123
2003) shall be reduced by a copayment equal to the copayment
amount specified in subparagraph (B)(ii) such year.
‘‘(ii) The copayment under clause (i) shall not apply—
‘‘(I) in the case of an individual who has been deter-
mined to be a qualified medicare beneficiary (as defined in
section 1905(p)(1)) or otherwise to be entitled to medical
assistance 
under 
section 
1902(a)(10)(A) 
or
1902(a)(10)(C); and
‘‘(II) in the case of an episode of care which consists
of 4 or fewer visits.
‘‘(B)(i) The Secretary shall estimate, before the beginning
of each year (beginning with 2003), the national average pay-
ment under this title per episode for home health services pro-
jected for the year involved.
‘‘(ii) For each year the copayment amount under this
clause is equal to 1.5 percent of the national average payment
estimated for the year involved under clause (i). Any amount
determined under the preceding sentence which is not a mul-
tiple of $5 shall be rounded to the nearest multiple of $5.
‘‘(iii) There shall be no administrative or judicial review
under section 1869, 1878, or otherwise of the estimation of av-
erage payment under clause (i).’’.
(2) TIMELY IMPLEMENTATION.—Unless the Secretary
of Health and Human Services otherwise provides on a
timely basis, the copayment amount specified under section
1813(a)(5)(B)(ii) of the Social Security Act (as added by
paragraph (1)) for 2003 shall be deemed to be $40.
(b) CONFORMING PROVISIONS.—
(1) Section 1833(a)(2)(A) (42 U.S.C. 1395l(a)(2)(A))
is amended by inserting ‘‘less the copayment amount appli-
cable under section 1813(a)(5)’’ after ‘‘1895’’.
(2) 
Section 
1866(a)(2)(A)(i) 
(42 
U.S.C.
1395cc(a)(2)(A)(i)) is amended—
(A) by striking ‘‘or coinsurance’’ and inserting ‘‘,
coinsurance, or copayment’’; and
(B) by striking ‘‘or (a)(4)’’ and inserting ‘‘(a)(4),
or (a)(5)’’.
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SEC. 603. UPDATE IN HOME HEALTH SERVICES.
(a) CHANGE TO CALENDAR YEAR UPDATE.—
(1) IN
GENERAL.—Section 1895(b) (42 U.S.C.
1395fff(b)(3)) is amended—
(A) in paragraph (3)(B)(i)—
(i) by striking ‘‘each fiscal year (beginning
with fiscal year 2002)’’ and inserting ‘‘fiscal year
2002 and for each subsequent year (beginning with
2003)’’; and
(ii) by inserting ‘‘or year’’ after ‘‘the fiscal
year’’;
(B) in paragraph (3)(B)(ii)—
(i) in subclause (II), by striking ‘‘fiscal year’’
and inserting ‘‘year’’ and by redesignating such
subclause as subclause (III); and
(ii) in subclause (I), by striking ‘‘each of fiscal
years 2002 and 2003’’ and inserting the following:
‘‘fiscal year 2002, the home health market basket
percentage increase (as defined in clause (iii))
minus 1.1 percentage points;
‘‘(II) 2003’’;
(C) in paragraph (3)(B)(iii), by inserting ‘‘or
year’’ after ‘‘fiscal year’’ each place it appears;
(D) in paragraph (3)(B)(iv)—
(i) by inserting ‘‘or year’’ after ‘‘fiscal year’’
each place it appears; and
(ii) by inserting ‘‘or years’’ after ‘‘fiscal
years’’; and
(E) in paragraph (5), by inserting ‘‘or year’’ after
‘‘fiscal year’’.
(2) TRANSITION
RULE.—The standard prospective
payment amount (or amounts) under section 1895(b)(3) of
the Social Security Act for the calendar quarter beginning
on October 1, 2002, shall be such amount (or amounts) for
the previous calendar quarter.
125
(b) CHANGES IN UPDATES FOR 2003, 2004, AND 2005.—
Section 1895(b)(3)(B)(ii) (42 U.S.C. 1395fff(b)(3)(B)(ii)), as
amended by subsection (a)(1)(B), is amended—
(1) in subclause (II), by striking ‘‘the home health
market basket percentage increase (as defined in clause
(iii)) minus 1.1 percentage points’’ and inserting ‘‘2.0 per-
centage points’’;
(2) by striking ‘‘or’’ at the end of subclause (II);
(3) by redesignating subclause (III) as subclause (V);
and
(4) by inserting after subclause (II) the following new
subclause:
‘‘(III) 2004, 1.0 percentage points;
‘‘(IV) 2005, the home health market bas-
ket percentage increase (as defined in clause
(iii)) minus 0.8 percentage points; or’’.
