I 
116TH CONGRESS 
2D SESSION 
H. R. 8834 
To amend title XVIII of the Social Security Act to extend and improve 
the Independence at Home Medical Practice Demonstration Program 
under the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 2, 2020 
Mrs. DINGELL (for herself, Ms. STEVENS, Mr. BLUMENAUER, and Mr. 
THOMPSON of California) introduced the following bill; which was re-
ferred to the Committee on Ways and Means, and in addition to the 
Committee on Energy and Commerce, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to extend 
and improve the Independence at Home Medical Practice 
Demonstration Program under the Medicare program. 
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 ‘‘Independence at Home 
Demonstration Improvement Act of 2020’’. 
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SEC. 2. EXTENDING AND IMPROVING THE INDEPENDENCE 
AT HOME MEDICAL PRACTICE DEMONSTRA-
TION PROGRAM UNDER THE MEDICARE PRO-
GRAM. 
Section 1866E of the Social Security Act (42 U.S.C. 
1395cc–5) is amended— 
(1) in subsection (e)— 
(A) in paragraph (1), by striking ‘‘7’’ and 
inserting ‘‘10’’; 
(B) in paragraph (2)— 
(i) in the header, by striking ‘‘NO 
PHYSICIAN’’ and inserting ‘‘PHYSICIAN’’; 
and 
(ii) by adding at the end the following 
new sentence: ‘‘Nothing in the previous 
sentence shall be construed to prohibit an 
independence at home medical practice 
from participating in any model or dem-
onstration with a shared savings compo-
nent under this title (other than the pro-
gram under section 1899) or under section 
1115A if such participation is determined 
appropriate by the Secretary.’’; and 
(C) in paragraph (4)— 
(i) by redesignating subparagraphs 
(A) through (C) as clauses (i) through 
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(iii), respectively, and adjusting the mar-
gins accordingly; 
(ii) in clause (i), as so redesignated, 
by inserting ‘‘are’’ before ‘‘located’’; 
(iii) in clause (iii), as so redesignated, 
by striking the period at the end and in-
serting ‘‘; and’’; 
(iv) in the matter preceding clause (i), 
as so redesignated, by striking ‘‘to prac-
tices that are—’’ and inserting the fol-
lowing: ‘‘to— 
‘‘(A) practices that—’’; and 
(v) by adding at the end the following 
new subparagraph: 
‘‘(B) practices with the same tax identi-
fication number as an independence at home 
medical practice approved under this paragraph 
as of the date of the enactment of this subpara-
graph.’’; and 
(D) in paragraph (5)— 
(i) in the first sentence, by inserting 
‘‘in 2019’’ after ‘‘15,000’’; 
(ii) by inserting ‘‘For each subsequent 
year, the beneficiary limitation in effect 
under this paragraph for the previous year 
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(including, if applicable, any increase made 
under this sentence) shall be increased by 
5,000 if the Secretary determines that op-
eration of the program under this section 
for such previous year resulted in aggre-
gate savings under this title for such year 
compared to expenditures under this title 
for such year had such program not been 
in effect.’’ after the first sentence; 
(iii) by striking ‘‘the increase from 
10,000 to 15,000 in the preceding sen-
tence’’ and inserting ‘‘an increase’’; 
(iv) by inserting ‘‘or the amendment 
made by section 2(1)(D)(ii) of the Inde-
pendence at Home Demonstration Im-
provement Act of 2020’’ after ‘‘Social 
Services Act’’; 
(v) by striking ‘‘and seventh’’ and in-
serting ‘‘through tenth’’; and 
(vi) by inserting ‘‘, as applicable’’ 
after ‘‘such program’’; 
(2) in subsection (g)— 
(A) by striking ‘‘The Secretary shall’’ and 
inserting the following: 
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‘‘(2) FINAL
REPORT.—The Secretary shall’’; 
and 
(B) by inserting before paragraph (2), as 
designated by subparagraph (A), the following 
new paragraph: 
‘‘(1) ANNUAL REPORTS.—The Secretary shall 
conduct an independent evaluation of the demonstra-
tion program and submit to Congress an annual re-
port at the close of each performance year (begin-
ning with performance year 2021), including a speci-
fication of any improvements made to the program 
for such year. Such report shall include an analysis 
such improvements’ impact on coordination of care, 
expenditures under this title, applicable beneficiary 
access to services, and the quality of health care 
services provided to applicable beneficiaries.’’; 
(3) in subsection (h), by striking ‘‘each of fiscal 
years 2010 through 2015’’ and inserting ‘‘fiscal year 
2021’’; and 
(4) by adding at the end the following new sub-
section: 
‘‘(j) AUTHORITY TO IMPLEMENT IMPROVEMENTS TO 
PROGRAM.—The Secretary may make such improvements 
to the demonstration program not inconsistent with the 
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preceding provisions of this section as the Secretary deter-
mines appropriate for purposes of— 
‘‘(1) improving coordination of care; 
‘‘(2) lowering expenditures; 
‘‘(3) increasing access to items and services 
under the program; or 
‘‘(4) improving the quality of items and services 
furnished under the program.’’. 
Æ 
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