I 

112TH CONGRESS 

1ST SESSION H. R. 2267 

To amend title XVIII of the Social Security Act to ensure more timely 

access to home health services for Medicare beneficiaries under the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 21, 2011 

Mr. WALDEN (for himself, Ms. SCHWARTZ, Mr. JONES, Mr. ELLISON, Mr. 

LANCE, Ms. HANABUSA, Mr. WU, Mr. BARLETTA, Mr. GRIJALVA, Mr. 

COFFMAN of Colorado, Mr. LANGEVIN, Mr. BILBRAY, Mr. BLUMENAUER, 

Mr. LATHAM, Mr. SCHRADER, Mr. LATOURETTE, Mrs. CAPPS, Mr. 

HANNA, Mr. THOMPSON of California, Mr. TERRY, Mr. NEAL, Mr. BASS

of New Hampshire, Mr. CHANDLER, Ms. LEE of California, Ms. SCHAKOWSKY, Mr. CICILLINE, Mr. BRADY of Pennsylvania, and Mr. BOSWELL) introduced the following bill; which was referred to the Committee 

on Ways and Means, and in addition to the Committee on Energy and 

Commerce, for a period to be subsequently determined by the Speaker, 

in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to ensure 

more timely access to home health services for Medicare 

beneficiaries under the Medicare program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Home Health Care 

3 Planning Improvement Act of 2011’’. 

4 SEC. 2. IMPROVING CARE PLANNING FOR MEDICARE HOME 

5 HEALTH SERVICES. 

6 (a) PART A PROVISIONS.—Section 1814(a) of the So7 cial Security Act (42 U.S.C. 1395f(a)) is amended— 

8 (1) in paragraph (2)— 

9 (A) in the matter preceding subparagraph 

10 (A), by inserting ‘‘, a nurse practitioner or clin11 ical nurse specialist who is working in collabo12 ration with a physician in accordance with 

13 State law, a certified nurse-midwife (as defined 

14 in section 1861(gg)) as authorized by State law, 

15 or a physician assistant (as defined in section 

16 1861(aa)(5)) under the supervision of a physi17 cian’’ after ‘‘1866(j)’’; and 

18 (B) in subparagraph (C)— 

19 (i) by inserting ‘‘, a nurse practi20 tioner, a clinical nurse specialist, a cer21 tified nurse-midwife, or a physician assist22 ant (as the case may be)’’ after ‘‘physi23 cian’’ the first 2 times it appears; and 

24 (ii) by striking ‘‘, and, in the case of 

25 a certification made by a physician’’ and 

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1 counter’’ and inserting ‘‘, and, in the case 

2 of a certification made by a physician after 

3 January 1, 2010, or by a nurse practi4 tioner, clinical nurse specialist, certified 

5 nurse-midwife, or physician assistant (as 

6 the case may be) after January 1, 2012, 

7 prior to making such certification the phy8 sician, nurse practitioner, clinical nurse 

9 specialist, certified nurse-midwife, or physi10 cian assistant must document that the 

11 physician, nurse practitioner, clinical nurse 

12 specialist, certified nurse-midwife, or physi13 cian assistant has had a face-to-face en14 counter’’; 

15 (2) in the second sentence, by inserting ‘‘cer16 tified nurse-midwife,’’ after ‘‘clinical nurse spe17 cialist,’’; 

18 (3) in the third sentence— 

19 (A) by striking ‘‘physician certification’’ 

20 and inserting ‘‘certification’’; 

21 (B) by inserting ‘‘(or on January 1, 2012, 

22 in the case of regulations to implement the 

23 amendments made by section 2 of the Home 

24 Health Care Planning Improvement Act of 

25 2011)’’ after ‘‘1981’’; and 


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1 (C) by striking ‘‘a physician who’’ and in2 serting ‘‘a physician, nurse practitioner, clinical 

3 nurse specialist, certified nurse-midwife, or phy4 sician assistant who’’; and 

5 (4) in the fourth sentence, by inserting ‘‘, nurse 

6 practitioner, clinical nurse specialist, certified nurse7 midwife, or physician assistant’’ after ‘‘physician’’. 

8 (b) PART B PROVISIONS.—Section 1835(a) of the So9 cial Security Act (42 U.S.C. 1395n(a)) is amended— 

10 (1) in paragraph (2)— 

11 (A) in the matter preceding subparagraph 

12 (A), by inserting ‘‘, a nurse practitioner or clin13 ical nurse specialist (as those terms are defined 

14 in 1861(aa)(5)) who is working in collaboration 

15 with a physician in accordance with State law, 

16 a certified nurse-midwife (as defined in section 

17 1861(gg)) as authorized by State law, or a phy18 sician assistant (as defined in section 

19 1861(aa)(5)) under the supervision of a physi20 cian’’ after ‘‘1866(j)’’; 

21 (B) in subparagraph (A)— 

22 (i) in each of clauses (ii) and (iii) of 

23 subparagraph (A) by inserting ‘‘, a nurse 

24 practitioner, a clinical nurse specialist, a 

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1 sistant (as the case may be)’’ after ‘‘physi2 cian’’; and 

