Sec. 3708. IMPROVING CARE PLANNING FOR MEDICARE HOME HEALTH SERVICES
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## SEC. 3708 IMPROVING CARE PLANNING FOR MEDICARE HOME HEALTH SERVICES ###
(a)Part A Provisions Section 1814(a) of the Social Security Act (42 U.S.C. 1395f(a)) is amended— ####
(1)in paragraph (2)— #####
(A)in the matter preceding subparagraph (A), by inserting “, a nurse practitioner or clinical nurse specialist (as such terms are defined in section 1861(aa)(5)) who is working in accordance with State law, or a physician assistant (as defined in section 1861(aa)(5)) who is working in accordance with State law, who is” after “in the case of services described in subparagraph (C), a physician”; and #####
(B)in subparagraph (C)— ######
(i)by inserting “, a nurse practitioner, a clinical nurse specialist, or a physician assistant (as the case may be)” after “physician” the first 2 times it appears; and ######
(ii)by striking “, and, in the case of a certification made by a physician” and all that follows through “face-to-face encounter” and inserting “, and, in the case of a certification made by a physician after January 1, 2010, or by a nurse practitioner, clinical nurse specialist, or physician assistant (as the case may be) after a date specified by the Secretary (but in no case later than the date that is 6 months after the date of the enactment of the CARES Act), prior to making such certification a physician, nurse practitioner, clinical nurse specialist, or physician assistant must document that a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife (as defined in section 1861(gg)) as authorized by State law, or physician assistant has had a face-to-face encounter”; ####
(2)in the third sentence— #####
(A)by striking “physician certification” and inserting “certification”; #####
(B)by inserting “(or in the case of regulations to implement the amendments made by section 3708 of the CARES Act, the Secretary shall prescribe regulations, which shall become effective no later than 6 months after the date of the enactment of such Act)” after “1981”; and #####
(C)by striking “a physician who” and inserting “a physician, nurse practitioner, clinical nurse specialist, or physician assistant who”; ####
(3)in the fourth sentence, by inserting “, nurse practitioner, clinical nurse specialist, or physician assistant” after “physician”; and ####
(4)in the fifth sentence— #####
(A)by inserting “or no later than 6 months after the date of the enactment of the CARES Act for purposes of documentation for certification and recertification made under paragraph
(2)by a nurse practitioner, clinical nurse specialist, or physician assistant,” after “January 1, 2019”; and #####
(B)by inserting “, nurse practitioner, clinical nurse specialist, or physician assistant” after “of the physician”. ###
(b)Part B Provisions Section 1835(a) of the Social Security Act (42 U.S.C. 1395n(a)) is amended— ####
(1)in paragraph (2)— #####
(A)in the matter preceding subparagraph (A), by inserting “, a nurse practitioner or clinical nurse specialist (as those terms are defined in section 1861(aa)(5)) who is working in accordance with State law, or a physician assistant (as defined in section 1861(aa)(5)) who is working in accordance with State law, who is” after “in the case of services described in subparagraph (A), a physician”; and #####
(B)in subparagraph (A)— ######
(i)in each of clauses
(ii)and
(iii)of subparagraph
(A)by inserting “, a nurse practitioner, a clinical nurse specialist, or a physician assistant (as the case may be)” after “physician”; and ######
(ii)in clause (iv), by striking “after January 1, 2010” and all that follows through “face-to-face encounter” and inserting “made by a physician after January 1, 2010, or by a nurse practitioner, clinical nurse specialist, or physician assistant (as the case may be) after a date specified by the Secretary (but in no case later than the date that is 6 months after the date of the enactment of the CARES Act), prior to making such certification a physician, nurse practitioner, clinical nurse specialist, or physician assistant must document that a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife (as defined in section 1861(gg)) as authorized by State law, or physician assistant has had a face-to-face encounter”; ####
(2)in the third sentence, by inserting “, nurse practitioner, clinical nurse specialist, or physician assistant (as the case may be)” after physician; ####
