H. R. 2617—1466 
beneficiaries and consult with relevant stakeholders as deter-
mined appropriate by the Secretary. 
(3) EXCLUSIVE TREATMENT.—Any drug, biological product, 
or medical device that is a non-opioid treatment for pain relief 
(as defined in section 1833(t)(16)(G)(iv) of the Social Security 
Act, as added by subsection (a)) shall not be considered a 
therapeutic service for purposes of the report under paragraph 
(1). 
SEC. 4136. TECHNICAL AMENDMENTS TO MEDICARE SEPARATE PAY-
MENT FOR DISPOSABLE NEGATIVE PRESSURE WOUND 
THERAPY DEVICES. 
(a) IN GENERAL.—Section 1834(s) of the Social Security Act 
(42 U.S.C. 1395m(s)) is amended— 
(1) by amending paragraph (3) to read as follows: 
‘‘(3) PAYMENT.— 
‘‘(A) IN
GENERAL.—The separate payment amount 
established under this paragraph for an applicable dispos-
able device for a year shall be equal to— 
‘‘(i) for a year before 2024, the amount of the 
payment that would be made under section 1833(t) 
(relating to payment for covered OPD services) for 
the year for the Level I Healthcare Common Procedure 
Coding System (HCPCS) code for which the description 
for a professional service includes the furnishing of 
such device; 
‘‘(ii) for 2024, the supply price used to determine 
the relative value for the service under the fee schedule 
under section 1848 (as of January 1, 2022) for the 
applicable disposable device, updated by the specified 
adjustment described in subparagraph (B) for such 
year; and 
‘‘(iii) for 2025 and each subsequent year, the pay-
ment amount established under this paragraph for 
such device for the previous year, updated by the speci-
fied adjustment described in subparagraph (B) for such 
year. 
‘‘(B) SPECIFIED ADJUSTMENT.— 
‘‘(i) IN GENERAL.—For purposes of subparagraph 
(A), the specified adjustment described in this subpara-
graph for a year is equal to— 
‘‘(I) the percentage increase in the consumer 
price index for all urban consumers (United States 
city average) for the 12-month period ending in 
June of the previous year; minus 
‘‘(II) the productivity adjustment described in 
section 1886(b)(3)(B)(xi)(II) for such year. 
‘‘(ii) CLARIFICATION
ON
APPLICATION
OF
THE 
PRODUCTIVITY ADJUSTMENT.—The application of clause 
(i)(II) may result in a specified adjustment of less than 
0.0 for a year, and may result in the separate payment 
amount under this subsection for an applicable device 
for a year being less than such separate payment 
amount for such device for the preceding year. 
‘‘(C) EXCLUSION OF NURSING AND THERAPY SERVICES 
FROM
SEPARATE
PAYMENT.—With respect to applicable 
devices furnished on or after January 1, 2024, the separate
H. R. 2617—1467 
payment amount determined under this paragraph shall 
not include payment for nursing or therapy services 
described in section 1861(m). Payment for such nursing 
or therapy services shall be made under the prospective 
payment system established under section 1895 and shall 
not be separately billable.’’; and 
(2) by adding at the end the following new paragraph: 
‘‘(4) IMPLEMENTATION.—As part of submitting claims for 
the separate payment established under this subsection, begin-
ning with 2024, the Secretary shall accept and process claims 
submitted using the type of bill that is most commonly used 
by home health agencies to bill services under a home health 
plan of care.’’. 
SEC. 4137. EXTENSION OF CERTAIN HOME HEALTH RURAL ADD-ON 
PAYMENTS. 