3 (ii) in clause (iv), by striking ‘‘after 

4 January 1, 2010’’ and all that follows 

5 through ‘‘face-to-face encounter’’ and in6 serting ‘‘made by a physician after Janu7 ary 1, 2010, or by a nurse practitioner, 

8 clinical nurse specialist, certified nurse9 midwife, or physician assistant (as the case 

10 may be) after January 1, 2012, prior to 

11 making such certification the physician, 

12 nurse practitioner, clinical nurse specialist, 

13 certified nurse-midwife, or physician assist14 ant must document that the physician, 

15 nurse practitioner, clinical nurse specialist, 

16 certified nurse-midwife, or physician assist17 ant has had a face-to-face encounter’’; 

18 (2) in the third sentence, by inserting ‘‘, nurse 

19 practitioner, clinical nurse specialist, certified nurse20 midwife, or physician assistant (as the case may 

21 be)’’ after physician; 

22 (3) in the fourth sentence— 

23 (A) by striking ‘‘physician certification’’ 

24 and inserting ‘‘certification’’; 


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1 (B) by inserting ‘‘(or on January 1, 2012, 

2 in the case of regulations to implement the 

3 amendments made by section 2 of the Home 

4 Health Care Planning Improvement Act of 

5 2011)’’ after ‘‘1981’’; and 

6 (C) by striking ‘‘a physician who’’ and in7 serting ‘‘a physician, nurse practitioner, clinical 

8 nurse specialist, certified nurse-midwife, or phy9 sician assistant who’’; and 

10 (4) in the fifth sentence, by inserting ‘‘, nurse 

11 practitioner, clinical nurse specialist, certified nurse12 midwife, or physician assistant’’ after ‘‘physician’’. 

13 (c) DEFINITION PROVISIONS.— 

14 (1) HOME HEALTH SERVICES.—Section 

15 1861(m) of the Social Security Act (42 U.S.C. 

16 1395x(m)) is amended— 

17 (A) in the matter preceding paragraph 

18 (1)— 

19 (i) by inserting ‘‘, a nurse practitioner 

20 or a clinical nurse specialist (as those 

21 terms are defined in subsection (aa)(5)), a 

22 certified nurse-midwife (as defined in sec23 tion 1861(gg)), or a physician assistant (as 

24 defined in subsection (aa)(5))’’ after ‘‘phy25 sician’’ the first place it appears; and 


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1 (ii) by inserting ‘‘, a nurse practi2 tioner, a clinical nurse specialist, a cer3 tified nurse-midwife, or a physician assist4 ant’’ after ‘‘physician’’ the second place it 

5 appears; and 

6 (B) in paragraph (3), by inserting ‘‘, a 

7 nurse practitioner, a clinical nurse specialist, a 

8 certified nurse-midwife, or a physician assist9 ant’’ after ‘‘physician’’. 

10 (2) HOME HEALTH AGENCY.—Section 

11 1861(o)(2) of the Social Security Act (42 U.S.C. 

12 1395x(o)(2)) is amended— 

13 (A) by inserting ‘‘, nurse practitioners or 

14 clinical nurse specialists (as those terms are de15 fined in subsection (aa)(5)), certified nurse-mid16 wives (as defined in section 1861(gg)), or physi17 cian assistants (as defined in subsection 

18 (aa)(5))’’ after ‘‘physicians’’; and 

19 (B) by inserting ‘‘, nurse practitioner, clin20 ical nurse specialist, certified nurse-midwife, 

21 physician assistant,’’ after ‘‘physician’’. 

22 (d) HOME HEALTH PROSPECTIVE PAYMENT SYSTEM

23 PROVISIONS.—Section 1895 of the Social Security Act (42 

24 U.S.C. 1395fff) is amended— 


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1 (1) in subsection (c)(1), by inserting ‘‘, the 

2 nurse practitioner or clinical nurse specialist (as 

3 those terms are defined in section 1861(aa)(5)), the 

4 certified nurse-midwife (as defined in section 

5 1861(gg)), or the physician assistant (as defined in 

6 section 1861(aa)(5)),’’ after ‘‘physician’’; and 

7 (2) in subsection (e)— 

8 (A) in paragraph (1)(A), by inserting ‘‘, a 

9 nurse practitioner or clinical nurse specialist (as 

10 those terms are defined in section 1861(aa)(5)), 

11 a certified nurse-midwife (as defined in section 

12 1861(gg)), or a physician assistant (as defined 

13 in section 1861(aa)(5))’’ after ‘‘physician’’; and 

14 (B) in paragraph (2)— 

15 (i) in the heading, by striking ‘‘PHY16 SICIAN CERTIFICATION’’ and inserting 

17 ‘‘RULE OF CONSTRUCTION REGARDING RE18 QUIREMENT FOR CERTIFICATION’’; and 

19 (ii) by striking ‘‘physician’’. 

20 (e) EFFECTIVE DATE.—The amendments made by 

21 this section shall apply to items and services furnished on 

22 or after January 1, 2012. 

Æ 


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