II
115th CONGRESS
2d Session
S. 3458
IN THE SENATE OF THE UNITED STATES
September 18, 2018
Mr. Kennedy (for himself and Mr. Cassidy) 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.
Improvements to home health payment reforms under Medicare
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—
in subparagraph (A)(iv), in the fourth sentence—
by striking shall make
and inserting shall not make
; and
by striking and shall provide a description
and all that follows through the period and inserting a period; and
in subparagraph (D)—
in the subparagraph heading, by striking assumptions
and inserting observed evidence
;
in clause (i)—
by striking differences between assumed
and all that follows through and actual
;
by inserting attributable to the implementation of paragraphs (2)(B) and (4)(B)
after behavior changes
; and
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 observed 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 observed evidence means statistically valid data from the most recent cost report and claims regarding changes in the nature of home health agency patients, patterns of care, service costs, and claims coding after January 1, 2020, reflecting 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).
;
in clause (ii), by inserting attributable to the implementation of paragraphs (2)(B) and (4)(B)
after expenditures
; and
in clause (iii)—
by adding attributable to the implementation of paragraphs (2)(B) and (4)(B)
after expenditures
; and
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; however, if such a temporary increase or decrease exceeds 2.00, to provide for minimal disruption to patients and providers, 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.
.
Effective date
The amendments made by this section shall take effect as if included in the enactment of such section 51001(a)(2).