[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 1580 Introduced in Senate (IS)]







105th CONGRESS
  2d Session
                                S. 1580

     To amend the Balanced Budget Act of 1997 to place an 18-month 
moratorium on the prohibition of payment under the medicare program for 
home health services consisting of venipuncture solely for the purpose 
of obtaining a blood sample, and to require the Secretary of Health and 
 Human Services to study potential fraud and abuse under such program 
                     with respect to such services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 28, 1998

  Mr. Shelby introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
     To amend the Balanced Budget Act of 1997 to place an 18-month 
moratorium on the prohibition of payment under the medicare program for 
home health services consisting of venipuncture solely for the purpose 
of obtaining a blood sample, and to require the Secretary of Health and 
 Human Services to study potential fraud and abuse under such program 
                     with respect to such services.

    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 Venipuncture Assessment Act 
of 1998''.

SEC. 2. 18-MONTH MORATORIUM ON PROHIBITION ON PAYMENT FOR HOME HEALTH 
              SERVICES SOLELY FOR PURPOSES OF OBTAINING A BLOOD SAMPLE; 
              REPORT.

    (a) Moratorium.--Section 4615(b) of the Balanced Budget Act of 1997 
(Public Law 105-33; 111 Stat. 475) is amended to read as follows:
    ``(b) Effective Date.--
            ``(1) In general.--Subject to paragraph (2), the amendments 
        made by subsection (a) apply to home health services furnished 
        after the 6-month period beginning after the date of enactment 
        of this Act.
            ``(2) 18-month moratorium.--During the period that begins 
        on the date of enactment of the Medicare Venipuncture 
        Assessment Act of 1998 and ends on the date that is 18 months 
        after the date of enactment of that Act, the amendments made by 
        subsection (a) shall not apply to home health services 
        furnished during that period. For purposes of calculating the 
        6-month period described in subsection (a), any month 
        (including any portion thereof) in which the period described 
        in this paragraph is in effect shall not be included in such 
        calculation.''.
    (b) Report to Congress.--The Balanced Budget Act of 1997 (Public 
Law 105-33; 111 Stat. 251 et seq.) is amended by inserting after 
section 4615 the following:

``SEC. 4615A. REPORT TO CONGRESS ON HOME HEALTH BENEFITS BASED SOLELY 
              ON DRAWING BLOOD.

    ``(a) Study.--The Secretary of Health and Human Services shall 
conduct a study with respect to the provision of home health services 
consisting of venipuncture under title XVIII of the Social Security 
Act. In conducting such study, the Secretary, using the most recent 
data available, shall--
            ``(1) determine the number of beneficiaries who are 
        provided home health services under the medicare program;
            ``(2) determine the number of beneficiaries who receive 
        such services consisting of venipuncture;
            ``(3) compare the instances (including the costs) in which 
        the only home health service provided in a home health visit is 
        venipuncture solely for the purposes of obtaining a blood 
        sample and those instances in which venipuncture is provided in 
        such a visit in conjunction with the provision of other home 
        health services;
            ``(4) in the case of beneficiaries who qualify for home 
        health services because venipuncture solely for the purposes of 
        obtaining a blood sample is a qualifying skill, compare the 
        instances (including the costs) in which the only home health 
        service provided in a home health visit is venipuncture solely 
        for the purposes of obtaining a blood sample and those 
        instances in which no venipuncture is provided in such a visit;
            ``(5) determine the costs of providing payment for home 
        health services consisting of venipuncture solely for the 
        purpose of obtaining a blood sample, including in such 
        determination an analysis of the increase in such costs that 
        are attributable to fraud and abuse in the provision of, or 
        billing for, such services under the medicare program;
            ``(6) determine--
                    ``(A) the costs to beneficiaries if payment under 
                the medicare program is prohibited for home health 
                services consisting of venipuncture solely for the 
                purposes of obtaining a blood sample, and
                    ``(B) the costs to States through potentially 
                increased use of personal care services and nursing 
                home placements if payment under the medicare program 
is prohibited for home health services consisting of venipuncture 
solely for the purposes of obtaining a blood sample;
            ``(7) determine the number of beneficiaries that will no 
        longer be eligible for home health services because 
        venipuncture solely for the purpose of obtaining a blood sample 
        is no longer treated as a qualifying skill;
            ``(8) with respect to the beneficiaries determined under 
        paragraph (7), determine the number of such beneficiaries that 
        subsequently receive home health benefits because they qualify 
        for such services by reason of a qualifying skill other than 
        venipuncture solely for the purpose of obtaining a blood 
        sample; and
            ``(9) with respect to the beneficiaries determined under 
        paragraph (7), particularly those that reside in a rural area, 
        determine the number of such beneficiaries that subsequently--
                    ``(A) are ineligible to receive home health 
                services under this title because they do not qualify 
                for such services by reason of a qualifying skill other 
                than venipuncture solely for the purpose of obtaining a 
                blood sample; but
                    ``(B) become eligible for venipuncture services 
                under part B of this title.
    ``(b) Report.--Not later than 1 year after the date of enactment of 
the Medicare Venipuncture Assessment Act of 1998, the Secretary shall 
submit to Congress a report consisting of the findings of the study 
conducted under subsection (a).''.
    (c) Additional Requirements for Report on Definition of 
Homebound.--Section 4613(b) of the Balanced Budget Act of 1997 (Public 
Law 105-33; 111 Stat. 474) is amended by adding at the end the 
following: ``The report shall also include specific legislative 
recommendations to reduce waste, fraud, and abuse (if any) in the 
determination of whether an individual is homebound without 
jeopardizing the services provided under title XVIII of the Social 
Security Act to beneficiaries that have serious medical conditions.''.
    (d) Clerical Amendment.--The table of contents of title IV of the 
Balanced Budget Act of 1998 (Public Law 105-33; 111 Stat. 270 et seq.) 
is amended by inserting after the item relating to section 4615 the 
following:

``Sec. 4615A. Report to Congress on home health benefits based solely 
                            on drawing blood.''.
    (e) Effective Date.--The amendments made by this section take 
effect as if included in the enactment of the Balanced Budget Act of 
1997 (Public Law 105-33; 111 Stat. 251 et seq.).
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