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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5128 Introduced in House (IH)]

<DOC>

118th CONGRESS
  1st Session
                                H. R. 5128

To amend title XVIII of the Social Security Act to ensure stability in 
      payments to home health agencies under the Medicare program.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             August 1, 2023

  Ms. Sewell 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 stability in 
      payments to home health agencies under the Medicare program.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preserving Access to Home Health Act 
of 2023''.

SEC. 2. ENSURING STABILITY IN PAYMENTS TO HOME HEALTH AGENCIES.

    (a) Repeal of Permanent and Temporary Adjustments.--Section 
1895(b)(3) of the Social Security Act (42 U.S.C. 1395fff(b)(3)) is 
amended by striking subparagraph (D).
    (b) Effective Date; Implementation.--
            (1) Effective date.--The amendment made by subsection (a) 
        shall take effect as if included in the enactment of the 
        Bipartisan Budget Act of 2018 (Public Law 115-123).
            (2) Implementation.--The Secretary of Health and Human 
        Services (in this section referred to as the ``Secretary'') 
        shall implement such section 1895(b)(3) for 2024 and subsequent 
        years as if the amendment made by section 51001(a)(2)(B) of 
        division E of the Bipartisan Budget Act of 2018 (Public Law 
        115-123) (adding such subparagraph (D)) had not been made.
    (c) Construction.--Nothing in this section shall be construed as 
signifying congressional approval or disapproval of the methodology 
promulgated by the Secretary to implement section 1895(b)(3)(D) of the 
Social Security Act in the final rule entitled, ``Medicare Program; 
Calendar Year (CY) 2023 Home Health Prospective Payment System Rate 
Update; Home Health Quality Reporting Program Requirements; Home Health 
Value-Based Purchasing Expanded Model Requirements; and Home Infusion 
Therapy Services Requirements'' published in the Federal Register on 
November 4, 2022 (87 Fed. Reg. 66790).

SEC. 3. INTERACTION OF MEDICARE PAYMENT POLICIES WITH HEALTH CARE 
              DELIVERY GENERALLY.

    Section 1805(b)(2)(C) of the Social Security Act (42 U.S.C. 1395b-
6(b)(2)(C)) is amended--
            (1) by striking ``generally.--Specifically,'' and inserting 
        ``generally.--
                            ``(i) In general.--Specifically,''; and
            (2) by adding at the end the following new clause:
                            ``(ii) Special rule for home health 
                        agencies.--
                                    ``(I) In general.--When conducting 
                                the review of home health agency 
                                financial performance and its impact on 
                                access to care under the original fee-
                                for-service system, the Commission 
                                shall--
                                            ``(aa) review and report on 
                                        aggregate trends in spending, 
                                        utilization, and financial 
                                        performance under the Medicare 
                                        Advantage program, the Medicaid 
                                        program under title XIX (both 
                                        fee-for-service and managed 
                                        care payment models), and other 
                                        payers for home health agency 
                                        services;
                                            ``(bb) evaluate and 
                                        consider the impact of all 
                                        payers on access to care for 
                                        Medicare beneficiaries; and
                                            ``(cc) comprehensively 
                                        disclose the methodologies used 
                                        to evaluate and calculate home 
                                        health agency margins under 
                                        this title and all other 
                                        payers, including the process 
                                        for developing the data used.
                                Where appropriate, the Commission shall 
                                conduct such reviews in consultation 
                                with the Medicaid and CHIP Payment and 
                                Access Commission established under 
                                section 1900.
                                    ``(II) Medicare home health cost 
                                report amendments.--For cost reporting 
                                periods beginning in 2025 and 
                                subsequent years, the Secretary shall 
                                have in effect an amended Medicare home 
                                health cost report that collects data 
                                on visit utilization and total payments 
                                by payer source, including original 
                                fee-for-service payments, Medicare 
                                Advantage, the Medicaid program under 
                                title XIX (both fee-for-service and 
                                managed care payment models), and other 
                                payers. The Secretary shall make such 
                                amended cost reports available to the 
                                Commission in the form and manner 
                                necessary to conduct the analysis 
                                described in subclause (I).
                                    ``(III) Financial data.--Prior to 
                                the availability of cost report data as 
                                described in subclause (II), the 
                                Commission shall utilize data on cost 
                                and revenues from sources it deems as 
                                reliable and valid for purposes of 
                                conducting the analysis described in 
                                subclause (I).''.
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