[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1184 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 1184

  To amend title XVIII of the Social Security Act to revise Medicare 
coverage and payment for advanced surgical dressings in skilled nursing 
      facilities and home health settings, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 27, 2015

 Mr. Sessions introduced the following bill; which was referred to the 
 Committee on Energy and 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 amend title XVIII of the Social Security Act to revise Medicare 
coverage and payment for advanced surgical dressings in skilled nursing 
      facilities and home health settings, 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; PURPOSE.

    (a) Short Title.-- This Act may be cited as the ``Medicare Skilled 
Nursing and Home Health Services Continuity of Care Act of 2015''.
    (b) Purpose.--The purpose of this Act is to ensure Medicare 
beneficiary access to advance wound care products while in a skilled 
nursing facility or while on a home health plan of care by allowing 
separate payment to be made for advanced surgical dressings under part 
B of title XVIII of the Social Security Act as a durable medical 
equipment prosthetics, orthotics, and supplies (DMEPOS) benefit.

SEC. 2. MEDICARE COVERAGE OF AND PAYMENT FOR ADVANCED SURGICAL 
              DRESSINGS FURNISHED IN A SKILLED NURSING FACILITY OR IN A 
              HOME HEALTH SETTING AS DURABLE MEDICAL EQUIPMENT.

    (a) Exclusion From Payment as Part of Skilled Nursing Facility 
Services.--Section 1888(e)(2)(A)(iii) of the Social Security Act (42 
U.S.C. 1395yy(e)(2)(A)(iii)) is amended by adding at the end the 
following:
                                    ``(VI) Surgical dressings 
                                (identified as most current of January 
                                1, 2017, by HCPCS codes A4450-A6549, 
                                and as subsequently modified by the 
                                Secretary), if delivered to an 
                                individual who is a patient in a 
                                skilled nursing facility for use during 
                                the individual's stay in the 
                                facility.''.
    (b) Exclusion From Coverage as Part of Home Health Services.--
Section 1861(m)(5) of the Social Security Act (42 U.S.C. 1395x(m)(5)) 
is amended by striking ``and durable medical equipment'' and inserting 
``, durable medical equipment, and surgical dressings (identified as 
most current of January 1, 2017, by HCPCS codes A4450-A6549, and as 
subsequently modified by the Secretary)''.
    (c) Processing of Claims for Advanced Surgical Dressings.--Section 
1874A(a) of the Social Security Act (42 U.S.C. 1395kk-1(a)) is amended 
by adding at the end the following new paragraph:
            ``(7) Use of medicare administrative contractors for 
        processing claims for advanced surgical dressings.--The 
        Secretary shall provide for the submission and processing of 
        claims for surgical dressings referred to in sections 
        1888(e)(2)(A)(iii)(VI) and 1861(m)(5) for payment under part B 
        by the same medicare administrative contractors as process 
        claims for other durable medical equipment.''.
    (d) Education Incentive Program To Improve Quality of Wound Care.--
            (1) In general.--The Secretary of Health and Human Services 
        shall establish an education incentive program to encourage 
        each nursing facility, skilled nursing facility, or home health 
        agency certified under title XVIII or XIX of the Social 
        Security Act to provide their clinical staff members annually 
        with access to wound care education. Such education shall be of 
        a scope and level to be determined by the Secretary.
            (2) Monitoring.--The Secretary shall establish a means of 
        measuring such education on a regular basis, as determined by 
        the Secretary.
            (3) Impact and incentives.--The Secretary shall determine 
        the overall impact of the education incentive program on the 
        quality of care provided. The type and level of incentive to be 
        provided under the program shall be determined by the 
        Secretary, in the Secretary's discretion and subject to amounts 
        available in advance from appropriations, based on the 
        Secretary's determination of such impact.
    (e) Effective Date.--The amendments made by this section shall 
apply to surgical dressings furnished on or after January 1, 2017.
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