,,ii  #aad? ,,congress  #a/ ,session    
,s4 #afej  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #bc1 #bjae ,mr4  
,m55dez 7= himself & ,mr4 ,rob]ts7      
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
make *anges to ! ,m$ic>e home heal?     
face-to-face enc\nt] requirem5ts4  #a4  
,%ort title  ,?is ,act may be cit$ z !  
,home ,heal? ,docum5tation & ,program   
,improvem5t ,act ( #bjae4  #b4          
,developm5t ( a s+le =m or docum5t to   
satisfy ! home heal? c]tification       
requirem5t  7a7 ,"p ,a ,section #ahad ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acie;f7 is am5d$-- 7#a7 9 subsection   
7a77#b77;,c71 by /rik+ has _h a         
face-to-face enc\nt] & ins]t+ has1      
subject to subsection 7m71 _h a         
face-to-face enc\nt]2 &  7#b7 by add+ at
 ! end ! foll[+ new subsection3  7m7    
,implem5tation ( requirem5t =           
c]tification = home heal? s]vices  7#a7 

,9 g5]al ,! ,secret>y %all develop a    
s+le =m or docum5t to be us$ by a       
physician to satisfy ! docum5tation     
requirem5ts necess>y to fulfill !       
requirem5t ( a face-to-face enc\nt] &   
o!r crit]ia = home heal? eligibility "u 
subsection 7a77#b77;,c7 7o!rwise kn[n z 
! c]tification = home heal? s]vices74   
7#b7 ,/akehold] input ,9 develop+ ! =m  
or docum5t "u p>agraph 7#a71 ! ,secret>y
 %all seek input f /akehold]s1 includ+  
physicians & o!r non-physician provid]s 
7su* z nurse practition]s or cl9ical    
nurse speciali/s 7z ^? t]ms are def9$ 9 
section #ahfa7;aa77#e7771 home heal?    
ag5cies1 hospitals1 pati5ts or          
repres5tatives ( pati5ts1 & o!r entities
 7su* z electronic m$ical record v5dors7
 ! ,secret>y det]m9es appropriate4 ,!   
,secret>y %all provide ! opportunity =  
su* /akehold]s to (f] input on ! =m or  
docum5t dur+ its initial developm5t z   
well z ! opportunity to make comm5ts on 
a propos$ v]sion prior to its           
f9alization4 ,! ,secret>y %all also set 

up a process to educate physicians &    
non-physicians on h[ to appropriately   
fulfill ! requirem5ts relat$ to ! =m or 
docum5t 9 ?is section prior to          
implem5tation4  7#c7 ,cont5t ( =m ,!    
,secret>y %all accept ! foll[+ cont5t z 
docum5tation ( an individual's          
eligibility = home heal? s]vices3  7,a7 
,) respect to ! face-to-face enc\nt]    
requirem5t1 ! date ( ! enc\nt]4  7,b7 ,)
 respect to homeb\nd /atus1 a /atem5t t 
provides ! cl9ical basis = :y !         
individual is det]m9$ to be conf9$ to ! 
home4  7,c7 ,) respect to ! ne$ = skill$
 s]vices1 a selection1 via *eckbox1 ( ! 
types ( skill$ s]vices requir$ by !     
individual & a /atem5t ) ! cl9ical basis
 = ea* type ( skill$ s]vice ord]$4  7#d7
 ,deem$ satisfaction ( requirem5ts ,!   
,secret>y %all1 ?r\gh guidance1 all[ !  
requirem5t = docum5tation ( a           
face-to-face enc\nt] & o!r crit]ia =    
home heal? eligibility "u subsection    
7a77#b77;,c7 to be deem$ satisfi$ )     
respect to an individual if a home heal?

 ag5cy completes ! =m or docum5t "u     
p>agraph 7#a7 & ! ord]+ physician signs 
or atte/s to ! cont5ts ( ! =m or        
docum5t4  7#e7 ,exception to            
face-to-face enc\nt] requirem5t ,!      
,secret>y %all waive ! requirem5t = a   
face-to-face enc\nt] "u subsection      
7a77#b77;,c7 relat$ to home heal?       
s]vices provid$ to an individual if !   
individual has be5 dis*>g$ f a hospital 
7includ+ f ! em]g5cy dep>tm5t7 or skill$
 nurs+ facility )9 #ad days prior to !  
initiation ( su* home heal? s]vices4    
7#f7 ,guidance to contractors  7,a7 ,9  
g5]al ,! ,secret>y %all provide         
notification1 guidance1 & education     
reg>d+ ! application ( ! =m or docum5t  
"u p>agraph 7#a7 z x p]ta9s to satisfy+ 
! docum5tation requirem5ts = home heal? 
s]vices "u subsection 7a77#b77;,c7 to   
m$ic>e adm9i/rative contractors 7z def9$
 9 section #ahgd;,a71 recov]y audit     
contractors 7z def9$ 9 section          
#ahic7;h771 & any o!r entity :i* !      
,secret>y det]m9es appropriate4  7,b7   

