Medicare Home Health Payment Improvement Act of 1999

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Home Health Payment 
Improvement Act of 1999''.

SEC. 2. ELIMINATION OF SCHEDULED 15 PERCENT REDUCTION.

    (a) Prospective Payment System.--
            (1) In general.--Section 1895(b)(3)(A) of the Social 
        Security Act (42 U.S.C. 1395fff(b)(3)(A)) is amended--
                    (A) in clause (i)--
                            (i) by striking ``but if the reduction in 
                        limits described in clause (ii) had been in 
                        effect''; and
                            (ii) by striking ``(i) In general.--'' and 
                        adjusting the margin accordingly; and
                    (B) by striking clause (ii).
            (2) Conforming amendment.--Section 1895(d)(3) of such Act 
        (42 U.S.C. 1395fff(d)(3)) is amended by striking ``(including 
        the reduction described in clause (ii) of such subsection)''.
    (b) Interim Payment System.--Section 4603 of the Balanced Budget 
Act of 1997 (Public Law 105-33), as amended by section 5101(c)(3) of 
the Tax and Trade Relief Extension Act of 1998 (Public Law 105-277), is 
amended by striking subsection (e).

SEC. 3. EXTENSION OF REPAYMENT PERIOD FOR OVERPAYMENTS.

    (a) 60-Month Repayment Period.--In the case of an overpayment by 
the Secretary of Health and Human Services to a home health agency for 
home health services furnished under the medicare program during a cost 
reporting period beginning on or after October 1, 1997, as a result of 
payment limitations provided for under clause (v), (vi), or (viii) of 
section 1861(v)(1)(L) of the Social Security Act (42 U.S.C. 
1395x(v)(1)(L)), the home health agency may elect to repay the amount 
of such overpayment over a 60-month period beginning on the date of 
notification of such overpayment.
    (b) Interest on Overpayment Amounts.--
            (1) 60-month grace period.--
                    (A) In general.--In the case of an agency that 
                makes an election under subsection (a), no interest 
                shall accrue on the outstanding balance of the amount 
                of overpayment during such 60-month period.
                    (B) Overdue balances.--In the case of such an 
                agency, interest shall accrue on any outstanding 
                balance of the amount of overpayment after termination 
                of such 60-month period. Interest shall accrue under 
                this subparagraph at the rate of interest charged by 
                banks for loans to their most favored commercial 
                customers, as published in the Wall Street Journal on 
                the Friday immediately following the date of the 
                enactment of this Act.
            (2) Other agencies.--In the case of an agency described in 
        subsection (a) that does not make an election under subsection 
        (a), interest shall accrue on the outstanding balance of the 
        amount of overpayment at the rate described in the second 
        sentence of paragraph (1)(B).
    (c) Termination.--No election under subsection (a) may be made for 
cost reporting periods, or portions of cost reporting periods, 
beginning on or after the date of the implementation of the prospective 
payment system for home health services under section 1895 of the 
Social Security Act (42 U.S.C. 1395fff).
    (d) Effective Date.--The provisions of this section shall take 
effect as if included in the enactment of the Balanced Budget Act of 
1997.

SEC. 4. REPORT TO CONGRESS ON ADMINISTRATIVE BURDENS ON MEDICARE HOME 
              HEALTH AGENCIES IN COMPLYING WITH OUTCOME AND ASSESSMENT 
              INFORMATION SET (OASIS) REQUIREMENT.

    (a) Report to Congress.--Not later than 90 days after the date of 
the enactment of this Act, the Secretary of Health and Human Services 
shall submit to Congress and the Comptroller General of the United 
States a report describing costs incurred by medicare home health 
agencies in complying with the data collection requirement of patients 
of such agencies under the Outcome and Assessment Information Set 
(OASIS) standard as part of the comprehensive assessment of patients.
    (b) GAO Audit.--The Comptroller General of the United States shall 
conduct an independent audit of the costs described in subsection (a). 
Not later than 180 days after receipt of the report under subsection 
(a), the Comptroller General shall submit to Congress a report 
describing the Comptroller General's findings with respect to such 
audit, and shall include comments on the report submitted to Congress 
by the Secretary of Health and Human Services under subsection (a).
    (c) Definitions.--In this section:
            (1) Comprehensive assessment of patients.--The term 
        ``comprehensive assessment of patients'' means the rule 
        published by the Health Care Financing Administration that 
        requires, as a condition of participation in the medicare 
        program, a home health agency to provide a patient-specific 
        comprehensive assessment that accurately reflects the patient's 
        current status and that incorporates the Outcome and Assessment 
        Information Set (OASIS).
            (2) Outcome and assessment information set.--The term 
        ``Outcome and Assessment Information Set'' means the standard 
        provided under the rule relating to data items that must be 
        used in conducting a comprehensive assessment of patients.

SEC. 5. ELIMINATION OF INCREMENTAL BILLING REQUIREMENT.

    (a) In General.--Section 1895(c)(2) of the Social Security Act (42 
U.S.C. 1395fff(c)(2)) is amended by striking ``, as measured in 15 
minute increments.'' and inserting a period.
    (b) Effective Date.--The amendment made by subsection (a) takes 
effect as if included in the enactment of the Balanced Budget Act of 
1997 (Public Law 105-33).

Summary: Allows home health agencies to elect to repay certain overpayments made by the Secretary of Health and Human Services over a 60-month no- interest grace period. Makes such an election effective as if included in BBA '97.
Directs the Secretary to report to Congress and the Comptroller General (CG) on the costs incurred by Medicare home health agencies in complying with the Outcome and Assessment Information Set (OASIS) patient data collection requirement. Requires the CG to conduct an independent audit of such costs for a report to Congress.
Amends SSA title XVIII to eliminate the incremental billing requirement with respect to home health service visits under the Medicare program.