```

[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. Con. Res. 47 Introduced in Senate (IS)]

106th CONGRESS
  1st Session
S. CON. RES. 47

 Expressing the sense of Congress regarding the regulatory burdens on 
                         home health agencies.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             July 21, 1999

  Mrs. Hutchison (for herself, Mr. Bond, Ms. Collins, Mr. Frist, Mr. 
  Allard, Mr. Edwards, Mr. Cochran, Mr. Cleland, Mr. Roberts, and Mr. 
 Torricelli) submitted the following concurrent resolution; which was 
                  referred to the Committee on Finance

_______________________________________________________________________

                         CONCURRENT RESOLUTION

 
 Expressing the sense of Congress regarding the regulatory burdens on 
                         home health agencies.

Whereas 3,900,000 elderly persons currently use health care services provided 
        under the medicare home health program;
Whereas the Balanced Budget Act of 1997 made a number of changes to the 
        administration of the medicare home health program;
Whereas many such changes imposed by such Act were required to be implemented by 
        the Health Care Financing Administration (referred to in this resolution 
        as ``HCFA'') of the Department of Health and Human Services;
Whereas many of such regulations promulgated by HCFA in order to implement such 
        changes have proven to be administratively burdensome, have diverted 
        funds away from needed beneficiary care, and were promulgated as final 
        rules without prior opportunity for comment by the home health industry 
        and home health patients;
Whereas HCFA has implemented a branch office policy that imposes arbitrary 
        distance and suspension requirements that are administratively 
        burdensome and threaten access to home health services, particularly in 
        rural areas;
Whereas, in order to implement the shift of medicare payment for home health 
        services from part A to part B, HCFA imposed a sequential billing policy 
        that prohibited home health agencies from submitting bills for patient 
        services if a previous bill was submitted for that patient who was 
        undergoing medical review;
Whereas HCFA has expanded medical reviews of home health claims so that the 
        processing of such claims has slowed down significantly nationwide;
Whereas HCFA is requiring home health agencies to submit patient data using the 
        Outcomes and Assessment Information Set (referred to in this resolution 
        as ``OASIS'') in anticipation of and to assist the development of a 
        prospective payment system (PPS) for home health services;
Whereas HCFA plans to implement an overly burdensome requirement that agencies 
        report visit times in 15-minute increments that fails to account for the 
        entire time spent in the home and on activities such as care planning, 
        coordination, documentation, and travel that are essential for a home 
        health visit;
Whereas most home health agencies will not be reimbursed for any of the costs or 
        the increase in administrative requirements associated with OASIS;
Whereas the slowdown in claims processing, coupled with sequential billing and 
        implementation of OASIS, has substantially increased home health agency 
        cash flow problems because payments are often delayed by 3 months or 
        more;
Whereas the vast majority of home health agencies are small businesses that 
        cannot operate with such significant cash flow problems; and
Whereas there are many other elements of the medicare home health program, such 
        as the interim payment system, which have created financial problems for 
        home health agencies, such that more than 2,200 agencies nationwide have 
        already closed: Now, therefore, be it
    Resolved by the Senate (the House of Representatives concurring), 
That it is the sense of Congress that--
            (1) Congress should actively oversee the administration by 
        the Health Care Financing Administration (referred to in this 
        resolution as ``HCFA'') of the medicare home health program;
            (2) in overseeing such administration, Congress should pay 
        particular attention to HCFA's compliance with the public 
        notice and comment requirements of the Administrative 
        Procedures Act (5 U.S.C. 551 et seq.), HCFA's consideration of 
        input from the home health community, and HCFA's coordination 
        and consistent application of policies among HCFA's central and 
        regional offices; and
            (3) Congress should monitor HCFA's adherence to and 
        implementation of Congressional intent when executing changes 
        during such administration.
                                 <all>
```