I 
115TH CONGRESS 
1ST SESSION H. R. 2663 
To amend title XVIII of the Social Security Act to make changes to docu-
mentation of eligibility for Medicare home health services, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 25, 2017 
Mr. MARCHANT (for himself and Mr. BLUMENAUER) 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 con-
cerned 
A BILL 
To amend title XVIII of the Social Security Act to make 
changes to documentation of eligibility for Medicare 
home health services, 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 ‘‘Home Health Docu-
mentation and Program Improvement Act of 2017’’. 
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SEC. 2. INFORMATION TO SATISFY DOCUMENTATION OF 
MEDICARE ELIGIBILITY FOR HOME HEALTH 
SERVICES. 
(a) PART A.—Section 1814(a) of the Social Security 
Act (42 U.S.C. 1395f(a)) is amended by inserting before 
‘‘For purposes of paragraph (2)(C),’’ the following new 
sentence: ‘‘For purposes of documentation for physician 
certification and recertification made under paragraph (2) 
on or after January 1, 2018, and made with respect to 
home health services furnished by a home health agency, 
in addition to using documentation in the medical record 
of the physician who so certifies or the medical record of 
the acute or post-acute care facility (in the case that home 
health services were furnished to an individual who was 
directly admitted to the home health agency from such a 
facility), the Secretary shall use documentation in the 
medical record of the home health agency as supporting 
material, as appropriate to the case involved.’’. 
(b) PART B.—Section 1835(a) of the Social Security 
Act (42 U.S.C. 1395n(a)) is amended by inserting before 
‘‘For purposes of paragraph (2)(A),’’ the following new 
sentence: ‘‘For purposes of documentation for physician 
certification and recertification made under paragraph (2) 
on or after January 1, 2018, and made with respect to 
home health services furnished by a home health agency, 
in addition to using documentation in the medical record 
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of the physician who so certifies or the medical record of 
the acute or post-acute care facility (in the case that home 
health services were furnished to an individual who was 
directly admitted to the home health agency from such a 
facility), the Secretary shall use documentation in the 
medical record of the home health agency as supporting 
material, as appropriate to the case involved.’’. 
SEC. 3. VOLUNTARY SETTLEMENT OF HOME HEALTH 
CLAIMS. 
(a) SETTLEMENT PROCESS
FOR HOME HEALTH 
CLAIMS.— 
(1) IN
GENERAL.—Not later than one year 
after the date of enactment of this Act, the Sec-
retary of Health and Human Services shall establish 
a settlement process under which a home health 
agency entitled to an eligible administrative appeal 
has the option to enter into a settlement with the 
Secretary that is reached in a manner consistent 
with the succeeding paragraphs of this subsection. 
(2) PROCESS
AND
CONSIDERATION
OF
HOME 
HEALTH
CLAIMS.—A settlement under paragraph 
(1) with a home health agency that is with respect 
to an eligible administrative appeal may only be 
reached in accordance with the following process: 
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(A) A settlement under such paragraph 
with the home health agency shall be with re-
spect to all claims by such agency, subject to 
paragraph (4), that, as of the date of such set-
tlement, are under an eligible administrative 
appeal. 
(B) For the duration of the settlement 
process with such agency, an eligible adminis-
trative appeal that is with respect to any such 
claim by such agency shall be suspended. 
(C) Under the settlement process, the Sec-
retary shall determine an aggregate amount to 
be paid to the home health agency with respect 
to all claims by such agency that are under an 
eligible administrative appeal in the following 
manner: 
(i) The Secretary shall, for purposes 
of applying clause (ii) with respect to all 
settlements under paragraph (1), select a 
percentage. In selecting such percentage, 
the Secretary shall consider the percentage 
used under the Centers for Medicare & 
Medicaid Services hospital appeals settle-
ment that began on October 31, 2014. 
