[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3041 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 3041

 To provide for a demonstration project to allow certain organizations 
 that provide care under Medicare to purchase home-care services from 
     self-employed caregivers through home-care referral agencies.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 7, 1999

 Mr. Deutsch introduced the following bill; which was referred to the 
  Committee on Commerce, and in addition to the Committee on Ways and 
 Means, 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 provide for a demonstration project to allow certain organizations 
 that provide care under Medicare to purchase home-care services from 
     self-employed caregivers through home-care referral agencies.

    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 ``Home Health Availability Act of 
1999''.

SEC. 2. MEDICARE DEMONSTRATION PROJECT FOR HOME HEALTH.

    (a) Definitions.--In this section:
            (1) Caregiver.--The term ``caregiver'' means a self-
        employed individual who is a registered nurse, licensed 
        practical nurse, certified nursing assistant, home health aide, 
        homemaker, companion, or sitter who is engaged in providing 
        services for patients in their homes or places of residence.
            (2) Client.--The term ``client'' means an individual 
        eligible to receive home health services under title XVIII of 
        the Social Security Act (42 U.S.C. 1395 et seq.).
            (3) Demonstration project; project.--The terms 
        ``demonstration project'' and ``project'' mean the 
        demonstration project carried out under this section.
            (4) Demonstration project state.--The term ``demonstrate 
        project state'' means the State of Florida.
            (5) Home-care referral agency; referral agency.--The term 
        ``home-care referral agency'' or ``referral agency'' means a 
        public agency or private entity or a subdivision of one of the 
        foregoing that meets applicable State licensing requirements 
        and is lawfully engaged in the business of procuring, offering, 
        promising, or attempting to secure health care or home health 
        related contracts (including, but not limited to, contracts for 
        the provision of services to patients in their homes or places 
        of residence and contracts for the provision of services 
        including private duty or supplemental staffing at health-care 
        facilities) for caregivers.
            (6) Participating organization.--The term ``participating 
        organization'' means a Medicare+Choice organization (as defined 
        in section 1859(a)(1) of the Social Security Act, 42 U.S.C. 
        1395w-29(a)(1)), that elects to participate in the 
        demonstration project.
            (7) Self-employed individual.--The term ``self-employed 
        individual'' means an individual who contracts with a referral 
        agency for providing services if any payment made to the 
        individual under such contract constitutes self-employment 
        income (as defined in section 1402(b) of the Internal Revenue 
        Code of 1986).
    (b) Demonstration Project.--
            (1) In general.--
                    (A) Establishment.--The Secretary of Health and 
                Human Services (in this section referred to as the 
                ``Secretary'') shall establish a demonstration project 
                under which a participating organization will be 
                authorized to purchase home health services, as defined 
                in section 1861(m) of the Social Security Act (42 
                U.S.C. 1395x(m)), from a caregiver through a home-care 
                referral agency and, solely for purposes of this 
                section and only when home health services are being 
                purchased under the demonstration project, the term 
                ``home health services'', as so defined, shall be 
                modified by substituting in lieu of the term ``home 
                health agency'' wherever it appears therein, the term 
                ``home-care referral agency''.
                    (B) No effect on home health agencies.--The 
                demonstration project shall not in any way affect a 
                home health agency, as defined in section 1861(o) of 
                the Social Security Act (42 U.S.C. 1395x(o)). The 
                project's sole purpose is to provide participating 
                organizations with the option of purchasing home health 
                services from an additional source.
                    (C) Voluntary participation.--Participation 
                organizations that elect to participate in the 
                demonstration project are under no obligation to 
                purchase all, or any specified minimum percentage of, 
home health services under the demonstration project, and shall have 
the right to cease participating in the demonstration project at any 
time.
                    (D) Election to participate in the demonstration 
                project.--In order to participate in the demonstration 
                project, a participating organization must provide the 
                Secretary with a written notice of election to 
                participate, which notice shall state--
                            (i) the name and address of the 
                        organization;
                            (ii) the effective date of the 
                        organization's election to participate; and
                            (iii) the cities within the demonstration 
                        project State in which the organization has 
                        operations and elects to participate.
            (2) Duration.--The Secretary shall conduct the 
        demonstration project during the 3-year period beginning on 
        September 1, 2000.
    (c) Authority To Waive Certain Medicare Requirements.--The 
Secretary may, to the extent necessary to carry out the demonstration 
project, waive any requirements under title XVIII of the Social 
Security Act.
    (d) Evaluation and Reports.--
            (1) Independent evaluation.--
                    (A) General.--The Secretary shall arrange for an 
                independent entity with expertise in the evaluation of 
                health care services to conduct an evaluation of the 
                demonstration project.
                    (B) Contents.--The evaluation conducted under 
                subparagraph (A) shall include an assessment of the 
                following:
                            (i) A comparison of the quality of care 
                        provided by caregivers under the demonstration 
                        project relative to the quality of care 
                        provided by a home health agency.
                            (ii) A comparison of the cost of care 
                        provided by caregivers under the demonstration 
                        project relative to the cost of care provided 
                        by a home health agency.
                            (iii) A comparison of the level of 
                        satisfaction with the care received by 
                        individuals who have received home care under 
                        the demonstration project relative to the level 
                        of satisfaction by such individuals with the 
                        home care they received from a home health 
                        agency.
                    (C) Annual reports.--The independent entity 
                conducting the evaluation under subparagraph (A) shall 
                submit reports on such evaluations to the Secretary and 
                to the committees of jurisdiction in the Congress as 
                follows:
                            (i) Initial report.--The entity shall 
                        submit an initial report not later than 12 
                        months after the date on which the 
                        demonstration project begins operation.
                            (ii) Second annual report.--The entity 
                        shall submit a second annual report not later 
                        than 24 months after the date on which the 
                        demonstration project begins operation.
                            (iii) Final report.--The entity shall 
                        submit a final report not later than 30 months 
                        after the date on which the demonstration 
                        project begins operation.
            (2) Report on extension and expansion of demonstration 
        project.--Not later than 30 months after the date on which the 
        demonstration project begins operation, the Secretary shall 
        submit to Congress a report containing--
                    (A) a recommendation as to--
                            (i) whether to extend the demonstration 
                        project or make the project permanent;
                            (ii) whether to expand the project to cover 
                        additional States; and
                            (iii) whether the terms and conditions of 
                        the project should be continued (or modified) 
                        if the project is extended or expanded; and
                    (B) a detailed description of any costs associated 
                with their recommendation made pursuant to clauses (i) 
                and (ii) of subparagraph (A).
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