Sec. 50208. EXTENSION OF HOME HEALTH RURAL ADD-ON

947 words·~4 min read·/statute-compilations/comps-14173/sec-50208

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

## SEC. 50208 EXTENSION OF HOME HEALTH RURAL ADD-ON ###

(a)Extension ####

(1)In general Section 421 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2283; 42 U.S.C. 1395fff note), as amended by section 5201(b) of the Deficit Reduction Act of 2005 (Public Law 109–171; 120 Stat. 46), section 3131(c) of the Patient Protection and Affordable Care Act (Public Law 111–148; 124 Stat. 428), and section 210 of the Medicare Access and CHIP Reauthorization Act of 2015 (Public Law 114–10; 129 Stat. 151) is amended— #####

(A)in subsection (a), by striking “January 1, 2018” and inserting “January 1, 2019” each place it appears; #####

(B)by redesignating subsections

(b)and

(c)as subsections

(c)and (d), respectively; #####

(C)in each of subsections

(c)and (d), as so redesignated, by striking “subsection (a)” and inserting “subsection

(a)or (b)”; and #####

(D)by inserting after subsection

(a)the following new subsection: > > ### “(b) Subsequent Temporary Increase > > > #### “(1) In general > > The Secretary shall increase the payment amount otherwise made under such section 1895 for home health services furnished in a county (or equivalent area) in a rural area (as defined in such section 1886(d)(2)(D)) that, as determined by the Secretary— > > > ##### “(A) > > is in the highest quartile of all counties (or equivalent areas) based on the number of Medicare home health episodes furnished per 100 individuals who are entitled to, or enrolled for, benefits under part A of title XVIII of the Social Security Act or enrolled for benefits under part B of such title (but not enrolled in a plan under part C of such title)— > > > ###### “(i) > > in the case of episodes and visits ending during 2019, by 1.5 percent; and > > > ###### “(ii) > > in the case of episodes and visits ending during 2020, by 0.5 percent; > > > ##### “(B) > > has a population density of 6 individuals or fewer per square mile of land area and is not described in subparagraph (A)— > > > ###### “(i) > > in the case of episodes and visits ending during 2019, by 4 percent; > > > ###### “(ii) > > in the case of episodes and visits ending during 2020, by 3 percent; > > > ###### “(iii) > > in the case of episodes and visits ending during 2021, by 2 percent; and > > > ###### “(iv) > > in the case of episodes and visits ending during 2022, by 1 percent; and > > > ##### “(C) > > is not described in either subparagraph

(A)or (B)— > > > ###### “(i) > > in the case of episodes and visits ending during 2019, by 3 percent; > > > ###### “(ii) > > in the case of episodes and visits ending during 2020, by 2 percent; and > > > ###### “(iii) > > in the case of episodes and visits ending during 2021, by 1 percent. > > > #### “(2) Rules for determinations > > > ##### “(A) No switching > > For purposes of this subsection, the determination by the Secretary as to which subparagraph of paragraph

(1)applies to a county (or equivalent area) shall be made a single time and shall apply for the duration of the period to which this subsection applies. > > > ##### “(B) Utilization > > In determining which counties (or equivalent areas) are in the highest quartile under paragraph (1)(A), the following rules shall apply: > > > ###### “(i) > > The Secretary shall use data from 2015. > > > ###### “(ii) > > The Secretary shall exclude data from the territories (and the territories shall not be described in such paragraph). > > > ###### “(iii) > > The Secretary may exclude data from counties (or equivalent areas) in rural areas with a low volume of home health episodes (and if data is so excluded with respect to a county (or equivalent area), such county (or equivalent area) shall not be described in such paragraph). > > > ##### “(C) Population density > > In determining population density under paragraph (1)(B), the Secretary shall use data from the 2010 decennial Census. > > > #### “(3) Limitations on review > > There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of determinations under paragraph (1).” > . ####

(2)Requirement to submit county data on claim form Section 1895(c) of the Social Security Act (42 U.S.C. 1395fff(c)) is amended— #####

(A)in paragraph (1), by striking “and” at the end; #####

(B)in paragraph (2), by striking the period at the end and inserting “; and”; and #####

(C)by adding at the end the following new paragraph: > > #### “(3) > > in the case of home health services furnished on or after January 1, 2019, the claim contains the code for the county (or equivalent area) in which the home health service was furnished.” > . ###

(b)HHS OIG Analysis Not later than January 1, 2023, the Inspector General of the Department of Health and Human Services shall submit to Congress— ####

(1)an analysis of the home health claims and utilization of home health services by county (or equivalent area) under the Medicare program; and ####

(2)recommendations the Inspector General determines appropriate based on such analysis. # TITLE III CREATING HIGH-QUALITY RESULTS AND OUTCOMES NECESSARY TO IMPROVE CHRONIC (CHRONIC) CARE ## Subtitle A Receiving High Quality Care in the Home

Connectionstraces to 2

Traces to 2 documents

U.S. Code