Preventive Home Visit Act

II 116TH CONGRESS 2D SESSION S. 3238 To amend title XVIII of the Social Security Act to provide coverage of preventive home visits under Medicare, and for other purposes. IN THE SENATE OF THE UNITED STATES JANUARY 28, 2020 Mr. KING introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to provide coverage of preventive home visits under Medicare, and for other purposes. 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 ‘‘Preventive Home Visit 4 Act’’. 5 SEC. 2. MEDICARE COVERAGE OF PREVENTIVE HOME VIS- 6 ITS. 7 (a) IN GENERAL.—Section 1861 of the Social Secu- 8 rity Act (42 U.S.C. 1395x) is amended— 9 (1) in subsection (s)(2)— 10 VerDate Sep 11 2014 22:30 Jan 28, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3238.IS S3238 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 3238 IS (A) in subparagraph (GG), by striking 1 ‘‘and’’ at the end; 2 (B) in subparagraph (HH), by striking the 3 period at the end and inserting ‘‘; and’’; and 4 (C) by adding at the end the following new 5 subparagraph: 6 ‘‘(II) a preventive home visit as defined in sub- 7 section (kkk).’’; and 8 (2) by adding at the end the following new sub- 9 section: 10 ‘‘Preventive Home Visit 11 ‘‘(kkk) The term ‘preventive home visit’ means a visit 12 to the home of an individual by a qualified professional 13 (as defined by the Secretary), not more frequently than 14 once every two years, during which the qualified profes- 15 sional provides an assessment of the home environment 16 of the individual, identifies health risks, and provides a 17 referral, as appropriate, for interventions or home modi- 18 fications to improve physical activity, fall prevention, and 19 nutrition with respect to the individual.’’. 20 (b) PAYMENT.— 21 (1) IN GENERAL.—Section 1833(a)(1) of the 22 Social Security Act (42 U.S.C. 1395l(a)(1)) is 23 amended— 24 VerDate Sep 11 2014 22:30 Jan 28, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3238.IS S3238 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 3238 IS (A) by striking ‘‘and (CC)’’ and inserting 1 ‘‘(CC)’’; and 2 (B) by inserting before the semicolon at 3 the end the following: ‘‘and (DD) with respect 4 to a home visit as defined in section 1861(kkk), 5 the amount paid shall be equal to 100 percent 6 of the lesser of the actual charge for the service 7 or the amount determined under section 8 1834(x)’’. 9 (2) PAYMENT DETERMINATION.—Section 1834 10 of the Social Security Act (42 U.S.C. 1395m) is 11 amended by adding at the end the following new 12 subparagraph: 13 ‘‘(x) PREVENTIVE HOME VISITS.—The Secretary 14 shall establish a bundled payment amount for a preventive 15 home visit, including any referrals made in connection 16 with the visit.’’. 17 (c) FREQUENCY LIMITATION.—Section 1862(a)(1) of 18 the Social Security Act (42 U.S.C. 1395y(a)(1)) is amend- 19 ed— 20 (1) in subsection (O), by striking ‘‘and’’ at the 21 end; 22 (2) in subsection (P), by striking the semicolon 23 and inserting ‘‘, and’’; and 24 VerDate Sep 11 2014 22:30 Jan 28, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3238.IS S3238 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 3238 IS (3) by adding at the end the following new sub- 1 paragraph: 2 ‘‘(Q) in the case of a preventive home visit as 3 defined in section 1861(kkk), which is provided more 4 frequently than is covered under such section.’’. 5 Æ VerDate Sep 11 2014 22:30 Jan 28, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\S3238.IS S3238 pamtmann on DSKBC07HB2PROD with BILLS