I 

111TH CONGRESS 

1ST SESSION H. R. 3030 

To establish pilot projects under the Medicare Program to provide incentives 

for home health agencies to utilize home monitoring and communications 

technologies. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 24, 2009 

Mr. WALZ (for himself and Ms. GINNY BROWN-WAITE of Florida) 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 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 2009’’. 

6 SEC. 2. REMOTE MONITORING PILOT PROJECTS. 

7 (a) PILOT PROJECTS.— 


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

2 after the date of enactment of this Act, the Sec3 retary of Health and Human Services (in this sec4 tion referred to as the ‘‘Secretary’’) shall conduct 

5 pilot projects under title XVIII of the Social Secu6 rity Act for the purpose of providing incentives to 

7 home health agencies to utilize home monitoring and 

8 communications technologies that— 

9 (A) enhance health outcomes for Medicare 

10 beneficiaries; and 

11 (B) reduce expenditures under such title. 

12 (2) SITE REQUIREMENTS.— 

13 (A) URBAN AND RURAL.—The Secretary 

14 shall conduct the pilot projects under this sec15 tion in both urban and rural areas. 

16 (B) SITE IN A SMALL STATE.—The Sec17 retary shall conduct at least 1 of the pilot 

18 projects in a State with a population of less 

19 than 1,000,000. 

20 (3) DEFINITION OF HOME HEALTH AGENCY.— 

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

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

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

24 (b) MEDICARE BENEFICIARIES WITHIN THE SCOPE

25 OF PROJECTS.—The Secretary shall specify the criteria 


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1 for identifying those Medicare beneficiaries who shall be 

2 considered within the scope of the pilot projects under this 

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

4 and for the assessment of the effectiveness of the home 

5 health agency in achieving the objectives of this section. 

6 Such criteria may provide for the inclusion in the projects 

7 of Medicare beneficiaries who begin receiving home health 

8 services under title XVIII of the Social Security Act after 

9 the date of the implementation of the projects. 

10 (c) INCENTIVES.— 

11 (1) PERFORMANCE TARGETS.—The Secretary 

12 shall establish for each home health agency partici13 pating in a pilot project under this section a per14 formance target using one of the following meth15 odologies, as determined appropriate by the Sec16 retary: 

17 (A) ADJUSTED HISTORICAL PERFORMANCE

18 TARGET.—The Secretary shall establish for the 

19 agency— 

20 (i) a base expenditure amount equal 

21 to the average total payments made to the 

22 agency under parts A and B of title XVIII 

23 of the Social Security Act for Medicare 

24 beneficiaries determined to be within the 


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1 scope of the pilot project in a base period 

2 determined by the Secretary; and 

3 (ii) an annual per capita expenditure 

4 target for such beneficiaries, reflecting the 

5 base expenditure amount adjusted for risk 

6 and adjusted growth rates. 

7 (B) COMPARATIVE PERFORMANCE TAR8 GET.—The Secretary shall establish for the 

9 agency a comparative performance target equal 

10 to the average total payments under such parts 

11 A and B during the pilot project for comparable 

12 individuals in the same geographic area that 

13 are not determined to be within the scope of the 

14 pilot project. 

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

16 Secretary shall pay to each participating home care 

17 agency an incentive payment for each year under the 

18 pilot project equal to a portion of the Medicare sav19 ings realized for such year relative to the perform20 ance target under paragraph (1). 

21 (3) LIMITATION ON EXPENDITURES.—The Sec22 retary shall limit incentive payments under this sec23 tion in order to ensure that the aggregate expendi24 tures under title XVIII of the Social Security Act 

25 (including incentive payments under this subsection) 


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1 do not exceed the amount that the Secretary esti2 mates would have been expended if the pilot projects 

3 under this section had not been implemented. 

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

5 such provisions of titles XI and XVIII of the Social Secu6 rity Act as the Secretary determines to be appropriate for 

7 the conduct of the pilot projects under this section. 

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

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

10 is implemented, the Secretary shall submit to Congress a 

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

12 detailed description of issues related to the expansion of 

13 the projects under subsection (f) and recommendations for 

14 such legislation and administrative actions as the Sec15 retary considers appropriate. 

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

17 any of the pilot projects under this section enhance health 

18 outcomes for Medicare beneficiaries and reduce expendi19 tures under title XVIII of the Social Security Act, the Sec20 retary may initiate comparable projects in additional 

21 areas. 

22 (g) INCENTIVE PAYMENTS HAVE NO EFFECT ON

23 OTHER MEDICARE PAYMENTS TO AGENCIES.—An incen24 tive payment under this section— 


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

2 home health agency would otherwise receive under 

3 title XVIII of the Social Security Act for the provi4 sion of home health services; and 

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

6 payments. 

Æ 


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