‘‘(i) a hospice physician, a nurse prac-
titioner, a clinical nurse specialist, or a 
physician assistant (as those terms are de-
fined in section 1861(aa)(5)), or other 
health professional (as designated by the 
Secretary), has a face-to-face encounter 
with the individual to determine continued 
eligibility of the individual for hospice care 
prior to the first 60-day period and each 
subsequent recertification under subpara-
graph (A)(ii) (or, in the case where a hos-
pice program newly admits an individual 
who would be entering their first 60-day 
period or a subsequent hospice benefit pe-
riod or where exceptional circumstances, as 
defined by the Secretary, may prevent a 
face-to-face encounter prior to the begin-
ning of the hospice benefit period, not later 
than 7 calendar days after the individual’s 
election under section 1812(d)(1) with re-
spect to the hospice program) and attests 
that such visit took place (in accordance 
with procedures established by the Sec-
retary); and’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) takes effect on the date of enactment of 
this Act and applies to hospice care furnished on or after 
such date. 
SEC. 3. RESTORING AND PROTECTING THE MEDICARE HOS-
PICE BENEFIT. 
(a) IN GENERAL.—Section 1814(i) of the Social Se-
curity Act (42 U.S.C. 1395f(i)) is amended— 
(1) in subparagraph (1)(C)— 
(A) in clause (ii)— 
(i) in the matter preceding subclause 
(I), by striking ‘‘(6)(D)’’ and inserting 
‘‘(6)(E)’’; and 
(ii) in subclause (VII), by striking 
‘‘(6)(D)’’ and inserting ‘‘(6)(E)’’; and 
(B) in clause (iii), by moving such clause 
6 ems to the left and striking ‘‘(6)(D)’’ and in-
serting ‘‘(6)(E)’’; and 
(2) in paragraph (6)— 
(A) in subparagraph (A), by striking ‘‘sub-
paragraph (D)’’ and inserting ‘‘subparagraph 
(E)’’; 
(B) by redesignating subparagraphs (D) 
and (E) as subparagraphs (E) and (F), respec-
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tively, and inserting after subparagraph (C) the 
following new subparagraph: 
‘‘(D) HOSPICE PAYMENT REFORM DEMONSTRA-
TION PROGRAM.— 
‘‘(i) ESTABLISHMENT OF DEMONSTRATION 
PROGRAM.— 
‘‘(I) IN
GENERAL.—Prior to imple-
menting any revisions to the methodology 
for determining the payment rates for rou-
tine home care and other services included 
in hospice care under subparagraph (E), 
the Secretary shall establish a Medicare 
Hospice Payment Reform demonstration 
program to test such proposed revisions. 
‘‘(II) DURATION.—The demonstration 
program shall be conducted for a 2-year 
period beginning on or after October 1, 
2013. 
‘‘(III) SCOPE.—The Secretary shall 
select not more than 15 hospice programs 
at which the demonstration program under 
this subparagraph shall be conducted. 
‘‘(IV) REPRESENTATIVE
PARTICIPA-
TION.—Hospice programs selected under 
subclause (III) to participate in the dem-
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onstration program shall include a rep-
resentative cross-section of such programs 
throughout the United States, including 
programs located in urban and rural areas. 
‘‘(V) VOLUNTARY
PARTICIPATION.— 
Hospice program participation in the dem-
onstration program shall be on a voluntary 
basis. 
‘‘(ii) EVALUATION AND REPORT.— 
‘‘(I) 
EVALUATION.—The 
Secretary 
shall conduct an evaluation of the dem-
onstration program under this subpara-
graph. Such evaluation shall include an 
analysis of whether the use of the revised 
payment methodology under the dem-
onstration program has improved the qual-
ity of patient care and access to hospice 
services for beneficiaries under this title 
and the impact of such payment revisions 
on hospice care providers, including the 
impact, if any, on the ability of hospice 
programs to furnish quality care to bene-
ficiaries under this title. 
‘‘(II) REPORT.—Not later than 1 year 
after the completion of the demonstration 
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program, the Secretary shall submit to 
Congress a report containing the results of 
the evaluation conducted under subclause 
(I), together with recommendations for 
such legislation and administrative action 
as the Secretary determines appropriate. 
‘‘(iii) BUDGET NEUTRALITY.—With respect 
to the 2-year period of the demonstration pro-
gram under this subparagraph, the Secretary 
shall ensure that the estimated amount of ag-
gregate payments under this title to each hos-
pice program participating in the demonstration 
program for such period shall not be more than 
5 percent higher or 5 percent lower than the es-
timated amount of aggregate payments that 
would have been made under this title to each 
such hospice program during such period had 
they not participated in the demonstration pro-
gram under this subparagraph.’’; 
(C) in subparagraph (E), as redesignated 
by subparagraph (B)— 
(i) in clause (i)— 
(I) in the first sentence, by strik-
ing ‘‘October 1, 2013, the Secretary 
shall, by regulation’’ and inserting 
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‘‘subject to clause (iii), the later of 2 
years after the demonstration pro-
gram under subparagraph (D) is com-
pleted or October 1, 2017, the Sec-
retary shall, by regulation, preceded 
by notice of the proposed regulation in 
the Federal Register and a period for 
public comment in accordance with 
section 1871(b)(1),’’; and 
(II) in the second sentence, by 
inserting ‘‘, and shall take into ac-
count the results of the evaluation 
conducted 
under 
subparagraph 
(D)(ii)’’ before the period; and 
(ii) by adding at the end the following 
new clause: 
‘‘(iii) In no case may the Secretary imple-
ment any revisions in payment pursuant to 
clause (i) unless the Secretary determines that 
the demonstration program under subparagraph 
(D) demonstrated that such revisions would not 
adversely affect access to quality hospice care 
by beneficiaries under this title.’’; and 
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