II
116th CONGRESS
1st Session
S. 296
IN THE SENATE OF THE UNITED STATES
January 31, 2019
Ms. Collins (for herself and Mr. Cardin) introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend title XVIII of the Social Security Act to ensure more timely access to home health services for Medicare beneficiaries under the Medicare program.
Short title
This Act may be cited as the Home Health Care Planning Improvement Act of 2019
.
Improving care planning for Medicare home health services
Part A provisions
Section 1814(a) of the Social Security Act (42 U.S.C. 1395f(a)) is amended—
in paragraph (2)—
in the matter preceding subparagraph (A), by inserting , a nurse practitioner or clinical nurse specialist who is working in collaboration with a physician in accordance with State law, a certified nurse-midwife (as defined in section 1861(gg)) as authorized by State law, or a physician assistant (as defined in section 1861(aa)(5)) under the supervision of a physician
after 1866(j)
; and
in subparagraph (C)—
by inserting , a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant (as the case may be)
after physician
the first 2 times it appears; and
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, certified nurse-midwife, or physician assistant (as the case may be) after January 1, 2020, prior to making such certification the physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant must document that the physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant has had a face-to-face encounter
;
in the second sentence, by inserting certified nurse-midwife,
after clinical nurse specialist,
;
in the third sentence—
by striking physician certification
and inserting certification
;
by inserting (or on January 1, 2020, in the case of regulations to implement the amendments made by section 2 of the Home Health Care Planning Improvement Act of 2019)
after 1981
; and
by striking a physician who
and inserting a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant who
; and
in the fourth sentence, by inserting , nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant
after physician
.
Part B provisions
Section 1835(a) of the Social Security Act (42 U.S.C. 1395n(a)) is amended—
in paragraph (2)—
in the matter preceding subparagraph (A), by inserting , a nurse practitioner or clinical nurse specialist (as those terms are defined in 1861(aa)(5)) who is working in collaboration with a physician in accordance with State law, a certified nurse-midwife (as defined in section 1861(gg)) as authorized by State law, or a physician assistant (as defined in section 1861(aa)(5)) under the supervision of a physician
after 1866(j)
; and
in subparagraph (A)—
in each of clauses (ii) and (iii) of subparagraph (A) by inserting , a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant (as the case may be)
after physician
; and
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, certified nurse-midwife, or physician assistant (as the case may be) after January 1, 2020, prior to making such certification the physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant must document that the physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant has had a face-to-face encounter
;
in the third sentence, by inserting , nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant (as the case may be)
after physician;
in the fourth sentence—
by striking physician certification
and inserting certification
;
by inserting (or on January 1, 2020, in the case of regulations to implement the amendments made by section 2 of the Home Health Care Planning Improvement Act of 2019)
after 1981
; and
by striking a physician who
and inserting a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant who
; and
in the fifth sentence, by inserting , nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant
after physician
.
Definition provisions
Home health services
Section 1861(m) of the Social Security Act (42 U.S.C. 1395x(m)) is amended—
in the matter preceding paragraph (1)—
by inserting , a nurse practitioner or a clinical nurse specialist (as those terms are defined in subsection (aa)(5)), a certified nurse-midwife (as defined in section 1861(gg)), or a physician assistant (as defined in subsection (aa)(5))
after physician
the first place it appears; and
by inserting , a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant
after physician
the second place it appears; and
in paragraph (3), by inserting , a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant
after physician
.
Home health agency
Section 1861(o)(2) of the Social Security Act (42 U.S.C. 1395x(o)(2)) is amended—
by inserting , nurse practitioners or clinical nurse specialists (as those terms are defined in subsection (aa)(5)), certified nurse-midwives (as defined in section 1861(gg)), or physician assistants (as defined in subsection (aa)(5))
after physicians
; and
by inserting , nurse practitioner, clinical nurse specialist, certified nurse-midwife, physician assistant,
after physician
.
Home health prospective payment system provisions
Section 1895 of the Social Security Act (42 U.S.C. 1395fff) is amended—
in subsection (c)(1), by inserting , the nurse practitioner or clinical nurse specialist (as those terms are defined in section 1861(aa)(5)), the certified nurse-midwife (as defined in section 1861(gg)), or the physician assistant (as defined in section 1861(aa)(5)),
after physician
; and
in subsection (e)—
in paragraph (1)(A), by inserting , a nurse practitioner or clinical nurse specialist (as those terms are defined in section 1861(aa)(5)), a certified nurse-midwife (as defined in section 1861(gg)), or a physician assistant (as defined in section 1861(aa)(5))
after physician
; and
in paragraph (2)—
in the heading, by striking Physician certification
and inserting Rule of construction regarding requirement for certification
; and
by striking physician
.
Effective Date
The amendments made by this section shall apply to items and services furnished on or after January 1, 2020.
