Independence at Home Demonstration Improvement Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 8834 To amend title XVIII of the Social Security Act to extend and improve the Independence at Home Medical Practice Demonstration Program under the Medicare program. IN THE HOUSE OF REPRESENTATIVES DECEMBER 2, 2020 Mrs. DINGELL (for herself, Ms. STEVENS, Mr. BLUMENAUER, and Mr. THOMPSON of California) introduced the following bill; which was re- ferred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently de- termined 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 extend and improve the Independence at Home Medical Practice Demonstration Program 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 ‘‘Independence at Home 4 Demonstration Improvement Act of 2020’’. 5 VerDate Sep 11 2014 07:34 Dec 10, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8834.IH H8834 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 8834 IH SEC. 2. EXTENDING AND IMPROVING THE INDEPENDENCE 1 AT HOME MEDICAL PRACTICE DEMONSTRA- 2 TION PROGRAM UNDER THE MEDICARE PRO- 3 GRAM. 4 Section 1866E of the Social Security Act (42 U.S.C. 5 1395cc–5) is amended— 6 (1) in subsection (e)— 7 (A) in paragraph (1), by striking ‘‘7’’ and 8 inserting ‘‘10’’; 9 (B) in paragraph (2)— 10 (i) in the header, by striking ‘‘NO 11 PHYSICIAN’’ and inserting ‘‘PHYSICIAN’’; 12 and 13 (ii) by adding at the end the following 14 new sentence: ‘‘Nothing in the previous 15 sentence shall be construed to prohibit an 16 independence at home medical practice 17 from participating in any model or dem- 18 onstration with a shared savings compo- 19 nent under this title (other than the pro- 20 gram under section 1899) or under section 21 1115A if such participation is determined 22 appropriate by the Secretary.’’; and 23 (C) in paragraph (4)— 24 (i) by redesignating subparagraphs 25 (A) through (C) as clauses (i) through 26 VerDate Sep 11 2014 07:34 Dec 10, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8834.IH H8834 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 8834 IH (iii), respectively, and adjusting the mar- 1 gins accordingly; 2 (ii) in clause (i), as so redesignated, 3 by inserting ‘‘are’’ before ‘‘located’’; 4 (iii) in clause (iii), as so redesignated, 5 by striking the period at the end and in- 6 serting ‘‘; and’’; 7 (iv) in the matter preceding clause (i), 8 as so redesignated, by striking ‘‘to prac- 9 tices that are—’’ and inserting the fol- 10 lowing: ‘‘to— 11 ‘‘(A) practices that—’’; and 12 (v) by adding at the end the following 13 new subparagraph: 14 ‘‘(B) practices with the same tax identi- 15 fication number as an independence at home 16 medical practice approved under this paragraph 17 as of the date of the enactment of this subpara- 18 graph.’’; and 19 (D) in paragraph (5)— 20 (i) in the first sentence, by inserting 21 ‘‘in 2019’’ after ‘‘15,000’’; 22 (ii) by inserting ‘‘For each subsequent 23 year, the beneficiary limitation in effect 24 under this paragraph for the previous year 25 VerDate Sep 11 2014 07:34 Dec 10, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8834.IH H8834 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 8834 IH (including, if applicable, any increase made 1 under this sentence) shall be increased by 2 5,000 if the Secretary determines that op- 3 eration of the program under this section 4 for such previous year resulted in aggre- 5 gate savings under this title for such year 6 compared to expenditures under this title 7 for such year had such program not been 8 in effect.’’ after the first sentence; 9 (iii) by striking ‘‘the increase from 10 10,000 to 15,000 in the preceding sen- 11 tence’’ and inserting ‘‘an increase’’; 12 (iv) by inserting ‘‘or the amendment 13 made by section 2(1)(D)(ii) of the Inde- 14 pendence at Home Demonstration Im- 15 provement Act of 2020’’ after ‘‘Social 16 Services Act’’; 17 (v) by striking ‘‘and seventh’’ and in- 18 serting ‘‘through tenth’’; and 19 (vi) by inserting ‘‘, as applicable’’ 20 after ‘‘such program’’; 21 (2) in subsection (g)— 22 (A) by striking ‘‘The Secretary shall’’ and 23 inserting the following: 24 VerDate Sep 11 2014 07:34 Dec 10, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H8834.IH H8834 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 8834 IH ‘‘(2) FINAL REPORT.—The Secretary shall’’; 1 and 2 (B) by inserting before paragraph (2), as 3 designated by subparagraph (A), the following 4 new paragraph: 5 ‘‘(1) ANNUAL REPORTS.—The Secretary shall 6 conduct an independent evaluation of the demonstra- 7 tion program and submit to Congress an annual re- 8 port at the close of each performance year (begin- 9 ning with performance year 2021), including a speci- 10 fication of any improvements made to the program 11 for such year. Such report shall include an analysis 12 such improvements’ impact on coordination of care, 13 expenditures under this title, applicable beneficiary 14 access to services, and the quality of health care 15 services provided to applicable beneficiaries.’’; 16 (3) in subsection (h), by striking ‘‘each of fiscal 17 years 2010 through 2015’’ and inserting ‘‘fiscal year 18 2021’’; and 19 (4) by adding at the end the following new sub- 20 section: 21 ‘‘(j) AUTHORITY TO IMPLEMENT IMPROVEMENTS TO 22 PROGRAM.—The Secretary may make such improvements 23 to the demonstration program not inconsistent with the 24 VerDate Sep 11 2014 07:34 Dec 10, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H8834.IH H8834 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 8834 IH preceding provisions of this section as the Secretary deter- 1 mines appropriate for purposes of— 2 ‘‘(1) improving coordination of care; 3 ‘‘(2) lowering expenditures; 4 ‘‘(3) increasing access to items and services 5 under the program; or 6 ‘‘(4) improving the quality of items and services 7 furnished under the program.’’. 8 Æ VerDate Sep 11 2014 07:34 Dec 10, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H8834.IH H8834 pbinns on DSKJLVW7X2PROD with BILLS