I 

116TH CONGRESS 

1ST SESSION H. R. 2150 

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 

APRIL 9, 2019 

Ms. SCHAKOWSKY (for herself, Mr. CARTER of Georgia, Mr. KIND, Mr. KELLY

of Pennsylvania, Ms. WILD, and Mr. JOYCE of Ohio) 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, 

3 SECTION 1. SHORT TITLE. 

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

5 Planning Improvement Act of 2019’’. 


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1 SEC. 2. IMPROVING CARE PLANNING FOR MEDICARE HOME 

2 HEALTH SERVICES. 

3 (a) PART A PROVISIONS.—Section 1814(a) of the So4 cial Security Act (42 U.S.C. 1395f(a)) is amended— 

5 (1) in paragraph (2)— 

6 (A) in the matter preceding subparagraph 

7 (A), by inserting ‘‘, a nurse practitioner or clin8 ical nurse specialist who is working in collabo9 ration with a physician in accordance with 

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

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

12 or a physician assistant (as defined in section 

13 1861(aa)(5)) under the supervision of a physi14 cian’’ after ‘‘1866(j)’’; and 

15 (B) in subparagraph (C)— 

16 (i) by inserting ‘‘, a nurse practi17 tioner, a clinical nurse specialist, a cer18 tified nurse-midwife, or a physician assist19 ant (as the case may be)’’ after ‘‘physi20 cian’’ the first 2 times it appears; and 

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

22 a certification made by a physician’’ and 

23 all that follows through ‘‘face-to-face en24 counter’’ and inserting ‘‘, and, in the case 

25 of a certification made by a physician after 

26 January 1, 2010, or by a nurse practiVerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2150.IH H2150

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1 tioner, clinical nurse specialist, certified 

2 nurse-midwife, or physician assistant (as 

3 the case may be) after January 1, 2020, 

4 prior to making such certification the phy5 sician, nurse practitioner, clinical nurse 

6 specialist, certified nurse-midwife, or physi7 cian assistant must document that the 

8 physician, nurse practitioner, clinical nurse 

9 specialist, certified nurse-midwife, or physi10 cian assistant has had a face-to-face en11 counter’’; 

12 (2) in the second sentence, by inserting ‘‘cer13 tified nurse-midwife,’’ after ‘‘clinical nurse spe14 cialist,’’; 

15 (3) in the third sentence— 

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

17 and inserting ‘‘certification’’; 

18 (B) by inserting ‘‘(or on January 1, 2020, 

19 in the case of regulations to implement the 

20 amendments made by section 2 of the Home 

21 Health Care Planning Improvement Act of 

22 2019)’’ after ‘‘1981’’; and 

23 (C) by striking ‘‘a physician who’’ and in24 serting ‘‘a physician, nurse practitioner, clinical 


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1 nurse specialist, certified nurse-midwife, or phy2 sician assistant who’’; and 

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

4 practitioner, clinical nurse specialist, certified nurse5 midwife, or physician assistant’’ after ‘‘physician’’. 

6 (b) PART B PROVISIONS.—Section 1835(a) of the So7 cial Security Act (42 U.S.C. 1395n(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 (as those terms are defined 

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

13 with a physician in accordance with State law, 

14 a certified nurse-midwife (as defined in section 

15 1861(gg)) as authorized by State law, or a phy16 sician assistant (as defined in section 

17 1861(aa)(5)) under the supervision of a physi18 cian’’ after ‘‘1866(j)’’; and 

19 (B) in subparagraph (A)— 

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

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

22 practitioner, a clinical nurse specialist, a 

23 certified nurse-midwife, or a physician as24 sistant (as the case may be)’’ after ‘‘physi25 cian’’; and 


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

2 January 1, 2010’’ and all that follows 

3 through ‘‘face-to-face encounter’’ and in4 serting ‘‘made by a physician after Janu5 ary 1, 2010, or by a nurse practitioner, 

6 clinical nurse specialist, certified nurse7 midwife, or physician assistant (as the case 

8 may be) after January 1, 2020, prior to 

9 making such certification the physician, 

10 nurse practitioner, clinical nurse specialist, 

11 certified nurse-midwife, or physician assist12 ant must document that the physician, 

13 nurse practitioner, clinical nurse specialist, 

14 certified nurse-midwife, or physician assist15 ant has had a face-to-face encounter’’; 

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

17 practitioner, clinical nurse specialist, certified nurse18 midwife, or physician assistant (as the case may 

19 be)’’ after physician; 

20 (3) in the fourth sentence— 

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

22 and inserting ‘‘certification’’; 

23 (B) by inserting ‘‘(or on January 1, 2020, 

24 in the case of regulations to implement the 

25 amendments made by section 2 of the Home 


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1 Health Care Planning Improvement Act of 

2 2019)’’ after ‘‘1981’’; and 

3 (C) by striking ‘‘a physician who’’ and in4 serting ‘‘a physician, nurse practitioner, clinical 

5 nurse specialist, certified nurse-midwife, or phy6 sician assistant who’’; and 

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

8 practitioner, clinical nurse specialist, certified nurse9 midwife, or physician assistant’’ after ‘‘physician’’. 

10 (c) DEFINITION PROVISIONS.— 

11 (1) HOME HEALTH SERVICES.—Section 

12 1861(m) of the Social Security Act (42 U.S.C. 

13 1395x(m)) is amended— 

14 (A) in the matter preceding paragraph 

15 (1)— 

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

17 or a clinical nurse specialist (as those 

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

19 certified nurse-midwife (as defined in sec20 tion 1861(gg)), or a physician assistant (as 

21 defined in subsection (aa)(5))’’ after ‘‘phy22 sician’’ the first place it appears; and 

23 (ii) by inserting ‘‘, a nurse practi24 tioner, a clinical nurse specialist, a cer25 tified nurse-midwife, or a physician assistVerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2150.IH H2150

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1 ant’’ after ‘‘physician’’ the second place it 

2 appears; and 

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

4 nurse practitioner, a clinical nurse specialist, a 

5 certified nurse-midwife, or a physician assist6 ant’’ after ‘‘physician’’. 

7 (2) HOME HEALTH AGENCY.—Section 

8 1861(o)(2) of the Social Security Act (42 U.S.C. 

9 1395x(o)(2)) is amended— 

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

11 clinical nurse specialists (as those terms are de12 fined in subsection (aa)(5)), certified nurse-mid13 wives (as defined in section 1861(gg)), or physi14 cian assistants (as defined in subsection 

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

16 (B) by inserting ‘‘, nurse practitioner, clin17 ical nurse specialist, certified nurse-midwife, 

18 physician assistant,’’ after ‘‘physician’’. 

19 (d) HOME HEALTH PROSPECTIVE PAYMENT SYSTEM

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

21 U.S.C. 1395fff) is amended— 

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

23 nurse practitioner or clinical nurse specialist (as 

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

25 certified nurse-midwife (as defined in section 


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1 1861(gg)), or the physician assistant (as defined in 

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

3 (2) in subsection (e)— 

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

5 nurse practitioner or clinical nurse specialist (as 

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

7 a certified nurse-midwife (as defined in section 

8 1861(gg)), or a physician assistant (as defined 

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

10 (B) in paragraph (2)— 

11 (i) in the heading, by striking ‘‘PHY12 SICIAN CERTIFICATION’’ and inserting 

13 ‘‘RULE OF CONSTRUCTION REGARDING RE14 QUIREMENT FOR CERTIFICATION’’; and 

15 (ii) by striking ‘‘physician’’. 

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

17 this section shall apply to items and services furnished on 

18 or after January 1, 2020. 

Æ 


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