,national applicability ,! ,secret>y    
%all ensure t all m$ic>e adm9i/rative   
contractors1 recov]y audit contractors1 
& any o!r entity :i* ! ,secret>y        
det]m9es appropriate apply ! guidance "u
 ?is p>agraph 9 a nationally consi/5t & 
uni=m mann] & t all audit activities1   
policies1 & practices reg>d+            
docum5tation = home heal? s]vices are   
likewise appli$ 9 a nationally consi/5t 
& uni=m mann]4  7,c7 ,/udy ,n lat] ?an  
#ah mon?s aft] ! date ( ! enactm5t ( ?is
 p>agraph1 ! ,secret>y %all submit to   
,congress a report on--  7i7 ! adh]5ce (
 m$ic>e adm9i/rative contractors1       
recov]y audit contractors1 & any o!r    
entity :i* ! ,secret>y det]m9es         
appropriate to nationally consi/5t &    
uni=m audit activities1 policies1 &     
practices z describ$ 9 subp>agraph 7,b72
 &  7ii7 ! rate ( appeals = d5ial (     
paym5t bas$ solely on ! face-to-face    
enc\nt] requirem5ts = home heal? s]vices
 "u ?is section & ! rate ( su* appeals t
 are ultimately successful4  4  7b7 ,"p 

,b ,section #ahce ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acien7 is am5d$--  
7#a7 9 subsection 7a77#b77;,a71 by /rik+
 has _h a face-to-face enc\nt] & ins]t+ 
has1 subject to subsection 7f71 _h a    
face-to-face enc\nt]2 &  7#b7 by add+ at
 ! end ! foll[+ new subsection3  7f7    
,application ( docum5tation1 guidance1 &
 treatm5t ( c]ta9 home heal? claims     
provisions "u "p ,a ,! provisions (     
section #ahad7m7 %all apply ) respect to
 ! application ( docum5tation           
requirem5ts = home heal? s]vices "u     
subsection 7a77#b77;,a7 9 ! same mann] z
 su* provisions apply ) respect to !    
application ( ! docum5tation requirem5ts
 = home heal? s]vices "u section        
#ahad7;a77#b77;,c74  4  #c4 ,effective  
date2 treatm5t ( c]ta9 home heal? claims
  7a7 ,effective date ,! am5dm5ts made  
by section #b %all apply ) respect to   
home heal? s]vices furni%$ on or aft]   
,octob] #a1 #bjaf4  7b7 ,treatm5t (     
c]ta9 home heal? claims  7#a7 ,d5i$     
claims  7,a7 ,9 g5]al ,n lat] ?an #ab   

mon?s aft] ! date ( ! enactm5t ( ?is    
,act1 ! ,secret>y ( ,heal? & ,human     
,s]vices %all--  7i7 ?r\gh guidance1    
develop & implem5t processes to op5 &   
review claims t 7 d5i$ on or aft]       
,janu>y #a1 #bjaa1 & be=e ! date ( !    
enactm5t ( ?is ,act1 due solely to !    
face-to-face docum5tation requirem5ts "u
 section #ahad7;a77#b77;,c7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acie;f7a77#b77;,c77 or section         
#ahce7;a77#b77;,a7 ( su* ,act 7#db      
,u4,s4,c4 #acie;f7a77#b77;,a772 &  7ii7 
issue revis$ decisions ( su* d5ials z if
 ! n>rative requirem5ts ( section       
#dbd4bb7v7 ( title #db1 ,code ( ,f$]al  
,regulations1 did n apply at ! "t su*   
s]vices 7 furni%$4  7,b7 ,settlem5t     
agreem5ts = d5i$ claims ,9 addition to !
 processes "u subp>agraph 7,a71 n lat]  
?an #fj days aft] ! date ( ! enactm5t ( 
?is ,act1 ! ,secret>y %all e/abli% a    
volunt>y process = home heal? ag5cies to
 ent] into a settlem5t agreem5t ) !     
,secret>y ( ,heal? & ,human ,s]vices 9  

lieu ( reprocess+ claims = paym5t :i*   
are requir$ to be paid by reason (      
subp>agraph 7,a77ii74  7#b7 ,o!r claims 
,9 ! case ( a claim = home heal? s]vices
 furni%$ on or aft] ,janu>y #a1 #bjaa1 &
 be=e ,octob] #a1 #bjaf1 t is n describ$
 9 p>agraph 7#a77;,a71 su* claim %all be
 det]m9$ & process$ z if ! n>rative     
requirem5ts ( section #dbd4bb7v7 ( title
 #db1 ,code ( ,f$]al ,regulations1 did n
 apply at ! "t su* s]vices 7 furni%$4