[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 433 Introduced in Senate (IS)]
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116th CONGRESS
1st Session
S. 433
To amend title XVIII of the Social Security Act to improve home health
payment reforms under the Medicare program.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 11, 2019
Ms. Collins (for herself, Ms. Stabenow, Mr. Kennedy, Mr. Jones, Mr.
Cassidy, Mr. Paul, and Mrs. Shaheen) introduced the following bill;
which was read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to improve home health
payment reforms under the Medicare program.
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 Payment Innovation Act
of 2019''.
SEC. 2. IMPROVEMENTS TO MEDICARE INNOVATIONS AND MANAGED CARE RELATED
TO HOME HEALTH SERVICES.
(a) Expanded Waivers in Shared Savings Programs.--Section 1899(f)
of the Social Security Act (42 U.S.C. 395jjj(f)), is amended by adding
at the end the following: ``Beginning not later than January 1, 2020,
the Secretary shall include a waiver of the `confined to his home'
requirement under sections 1814(a)(2)(C) and 1835(a)(2)(A) in one or
more programs under this section.''.
(b) Flexibility in Medicare Advantage Plans.--Section 1852 of the
Social Security Act (42 U.S.C. 1395ww-2) is amended by adding at the
end the following:
``(o) Flexibility if Providing Home Health Services.--
Notwithstanding any other provision of law, any MA organization shall
be permitted to waive the `confined to his home' requirement in the
home health services benefit when the organization determines it is in
the best interest of the enrollee.''.
SEC. 3. IMPROVEMENTS TO HOME HEALTH PAYMENT REFORMS UNDER MEDICARE.
(a) Application of Budget Neutrality.--Section 1895(b)(3) of the
Social Security Act (42 U.S.C. 1395fff(b)(3)), as amended by section
51001(a)(2) of the Bipartisan Budget Act of 2018 (Public Law 115-123),
is amended--
(1) in subparagraph (A)(iv), in the fourth sentence--
(A) by striking ``shall make'' and inserting
``shall not make''; and
(B) by striking ``and shall provide a description''
and all that follows through the period and inserting a
period; and
(2) in subparagraph (D)--
(A) in the subparagraph heading, by striking
``assumptions'' and inserting ``evidence'';
(B) in clause (i)--
(i) by striking ``differences between
assumed'' and all that follows through ``and
actual'';
(ii) by inserting ``attributable to the
implementation of paragraphs (2)(B) and
(4)(B)'' after ``behavior changes''; and
(iii) by adding at the end the following:
``The Secretary shall publish the determination
under this clause with respect to an applicable
year, including a description of the evidence
used to make such determination, in the notice
and comment rulemaking to update the
prospective payment system under this
subsection for such year. For purposes of the
preceding sentence, the term `evidence' means
the most recent data after January 1, 2020,
that reflects the difference between real
changes in case mix and behavioral changes
relating to implementation of the provisions of
and amendments made by section 51001 of the
Bipartisan Budget Act of 2018 (Public Law 115-
123).'';
(C) in clause (ii), by inserting ``attributable to
the implementation of paragraphs (2)(B) and (4)(B)''
after ``expenditures''; and
(D) in clause (iii)--
(i) by adding ``attributable to the
implementation of paragraphs (2)(B) and
(4)(B)'' after ``expenditures''; and
(ii) by adding at the end the following:
``If such a temporary increase or decrease does
not exceed 2.00 percent in any given year, the
Secretary shall apply the entire increase or
decrease in the next calendar year payment
update. In the case where such a temporary
increase or decrease exceeds 2.00, the
Secretary shall phase in the temporary increase
or decrease in equal amounts not to exceed 2.00
percent in any given year through the
respective calendar year payment updates.
Notwithstanding the preceding sentence, the
Secretary shall complete any such phase-in
adjustment no later than 2029 and shall have
the authority, after 2025, to waive the phase-
in requirement as necessary to achieve budget
neutrality by 2029. Prior to implementing such
phase-in adjustments after 2025, the Secretary
shall first receive certification from the
Office of the Actuary of the Centers for
Medicare & Medicaid Services that any such
adjustments are appropriate.''.
(b) Effective Date.--The amendments made by this section shall take
effect as if included in the enactment of such section 51001(a)(2).
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