,i #aac? ,,congress #a/ ,session ,h4 ,r4 #bcjb ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,june #f1 #bjac ,mr4 ,re$ 7= himself1 ,mr4 ,?ompson ( ,cali=nia1 ,mr4 ,pauls51 ,mr4 ,blum5au]1 ,mr4 ,mi*aud1 ,mr4 ,connolly1 ,mr4 ,"y ( ,florida1 ,mr4 ,k+ ( ,i[a1 & ,mr4 ,grijalva7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,ways & ,means1 & 9 addition to ! ,committee on ,en]gy & ,comm]ce1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to /r5g!n & protect ,m$ic>e hospice programs4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,hospice ,evaluation & ,legitimate ,paym5t ,act ( #bjac4 #b4 ,ensur+ timely access to hospice c>e 7a7 ,9 g5]al ,section #ahad7;a77#g77;,d77i7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;f7a77#g77;,d77i77 is am5d$ to read z foll[s3 7i7 a hospice physician1 nurse practition]1 cl9ical nurse speciali/1 or physician assi/ant 7z ^? t]ms are def9$ 9 section #ahfa7;aa77#e771 or o!r heal? pr(essional 7z designat$ by ! ,secret>y71 has a face-to-face enc\nt] ) ! individual to det]m9e cont9u$ eligibility ( ! individual = hospice c>e prior to ! fir/ #fj-;day p]iod & ea* subsequ5t rec]tification "u subp>agraph 7,a77ii7 7or1 9 ! case :]e a hospice program newly admits an individual :o w\ld be ent]+ _! fir/ #fj-;day p]iod or a subsequ5t hospice b5efit p]iod or :]e exceptional circum/ances1 z def9$ by ! ,secret>y1 may prev5t a face-to-face enc\nt] prior to ! beg9n+ ( ! hospice b5efit p]iod1 n lat] ?an #g cal5d> days aft] ! individual's election "u section #ahab7;d77#a7 ) respect to ! hospice program7 & atte/s t su* visit took place 79 accordance ) proc$ures e/abli%$ by ! ,secret>y72 & 4 7b7 ,effective date ,! am5dm5t made by subsection 7a7 takes effect on ,janu>y #a1 #bjad1 & applies to hospice c>e furni%$ on or aft] su* date4 #c4 ,re/or+ & protect+ ! ,m$ic>e hospice b5efit 7a7 ,9 g5]al ,section #ahad7;i7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;f7i77 is am5d$-- 7#a7 9 p>agraph 7#f7-- 7,a7 9 subp>agraph 7,d7-- 7i7 9 clause 7i7-- 7,i7 9 ! fir/ s5t5ce1 by /rik+ n e>li] ?an ,octob] #a1 #bjac1 ! ,secret>y %all1 by regulation1 & ins]t+ subject to clause 7iii71 n e>li] ?an ! lat] ( #b ye>s aft] ! demon/ration program "u subp>agraph 7,f7 is complet$ or ,octob] #a1 #bjag1 ! ,secret>y %all1 by regulation1 prec$$ by a notice ( ! propos$ regulation 9 ! ,f$]al ,regi/] & a p]iod = public comm5t 9 accordance ) section #ahga7;b77#a712 & 7,,ii7 9 ! second s5t5ce1 by ins]t+ & %all take into acc\nt ! results ( ! evaluation conduct$ "u subp>agraph 7,f77ii7 be=e ! p]iod2 & 7ii7 by add+ at ! end ! foll[+ new clause3 7iii7 ,! ,secret>y %all implem5t ! revisions 9 paym5t pursuant to clause 7i7 unless ! ,secret>y det]m9es t ! demon/ration program "u subp>agraph 7,f7 demon/rat$ t su* revisions w\ld adv]sely affect access to quality hospice c>e by b5efici>ies "u ?is title4 2 & 7,b7 by add+ at ! end ! foll[+ new subp>agraph3 7,f7 ,hospice paym5t re=m demon/ration program 7i7 ,e/abli%m5t ( demon/ration program 7,i7 ,9 g5]al ,be=e implem5t+ any revisions to ! me?odology = det]m9+ ! paym5t rates = r\t9e home c>e & o!r s]vices includ$ 9 hospice c>e "u subp>agraph 7,d71 ! ,secret>y %all e/abli% a ,m$ic>e ,hospice ,paym5t ,re=m demon/ration program 79 ?is subp>agraph ref]r$ to z ! demon/ration program7 to te/ su* propos$ revisions4 7,,ii7 ,duration ,! demon/ration program %all be conduct$ = a #b-ye> p]iod beg9n+ on or aft] ,octob] #a1 #bjac4 7,,iii7 ,scope ,any c]tifi$ hospice program may apply to p>ticipate 9 ! demon/ration program & ! ,secret>y %all select n m ?an #ae su* hospice programs to p>ticipate 9 ! demon/ration program4 7,,iv7 ,repres5tative p>ticipation ,hospice programs select$ "u subclause 7,,iii7 to p>ticipate 9 ! demon/ration program %all include a repres5tative cross-section ( hospice programs ?r\gh\t ! ,unit$ ,/ates1 includ+ programs locat$ 9 urban & rural areas4 7ii7 ,evaluation & report 7,i7 ,evaluation ,! ,secret>y %all conduct an evaluation ( ! demon/ration program4 ,su* evaluation %all include an analysis ( :e!r ! use ( ! revis$ paym5t me?odology "u ! demon/ration program has improv$ ! quality ( pati5t c>e & access to hospice c>e = b5efici>ies "u ?is title & ! impact ( su* paym5t revisions on hospice c>e provid]s1 includ+ ! impact1 if any1 on ! ability ( hospice programs to furni% quality c>e to b5efici>ies "u ?is title4 7,,ii7 ,report ,n lat] ?an #b ye>s aft] ! completion ( ! demon/ration program1 ! ,secret>y %all submit to ,congress a report conta9+ ! results ( ! evaluation conduct$ "u subclause 7,i71 toge!r ) recomm5dations = su* legislation & adm9i/rative action z ! ,secret>y det]m9es appropriate4 7iii7 ,budget neutrality ,) respect to ! #b-ye> p]iod ( ! demon/ration program1 ! ,secret>y %all ensure t revisions 9 paym5t implem5t$ z "p ( ! demon/ration program %all result 9 ! same e/imat$ am\nt ( aggregate paym5ts "u ?is title = hospice c>e = ! programs p>ticipat+ 9 ! demon/ration z w\ld h be5 made if ! hospice programs _h n p>ticipat$ 9 ! demon/ration program4 4 #d4 ,hospice survey requirem5t ,section #ahfa7;dd77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7dd77#d77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,c7 ,any entity t is c]tifi$ z a hospice program %all be subject to a /&>d survey by an appropriate ,/ate or local survey ag5cy1 or an approv$ accr$itation ag5cy1 z det]m9$ by ! ,secret>y1 n less frequ5tly ?an once e #cf mon?s beg9n+ #f mon?s aft] ! date ( ! enactm5t ( ?is subp>agraph4 4