Home Health Care Planning Improvement Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 2150 To amend title XVIII of the Social Security Act to ensure more timely access to home health services for Medicare beneficiaries under the Medi- care program. IN THE HOUSE OF REPRESENTATIVES APRIL 9, 2019 Ms. SCHAKOWSKY (for herself, Mr. CARTER of Georgia, Mr. KIND, Mr. KELLY of Pennsylvania, Ms. WILD, and Mr. JOYCE of Ohio) introduced the fol- lowing 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 consider- ation 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 more timely access to home health services for Medicare beneficiaries under the Medicare program. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Home Health Care 4 Planning Improvement Act of 2019’’. 5 VerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2150.IH H2150 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 2150 IH SEC. 2. IMPROVING CARE PLANNING FOR MEDICARE HOME 1 HEALTH SERVICES. 2 (a) PART A PROVISIONS.—Section 1814(a) of the So- 3 cial Security Act (42 U.S.C. 1395f(a)) is amended— 4 (1) in paragraph (2)— 5 (A) in the matter preceding subparagraph 6 (A), by inserting ‘‘, a nurse practitioner or clin- 7 ical nurse specialist who is working in collabo- 8 ration with a physician in accordance with 9 State law, a certified nurse-midwife (as defined 10 in section 1861(gg)) as authorized by State law, 11 or a physician assistant (as defined in section 12 1861(aa)(5)) under the supervision of a physi- 13 cian’’ after ‘‘1866(j)’’; and 14 (B) in subparagraph (C)— 15 (i) by inserting ‘‘, a nurse practi- 16 tioner, a clinical nurse specialist, a cer- 17 tified nurse-midwife, or a physician assist- 18 ant (as the case may be)’’ after ‘‘physi- 19 cian’’ the first 2 times it appears; and 20 (ii) by striking ‘‘, and, in the case of 21 a certification made by a physician’’ and 22 all that follows through ‘‘face-to-face en- 23 counter’’ and inserting ‘‘, and, in the case 24 of a certification made by a physician after 25 January 1, 2010, or by a nurse practi- 26 VerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2150.IH H2150 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 2150 IH tioner, clinical nurse specialist, certified 1 nurse-midwife, or physician assistant (as 2 the case may be) after January 1, 2020, 3 prior to making such certification the phy- 4 sician, nurse practitioner, clinical nurse 5 specialist, certified nurse-midwife, or physi- 6 cian assistant must document that the 7 physician, nurse practitioner, clinical nurse 8 specialist, certified nurse-midwife, or physi- 9 cian assistant has had a face-to-face en- 10 counter’’; 11 (2) in the second sentence, by inserting ‘‘cer- 12 tified nurse-midwife,’’ after ‘‘clinical nurse spe- 13 cialist,’’; 14 (3) in the third sentence— 15 (A) by striking ‘‘physician certification’’ 16 and inserting ‘‘certification’’; 17 (B) by inserting ‘‘(or on January 1, 2020, 18 in the case of regulations to implement the 19 amendments made by section 2 of the Home 20 Health Care Planning Improvement Act of 21 2019)’’ after ‘‘1981’’; and 22 (C) by striking ‘‘a physician who’’ and in- 23 serting ‘‘a physician, nurse practitioner, clinical 24 VerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2150.IH H2150 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 2150 IH nurse specialist, certified nurse-midwife, or phy- 1 sician assistant who’’; and 2 (4) in the fourth sentence, by inserting ‘‘, nurse 3 practitioner, clinical nurse specialist, certified nurse- 4 midwife, or physician assistant’’ after ‘‘physician’’. 5 (b) PART B PROVISIONS.—Section 1835(a) of the So- 6 cial Security Act (42 U.S.C. 1395n(a)) is amended— 7 (1) in paragraph (2)— 8 (A) in the matter preceding subparagraph 9 (A), by inserting ‘‘, a nurse practitioner or clin- 10 ical nurse specialist (as those terms are defined 11 in 1861(aa)(5)) who is working in collaboration 12 with a physician in accordance with State law, 13 a certified nurse-midwife (as defined in section 14 1861(gg)) as authorized by State law, or a phy- 15 sician assistant (as defined in section 16 1861(aa)(5)) under the supervision of a physi- 17 cian’’ after ‘‘1866(j)’’; and 18 (B) in subparagraph (A)— 19 (i) in each of clauses (ii) and (iii) of 20 subparagraph (A) by inserting ‘‘, a nurse 21 practitioner, a clinical nurse specialist, a 22 certified nurse-midwife, or a physician as- 23 sistant (as the case may be)’’ after ‘‘physi- 24 cian’’; and 25 VerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2150.IH H2150 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 2150 IH (ii) in clause (iv), by