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(ii) The Secretary shall, with respect 
to each denied claim for such agency that 
is under an eligible administrative appeal, 
calculate an amount (referred to in this 
subparagraph as an ‘‘individual claim 
amount’’) by multiplying the net payable 
amount for such claim by the percentage 
selected under clause (i). 
(iii) Such aggregate amount with re-
spect to such agency shall be determined 
by calculating the total sum of all the indi-
vidual claim amounts calculated under 
clause (ii) with respect to such agency. 
(3) EFFECT OF PROCESS.— 
(A) EFFECT OF SETTLEMENT.— 
(i) FURTHER
APPEAL.—As part of 
any settlement under paragraph (1) be-
tween a home health agency and the Sec-
retary, such home health agency shall be 
required to forego the right to an adminis-
trative appeal under section 1869 of the 
Social Security Act (42 U.S.C. 1395ff) or 
section 1878 of such Act (42 U.S.C. 
1395oo) (including any redetermination, 
reconsideration, hearing, or review) with 
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respect to any claims for home health serv-
ices that are subject to the settlement. 
(ii) JUDICIAL
REVIEW.—There shall 
be no administrative or judicial review 
under such section 1869 or otherwise of a 
settlement under paragraph (1) and the 
claims covered by the settlement. 
(B) EFFECT OF NO SETTLEMENT.—In the 
event that the process described in paragraph 
(2) does not, with respect to a home health 
agency, result in a settlement under paragraph 
(1) with such agency, any appeal under such 
section 1869 that is with respect to a claim by 
such agency that was suspended pursuant to 
paragraph (2)(B) shall resume under such sec-
tion. 
(4) 
COORDINATION
WITH
LAW
ENFORCE-
MENT.—The Secretary of Health and Human Serv-
ices shall establish a process under which individuals 
in the Department of Health and Human Services 
responsible for executing a settlement under para-
graph (1) may, in order to avoid the inadvertent set-
tlement of cases that involve fraud or other criminal 
activity, coordinate with appropriate law enforce-
ment agencies. 
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(b) NO ENTITLEMENT TO SETTLEMENT PROCESS.— 
Nothing in this section shall be construed as creating an 
entitlement to enter into a settlement process established 
pursuant to subsection (a). 
(c) ELIGIBLE ADMINISTRATIVE APPEAL DEFINED.— 
For purposes of this section, the term ‘‘eligible administra-
tive appeal’’ means an appeal under section 1869 of the 
Social Security Act (42 U.S.C. 1395ff) (including any re-
determination, reconsideration, hearing, or review)— 
(1) that is with respect to one or more claims 
that— 
(A) are for home health services that— 
(i) were furnished on or after January 
1, 2011, and before January 1, 2015; and 
(ii) were reasonable and necessary 
under section 1862(a)(1)(A) of such Act 
(42 U.S.C. 1395y(a)(1)(A)); and 
(B) were timely filed consistent with sec-
tion 1814(a)(1) of such Act (42 U.S.C. 
1395f(a)(1)) 
or 
sections 
1835(a)(1) 
and 
1842(b)(3) of such Act (42 U.S.C. 1395n(a)(1), 
1395u(b)(3)); and 
(2) either— 
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(A) was timely filed consistent with section 
1869 of such Act (42 U.S.C. 1395ff) and is 
pending; or 
(B) for which the applicable time frame to 
file an appeal has not expired. 
(d) CONFORMING AMENDMENT.—Section 1869 of the 
Social Security Act (42 U.S.C. 1395ff) is amended by add-
ing at the end the following new subsection: 
‘‘(j) APPLICATION WITH RESPECT
TO CERTAIN 
HOME HEALTH CLAIMS.—For the application of the pro-
visions of this section with respect to certain claims for 
home health services that were furnished on or after Janu-
ary 1, 2011, and before January 1, 2015, see section 3 
of the Home Health Documentation and Program Im-
provement Act of 2017.’’. 
Æ 
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