S. 1053Senate113th Congress (2013-2015)In Committee

Hospice Evaluation and Legitimate Payment Act of 2013

A bill to amend title XVIII of the Social Security Act to strengthen and protect Medicare hospice programs.

Sponsored by Ron WydenSen. Ron Wyden (D-OR)
Introduced May 23, 2013

Legislative Activity

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SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S3852)

May 23, 2013

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SenateIntro Referral

Introduced in Senate

May 23, 2013

SenateIntro Referral

Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S3852)

May 23, 2013

Floor Debate

11 members

What members said about S. 1053 on the floor

2 Republicans9 Democrats
Benjamin L. Cardin
Sen. Benjamin L. CardinD-MD · May 23, 2013

Mr. President, today I rise to introduce legislation in the Senate that would prohibit the use of racial profiling by Federal, State, or local law enforcement agencies. This legislation is entitled…

Jack Reed
Sen. Jack ReedD-RI · May 23, 2013

Mr. President, we rely on our public schools to prepare the next generation for success as citizens, workers, and innovators. We have asked educators to raise the bar and educate all students to…

Richard Blumenthal
Sen. Richard BlumenthalD-CT · May 23, 2013

Mr. President, I rise today to introduce the Military Crime Victims Rights Act of 2013. There are 26,000 victims of sexual assault in the military every year; at least last year there were that…

Ron Wyden
Sen. Ron WydenD-OR · May 23, 2013

Mr. President, today I am being joined by my colleagues Senators Collins, Merkley, and King on the introduction of the Storage Technology for Renewable and Green Energy Act of 2013 or the STORAGE…

Harry Reid
Sen. Harry ReidD-NV · May 23, 2013

Mr. President, today I rise to introduce the Gold Butte National Conservation Area Act of 2013. This legislation will designate the Gold Butte National Conservation Area in Southern Nevada and…

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Richard J. Durbin
Sen. Richard J. DurbinD-IL · May 23, 2013

Mr. President, today I am introducing legislation designed to improve educational opportunities for students. The All Students Achieving Through Reform Act, or All-STAR Act, would provide Federal…

Tim Kaine
Sen. Tim KaineD-VA · May 23, 2013

Mr. President, I am pleased to introduce the Thomasina E. Jordan Indian Tribes of Virginia Federal Recognition Act of 2013. This legislation is critically important, because it is a major step…

Mark Kirk
Sen. Mark KirkR-IL · May 23, 2013

Mr. President, I rise today to introduce a bill that waives the naturalization requirements for non-citizen recipients of our armed forces' combat service awards. When a soldier, sailor, airman, or…

Carl Levin
Sen. Carl LevinD-MI · May 23, 2013

Mr. President, Senator Inhofe and I are introducing, by request, the administration's proposed National Defense Authorization Act for fiscal year 2014. As is the case with any bill that is introduced…

Susan M. Collins
Sen. Susan M. CollinsR-ME · May 23, 2013

Mr. President, I rise today to introduce a bipartisan bill cosponsored by Senator King that would ensure the Department of Defense provides military recruits with athletic footwear made in the

Brian Schatz
Sen. Brian SchatzD-HI · May 23, 2013

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Ron Wyden
Sen. Ron WydenD-OR · May 23, 2013

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Bill Text

Latest available legislative text

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Introduced in SenateIssued May 23, 2013

II

113th CONGRESS

1st Session

S. 1053

IN THE SENATE OF THE UNITED STATES

May 23, 2013

Mr. Wyden (for himself and Mr. Roberts) 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 strengthen and protect Medicare hospice programs.

1.

Short title

This Act may be cited as the Hospice Evaluation and Legitimate Payment Act of 2013.

2.

