II 

110TH CONGRESS 

1ST SESSION S. 321 

To establish pilot projects under the Medicare program to provide incentives 

for home health agencies to utilize home monitoring and communications 

technologies. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 17, 2007 

Mr. THUNE (for himself and Ms. KLOBUCHAR) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To establish pilot projects under the Medicare program to 

provide incentives for home health agencies to utilize 

home monitoring and communications technologies. 

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 ‘‘Fostering Independ5 ence Through Technology Act of 2007’’. 

6 SEC. 2. REMOTE MONITORING PILOT PROJECTS. 

7 (a) PILOT PROJECTS.— 

8 (1) IN GENERAL.—Not later than 9 months 

9 after the date of enactment of this Act, the SecVerDate Aug 31 2005 18:33 Jan 18, 2007 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S321.IS S321

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1 retary of Health and Human Services (in this sec2 tion referred to as the ‘‘Secretary’’) shall conduct 

3 pilot projects under title XVIII of the Social Secu4 rity Act for the purpose of providing incentives to 

5 home health agencies to utilize home monitoring and 

6 communications technologies that— 

7 (A) enhance health outcomes for medicare 

8 beneficiaries; and 

9 (B) reduce expenditures under such title. 

10 (2) SITE REQUIREMENTS.— 

11 (A) URBAN AND RURAL.—The Secretary 

12 shall conduct the pilot projects under this sec13 tion in both urban and rural areas. 

14 (B) SITE IN A SMALL STATE.—The Sec15 retary shall conduct at least 1 of the pilot 

16 projects in a State with a population of less 

17 than 1,000,000. 

18 (3) DEFINITION OF HOME HEALTH AGENCY.— 

19 In this section, the term ‘‘home health agency’’ has 

20 the meaning given that term in section 1861(o) of 

21 the Social Security Act (42 U.S.C. 1395x(o)). 

22 (b) MEDICARE BENEFICIARIES WITHIN THE SCOPE

23 OF PROJECTS.—The Secretary shall specify the criteria 

24 for identifying those medicare beneficiaries who shall be 

25 considered within the scope of the pilot projects under this 


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1 section for purposes of the application of subsection (c) 

2 and for the assessment of the effectiveness of the home 

3 health agency in achieving the objectives of this section. 

4 Such criteria may provide for the inclusion in the projects 

5 of medicare beneficiaries who begin receiving home health 

6 services under title XVIII of the Social Security Act after 

7 the date of the implementation of the projects. 

8 (c) INCENTIVES.— 

9 (1) PERFORMANCE TARGETS.—The Secretary 

10 shall establish for each home health agency partici11 pating in a pilot project under this section a per12 formance target using one of the following meth13 odologies, as determined appropriate by the Sec14 retary: 

15 (A) ADJUSTED HISTORICAL PERFORMANCE

16 TARGET.—The Secretary shall establish for the 

17 agency— 

18 (i) a base expenditure amount equal 

19 to the average total payments made to the 

20 agency under parts A and B of title XVIII 

21 of the Social Security Act for medicare 

22 beneficiaries determined to be within the 

23 scope of the pilot project in a base period 

24 determined by the Secretary; and 


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1 (ii) an annual per capita expenditure 

2 target for such beneficiaries, reflecting the 

3 base expenditure amount adjusted for risk 

4 and adjusted growth rates. 

5 (B) COMPARATIVE PERFORMANCE TAR6 GET.—The Secretary shall establish for the 

7 agency a comparative performance target equal 

8 to the average total payments under such parts 

9 A and B during the pilot project for comparable 

10 individuals in the same geographic area that 

11 are not determined to be within the scope of the 

12 pilot project. 

13 (2) INCENTIVE.—Subject to paragraph (3), the 

14 Secretary shall pay to each participating home care 

15 agency an incentive payment for each year under the 

16 pilot project equal to a portion of the medicare sav17 ings realized for such year relative to the perform18 ance target under paragraph (1). 

19 (3) LIMITATION ON EXPENDITURES.—The Sec20 retary shall limit incentive payments under this sec21 tion in order to ensure that the aggregate expendi22 tures under title XVIII of the Social Security Act 

23 (including incentive payments under this subsection) 

24 do not exceed the amount that the Secretary estiVerDate Aug 31 2005 18:33 Jan 18, 2007 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S321.IS S321

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1 mates would have been expended if the pilot projects 

2 under this section had not been implemented. 

3 (d) WAIVER AUTHORITY.—The Secretary may waive 

4 such provisions of titles XI and XVIII of the Social Secu5 rity Act as the Secretary determines to be appropriate for 

6 the conduct of the pilot projects under this section. 

7 (e) REPORT TO CONGRESS.—Not later than 5 years 

8 after the date that the first pilot project under this section 

9 is implemented, the Secretary shall submit to Congress a 

10 report on the pilot projects. Such report shall contain a 

11 detailed description of issues related to the expansion of 

12 the projects under subsection (f) and recommendations for 

13 such legislation and administrative actions as the Sec14 retary considers appropriate. 

15 (f) EXPANSION.—If the Secretary determines that 

16 any of the pilot projects under this section enhance health 

17 outcomes for medicare beneficiaries and reduce expendi18 tures under title XVIII of the Social Security Act, the Sec19 retary may initiate comparable projects in additional 

20 areas. 

21 (g) INCENTIVE PAYMENTS HAVE NO EFFECT ON

22 OTHER MEDICARE PAYMENTS TO AGENCIES.—An incen23 tive payment under this section— 

24 (1) shall be in addition to the payments that a 

25 home health agency would otherwise receive under 


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1 title XVIII of the Social Security Act for the provi2 sion of home health services; and 

3 (2) shall have no effect on the amount of such 

4 payments. 

Æ 


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