striking ‘‘after 1 January 1, 2010’’ and all that follows 2 through ‘‘face-to-face encounter’’ and in- 3 serting ‘‘made by a physician after Janu- 4 ary 1, 2010, or by a nurse practitioner, 5 clinical nurse specialist, certified nurse- 6 midwife, or physician assistant (as the case 7 may be) after January 1, 2020, prior to 8 making such certification the physician, 9 nurse practitioner, clinical nurse specialist, 10 certified nurse-midwife, or physician assist- 11 ant must document that the physician, 12 nurse practitioner, clinical nurse specialist, 13 certified nurse-midwife, or physician assist- 14 ant has had a face-to-face encounter’’; 15 (2) in the third sentence, by inserting ‘‘, nurse 16 practitioner, clinical nurse specialist, certified nurse- 17 midwife, or physician assistant (as the case may 18 be)’’ after physician; 19 (3) in the fourth sentence— 20 (A) by striking ‘‘physician certification’’ 21 and inserting ‘‘certification’’; 22 (B) by inserting ‘‘(or on January 1, 2020, 23 in the case of regulations to implement the 24 amendments made by section 2 of the Home 25 VerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2150.IH H2150 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 2150 IH Health Care Planning Improvement Act of 1 2019)’’ after ‘‘1981’’; and 2 (C) by striking ‘‘a physician who’’ and in- 3 serting ‘‘a physician, nurse practitioner, clinical 4 nurse specialist, certified nurse-midwife, or phy- 5 sician assistant who’’; and 6 (4) in the fifth sentence, by inserting ‘‘, nurse 7 practitioner, clinical nurse specialist, certified nurse- 8 midwife, or physician assistant’’ after ‘‘physician’’. 9 (c) DEFINITION PROVISIONS.— 10 (1) HOME HEALTH SERVICES.—Section 11 1861(m) of the Social Security Act (42 U.S.C. 12 1395x(m)) is amended— 13 (A) in the matter preceding paragraph 14 (1)— 15 (i) by inserting ‘‘, a nurse practitioner 16 or a clinical nurse specialist (as those 17 terms are defined in subsection (aa)(5)), a 18 certified nurse-midwife (as defined in sec- 19 tion 1861(gg)), or a physician assistant (as 20 defined in subsection (aa)(5))’’ after ‘‘phy- 21 sician’’ the first place it appears; and 22 (ii) by inserting ‘‘, a nurse practi- 23 tioner, a clinical nurse specialist, a cer- 24 tified nurse-midwife, or a physician assist- 25 VerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2150.IH H2150 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 2150 IH ant’’ after ‘‘physician’’ the second place it 1 appears; and 2 (B) in paragraph (3), by inserting ‘‘, a 3 nurse practitioner, a clinical nurse specialist, a 4 certified nurse-midwife, or a physician assist- 5 ant’’ after ‘‘physician’’. 6 (2) HOME HEALTH AGENCY.—Section 7 1861(o)(2) of the Social Security Act (42 U.S.C. 8 1395x(o)(2)) is amended— 9 (A) by inserting ‘‘, nurse practitioners or 10 clinical nurse specialists (as those terms are de- 11 fined in subsection (aa)(5)), certified nurse-mid- 12 wives (as defined in section 1861(gg)), or physi- 13 cian assistants (as defined in subsection 14 (aa)(5))’’ after ‘‘physicians’’; and 15 (B) by inserting ‘‘, nurse practitioner, clin- 16 ical nurse specialist, certified nurse-midwife, 17 physician assistant,’’ after ‘‘physician’’. 18 (d) HOME HEALTH PROSPECTIVE PAYMENT SYSTEM 19 PROVISIONS.—Section 1895 of the Social Security Act (42 20 U.S.C. 1395fff) is amended— 21 (1) in subsection (c)(1), by inserting ‘‘, the 22 nurse practitioner or clinical nurse specialist (as 23 those terms are defined in section 1861(aa)(5)), the 24 certified nurse-midwife (as defined in section 25 VerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2150.IH H2150 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 2150 IH 1861(gg)), or the physician assistant (as defined in 1 section 1861(aa)(5)),’’ after ‘‘physician’’; and 2 (2) in subsection (e)— 3 (A) in paragraph (1)(A), by inserting ‘‘, a 4 nurse practitioner or clinical nurse specialist (as 5 those terms are defined in section 1861(aa)(5)), 6 a certified nurse-midwife (as defined in section 7 1861(gg)), or a physician assistant (as defined 8 in section 1861(aa)(5))’’ after ‘‘physician’’; and 9 (B) in paragraph (2)— 10 (i) in the heading, by striking ‘‘PHY- 11 SICIAN CERTIFICATION’’ and inserting 12 ‘‘RULE OF CONSTRUCTION REGARDING RE- 13 QUIREMENT FOR CERTIFICATION’’; and 14 (ii) by striking ‘‘physician’’. 15 (e) EFFECTIVE DATE.—The amendments made by 16 this section shall apply to items and services furnished on 17 or after January 1, 2020. 18 Æ VerDate Sep 11 2014 00:39 Apr 17, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H2150.IH H2150 pamtmann on DSKBFK8HB2PROD with BILLS