Summary: H.R.4339 — 105th Congress (1997-1998)All Information (Except Text)

There is one summary for H.R.4339. Bill summaries are authored by CRS.

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Introduced in House (07/27/1998)

Medicare Home Health Beneficiary Protection Act of 1998 - Amends part D (Miscellaneous Provisions) of title XVIII (Medicare) of the Social Security Act (SSA), as amended by the Balanced Budget Act of 1997 (BBA '97), to revise reasonable cost requirements with regard to the interim system of limited payments for services provided by home health agencies. Establishes a moratorium on implementation of per beneficiary limits and a three-year freeze on cost limits.

Amends BBA '97 to direct the Secretary of Health and Human Services (HHS) to: (1) establish a process for eliminating inappropriate utilization of home health services by reviewing claims for reimbursement of such services furnished under the Medicare program in which the number of home health visits provided to a beneficiary in a year exceeds the regional average of per beneficiary annual visits; (2) if appropriate, issue a determination denying payment for such a claim, and refer the name of the claimant-provider to the HHS Office of Inspector General for investigation; and (3) include in the annual reports to the Congress on home health cost containment any recommendations for changes to the method of payment, claims review, and scope of benefits that the Secretary determines is necessary to achieve actual outlays equal to estimated outlays under Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance) for such services during the following fiscal year.

(Sec. 4) Amends SSA title XVIII to provide for: (1) establishment of limits for calculating prospective payment rates for home health services under the payment system for such services; and (2) temporary restoration of periodic interim payment for such services.