Sec. 3132. HOSPICE REFORM
933 words·~4 min read·
/statute-compilations/comps-9307/sec-3132A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
## SEC. 3132 HOSPICE REFORM ###
(a)Hospice Care Payment Reforms ####
(1)In general Section 1814(i) of the Social Security Act (42 U.S.C. 1395f(i)), as amended by section 3004(c), is amended— #####
(A)by redesignating paragraph
(6)as paragraph (7); and #####
(B)by inserting after paragraph
(5)the following new paragraph: > > #### “(6) > > > #####
(A)> > The Secretary shall collect additional data and information as the Secretary determines appropriate to revise payments for hospice care under this subsection pursuant to subparagraph
(D)and for other purposes as determined appropriate by the Secretary. The Secretary shall begin to collect such data by not later than January 1, 2011. > > > ##### “(B) > > The additional data and information to be collected under subparagraph
(A)may include data and information on— > > > ###### “(i) > > charges and payments; > > > ###### “(ii) > > the number of days of hospice care which are attributable to individuals who are entitled to, or enrolled for, benefits under part A; and > > > ###### “(iii) > > with respect to each type of service included in hospice care— > > > ###### “(I) > > the number of days of hospice care attributable to the type of service; > > > ###### “(II) > > the cost of the type of service; and > > > ###### “(III) > > the amount of payment for the type of service; > > > ###### “(iv) > > charitable contributions and other revenue of the hospice program; > > > ###### “(v) > > the number of hospice visits; > > > ###### “(vi) > > the type of practitioner providing the visit; and > > > ###### “(vii) > > the length of the visit and other basic information with respect to the visit. > > > ##### “(C) > > The Secretary may collect the additional data and information under subparagraph
(A)on cost reports, claims, or other mechanisms as the Secretary determines to be appropriate. > > > ##### “(D) > > > ######
(i)> > Notwithstanding the preceding paragraphs of this subsection, not earlier than October 1, 2013, the Secretary shall, by regulation, implement revisions to the methodology for determining the payment rates for routine home care and other services included in hospice care under this part, as the Secretary determines to be appropriate. Such revisions may be based on an analysis of data and information collected under subparagraph (A). Such revisions may include adjustments to per diem payments that reflect changes in resource intensity in providing such care and services during the course of the entire episode of hospice care. > > > ###### “(ii) > > Revisions in payment implemented pursuant to clause
(i)shall result in the same estimated amount of aggregate expenditures under this title for hospice care furnished in the fiscal year in which such revisions in payment are implemented as would have been made under this title for such care in such fiscal year if such revisions had not been implemented. > > > ##### “(E) > > The Secretary shall consult with hospice programs and the Medicare Payment Advisory Commission regarding the additional data and information to be collected under subparagraph
(A)and the payment revisions under subparagraph (D).” > . ####
(2)Conforming amendments Section 1814(i)(1)(C) of the Social Security Act (42 U.S.C. 1395f(i)(1)(C)) is amended— #####
(A)in clause (ii)— ######
(i)in the matter preceding subclause (I), by inserting “(before the first fiscal year in which the payment revisions described in paragraph (6)(D) are implemented)” after “subsequent fiscal year”; and ######
(ii)in subclause (VII), by inserting “(before the first fiscal year in which the payment revisions described in paragraph (6)(D) are implemented), subject to clause (iv),” after “subsequent fiscal year”; and #####
(B)by adding at the end the following new clause: > > ###### “(iii) > > With respect to routine home care and other services included in hospice care furnished during fiscal years subsequent to the first fiscal year in which payment revisions described in paragraph (6)(D) are implemented, the payment rates for such care and services shall be the payment rates in effect under this clause during the preceding fiscal year increased by, subject to clause (iv), the market basket percentage increase (as defined in section 1886(b)(3)(B)(iii)) for the fiscal year.” > . ###
(b)Adoption of MedPAC Hospice Program Eligibility Recertification Recommendations Section 1814(a)(7) of the Social Security Act (42 U.S.C. 1395f(a)(7)) is amended— ####
(1)in subparagraph (B), by striking “and” at the end; and ####
(2)by adding at the end the following new subparagraph: > > ##### “(D) > > on and after January 1, 2011— > > > ###### “(i) > > a hospice physician or nurse practitioner has a face-to-face encounter with the individual to determine continued eligibility of the individual for hospice care prior to the 180th-day recertification and each subsequent recertification under subparagraph (A)(ii) and attests that such visit took place (in accordance with procedures established by the Secretary); and > > > ###### “(ii) > > in the case of hospice care provided an individual for more than 180 days by a hospice program for which the number of such cases for such program comprises more than a percent (specified by the Secretary) of the total number of such cases for all programs under this title, the hospice care provided to such individual is medically reviewed (in accordance with procedures established by the Secretary); and” > .
Connectionstraces to 1
Traces to 1 document