I 

113TH CONGRESS 

2D SESSION H. R. 4625 

To amend title XVIII of the Social Security Act to suspend the application 

of the rebasing of Medicare home health prospective payment amounts, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 9, 2014 

Mr. HALL 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 suspend 

the application of the rebasing of Medicare home health 

prospective payment amounts, and for other purposes. 

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 ‘‘Medicare Home Health 

5 Rebasing Relief and Reassessment Act’’. 


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1 SEC. 2. RELIEF AND REASSESSMENT OF THE REBASING OF 

2 MEDICARE HOME HEALTH PROSPECTIVE 

3 PAYMENT AMOUNTS. 

4 (a) SUSPENSION OF REBASING.—Section 

5 1895(b)(3)(A)(iii) of the Social Security Act (42 U.S.C. 

6 1395fff(b)(3)(A)(iii)) is amended— 

7 (1) in subclause (I), in the first sentence, by 

8 striking ‘‘subclause (II)’’ and inserting ‘‘subclauses 

9 (II) and (III)’’; 

10 (2) in subclause (II), in the first sentence, by 

11 striking ‘‘The Secretary’’ and inserting ‘‘Subject to 

12 subclause (III), the Secretary’’; and 

13 (3) by adding at the end the following new sub14 clause: 

15 ‘‘(III) SPECIAL RULE.—Sub16 clauses (I) and (II) shall not apply for 

17 the 12-month period beginning on the 

18 date of the enactment of this sub19 clause. For periods beginning after 

20 the period described in the previous 

21 sentence, the Secretary shall apply 

22 such subclauses as if the previous sen23 tence had not been enacted.’’. 

24 (b) REVISION OF HOME HEALTH OUTLIER ADJUST25 MENT.—Section 1895(b)(5)(A) of the Social Security Act 

26 (42 U.S.C. 1395fff(b)(5)(A)) is amended, in the second 


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1 sentence, by inserting ‘‘(or, in the case of each of the years 

2 2015 through 2023, 2.25 percent)’’ after ‘‘2.5 percent’’. 

3 (c) STUDY AND REPORT.— 

4 (1) STUDY.— 

5 (A) IN GENERAL.—The Secretary of 

6 Health and Human Services, in consultation 

7 with representatives of Medicare home health 

8 agencies and beneficiaries, shall conduct a study 

9 on alternative methods for determining the ap10 propriate adjustment under section 

11 1895(b)(3)(A)(iii) of the Social Security Act 

12 (42 U.S.C. 1395(b)(3)(A)(iii)), including meth13 ods offered by stakeholders. Such study shall 

14 include an analysis of each of the following: 

15 (i) The projected impact on Medicare 

16 beneficiary access to care during each of 

17 2014 through 2017 of applying section 

18 1895(b)(3) during each of such years with19 out application of subparagraph (A)(iii) of 

20 such section, compared to the projected 

21 impact on such access during each of such 

22 years of applying such section during each 

23 of such years with application of such sub24 paragraph. 


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1 (ii) The number and share of home 

2 health agencies that are projected to expe3 rience negative Medicare margins by 2017, 

4 including the location, size, and type of 

5 such agencies. 

6 (iii) With respect to home health 

7 agencies described in clause (ii)— 

8 (I) the total number, average 

9 age, average income, and average 

10 number of activities of daily living of 

11 the Medicare beneficiaries such agen12 cies serve; 

13 (II) the number of staff such 

14 agencies employ; 

15 (III) the number and location of 

16 counties in which such agencies serve 

17 as the sole provider of Medicare home 

18 health services; and 

19 (IV) to the extent practicable, the 

20 payer mix of such agencies. 

21 (iv) The impact of the adjustment on 

22 small home health agencies, as defined by 

23 the United States Small Business Adminis24 tration small business size standards, con25 sistent with the principles of the ReguVerDate Mar 15 2010 22:02 May 16, 2014 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4625.IH H4625

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1 latory Flexibility Act, which requires Fed2 eral agencies, including the Department of 

3 Health and Human Services, to fully con4 sider during the rulemaking process the 

5 economic impact of regulatory provisions, 

6 as well as less burdensome regulatory al7 ternatives, to small entities. 

8 (v) Any other areas determined appro9 priate by the Secretary. 

10 (B) REQUIREMENT FOR ALTERNATIVE

11 METHODS AND OTHER CONSIDERATIONS.—For 

12 purposes of the analysis under subparagraph 

13 (A)— 

14 (i) the alternative methods described 

15 in such subparagraph shall cover each of 

16 the years in which the rebasing adjustment 

17 under such section 1895(b)(3)(A)(iii) is to 

18 be applied; and 

19 (ii) the Secretary shall include a cu20 mulative analysis of other Medicare home 

21 health reimbursement reductions estab22 lished by statute or regulation, consistent 

23 with the requirements of Executive Order 

24 13563. 


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1 (2) REPORT.—Not later than 6 months after 

2 the date of the enactment of this Act, the Secretary 

3 of Health and Human Services shall submit to Con4 gress a report on the study conducted under para5 graph (1), together with such recommendations as 

6 the Secretary determines appropriate based on the 

7 findings of such study. Such report shall include— 

8 (A) a determination by the Secretary as to 

9 whether, as a result of the findings of such 

10 study, the Secretary intends to use the author11 ity under section 1871 of the Social Security 

12 Act (42 U.S.C. 1395hh) to modify the adjust13 ment described in paragraph (1)(A) and the ex14 tent of any such modification; and 

15 (B) in the case the Secretary determines 

16 not to use such authority, the rationale for such 

17 determination. 

Æ 


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