H.R.3567 - Medicare Home Health Equity Act of 1998105th Congress (1997-1998)
|Sponsor:||Rep. Pappas, Michael [R-NJ-12] (Introduced 03/26/1998)|
|Committees:||House - Ways and Means; Commerce|
|Latest Action:||06/10/1998 Sponsor introductory remarks on measure.|
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Text: H.R.3567 — 105th Congress (1997-1998)All Bill Information (Except Text)
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Introduced in House (03/26/1998)
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[Congressional Bills 105th Congress] [From the U.S. Government Printing Office] [H.R. 3567 Introduced in House (IH)] 105th CONGRESS 2d Session H. R. 3567 To amend title XVIII of the Social Security Act to provide for equitable payments to home health agencies under the Medicare Program. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES March 26, 1998 Mr. Pappas (for himself, Mr. Smith of New Jersey, Mr. Saxton, and Mr. Coyne) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on 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 provide for equitable payments to home health agencies under the Medicare Program. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. The Act may be cited as the ``Medicare Home Health Equity Act of 1998''. SEC. 2. PAYMENTS TO HOME HEALTH AGENCIES UNDER MEDICARE. (a) Restoration of Per Visit Cost Limit to 112 Percent of the Mean of Costs.--Section 1861(v)(1)(L)(i) of the Social Security Act (42 U.S.C. 1395x(v)(1)(L)(i)), as amended by section 4602(a) of the Balanced Budget Act of 1997, is amended-- (1) in subclause (II), by adding at the end ``or''; (2) in subclause (III), by striking ``and before October 1, 1997,'' and ``or''; and (3) by striking subclause (IV). (b) Revision of Interim Payment System for Home Health Services.-- (1) In general.--Section 1861 (v)(1)(L) of the Social Security Act (42 U.S.C. 1395x(v)(1)(L)), as amended by section 4602(c) of the Balanced Budget Act of 1997, is amended-- (A) by striking clauses (v) and (vi); (B) by redesignating clause (vii) as clause (viii); and (C) by inserting after clause (iv) the following new clauses: ``(v) For services furnished by home health agencies for cost reporting periods beginning on or after October 1, 1997, the Secretary shall provide for an interim system of limits. Payment shall not exceed the costs determined under the preceding provisions of this subparagraph or, if lower, the product of-- ``(I) an agency-specific per beneficiary annual limitation calculated based 75 percent on the reasonable costs (including nonroutine medical supplies) of the standardized national average cost per patient in fiscal year 1994 and 25 percent on the reasonable costs (including nonroutine medical supplies) of the standardized regional average cost per patient for the agency's census division in fiscal year 1995, such national and regional costs adjusted as appropriate under clause (vi) and updated by the home health market basket index; and ``(II) the agency's unduplicated census count of patients (entitled to benefits under this title) for the cost reporting period subject to the limitation. ``(vi)(I) The Secretary shall adjust the labor-related portion of costs determined under clause (v)(I) by the area wage index applicable under section 1886(d)(3)(E) for the area in which the agency is located (as determined without regard to any reclassification of the area under section 1886(d)(8)(B) or a decision of the Medicare Geographic Classification Review Board or the Secretary under section 1886(d)(10) for a cost reporting period beginning after October 1, 1995). ``(II) The Secretary shall provide for an addition or adjustment to the payment amount otherwise made under this subparagraph in the case of outliers because of unusual variations in the type or amount of medically necessary care. The total amount of the additional payments or payment adjustments made under this subclause with respect to a fiscal year may not exceed the total payments otherwise to be made under this subparagraph in that year. ``(vii) For beneficiaries who use services furnished by more than one home health agency, the per beneficiary limitations shall be prorated among the agencies.''. (2) Conforming Amendment.--Section 1861(v)(1)(L)(viii)) of such Act (42 U.S.C. 1395x(v)(1)(L)(viii)), as so redesignated in paragraph (1)(B), is amended by striking ``April 1, 1998'' and inserting ``May 1, 1998''. (c) Effective Date.--The amendments made by this section shall apply as if included in the enactment of the Balanced Budget Act of 1997. <all>