I 118th CONGRESS 1st Session H. R. 5159 IN THE HOUSE OF REPRESENTATIVES August 4, 2023 Ms. Sewell (for herself and Mr. Smith of Nebraska ) 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 concerned A BILL To amend title XVIII of the Social Security Act to ensure stability in payments to home health agencies under the Medicare program.

1. Short title This Act may be cited as the Preserving Access to Home Health Act of 2023 . 2. Ensuring stability in payments to home health agencies (a) Repeal of permanent and temporary adjustments Section 1895(b)(3) of the Social Security Act ( 42 U.S.C. 1395fff(b)(3) ) is amended by striking subparagraph (D). (b) Effective date; implementation (1) Effective date The amendment made by subsection (a) shall take effect as if included in the enactment of the Bipartisan Budget Act of 2018 ( Public Law 115–123 ). (2) Implementation The Secretary of Health and Human Services (in this section referred to as the Secretary ) shall implement such section 1895(b)(3) for 2024 and subsequent years as if the amendment made by section 51001(a)(2)(B) of division E of the Bipartisan Budget Act of 2018 ( Public Law 115–123 ) (adding such subparagraph (D)) had not been made. (c) Construction Nothing in this section shall be construed as signifying congressional approval or disapproval of the methodology promulgated by the Secretary to implement section 1895(b)(3)(D) of the Social Security Act in the final rule entitled, Medicare Program; Calendar Year (CY) 2023 Home Health Prospective Payment System Rate Update; Home Health Quality Reporting Program Requirements; Home Health Value-Based Purchasing Expanded Model Requirements; and Home Infusion Therapy Services Requirements published in the Federal Register on November 4, 2022 (87 Fed. Reg. 66790). 3. Interaction of medicare payment policies with health care delivery generally Section 1805(b)(2)(C) of the Social Security Act ( 42 U.S.C. 1395b–6(b)(2)(C) ) is amended— (1) by striking generally .—Specifically, and inserting “ generally .— (i) In general Specifically, ; and (2) by adding at the end the following new clause: (ii) Special rule for home health agencies (I) In general When conducting the review of home health agency financial performance and its impact on access to care under the original fee-for-service system, the Commission shall— (aa) review and report on aggregate trends in spending, utilization, and financial performance under the Medicare Advantage program, the Medicaid program under title XIX (both fee-for-service and managed care payment models), and other payers for home health agency services; (bb) evaluate and consider the impact of all payers on access to care for Medicare beneficiaries; and (cc) comprehensively disclose the methodologies used to evaluate and calculate home health agency margins under this title and all other payers, including the process for developing the data used. Where appropriate, the Commission shall conduct such reviews in consultation with the Medicaid and CHIP Payment and Access Commission established under section 1900. (II) Medicare home health cost report amendments For cost reporting periods beginning in 2025 and subsequent years, the Secretary shall have in effect an amended Medicare home health cost report that collects data on visit utilization and total payments by payer source, including original fee-for-service payments, Medicare Advantage, the Medicaid program under title XIX (both fee-for-service and managed care payment models), and other payers. The Secretary shall make such amended cost reports available to the Commission in the form and manner necessary to conduct the analysis described in subclause (I). (III) Financial data Prior to the availability of cost report data as described in subclause (II), the Commission shall utilize data on cost and revenues from sources it deems as reliable and valid for purposes of conducting the analysis described in subclause (I). .