H 2267
Version: Introduced
Author: Walden
HR 2267 IH
112th CONGRESS
1st Session
H. R. 2267
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.
IN THE HOUSE OF REPRESENTATIVES
June 21, 2011
MR. WALDEN (for himself, Ms. Schwartz, Mr. Jones, Mr. Ellison, Mr. Lance, Ms.
Hanabusa, Mr. Wu, Mr. Barletta, Mr. Grijalva, Mr. Coffman of Colorado, Mr.
Langevin, Mr. Bilbray, Mr. Blumenauer, Mr. Latham, Mr. Schrader, Mr.
LaTourette, Mrs. Capps, Mr. Hanna, Mr. Thompson of California, Mr. Terry, Mr.
Neal, Mr. Bass of New Hampshire, Mr. Chandler, Ms. Lee of California, Ms.
Schakowsky, Mr. Cicilline, Mr. Brady of Pennsylvania, and Mr. Boswell )
introduced the following bill; which was referred to the Committee on Ways and
Means, and in addition to the Committee on Energy and Commerce, for a period to
be subsequently determined by the Speaker, in each case for consideration of
such provisions as fall within the jurisdiction of the committee concerned
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.
Be it enacted by the Senate and House of Representatives of the United States
of America in Congress assembled,
SEC. 1. SHORT TITLE This Act may be cited as the " Home Health Care Planning
Improvement Act of 2011 ".
SEC. 2. 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 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
(B) in subparagraph (C) --
(i) 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
(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, certified nurse-midwife, or
physician assistant (as the case may be) after January 1, 2012, 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 ";
(2) in the second sentence, by inserting "certified nurse-midwife, " after
"clinical nurse specialist, ";
(3) in the third sentence --
(A) by striking "physician certification " and inserting "certification ";
(B) by inserting "(or on January 1, 2012, in the case of regulations to
implement the amendments made by section 2 of the Home Health Care Planning
Improvement Act of 2011 ) " after "1981 "; and
(C) by striking "a physician who " and inserting "a physician, nurse
practitioner, clinical nurse specialist, certified nurse-midwife, or physician
assistant who "; and
(4) in the fourth sentence, by inserting ", nurse practitioner, clinical nurse
specialist, certified nurse-midwife, or physician assistant " after "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
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) ";
(B) in subparagraph (A) --
(i) 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
(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,
certified nurse-midwife, or physician assistant (as the case may be) after
January 1, 2012, 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 ";
(2) in the third sentence, by inserting ", nurse practitioner, clinical nurse
specialist, certified nurse-midwife, 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 on January 1, 2012, in the case of regulations to
implement the amendments made by section 2 of the Home Health Care Planning
Improvement Act of 2011 ) " after "1981 "; and
(C) by striking "a physician who " and inserting "a physician, nurse
practitioner, clinical nurse specialist, certified nurse-midwife, or physician
assistant who "; and
(4) in the fifth sentence, by inserting ", nurse practitioner, clinical nurse
specialist, certified nurse-midwife, or physician assistant " after "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)), 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
(ii) 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
(B) in paragraph (3), by inserting ", a nurse practitioner, a clinical nurse
specialist, a certified nurse-midwife, 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 section 1861(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 ".
(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), 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
(2) in subsection (e) --
(A) 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
(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) EFFECTIVE DATE The amendments made by this section shall apply to items and
services furnished on or after January 1, 2012.