Summary: H.R.4404 — 105th Congress (1997-1998)All Information (Except Text)

There is one summary for H.R.4404. Bill summaries are authored by CRS.

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Introduced in House (08/05/1998)

Homebound Elderly Relief Opportunity Act of 1998 - Amends title XVIII (Medicare) of the Social Security Act (SSA), as amended by the Balanced Budget Act of 1997 (BBA '97), with respect to the computation formula of the interim system of limited payments for services provided by home health agencies. Declares that such interim system shall apply only if aggregate expenditures for home health services in a fiscal year exceed specified applicable amounts for FY 1998 and 1999 (with adjustments through FY 2002). Requires the Secretary of Health and Human Services, in the case of such an excess, to implement such system beginning January 1 of the year following the fiscal year in which such aggregate expenditures exceed the applicable amount.

Includes in the computation formula the separate determination of costs for agencies in rural and nonrural areas.

Provides for adjustment of payments (up to five percent of the aggregate projected or estimated payments) for outliers where the reasonable cost for home health services to an individual exceeds the per beneficiary limit by a fixed number of standard deviations.

Eliminates the special rule for new agencies with respect to determination of the reasonable cost of home health services.

Provides for a five percent increase in per-visit cost limits for cost reporting periods beginning on or after October 1, 1997.

Amends SSA title XVIII (Medicare) to modify calculation of the payment amount for home health services under the prospective payment system (PPS) for them created under BBA '97.

Provides for an adjustment in the current 15 percent reduction in cost and per beneficiary limits for cost reporting periods beginning before October 1, 2002, if the PPS is not established for the pertinent cost reporting periods, with a return of the current reduction for cost reporting periods beginning on or after such date.

Amends SSA title XVIII to provide for temporary restoration of periodic interim payment for home health services until the PPS for such services is implemented under Medicare.