Sec. 305. Adjust Post-Acute Payment Updates
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Section 1886(j) of the Social Security Act ( 42 U.S.C. 1395ww(j) ) is amended— in paragraph (3)— in subparagraph (C), by striking clause
(iii)and inserting the following: For fiscal years 2016 through 2025, after establishing the increase factor for a fiscal year pursuant to clauses
(i)and (ii), if such increase factor is greater than 0.0 percent the Secretary shall reduce the increase factor by an additional amount described in subparagraph (E). ; and by inserting at the end the following new subparagraph: If the increase factor, as established pursuant to clauses
(i)and
(ii)of subparagraph (C), is greater than zero, for purposes of subparagraph (C)(iii), the additional adjustment described in this subparagraph is 1.1 percentage point for each of fiscal years 2016 through 2025. If the application of the additional adjustment in subparagraph (C)(iii) would result in an increase factor that is less than 0.0 for a fiscal year, the additional adjustment shall be reduced such that the increase factor after its application is 0.0. If, in any of fiscal years 2016 through 2025, the increase factor as adjusted by clauses
(i)and
(ii)of subparagraph
(C)is less than or equal to zero, the additional adjustment described in subparagraph (C)(iii) for such year is 0.0 percentage point. ; and in paragraph (7)(A)(i), by striking and
(D)and inserting , (D), and
(E). Section 1886(m) of the Social Security Act ( 42 U.S.C. 1395ww(m) ) is amended— in paragraph (3)— in subparagraph (A)— in clause (i), by striking and at the end; in clause (ii), by striking the period at the end and inserting ; and ; and by adding at the end the following new clause: for each of rate years 2016 through 2025, by the additional adjustment described in subparagraph (C). ; and by striking subparagraph
(C)and inserting the following: If the annual update, as established pursuant to clauses
(i)and
(ii)of paragraph (3)(A), is greater than zero, for purposes of clause
(iii)of such paragraph, the additional adjustment is 1.1 percentage point for each of fiscal years 2016 through 2025. If the application of the additional adjustment in paragraph (3)(A)(iii) would result in an annual update that is less than 0.0 for a fiscal year, the additional adjustment shall be reduced such that the annual update after its application is 0.0. If, in any of the fiscal years 2016 through 2025, the annual update, as established pursuant to clauses
(i)and
(ii)of paragraph (3)(A), is less than or equal to zero, the additional adjustment described in paragraph (3)(A)(iii) for such year is 0.0 percentage point. ; and by adding at the end the following new paragraph: With respect to discharges occurring on or after October 1, 2010, the term rate year under this subsection shall mean fiscal year . . Section 1888(e)(5)(B) of the Social Security Act ( 42 U.S.C. 1395yy(e)(5)(B) ) is amended— by striking clause
(ii)and inserting the following new clause: The Secretary shall reduce the percentage determined in clause
(i)by the following amounts: For fiscal year 2012 and each subsequent fiscal year, by the productivity adjustment described in section 1886(b)(3)(B)(xi)(II). For each of fiscal years 2016 through 2025, by the other adjustment described in clause (iii). Such percentage shall be reduced first by the productivity adjustment in subclause (I). The application of the productivity adjustment described in subclause
(I)may result in such percentage being less than 0.0 for a fiscal year, and may result in payment rates under this subsection for a fiscal year being less than such payment rates for the preceding fiscal year. If the application of the productivity adjustment in subclause
(I)results in such percentage being 0.0 or less than 0.0 for a fiscal year, the other adjustment described in subclause
(II)shall not apply. ; and by striking clause
(iii)and inserting the following: For purposes of clause (ii)(II), the other adjustment described in this clause is −2.5 percentage points in each of fiscal years 2016 and 2017, −2.0 percentage points in each of fiscal years 2018 and 2019, −1.5 percentage points in each of fiscal years 2020 through 2022, and −0.97 percentage point in each of fiscal years 2023 through 2025. The other adjustment shall be applied to the percentage under clause
(i)as reduced by the productivity adjustment in clause (ii)(I). If the application of the adjustment in clause (ii)(II) would result in the percentage under clause
(i)being less than 0.0 for a fiscal year, the other adjustment shall be reduced such that the final percentage after its application is 0.0 percentage point. . Section 1895(b)(3)(B) of the Social Security Act ( 42 U.S.C. 1395fff(b)(3)(B) ) is amended— in clause (iii), by striking the last sentence; by striking clause
(vi)and inserting the following new clause: After determining the home health market basket percentage increase under clause (iii), and after application of clause (v), the Secretary shall reduce such percentage— for 2015 and each subsequent year, by the productivity adjustment described in section 1886(b)(3)(B)(xi)(II); for each of 2011 and 2012, by 1 percentage point; and for each of 2016 through 2025, by the other adjustment described in subparagraph (vii). The application of subclauses
(I)and
(II)may result in the home health market basket percentage increase under clause
(iii)being less than 0.0 for a year, and may result in payment rates under the system under this subsection for a year being less than such payment rates for the preceding year. In such case, the other adjustment in subclause
(III)shall not apply. ; and by adding at the end the following new clause: For purposes of clause (vi)(III), the other adjustment described in this clause is 1.1 percentage point for each of 2016 through 2025. If the application of the other adjustment in clause (vi)(III) would result in the home health market basket percentage increase being less than 0.0 for a year, the other adjustment shall be reduced such that the final market basket percentage increase after its application of the other adjustment is 0.0. If, in any of years 2016 through 2025, the home health market basket as adjusted by subclauses
(I)and
(II)is less than or equal to zero, the other adjustment for such year is 0.0 percentage point. .
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