(c) PAYMENT ADJUSTMENT.—
(1) IN
GENERAL.—Section 1895(b)(5) (42 U.S.C.
1395fff(b)(5)) is amended ‘‘5 percent’’ and inserting ‘‘3
percent’’.
(2) EFFECTIVE
DATE.—The amendment made by
paragraph (1) shall apply to years beginning with 2003.
SEC. 604. OASIS TASK FORCE; SUSPENSION OF CERTAIN
OASIS DATA COLLECTION REQUIREMENTS
PENDING TASK FORCE SUBMITTAL OF RE-
PORT.
(a) ESTABLISHMENT.—The Secretary of Health and
Human Services shall establish and appoint a task force (to be
known as the ‘‘OASIS Task Force’’) to examine the data col-
lection and reporting requirements under OASIS. For purposes
of this section, the term ‘‘OASIS’’ means the Outcome and As-
sessment Information Set required by reason of section 4602(e)
of Balanced Budget Act of 1997 (42 U.S.C. 1395fff note).
(b) COMPOSITION.—The OASIS Task Force shall be com-
posed of the following:
(1) Staff of the Centers for Medicare & Medicaid Serv-
ices with expertise in post-acute care.
126
(2) Representatives of home health agencies.
(3) Health care professionals and research and health
care quality experts outside the Federal Government with
expertise in post-acute care.
(4) Advocates for individuals requiring home health
services.
(c) DUTIES.—
(1) REVIEW
AND
RECOMMENDATIONS.—The OASIS
Task Force shall review and make recommendations to the
Secretary regarding changes in OASIS to improve and sim-
plify data collection for purposes of—
(A) assessing the quality of home health services;
and
(B) providing consistency in classification of pa-
tients into home health resource groups (HHRGs) for
payment under section 1895 of the Social Security Act
(42 U.S.C. 1395fff).
(2) SPECIFIC ITEMS.—In conducting the review under
paragraph (1), the OASIS Task Force shall specifically
examine—
(A) the 41 outcome measures currently in use;
(B) the timing and frequency of data collection;
and
(C) the collection of information on comorbidities
and clinical indicators.
(3) REPORT.—The OASIS Task Force shall submit a
report to the Secretary containing its findings and rec-
ommendations for changes in OASIS by not later than 18
months after the date of the enactment of this Act.
(d) SUNSET.—The OASIS Task Force shall terminate 60
days after the date on which the report is submitted under sub-
section (c)(2).
(e) NONAPPLICATION OF FACA.—The provisions of the
Federal Advisory Committee Act shall not apply to the OASIS
Task Force.
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(f) SUSPENSION OF OASIS REQUIREMENT FOR COLLEC-
TION OF DATA ON NON-MEDICARE AND NON-MEDICAID PA-
TIENTS PENDING TASK FORCE REPORT.—
(1) IN
GENERAL.—During the period described in
paragraph (2), the Secretary of Health and Human Serv-
ices may not require, under section 4602(e) of the Bal-
anced Budget Act of 1997 or otherwise under OASIS, a
home health agency to gather or submit information that
relates to an individual who is not eligible for benefits
under either title XVIII or title XIX of the Social Security
Act.
(2) PERIOD OF SUSPENSION.—The period described in
this paragraph—
(A) begins on January 1, 2003, and
(B) ends on the last day of the 2nd month begin-
ning after the date the report is submitted under sub-
section (c)(2).
SEC. 605. MEDPAC STUDY ON MEDICARE MARGINS OF
HOME HEALTH AGENCIES.
(a) STUDY.—The Medicare Payment Advisory Commission
shall conduct a study of payment margins of home health agen-
cies under the home health prospective payment system under
section 1895 of the Social Security Act (42 U.S.C. 1395fff).
Such study shall examine whether systematic differences in
payment margins are related to differences in case mix (as
measured by home health resource groups (HHRGs)) among
such agencies. The study shall use the partial or full-year cost
reports filed by home health agencies.
(b) REPORT.—Not later than 2 years after the date of the
enactment of this Act, the Commission shall submit to Con-
gress a report on the study under subsection (a).
Subtitle B—Direct Graduate Medical
Education
SEC. 611. EXTENSION OF UPDATE LIMITATION ON HIGH
COST PROGRAMS.
Section 
1886(h)(2)(D)(iv) 
(42 
U.S.C.
1395ww(h)(2)(D)(iv)) is amended—