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<bill bill-stage="Introduced-in-House" bill-type="olc" dms-id="H274ACC6844354D4A823808EC5864ED95" public-private="public">
<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>110 HR 6826 IH: Home Health Care Planning Improvement
</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2008-08-01</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
	<form>
		<distribution-code display="yes">I</distribution-code>
		<congress>110th CONGRESS</congress>
		<session>2d Session</session>
		<legis-num>H. R. 6826</legis-num>
		<current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber>
		<action>
			<action-date date="20080801">August 1, 2008</action-date>
			<action-desc><sponsor name-id="S001162">Ms. Schwartz</sponsor> (for
			 herself, <cosponsor name-id="M000590">Mr. McNulty</cosponsor>,
			 <cosponsor name-id="W000215">Mr. Waxman</cosponsor>,
			 <cosponsor name-id="D000216">Ms. DeLauro</cosponsor>,
			 <cosponsor name-id="S001145">Ms. Schakowsky</cosponsor>,
			 <cosponsor name-id="B000574">Mr. Blumenauer</cosponsor>,
			 <cosponsor name-id="R000486">Ms. Roybal-Allard</cosponsor>,
			 <cosponsor name-id="M000309">Mrs. McCarthy of New York</cosponsor>,
			 <cosponsor name-id="C001036">Mrs. Capps</cosponsor>,
			 <cosponsor name-id="G000551">Mr. Grijalva</cosponsor>,
			 <cosponsor name-id="C001066">Ms. Castor</cosponsor>,
			 <cosponsor name-id="Y000062">Mr. Yarmuth</cosponsor>,
			 <cosponsor name-id="K000009">Ms. Kaptur</cosponsor>,
			 <cosponsor name-id="B000652">Mr. Boswell</cosponsor>,
			 <cosponsor name-id="B000420">Mr. Berry</cosponsor>,
			 <cosponsor name-id="B001242">Mr. Bishop of New York</cosponsor>,
			 <cosponsor name-id="D000210">Mr. Delahunt</cosponsor>,
			 <cosponsor name-id="C001065">Mr. Carney</cosponsor>,
			 <cosponsor name-id="F000043">Mr. Fattah</cosponsor>,
			 <cosponsor name-id="M001168">Mr. Patrick J. Murphy of Pennsylvania</cosponsor>,
			 <cosponsor name-id="B001227">Mr. Brady of Pennsylvania</cosponsor>,
			 <cosponsor name-id="K000113">Mr. Kennedy</cosponsor>,
			 <cosponsor name-id="R000033">Mr. Ramstad</cosponsor>,
			 <cosponsor name-id="S001165">Mr. Sires</cosponsor>,
			 <cosponsor name-id="M001160">Ms. Moore of Wisconsin</cosponsor>,
			 <cosponsor name-id="L000551">Ms. Lee</cosponsor>, <cosponsor name-id="L000557">Mr. Larson of Connecticut</cosponsor>,
			 <cosponsor name-id="E000288">Mr. Ellison</cosponsor>,
			 <cosponsor name-id="A000357">Mr. Allen</cosponsor>,
			 <cosponsor name-id="C001069">Mr. Courtney</cosponsor>,
			 <cosponsor name-id="C001050">Mr. Cardoza</cosponsor>,
			 <cosponsor name-id="S001153">Ms. Solis</cosponsor>,
			 <cosponsor name-id="S000248">Mr. Serrano</cosponsor>,
			 <cosponsor name-id="C001067">Ms. Clarke</cosponsor>,
			 <cosponsor name-id="M000404">Mr. McDermott</cosponsor>,
			 <cosponsor name-id="T000057">Mrs. Tauscher</cosponsor>,
			 <cosponsor name-id="S001170">Ms. Shea-Porter</cosponsor>,
			 <cosponsor name-id="A000014">Mr. Abercrombie</cosponsor>,
			 <cosponsor name-id="B001230">Ms. Baldwin</cosponsor>, and
			 <cosponsor name-id="P000523">Mr. Price of North Carolina</cosponsor>)
			 introduced the following bill; which was referred to the
			 <committee-name committee-id="HWM00">Committee on Ways and
			 Means</committee-name>, and in addition to the Committee on
			 <committee-name committee-id="HIF00">Energy and Commerce</committee-name>, 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</action-desc>
		</action>
		<legis-type>A BILL</legis-type>
		<official-title>To amend title XVIII of the Social Security Act to ensure
		  more timely access to home health services for Medicare beneficiaries under the
		  Medicare Program.</official-title>
	</form>
	<legis-body id="HD5DE0DDFB082439BA6025D48A9A03E" style="OLC">
		<section id="H9F3CB40AE55040EFA64E1D28C625E2E4" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the
			 <quote><short-title>Home Health Care Planning Improvement
			 Act of 2008</short-title></quote>.</text>
		</section><section id="HDAB1431234C24CD9BF8C007CAE74FCC6"><enum>2.</enum><header>Improving care
			 planning for medicare home health services</header>
			<subsection id="H476133E5A4244312A972B3C2228582A7"><enum>(a)</enum><header>In
			 General</header><text>Section 1814(a)(2) of the Social Security Act (42 U.S.C.