Subsection (b)(1)(B) of section 421 of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 (Public Law 
108–173; 117 Stat. 2283; 42 U.S.C. 1395fff note), as amended by 
section 5201(b) of the Deficit Reduction Act of 2005 (Public Law 
109–171; 120 Stat. 46), section 3131(c) of the Patient Protection 
and Affordable Care Act (Public Law 111–148; 124 Stat. 428), 
section 210 of the Medicare Access and CHIP Reauthorization Act 
of 2015 (Public Law 114–10; 129 Stat. 151), and section 50208 
of the Bipartisan Budget Act of 2018 (Public Law 115–123; 132 
Stat. 187) is amended— 
(1) in clause (iii), by striking ‘‘and’’ at the end; and 
(2) by adding at the end the following new clause: 
‘‘(v) in the case of episodes and visits ending during 
2023, by 1 percent; and’’. 
SEC. 4138. REMEDYING ELECTION REVOCATIONS RELATING TO 
ADMINISTRATION OF COVID–19 VACCINES. 
(a) IN GENERAL.—Section 1821(b)(5)(A) of the Social Security 
Act (42 U.S.C. 1395i–5(b)(5)(A)) is amended— 
(1) in clause (i), by striking ‘‘or’’ or at the end; 
(2) in clause (ii), by striking the period at the end and 
inserting ‘‘, or’’; and 
(3) by adding at the end the following new clause: 
‘‘(iii) effective beginning on the date of the enact-
ment of this clause, that is a COVID–19 vaccine and 
its administration described in section 1861(s)(10)(A).’’. 
(b) SPECIAL RULES FOR COVID–19 VACCINES RELATING TO REV-
OCATION OF ELECTION.—Notwithstanding paragraphs (3) and (4) 
of section 1821(b) of the Social Security Act (42 U.S.C. 1395i– 
5(b)), in the case of an individual with a revocation of an election 
under such section prior to the date of enactment of this Act 
by reason of receiving a COVID–19 vaccine and its administration 
described in section 1861(s)(10)(A) of such Act (42 U.S.C. 
1395x(s)(10)(A)), the following rules shall apply: 
(1) Beginning on such date of enactment, such individual 
may make an election under such section, which shall take 
effect immediately upon its execution, if such individual would 
be eligible to make such an election if they had not received 
such COVID–19 vaccine and its administration. 
(2) Such revoked election shall not be taken into account 
for purposes of determining the effective date for an election 
described in subparagraph (A) or (B) of such paragraph (4).
H. R. 2617—1468 
SEC. 4139. PAYMENT RATES FOR DURABLE MEDICAL EQUIPMENT 
UNDER THE MEDICARE PROGRAM. 
(a) AREAS OTHER THAN RURAL AND NONCONTIGUOUS AREAS.— 
The Secretary shall implement section 414.210(g)(9)(v) of title 42, 
Code of Federal Regulations (or any successor regulation), to apply 
the transition rule described in the first sentence of such section 
to all applicable items and services furnished in areas other than 
rural or noncontiguous areas (as such terms are defined for purposes 
of such section) through the remainder of the duration of the 
emergency period described in section 1135(g)(1)(B) of the Social 
Security Act (42 U.S.C. 1320b–5(g)(1)(B)) or December 31, 2023, 
whichever is later. 
(b) ALL AREAS.—The Secretary shall not implement section 
414.210(g)(9)(vi) of title 42, Code of Federal Regulations (or any 
successor regulation) until the date immediately following the last 
day of the emergency period described in section 1135(g)(1)(B) of 
the Social Security Act (42 U.S.C. 1320b–5(g)(1)(B)), or January 
1, 2024, whichever is later. 
(c) IMPLEMENTATION.—Notwithstanding any other provision of 
law, the Secretary may implement the provisions of this section 
by program instruction or otherwise. 
SEC. 4140. EXTENDING ACUTE HOSPITAL CARE AT HOME WAIVERS 
AND FLEXIBILITIES. 
Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 
is amended by inserting after section 1866F the following new 
section: 
‘‘SEC. 1866G. EXTENSION OF ACUTE HOSPITAL CARE AT HOME INITIA-
TIVE. 
