S.Amdt. 2907

SA 2907. Ms. KLOBUCHAR (for herself, Mr. Thune, and Mr. Johnson)
submitted an amendment intended to be proposed to amendment SA 2786
proposed by Mr. Reid (for himself, Mr. Baucus, Mr. Dodd, and Mr.
Harkin) to the bill H.R. 3590, to amend the Internal Revenue Code of
1986 to modify the first-time homebuyers credit in the case of members
of the Armed Forces and certain other Federal employees, and for other
purposes; which was ordered to lie on the table; as follows:

On page 828, between lines 3 and 4, insert the following:

SEC. 3130. REMOTE MONITORING PILOT PROJECTS.

(a) Pilot Projects.--
(1) In general.--Not later than 9 months after the date of
enactment of this Act, the Secretary of Health and Human
Services (in this section referred to as the ``Secretary'')
shall conduct pilot projects under title XVIII of the Social
Security Act for the purpose of providing incentives to home
health agencies to utilize home monitoring and communications
technologies that--
(A) enhance health outcomes for medicare beneficiaries; and
(B) reduce expenditures under such title.
(2) Site requirements.--
(A) Urban and rural.--The Secretary shall conduct the pilot
projects under this section in both urban and rural areas.
(B) Site in a small state.--The Secretary shall conduct at
least 1 of the pilot projects in a State with a population of
less than 1,000,000.
(3) Definition of home health agency.--In this section, the
term ``home health agency'' has the meaning given that term
in section 1861(o) of the Social Security Act (42 U.S.C.
1395x(o)).
(b) Medicare Beneficiaries Within the Scope of Projects.--
The Secretary shall specify the criteria for identifying
those medicare beneficiaries who shall be considered within
the scope of the pilot projects under this section for
purposes of the application of subsection (c) and for the
assessment of the effectiveness of the home health agency in
achieving the objectives of this section. Such criteria may
provide for the inclusion in the projects of medicare
beneficiaries who begin receiving home health services under
title XVIII of the Social Security Act after the date of the
implementation of the projects.
(c) Incentives.--
(1) Performance targets.--The Secretary shall establish for
each home health agency participating in a pilot project
under this section a performance target using one of the
following methodologies, as determined appropriate by the
Secretary:
(A) Adjusted historical performance target.--The Secretary
shall establish for the agency--
(i) a base expenditure amount equal to the average total
payments made to the agency under parts A and B of title
XVIII of the Social Security Act for medicare beneficiaries
determined to be within the scope of the pilot project in a
base period determined by the Secretary; and
(ii) an annual per capita expenditure target for such
beneficiaries, reflecting the base expenditure amount
adjusted for risk and adjusted growth rates.
(B) Comparative performance target.--The Secretary shall
establish for the agency a comparative performance target
equal to the average total payments under such parts A and B
during the pilot project for comparable individuals in the
same geographic area that are not determined to be within the
scope of the pilot project.

[[Page S12427]]

(2) Incentive.--Subject to paragraph (3), the Secretary
shall pay to each participating home care agency an incentive
payment for each year under the pilot project equal to a
portion of the medicare savings realized for such year
relative to the performance target under paragraph (1).
(3) Limitation on expenditures.--The Secretary shall limit
incentive payments under this section in order to ensure that
the aggregate expenditures under title XVIII of the Social
Security Act (including incentive payments under this
subsection) do not exceed the amount that the Secretary
estimates would have been expended if the pilot projects
under this section had not been implemented.
(d) Waiver Authority.--The Secretary may waive such
provisions of titles XI and XVIII of the Social Security Act
as the Secretary determines to be appropriate for the conduct
of the pilot projects under this section.
(e) Report to Congress.--Not later than 5 years after the
date that the first pilot project under this section is
implemented, the Secretary shall submit to Congress a report
on the pilot projects. Such report shall contain a detailed
description of issues related to the expansion of the
projects under subsection (f) and recommendations for such
legislation and administrative actions as the Secretary
considers appropriate.
(f) Expansion.--If the Secretary determines that any of the
pilot projects under this section enhance health outcomes for
Medicare beneficiaries and reduce expenditures under title
XVIII of the Social Security Act, the Secretary may initiate
comparable projects in additional areas.
(g) Incentive Payments Have No Effect on Other Medicare
Payments to Agencies.--An incentive payment under this
section--
(1) shall be in addition to the payments that a home health
agency would otherwise receive under title XVIII of the
Social Security Act for the provision of home health
services; and
(2) shall have no effect on the amount of such payments.
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