Ensuring timely access to hospice care

(a)

In general

Section 1814(a)(7)(D)(i) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)) is amended to read as follows:

(i)

a hospice physician, nurse practitioner, clinical nurse specialist, or physician assistant (as those terms are defined in section 1861(aa)(5)), or other health professional (as designated by the Secretary), has a face-to-face encounter with the individual to determine continued eligibility of the individual for hospice care prior to the first 60-day period and each subsequent recertification under subparagraph (A)(ii) (or, in the case where a hospice program newly admits an individual who would be entering their first 60-day period or a subsequent hospice benefit period or where exceptional circumstances, as defined by the Secretary, may prevent a face-to-face encounter prior to the beginning of the hospice benefit period, not later than 7 calendar days after the individual’s election under section 1812(d)(1) with respect to the hospice program) and attests that such visit took place (in accordance with procedures established by the Secretary); and

.

(b)

Effective date

The amendment made by subsection (a) takes effect on January 1, 2014, and applies to hospice care furnished on or after such date.

3.

Restoring and protecting the Medicare hospice benefit

(a)

In general

Section 1814(i) of the Social Security Act (42 U.S.C. 1395f(i)) is amended—

(1)

in paragraph (6)—

(A)

in subparagraph (D)—

(i)

in clause (i)—

(I)

in the first sentence, by striking not earlier than October 1, 2013, the Secretary shall, by regulation, and inserting subject to clause (iii), not earlier than the later of 2 years after the demonstration program under subparagraph (F) is completed or October 1, 2017, the Secretary shall, by regulation, preceded by a notice of the proposed regulation in the Federal Register and a period for public comment in accordance with section 1871(b)(1),; and

(II)

in the second sentence, by inserting and shall take into account the results of the evaluation conducted under subparagraph (F)(ii) before the period; and

(ii)

by adding at the end the following new clause:

(iii)

The Secretary shall implement the revisions in payment pursuant to clause (i) unless the Secretary determines that the demonstration program under subparagraph (F) demonstrated that such revisions would adversely affect access to quality hospice care by beneficiaries under this title.

; and

(B)

by adding at the end the following new subparagraph:

(F)

Hospice payment reform demonstration program

(i)

Establishment of demonstration program

(I)

In general

Before implementing any revisions to the methodology for determining the payment rates for routine home care and other services included in hospice care under subparagraph (D), the Secretary shall establish a Medicare Hospice Payment Reform demonstration program (in this subparagraph referred to as the demonstration program) to test such proposed revisions.

(II)

Duration

The demonstration program shall be conducted for a 2-year period beginning on or after October 1, 2013.

(III)

Scope

Any certified hospice program may apply to participate in the demonstration program and the Secretary shall select not more than 15 such hospice programs to participate in the demonstration program.

(IV)

Representative participation

Hospice programs selected under subclause (III) to participate in the demonstration program shall include a representative cross-section of hospice programs throughout the United States, including programs located in urban and rural areas.

(ii)

Evaluation and report

(I)

Evaluation

The Secretary shall conduct an evaluation of the demonstration program. Such evaluation shall include an analysis of whether the use of the revised payment methodology under the demonstration program has improved the quality of patient care and access to hospice care for beneficiaries under this title and the impact of such payment revisions on hospice care providers, including the impact, if any, on the ability of hospice programs to furnish quality care to beneficiaries under this title.

(II)

Report

Not later than 2 years after the completion of the demonstration program, the Secretary shall submit to Congress a report containing the results of the evaluation conducted under subclause (I), together with recommendations for such legislation and administrative action as the Secretary determines appropriate.

(iii)

Budget neutrality

With respect to the 2-year period of the demonstration program, the Secretary shall ensure that revisions in payment implemented as part of the demonstration program shall result in the same estimated amount of aggregate payments under this title for hospice care for the programs participating in the demonstration as would have been made if the hospice programs had not participated in the demonstration program.

.

4.

Hospice survey requirement

Section 1861(dd)(4) of the Social Security Act (42 U.S.C. 1395x(dd)(4)) is amended by adding at the end the following new subparagraph:

(C)

Any entity that is certified as a hospice program shall be subject to a standard survey by an appropriate State or local survey agency, or an approved accreditation agency, as determined by the Secretary, not less frequently than once every 36 months beginning 6 months after the date of the enactment of this subparagraph.

.