[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.
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