and Home Infusion
Therapy Services Requirements'' published in the Federal Register on
November 4, 2022 (87 Fed. Reg. 66790).
SEC. 3. INTERACTION OF MEDICARE PAYMENT POLICIES WITH HEALTH CARE
DELIVERY GENERALLY.
Section 1805(b)(2)(C) of the Social Security Act (42 U.S.C. 1395b-
6(b)(2)(C)) is amended--
(1) by striking ``generally.--Specifically,'' and inserting
``generally.--
``(i) In general.--Specifically,''; and
(2) by adding at the end the following new clause:
``(ii) Special rule for home health
agencies.--
``(I) In general.--When conducting
the review of home health agency
financial performance and its impact on
access to care under the original fee-
for-service system, the Commission
shall--
``(aa) review and report on
aggregate trends in spending,
utilization, and financial
performance under the Medicare
Advantage program, the Medicaid
program under title XIX (both
fee-for-service and managed
care payment models), and other
payers for home health agency
services;
``(bb) evaluate and
consider the impact of all
payers on access to care for
Medicare beneficiaries; and
``(cc) comprehensively
disclose the methodologies used
to evaluate and calculate home
health agency margins under
this title and all other
payers, including the process
for developing the data used.
Where appropriate, the Commission shall
conduct such reviews in consultation
with the Medicaid and CHIP Payment and
Access Commission established under
section 1900.
``(II) Medicare home health cost
report amendments.--For cost reporting
periods beginning in 2025 and
subsequent years, the Secretary shall
have in effect an amended Medicare home
health cost report that collects data
on visit utilization and total payments
by payer source, including original
fee-for-service payments, Medicare
Advantage, the Medicaid program under
title XIX (both fee-for-service and
managed care payment models), and other
payers. The Secretary shall make such
amended cost reports available to the
Commission in the form and manner
necessary to conduct the analysis
described in subclause (I).
``(III) Financial data.--Prior to
the availability of cost report data as
described in subclause (II), the
Commission shall utilize data on cost
and revenues from sources it deems as
reliable and valid for purposes of
conducting the analysis described in
subclause (I).''.
<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.
Referred to the Subcommittee on Health.
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