Home Health Care Planning Improvement Act of 2019

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. Short title This Act may be cited as the Home Health Care Planning Improvement Act of 2019 2. Improving care planning for Medicare home health services (a) Part A provisions Section 1814(a) of the Social Security Act ( 42 U.S.C. 1395f(a) (1) in paragraph (2)— (A) in the matter preceding subparagraph (A), by inserting , a nurse practitioner or clinical nurse specialist who is working in collaboration with a physician in accordance with State law, a certified nurse-midwife (as defined in section 1861(gg)) as authorized by State law, or a physician assistant (as defined in section 1861(aa)(5)) under the supervision of a physician 1866(j) (B) in subparagraph (C)— (i) by inserting , a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant (as the case may be) physician (ii) by striking , and, in the case of a certification made by a physician face-to-face encounter , and, in the case of a certification made by a physician after January 1, 2010, or by a nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant (as the case may be) after January 1, 2020, prior to making such certification the physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant must document that the physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant has had a face-to-face encounter (2) in the second sentence, by inserting certified nurse-midwife, clinical nurse specialist, (3) in the third sentence— (A) by striking physician certification certification (B) by inserting (or on January 1, 2020, in the case of regulations to implement the amendments made by section 2 of the Home Health Care Planning Improvement Act of 2019 1981 (C) by striking a physician who a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant who (4) in the fourth sentence, by inserting , nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant physician (b) Part B provisions Section 1835(a) of the Social Security Act ( 42 U.S.C. 1395n(a) (1) in paragraph (2)— (A) in the matter preceding subparagraph (A), by inserting , a nurse practitioner or clinical nurse specialist (as those terms are defined in 1861(aa)(5)) who is working in collaboration with a physician in accordance with State law, a certified nurse-midwife (as defined in section 1861(gg)) as authorized by State law, or a physician assistant (as defined in section 1861(aa)(5)) under the supervision of a physician 1866(j) (B) in subparagraph (A)— (i) in each of clauses (ii) and (iii) of subparagraph (A) by inserting , a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant (as the case may be) physician (ii) in clause (iv), by striking after January 1, 2010 face-to-face encounter made by a physician after January 1, 2010, or by a nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant (as the case may be) after January 1, 2020, prior to making such certification the physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant must document that the physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant has had a face-to-face encounter (2) in the third sentence, by inserting , nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant (as the case may be) (3) in the fourth sentence— (A) by striking physician certification certification (B) by inserting (or on January 1, 2020, in the case of regulations to implement the amendments made by section 2 of the Home Health Care Planning Improvement Act of 2019 1981 (C) by striking a physician who a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant who (4) in the fifth sentence, by inserting , nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant physician (c) Definition provisions (1) Home health services Section 1861(m) of the Social Security Act ( 42 U.S.C. 1395x(m) (A) in the matter preceding paragraph (1)— (i) by inserting , a nurse practitioner or a clinical nurse specialist (as those terms are defined in subsection (aa)(5)), a certified nurse-midwife (as defined in section 1861(gg)), or a physician assistant (as defined in subsection (aa)(5)) physician (ii) by inserting , a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant physician (B) in paragraph (3), by inserting , a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant physician (2) Home health agency Section 1861(o)(2) of the Social Security Act ( 42 U.S.C. 1395x(o)(2) (A) by inserting , nurse practitioners or clinical nurse specialists (as those terms are defined in subsection (aa)(5)), certified nurse-midwives (as defined in section 1861(gg)), or physician assistants (as defined in subsection (aa)(5)) physicians (B) by inserting , nurse practitioner, clinical nurse specialist, certified nurse-midwife, physician assistant, physician (d) Home health prospective payment system provisions Section 1895 of the Social Security Act ( 42 U.S.C. 1395fff (1) in subsection (c)(1), by inserting , the nurse practitioner or clinical nurse specialist (as those terms are defined in section 1861(aa)(5)), the certified nurse-midwife (as defined in section 1861(gg)), or the physician assistant (as defined in section 1861(aa)(5)), physician (2) in subsection (e)— (A) in paragraph (1)(A), by inserting , a nurse practitioner or clinical nurse specialist (as those terms are defined in section 1861(aa)(5)), a certified nurse-midwife (as defined in section 1861(gg)), or a physician assistant (as defined in section 1861(aa)(5)) physician (B) in paragraph (2)— (i) in the heading, by striking Physician certification Rule of construction regarding requirement for certification (ii) by striking physician (e) Effective date The amendments made by this section shall apply to items and services furnished on or after January 1, 2020.

Summary: Home Health Care Planning Improvement Act of 2019 This bill allows Medicare payment for home health services ordered by a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant. Currently, coverage is provided only for services ordered by a physician.