,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #cbde  ,,in ,,the ,,house ,,of  
,,representatives  ,october #d1         
#bjac,mr4 ,matheson 7for himself and    
,mr4 ,guthrie7 introduced the following 
bill2 which was referred to the         
,committee on ,ways and ,means1 and in  
addition to the ,committee on ,energy   
and ,commerce1 for a period to be       
subsequently determined by the ,speaker1
 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 establish 
a maximum threshold for episode         
reimbursement to skilled home health    
agencies under ,medicare4  #a4 ,short   
title ,this ,act may be cited as the    
,medicare ,home ,health ,fraud          
,reduction ,act4  #b4 ,establishment of 
maximum threshold for episode           
reimbursement to skilled home health    
agencies under ,medicare ,section       
#ahie7;b7 of the ,social ,security ,act 

7#db ,u4,s4,c4 #acie;fff7b77 is amended 
by adding at the end the following new  
paragraph3  7#g7 ,episode utilization   
rate  7,a7 ,payment limitation ,for     
#bjad and each subsequent year1 payment 
may not be made to a skilled home health
 agency under this section for an       
episode of care to the extent that such 
episode exceeds the applicable episode  
utilization limit established under     
subparagraph 7,b7 for the agency for the
 year4  7,b7 ,applicable episode        
utilization limit  7i7 ,in general ,for 
#bjad and each subsequent year1 the     
,secretary shall establish an episode   
utilization limit for a skilled home    
health agency that is equal to the      
product of-- 7,i7 in the case of a      
skilled home health agency located in-- 
7aa7 a rural area1 #c4c episodes2 and   
7bb7 in an area not described in item   
7aa71 #b4g episodes2 and  7,,ii7 the    
total number of ,medicare beneficiaries 
for the skilled home health agency 7as  
defined in clause 7iii774  7ii7 ,episode

 defined ,for purposes of this          
paragraph1 the term episode has the     
meaning given such term for purposes of 
section #dhd4bje of title #db1 ,code of 
,federal ,regulations 7as in effect on  
,october #a1 #bjaa7 and includes partial
 episodes for which a partial episode   
payment is made pursuant to such section
 to the extent such partial episode is a
 percentage of a full episode4  7iii7   
,total number of medicare beneficiaries 
defined  7,i7 ,in general ,for purposes 
of clause 7i77,,ii71 the term total     
number of ,medicare beneficiaries means1
 with respect to a skilled home health  
agency and year1 the total number of    
unduplicated individuals who were       
furnished home health services under    
this title in the year by the agency4   
7,,ii7 ,special rule ,in calculating the
 total number of ,medicare beneficiaries
 under subclause 7,i71 in any case where
 an individual is furnished skilled home
 health care services from more than one
 agency1 the number of such individuals 

being counted toward the applicable     
episode utilization limit for each such 
agency shall be proportionally credited 
in an amount equal to the percentage of 
the total number of episodes provided by
 the agency4  4