			 1395f(a)(2)), in the matter preceding subparagraph (A), is amended—</text>
				<paragraph id="H7B74003A079E46928E006C26D3AF7051"><enum>(1)</enum><text>by inserting
			 <quote>(as those terms are defined in section 1861(aa)(5))</quote> after
			 <quote>clinical nurse specialist</quote>; and</text>
				</paragraph><paragraph id="H308C7FDE69BB4DD58DFAA29CEAA88BFD"><enum>(2)</enum><text>by inserting
			 <quote>, or in the case of services described in subparagraph (C), a physician,
			 or a nurse practitioner or clinical nurse specialist who is working in
			 collaboration with a physician in accordance with State law, or a certified
			 nurse-midwife (as defined in section 1861(gg)) as authorized by State law, or a
			 physician assistant (as defined in section 1861(aa)(5)) under the supervision
			 of a physician</quote> after <quote>collaboration with a
			 physician</quote>.</text>
				</paragraph></subsection><subsection id="H5071CA9F45DC426EA638A937D05F28C1"><enum>(b)</enum><header>Conforming
			 Amendments</header><paragraph commented="no" display-inline="yes-display-inline" id="HBEEBD13A491743C09868C91FA54B832B"><enum>(1)</enum><text>Section 1814(a) of the
			 Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395f">42 U.S.C. 1395f(a)</external-xref>) is amended—</text>
					<subparagraph id="H6AD064F09D994609BAD9B916F3B74D28" indent="up1"><enum>(A)</enum><text>in paragraph (2)(C), by inserting
			 <quote>, a nurse practitioner, a clinical nurse specialist, a certified
			 nurse-midwife, or a physician assistant (as the case may be)</quote> after
			 <quote>physician</quote> each place it appears;</text>
					</subparagraph><subparagraph id="H4FB8A91E5EC143D38100254E25A043B8" indent="up1"><enum>(B)</enum><text>in the second sentence, by striking
			 <quote>or clinical nurse specialist</quote> and inserting <quote>clinical nurse
			 specialist, certified nurse-midwife, or physician assistant</quote>;</text>
					</subparagraph><subparagraph id="H773B820025C941AF99D966CBFE9654B4" indent="up1"><enum>(C)</enum><text>in the third sentence—</text>
						<clause id="H89DEFFC876E143740037555BFA94FC1C"><enum>(i)</enum><text>by striking <quote>physician
			 certification</quote> and inserting <quote>certification</quote>;</text>
						</clause><clause id="H394E66755DA04C15B69654DAB7D2B4CE"><enum>(ii)</enum><text>by inserting <quote>(or on January
			 1, 2009, in the case of regulations to implement the amendments made by section
			 2 of the Home Health Care Planning Improvement Act of 2008)</quote> after
			 <quote>1981</quote>; and</text>
						</clause><clause id="H20DC99BB78CD426A8591C1DBA9DF7BCC"><enum>(iii)</enum><text>by striking <quote>a physician
			 who</quote> and inserting <quote>a physician, nurse practitioner, clinical
			 nurse specialist, certified nurse-midwife, or physician assistant who</quote>;
			 and</text>
						</clause></subparagraph><subparagraph id="H5C690D4DD39C4BE49BE72F07B5009976" indent="up1"><enum>(D)</enum><text>in the fourth sentence, by inserting
			 <quote>, nurse practitioner, clinical nurse specialist, certified
			 nurse-midwife, or physician assistant</quote> after
			 <quote>physician</quote>.</text>
					</subparagraph></paragraph><paragraph id="H7D9A67CB0E8D4140A09E659945A16637" indent="up1"><enum>(2)</enum><text>Section 1835(a) of the Social
			 Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395n">42 U.S.C. 1395n(a)</external-xref>) is amended—</text>
					<subparagraph id="H87FC89E73F4F4573A3B7F9161319421E"><enum>(A)</enum><text>in paragraph (2)—</text>
						<clause id="HDF48DE0C894341B0AE40192566FB0822"><enum>(i)</enum><text>in the matter preceding
