,i  #aacth ,,congress  #b;d ,session    
,h4 ,r4 #dfbe  ,,in ,,the ,,house ,,of  
,,representatives  ,may #i1 #bjad ,mr4  
,hall 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 suspend the           
application of the rebasing of ,medicare
 home health prospective payment        
amounts1 and for other purposes4  #a4   
,short title ,this ,act may be cited as 
the ,medicare ,home ,health ,rebasing   
,relief and ,reassessment ,act4  #b4    
,relief and reassessment of the rebasing
 of ,medicare home health prospective   
payment amounts  7a7 ,suspension of     
rebasing ,section                       
#ahie7;b77#c77;,a77iii7 of the ,social  

,security ,act 7#db ,u4,s4,c4           
#acie;fff7b77#c77;,a77iii77 is amended--
  7#a7 in subclause 7,i71 in the first  
sentence1 by striking subclause 7,,ii7  
and inserting subclauses 7,,ii7 and     
7,,iii72  7#b7 in subclause 7,,ii71 in  
the first sentence1 by striking ,the    
,secretary and inserting ,subject to    
subclause 7,,iii71 the ,secretary2 and  
7#c7 by adding at the end the following 
new subclause3  7,,iii7 ,special rule   
,subclauses 7,i7 and 7,,ii7 shall not   
apply for the #ab-month period beginning
 on the date of the enactment of this   
subclause4 ,for periods beginning after 
the period described in the previous    
sentence1 the ,secretary shall apply    
such subclauses as if the previous      
sentence had not been enacted4  4  7b7  
,revision of home health outlier        
adjustment ,section #ahie7;b77#e77;,a7  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acie;fff7b77#e77;,a77 is     
amended1 in the second sentence1 by     
inserting 7or1 in the case of each of   

the years #bjae through #bjbc1 #b4be    
percent7 after #b4e percent4  7c7 ,study
 and report  7#a7 ,study  7,a7 ,in      
general ,the ,secretary of ,health and  
,human ,services1 in consultation with  
representatives of ,medicare home health
 agencies and beneficiaries1 shall      
conduct a study on alternative methods  
for determining the appropriate         
adjustment under section                
#ahie7;b77#c77;,a77iii7 of the ,social  
,security ,act 7#db ,u4,s4,c4           
#acie7;b77#c77;,a77iii771 including     
methods offered by stakeholders4 ,such  
study shall include an analysis of each 
of the following3  7i7 ,the projected   
impact on ,medicare beneficiary access  
to care during each of #bjad through    
#bjag of applying section #ahie7;b77#c7 
during each of such years without       
application of subparagraph 7,a77iii7 of
 such section1 compared to the projected
 impact on such access during each of   
such years of applying such section     
during each of such years with          

application of such subparagraph4  7ii7 
,the number and share of home health    
agencies that are projected to          
experience negative ,medicare margins by
 #bjag1 including the location1 size1   
and type of such agencies4  7iii7 ,with 
respect to home health agencies         
described in clause 7ii7--  7,i7 the    
total number1 average age1 average      
income1 and average number of activities
 of daily living of the ,medicare       
beneficiaries such agencies serve2      
7,,ii7 the number of staff such agencies
 employ2  7,,iii7 the number and        
location of counties in which such      
agencies serve as the sole provider of  
,medicare home health services2 and     
7,,iv7 to the extent practicable1 the   
payer mix of such agencies4  7iv7 ,the  
impact of the adjustment on small home  
health agencies1 as defined by the      
,united ,states ,small ,business        
,administration small business size     
standards1 consistent with the          
principles of the ,regulatory           

,flexibility ,act1 which requires       
,federal agencies1 including the        
,department of ,health and ,human       
,services1 to fully consider during the 
rulemaking process the economic impact  
of regulatory provisions1 as well as    
less burdensome regulatory alternatives1
 to small entities4  7v7 ,any other     
areas determined appropriate by the     
,secretary4  7,b7 ,requirement for      
alternative methods and other           
considerations ,for purposes of the     
analysis under subparagraph 7,a7--  7i7 
the alternative methods described in    
such subparagraph shall cover each of   
the years in which the rebasing         
adjustment under such section           
#ahie7;b77#c77;,a77iii7 is to be        
applied2 and  7ii7 the ,secretary shall 
include a cumulative analysis of other  
,medicare home health reimbursement     
reductions established by statute or    
regulation1 consistent with the         
requirements of ,executive ,order       
#acefc4  7#b7 ,report ,not later than #f

 months after the date of the enactment 
of this ,act1 the ,secretary of ,health 
and ,human ,services shall submit to    
,congress a report on the study         
conducted under paragraph 7#a71 together
 with such recommendations as the       
,secretary determines appropriate based 
on the findings of such study4 ,such    
report shall include--  7,a7 a          
determination by the ,secretary as to   
whether1 as a result of the findings of 
such study1 the ,secretary intends to   
use the authority under section #ahga of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acie;hh7 to modify the       
adjustment described in paragraph       
7#a77;,a7 and the extent of any such    
modification2 and  7,b7 in the case the 
,secretary determines not to use such   
authority1 the rationale for such       
determination4