(3)in the fourth sentence— #####
(A)by striking “physician certification” and inserting “certification”; #####
(B)by inserting “(or in the case of regulations to implement the amendments made by section 3708 of the CARES Act the Secretary shall prescribe regulations which shall become effective no later than 6 months after the enactment of such Act)” after “1981”; and #####
(C)by striking “a physician who” and inserting “a physician, nurse practitioner, clinical nurse specialist, or physician assistant who”; ####
(4)in the fifth sentence, by inserting “, nurse practitioner, clinical nurse specialist, or physician assistant” after “physician”; and ####
(5)in the sixth sentence— #####
(A)by inserting “or no later than 6 months after the date of the enactment of the CARES Act for purposes of documentation for certification and recertification made under paragraph
(2)by a nurse practitioner, clinical nurse specialist, or physician assistant,” after “January 1, 2019”; and #####
(B)by inserting “, nurse practitioner, clinical nurse specialist, or physician assistant” after “of the physician”. ###
(c)Definition Provisions ####
(1)Home health services Section 1861(m) of the Social Security Act (42 U.S.C. 1395x(m)) is amended— #####
(A)in the matter preceding paragraph (1)— ######
(i)by inserting “, a nurse practitioner or a clinical nurse specialist (as those terms are defined in subsection (aa)(5)), or a physician assistant (as defined in subsection (aa)(5))” after “physician” the first place it appears; and ######
(ii)by inserting “, a nurse practitioner, a clinical nurse specialist, or a physician assistant” after “physician” the second place it appears; and #####
(B)in paragraph (3), by inserting “, a nurse practitioner, a clinical nurse specialist, or a physician assistant” after “physician”. ####
(2)Home health agency Section 1861(o)(2) of the Social Security Act (42 U.S.C. 1395x(o)(2)) is amended— #####
(A)by inserting “, nurse practitioners or clinical nurse specialists (as those terms are defined in subsection (aa)(5)), certified nurse-midwives (as defined in subsection (gg)), or physician assistants (as defined in subsection (aa)(5))” after “physicians”; and #####
(B)by inserting “, nurse practitioner, clinical nurse specialist, certified nurse-midwife, physician assistant,” after “physician”. ####
(3)Covered osteoporosis drug Section 1861(kk)(1) of the Social Security Act (42 U.S.C. 1395x(kk)(1)) is amended by inserting “, nurse practitioner or clinical nurse specialist (as those terms are defined in subsection (aa)(5)), certified nurse-midwife (as defined in subsection (gg)), or physician assistant (as defined in subsection (aa)(5))” after “attending physician”. ###
(d)Home Health Prospective Payment System Provisions Section 1895 of the Social Security Act (42 U.S.C. 1395fff) is amended— ####
(1)in subsection (c)(1)— #####
(A)by striking “(provided under section 1842(r))”; and #####
(B)by inserting “the nurse practitioner or clinical nurse specialist (as those terms are defined in section 1861(aa)(5)), or the physician assistant (as defined in section 1861(aa)(5))” after “physician”; and ####
(2)in subsection (e)— #####
(A)in paragraph (1)(A), by inserting “a nurse practitioner or clinical nurse specialist, or a physician assistant” after “physician”; and #####
(B)in paragraph (2)— ######
(i)in the heading, by striking “Physician certification” and inserting “Rule of construction regarding requirement for certification”; and ######
(ii)by striking “physician”. ###
(e)Application to Medicaid **[**[42 U.S.C. 1395f note](/us/usc/t42/s1395f)**]** The amendments made under this section shall apply under title XIX of the Social Security Act in the same manner and to the same extent as such requirements apply under title XVIII of such Act or regulations promulgated thereunder. ###
(f)Effective Date **[**[42 U.S.C. 1395f note](/us/usc/t42/s1395f)**]** The Secretary of Health and Human Services shall prescribe regulations to apply the amendments made by this section to items and services furnished, which shall become effective no later than 6 months after the date of the enactment of this legislation. The Secretary shall promulgate an interim final rule if necessary, to comply with the required effective date.
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Sec. 3708
IMPROVING CARE PLANNING FOR MEDICARE HOME HEALTH SERVICES
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