			 subparagraph (A), by inserting <quote>or, in the case of services described in
			 subparagraph (A), a physician, or a nurse practitioner or clinical nurse
			 specialist (as those terms are defined in 1861(aa)(5)) who is working in
			 collaboration with a physician in accordance with State law, or a certified
			 nurse-midwife (as defined in section 1861(gg)) as authorized by State law, or a
			 physician assistant (as defined in section 1861(aa)(5)) under the supervision
			 of a physician</quote> after <quote>a physician</quote>; and</text>
						</clause><clause id="H69C0A96B48DF4C6091A73457AC25917B"><enum>(ii)</enum><text>in each of clauses (ii) and (iii)
			 of subparagraph (A) by inserting <quote>, a nurse practitioner, a clinical
			 nurse specialist, a certified nurse-midwife, or a physician assistant (as the
			 case may be)</quote> after <quote>physician</quote>;</text>
						</clause></subparagraph><subparagraph id="HCDC43AA8CBE44D2EA8773E2BEC661342"><enum>(B)</enum><text>in the third sentence, by inserting
			 <quote>, nurse practitioner, clinical nurse specialist, certified
			 nurse-midwife, or physician assistant (as the case may be)</quote> after
			 physician;</text>
					</subparagraph><subparagraph id="H7E74A93F4FF642E5BB00961C09364079"><enum>(C)</enum><text>in the fourth sentence—</text>
						<clause id="H7D505595A2804DC8B9AF4BAE49AB4F53"><enum>(i)</enum><text>by striking <quote>physician
			 certification</quote> and inserting <quote>certification</quote>;</text>
						</clause><clause id="H057AB64B75EF42DFBB5FEE15C171C8C7"><enum>(ii)</enum><text>by inserting <quote>(or on January
			 1, 2008, in the case of regulations to implement the amendments made by section
			 2 of the Home Health Care Planning Improvement Act of 2008)</quote> after
			 <quote>1981</quote>; and</text>
						</clause><clause id="H9DDCE2C3DEE540488EEB1B981677B68D"><enum>(iii)</enum><text>by striking <quote>a physician
			 who</quote> and inserting <quote>a physician, nurse practitioner, clinical
			 nurse specialist, certified nurse-midwife, or physician assistant who</quote>;
			 and</text>
						</clause></subparagraph><subparagraph id="H92338520CB504AFC9CD31130A95233E5"><enum>(D)</enum><text>in the fifth sentence, by inserting
			 <quote>, nurse practitioner, clinical nurse specialist, certified
			 nurse-midwife, or physician assistant</quote> after
			 <quote>physician</quote>.</text>
					</subparagraph></paragraph><paragraph id="HCDA6B6EFADD2414A975C91D756D767F4" indent="up1"><enum>(3)</enum><text>Section 1861 of the Social Security
			 Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>) is amended—</text>
					<subparagraph id="H2A04EF7A42264F87ACCC96836177D79"><enum>(A)</enum><text>in subsection (m)—</text>
						<clause id="HB705347DB0314AD6A6BD080463E9D7B3"><enum>(i)</enum><text>in the matter preceding paragraph
			 (1)—</text>
							<subclause id="HCB6E0F98BBFE469B88B0A828C6CE839F"><enum>(I)</enum><text>by inserting <quote>a nurse practitioner
			 or a clinical nurse specialist (as those terms are defined in subsection
			 (aa)(5)), a certified nurse-midwife (as defined in section 1861(gg)), or a
			 physician assistant (as defined in subsection (aa)(5)),</quote> after
			 <quote>physician</quote> the first place it appears; and</text>
							</subclause><subclause id="HAB216A94634D4CDABCE5C979E6C83197"><enum>(II)</enum><text>by inserting <quote>a nurse
			 practitioner, a clinical nurse specialist, a certified nurse-midwife, or a
			 physician assistant</quote> after <quote>physician</quote> the second place it
			 appears; and</text>
							</subclause></clause><clause id="H8931CDBD5CAD4CDF82C032FDC001D93"><enum>(ii)</enum><text>in paragraph (3), by inserting
