I 

116TH CONGRESS 

2D SESSION H. R. 8834 

To amend title XVIII of the Social Security Act to extend and improve 

the Independence at Home Medical Practice Demonstration Program 

under the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 2, 2020 

Mrs. DINGELL (for herself, Ms. STEVENS, Mr. BLUMENAUER, and Mr. 

THOMPSON of California) 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 extend 

and improve the Independence at Home Medical Practice 

Demonstration Program 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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Independence at Home 

5 Demonstration Improvement Act of 2020’’. 


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1 SEC. 2. EXTENDING AND IMPROVING THE INDEPENDENCE 

2 AT HOME MEDICAL PRACTICE DEMONSTRA3 TION PROGRAM UNDER THE MEDICARE PRO4 GRAM. 

5 Section 1866E of the Social Security Act (42 U.S.C. 

6 1395cc–5) is amended— 

7 (1) in subsection (e)— 

8 (A) in paragraph (1), by striking ‘‘7’’ and 

9 inserting ‘‘10’’; 

10 (B) in paragraph (2)— 

11 (i) in the header, by striking ‘‘NO

12 PHYSICIAN’’ and inserting ‘‘PHYSICIAN’’; 

13 and 

14 (ii) by adding at the end the following 

15 new sentence: ‘‘Nothing in the previous 

16 sentence shall be construed to prohibit an 

17 independence at home medical practice 

18 from participating in any model or dem19 onstration with a shared savings compo20 nent under this title (other than the pro21 gram under section 1899) or under section 

22 1115A if such participation is determined 

23 appropriate by the Secretary.’’; and 

24 (C) in paragraph (4)— 

25 (i) by redesignating subparagraphs 

26 (A) through (C) as clauses (i) through 


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1 (iii), respectively, and adjusting the mar2 gins accordingly; 

3 (ii) in clause (i), as so redesignated, 

4 by inserting ‘‘are’’ before ‘‘located’’; 

5 (iii) in clause (iii), as so redesignated, 

6 by striking the period at the end and in7 serting ‘‘; and’’; 

8 (iv) in the matter preceding clause (i), 

9 as so redesignated, by striking ‘‘to prac10 tices that are—’’ and inserting the fol11 lowing: ‘‘to— 

12 ‘‘(A) practices that—’’; and 

13 (v) by adding at the end the following 

14 new subparagraph: 

15 ‘‘(B) practices with the same tax identi16 fication number as an independence at home 

17 medical practice approved under this paragraph 

18 as of the date of the enactment of this subpara19 graph.’’; and 

20 (D) in paragraph (5)— 

21 (i) in the first sentence, by inserting 

22 ‘‘in 2019’’ after ‘‘15,000’’; 

23 (ii) by inserting ‘‘For each subsequent 

24 year, the beneficiary limitation in effect 

25 under this paragraph for the previous year 


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1 (including, if applicable, any increase made 

2 under this sentence) shall be increased by 

3 5,000 if the Secretary determines that op4 eration of the program under this section 

5 for such previous year resulted in aggre6 gate savings under this title for such year 

7 compared to expenditures under this title 

8 for such year had such program not been 

9 in effect.’’ after the first sentence; 

10 (iii) by striking ‘‘the increase from 

11 10,000 to 15,000 in the preceding sen12 tence’’ and inserting ‘‘an increase’’; 

13 (iv) by inserting ‘‘or the amendment 

14 made by section 2(1)(D)(ii) of the Inde15 pendence at Home Demonstration Im16 provement Act of 2020’’ after ‘‘Social 

17 Services Act’’; 

18 (v) by striking ‘‘and seventh’’ and in19 serting ‘‘through tenth’’; and 

20 (vi) by inserting ‘‘, as applicable’’ 

21 after ‘‘such program’’; 

22 (2) in subsection (g)— 

23 (A) by striking ‘‘The Secretary shall’’ and 

24 inserting the following: 


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1 ‘‘(2) FINAL REPORT.—The Secretary shall’’; 

2 and 

3 (B) by inserting before paragraph (2), as 

4 designated by subparagraph (A), the following 

5 new paragraph: 

6 ‘‘(1) ANNUAL REPORTS.—The Secretary shall 

7 conduct an independent evaluation of the demonstra8 tion program and submit to Congress an annual re9 port at the close of each performance year (begin10 ning with performance year 2021), including a speci11 fication of any improvements made to the program 

12 for such year. Such report shall include an analysis 

13 such improvements’ impact on coordination of care, 

14 expenditures under this title, applicable beneficiary 

15 access to services, and the quality of health care 

16 services provided to applicable beneficiaries.’’; 

17 (3) in subsection (h), by striking ‘‘each of fiscal 

18 years 2010 through 2015’’ and inserting ‘‘fiscal year 

19 2021’’; and 

20 (4) by adding at the end the following new sub21 section: 

22 ‘‘(j) AUTHORITY TO IMPLEMENT IMPROVEMENTS TO

23 PROGRAM.—The Secretary may make such improvements 

24 to the demonstration program not inconsistent with the 


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1 preceding provisions of this section as the Secretary deter2 mines appropriate for purposes of— 

3 ‘‘(1) improving coordination of care; 

4 ‘‘(2) lowering expenditures; 

5 ‘‘(3) increasing access to items and services 

6 under the program; or 

7 ‘‘(4) improving the quality of items and services 

8 furnished under the program.’’. 

Æ 


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