‘‘(a) IN GENERAL.— 
‘‘(1) EXTENSION.—With respect to inpatient hospital admis-
sions occurring during the period beginning on the first day 
after the end of the emergency period described in section 
1135(g)(1)(B) and ending on December, 31, 2024, the Secretary 
of Health and Human Services shall grant waivers and flexibili-
ties (as described in paragraph (2)) to an individual hospital 
that submits a request for such waivers and flexibilities and 
meets specified criteria (as described in paragraph (3)) in order 
to participate in the Acute Hospital Care at Home initiative 
of the Secretary. 
‘‘(2) ACUTE HOSPITAL CARE AT HOME WAIVERS AND FLEXIBILI-
TIES.—For the purposes of paragraph (1), the waivers and flexi-
bilities described in this paragraph are the following waivers 
and flexibilities that were made available to individual hospitals 
under the Acute Hospital Care at Home initiative of the Sec-
retary during the emergency period described in section 
1135(g)(1)(B): 
‘‘(A) Subject to paragraph (3)(D), waiver of the require-
ments to provide 24-hour nursing services on premises 
and for the immediate availability of a registered nurse 
under section 482.23(b) of title 42, Code of Federal Regula-
tions (or any successor regulation), and the waivers of 
the physical environment and Life Safety Code require-
ments under section 482.41 of title 42, Code of Federal 
Regulations (or any successor regulation).
H. R. 2617—1469 
‘‘(B) Flexibility to allow a hospital to furnish inpatient 
services, including routine services, outside the hospital 
under arrangements, as described in Medicare Program: 
Hospital Outpatient Prospective Payment and Ambulatory 
Surgical Center Payment Systems and Quality Reporting 
Programs; Organ Acquisition; Rural Emergency Hospitals: 
Payment Policies, Conditions of Participation, Provider 
Enrollment, Physician Self-Referral; New Service Category 
for Hospital Outpatient Department Prior Authorization 
Process; Overall Hospital Quality Star Rating; COVID– 
19 (87 Fed. Reg. 71748 et seq.). 
‘‘(C) Waiver of the telehealth requirements under 
clause (i) of section 1834(m)(4)(C), as amended by section 
4113(a) of the Health Extenders, Improving Access to Medi-
care, Medicaid, and CHIP, and Strengthening Public 
Health Act of 2022, such that the originating sites described 
in clause (ii) of such section shall include the home or 
temporary residence of the individual. 
‘‘(D) Other waivers and flexibilities that, as of the 
date of enactment of this section, were in place for such 
initiative during such emergency period. 
‘‘(3) SPECIFIED CRITERIA.—For purposes of paragraph (1), 
the specified criteria for granting such waivers and flexibilities 
to individual hospitals are: 
‘‘(A) The hospital shall indicate to the Secretary the 
criteria it would use to ensure that hospital services be 
furnished only to an individual who requires an inpatient 
level of care, and shall require that a physician document 
in the medical record of each such individual that the 
individual meets such criteria. 
‘‘(B) The hospital and any other entities providing serv-
ices under arrangements with the hospital shall ensure 
that the standard of care to treat an individual at home 
is the same as the standard of care to treat such individual 
as an inpatient of the hospital. 
‘‘(C) The hospital shall ensure that an individual is 
only eligible for services under paragraph (1) if the indi-
vidual is a hospital inpatient or is a patient of the hospital’s 
emergency department for whom the hospital determines 
that an inpatient level of care is required (as described 
in subparagraph (A)). 
‘‘(D) The hospital shall meet all patient safety stand-
ards determined appropriate by the Secretary, in addition 
to those that otherwise apply to the hospital, except those 
for which the waivers and flexibilities under this subsection 
apply. 
‘‘(E) The hospital shall provide to the Secretary, at 
a time, form and manner determined by the Secretary, 
any data and information the Secretary determines nec-
essary to do the following: 
‘‘(i) Monitor the quality of care furnished, and to 
the extent practicable, ensure the safety of individuals 
and analyze costs of such care. 
‘‘(ii) Undertake the study described in subsection 
(b). 
‘‘(F) The hospital meets such other requirements and 
conditions as the Secretary determines appropriate.