			 <quote>, a nurse practitioner, a clinical nurse specialist, a certified
			 nurse-midwife, or a physician assistant</quote> after <quote>physician</quote>;
			 and</text>
						</clause></subparagraph><subparagraph id="H11E334EEC109487485F63874DAD3C8AA"><enum>(B)</enum><text>in subsection (o)(2)—</text>
						<clause id="HFAF666C4140A47AEA5D17250074B4DA"><enum>(i)</enum><text>by inserting <quote>, nurse
			 practitioners or clinical nurse specialists (as those terms are defined in
			 subsection (aa)(5)), certified nurse-midwives (as defined in section 1861(gg)),
			 or physician assistants (as defined in subsection (aa)(5))</quote> after
			 <quote>physicians</quote>; and</text>
						</clause><clause id="HD7819518AC754F0CA16F4B9EFCC9421B"><enum>(ii)</enum><text>by inserting <quote>, nurse
			 practitioner, clinical nurse specialist, certified nurse-midwife, physician
			 assistant,</quote> after <quote>physician</quote>.</text>
						</clause></subparagraph></paragraph><paragraph id="HC8D766D035D44A8AA3A3DD58543BB1DE" indent="up1"><enum>(4)</enum><text>Section 1895 of the Social Security
			 Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395fff">42 U.S.C. 1395fff</external-xref>) is amended—</text>
					<subparagraph id="H3F378BDE1EA24C4F8338A2526007D562"><enum>(A)</enum><text>in subsection (c)(1), by inserting
			 <quote>, the nurse practitioner or clinical nurse specialist (as those terms
			 are defined in section 1861(aa)(5)), the certified nurse-midwife (as defined in
			 section 1861(gg)), or the physician assistant (as defined in section
			 1861(aa)(5)),</quote> after <quote>physician</quote>; and</text>
					</subparagraph><subparagraph id="HD9B981A77D7540A48C9EE6E688E3C67"><enum>(B)</enum><text>in subsection (e)—</text>
						<clause id="HE50BECAEC6734AF291CFAED919617B73"><enum>(i)</enum><text>in paragraph (1)(A), by inserting
			 <quote>, a nurse practitioner or clinical nurse specialist (as those terms are
			 defined in section 1861(aa)(5)), a certified nurse-midwife (as defined in
			 section 1861(gg)), or a physician assistant (as defined in section
			 1861(aa)(5))</quote> after <quote>physician</quote>; and</text>
						</clause><clause id="H37D5577EFD3E43DD84D9D049E9C89C"><enum>(ii)</enum><text>in paragraph (2)—</text>
							<subclause id="H7AD6F5EE346546C0B5DB8F7562F9A7AD"><enum>(I)</enum><text>in the heading, by striking
			 <quote><header-in-text level="paragraph" style="OLC">Physician
			 certification</header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">Rule of construction regarding requirement for
			 certification</header-in-text></quote>; and</text>
							</subclause><subclause id="H2FC0B3364A144DAEAFE5EF8DC2992DA"><enum>(II)</enum><text>by striking
			 <quote>physician</quote>.</text>
							</subclause></clause></subparagraph></paragraph></subsection><subsection id="H28AE4752D7DF439BA104BBB138BCA53"><enum>(c)</enum><header>Rule of
			 construction</header><text display-inline="yes-display-inline">Nothing in the
			 amendments made by this section shall be construed as affecting the scope of
			 practice authorized under State law of a certified nurse-midwife (as defined in
			 section 1861(gg) of the Social Security Act) or a nurse practitioner, clinical
			 nurse specialist, or physician assistant (as such terms are defined in section
			 1861(aa)(5) of such Act).</text>
			</subsection><subsection id="H7623C87CC1C443E0861C599711C2D209"><enum>(d)</enum><header>Effective
			 Date</header><text>The amendments made by this section shall apply to items and
			 services furnished on or after January 1, 2009.</text>
			</subsection></section></legis-body>
</bill>


