H. R. 6466
IN THE HOUSE OF REPRESENTATIVES
September 20, 2012
Mr. Kissell introduced the following bill; which was referred to the Committee on Ways and Means
To amend title XVIII of the Social Security Act to exempt certain hospice programs from the limitation applicable to payments for hospice care under the Medicare program, and for other purposes.
Exception to Medicare hospice payment caps for certain minority owned hospices
Section 1814(i)(2) of the Social Security Act (42 U.S.C. 1395f(i)(2)) is amended—
(A), by striking
The amount of payment and inserting
Subject to subparagraph (E), the amount of payment; and
by adding at the end the following:
Subparagraph (A) shall not apply with respect to hospice care furnished on or after November 1, 2004, by (or under arrangements made by) a qualified hospice program.
Qualified hospice programs
Section 1814(i) of the Social Security Act (42 U.S.C. 1395f(i)) is amended by adding at the end the following:
For purposes of paragraph (2)(E):
The term qualified hospice program means, with respect to an accounting year, a hospice program—
for which at least 50 percent of the shares of common stock for such program are owned by a specified individual or group of specified individuals; and
for which at least 75 percent of the individuals making an election under subsection (d) with respect to such program reside in a county or parish that—
has a population that is more than 50 percent specified individuals; or
for which the average per capita income is in the lowest quantile of countries in the State in which the hospice program is located, ranked by average per capita income.
The term specified individual means an individual that self-identifies as being African-American, American Indian, Asian-American, or Latin-American.
The term American Indian includes an individual who is of a tribe, people, or culture that is indigenous to the United States, including individuals who are eligible for membership in an Indian tribe (as such term is defined in section 4 of the Indian Health Care Improvement Act).
Recalculation of payment amounts for certain years
If the Secretary of Health and Human Services applied the limitation on payment under section 1814(i)(2)(A) of the Social Security Act (42 U.S.C. 1395f(i)(2)(A)), as in effect before the date of enactment of this Act, with respect to hospice care that was furnished during the period beginning on November 1, 2004, and ending on the date of enactment of this Act by (or under arrangements made by) a qualified hospice program (as defined in section 1814(i)(8) of such Act, as added by subsection (b)), the Secretary shall—
recalculate the amount payable under part A of title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.) for such services, after application of subparagraph (E) of section 1814(i)(2) of such Act (as added by subsection (a)); and
take such measures as are necessary to reconcile payments made under such part for such services and period accordingly.