I 
113TH CONGRESS 
2D SESSION 
H. R. 4625 
To amend title XVIII of the Social Security Act to suspend the application 
of the rebasing of Medicare home health prospective payment amounts, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 9, 2014 
Mr. HALL 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 juris-
diction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to suspend 
the application of the rebasing of Medicare home health 
prospective payment amounts, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Home Health 
Rebasing Relief and Reassessment Act’’. 
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SEC. 2. RELIEF AND REASSESSMENT OF THE REBASING OF 
MEDICARE 
HOME 
HEALTH 
PROSPECTIVE 
PAYMENT AMOUNTS. 
(a) 
SUSPENSION
OF
REBASING.—Section 
1895(b)(3)(A)(iii) of the Social Security Act (42 U.S.C. 
1395fff(b)(3)(A)(iii)) is amended— 
(1) in subclause (I), in the first sentence, by 
striking ‘‘subclause (II)’’ and inserting ‘‘subclauses 
(II) and (III)’’; 
(2) in subclause (II), in the first sentence, by 
striking ‘‘The Secretary’’ and inserting ‘‘Subject to 
subclause (III), the Secretary’’; and 
(3) by adding at the end the following new sub-
clause: 
‘‘(III) 
SPECIAL
RULE.—Sub-
clauses (I) and (II) shall not apply for 
the 12-month period beginning on the 
date of the enactment of this sub-
clause. For periods beginning after 
the period described in the previous 
sentence, the Secretary shall apply 
such subclauses as if the previous sen-
tence had not been enacted.’’. 
(b) REVISION OF HOME HEALTH OUTLIER ADJUST-
MENT.—Section 1895(b)(5)(A) of the Social Security Act 
(42 U.S.C. 1395fff(b)(5)(A)) is amended, in the second 
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sentence, by inserting ‘‘(or, in the case of each of the years 
2015 through 2023, 2.25 percent)’’ after ‘‘2.5 percent’’. 
(c) STUDY AND REPORT.— 
(1) STUDY.— 
(A) 
IN
GENERAL.—The 
Secretary 
of 
Health and Human Services, in consultation 
with representatives of Medicare home health 
agencies and beneficiaries, shall conduct a study 
on alternative methods for determining the ap-
propriate 
adjustment 
under 
section 
1895(b)(3)(A)(iii) of the Social Security Act 
(42 U.S.C. 1395(b)(3)(A)(iii)), including meth-
ods offered by stakeholders. Such study shall 
include an analysis of each of the following: 
(i) The projected impact on Medicare 
beneficiary access to care during each of 
2014 through 2017 of applying section 
1895(b)(3) during each of such years with-
out application of subparagraph (A)(iii) of 
such section, compared to the projected 
impact on such access during each of such 
years of applying such section during each 
of such years with application of such sub-
paragraph. 
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(ii) The number and share of home 
health agencies that are projected to expe-
rience negative Medicare margins by 2017, 
including the location, size, and type of 
such agencies. 
(iii) With respect to home health 
agencies described in clause (ii)— 
(I) the total number, average 
age, average income, and average 
number of activities of daily living of 
the Medicare beneficiaries such agen-
cies serve; 
(II) the number of staff such 
agencies employ; 
(III) the number and location of 
counties in which such agencies serve 
as the sole provider of Medicare home 
health services; and 
(IV) to the extent practicable, the 
payer mix of such agencies. 
(iv) The impact of the adjustment on 
small home health agencies, as defined by 
the United States Small Business Adminis-
tration small business size standards, con-
sistent with the principles of the Regu-
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latory Flexibility Act, which requires Fed-
eral agencies, including the Department of 
Health and Human Services, to fully con-
sider during the rulemaking process the 
economic impact of regulatory provisions, 
as well as less burdensome regulatory al-
ternatives, to small entities. 
(v) Any other areas determined appro-
priate by the Secretary. 
(B) REQUIREMENT
FOR
ALTERNATIVE 
METHODS AND OTHER CONSIDERATIONS.—For 
purposes of the analysis under subparagraph 
(A)— 
(i) the alternative methods described 
in such subparagraph shall cover each of 
the years in which the rebasing adjustment 
under such section 1895(b)(3)(A)(iii) is to 
be applied; and 
(ii) the Secretary shall include a cu-
mulative analysis of other Medicare home 
health reimbursement reductions estab-
lished by statute or regulation, consistent 
with the requirements of Executive Order 
13563. 
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