,,ii #aafth ,,congress #ast ,session ,s4 #bhjg ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,november #g1 #bjai,mr4 ,portman 7for himself and ,mr4 ,cardin7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to improve the quality of care furnished by hospice programs under the ,medicare program4 #a4 ,short title ,this ,act may be cited as the ,hospice ,care ,improvement ,act of #bjai4 #b4 ,improving quality reporting and transparency for hospice care 7a7 ,increasing reported hospice data 7#a7 ,availability of hospice accreditation surveys 7,a7 ,in general ,section #ahfe7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;bb7b77 is amended by inserting or a hospice program after home health agency4 7,b7 ,effective date ,the amendment made by subparagraph 7,a7 shall apply to surveys conducted on or after the date of the enactment of this ,act4 7#b7 ,inclusion of reports by ,state and local survey agencies and approved accreditation agencies on ,hospice compare ,section #ahfa7;dd77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7dd77#d77 is amended by adding at the end the following new subparagraph3 7,d7 7i7 ,not later than #f months after the date of the enactment of this subparagraph1 the ,secretary1 subject to clauses 7ii7 and 7iii71 shall include on what is commonly referred to as the ,hospice ,compare internet website 7or any successor website7 information from reports by ,state and local survey agencies and approved accreditation agencies described in subparagraph 7,c77i74 7ii7 ,the information required to be included under clause 7i7 shall be presented in a manner that is prominent1 updated and removed on a timely basis1 targeted to deficiencies related to quality of care1 easily accessible1 readily understandable to consumers of hospice services1 and searchable4 ,such information shall also include a link to the reports4 7iii7 ,in determining the information required to be included under clause 7i7 and the format of such information under 7ii71 the ,secretary shall consult with-- 7,i7 employees of hospice programs and their representatives2 7,,ii7 provider stakeholder groups2 7,,iii7 accreditation organizations2 7,,iv7 ,state and local survey agencies2 7,v7 caregivers of current or former hospice patients2 and 7,,vi7 any other representatives of programs or groups the ,secretary determines appropriate4 4 7#c7 ,increased deficiency data reporting by approved hospice accreditation agencies ,not later than #f months after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall expand the information that approved accreditation agencies 7as described in section #ahfa7;dd77#d77;,c77i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7dd77#d77;,c77i7771 as amended by subsection 7b71 are required to report with respect to deficiencies by a hospice program to be comparable to the information that ,state and local survey agencies 7as described in such section7 report with respect to such deficiencies4 7b7 ,improving the hospice survey process ,section #ahfa7;dd77#d77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7dd77#d77;,c77 is amended to read as follows3 7,c7 7i7 ,subject to the succeeding provisions of this subparagraph1 beginning #f months after the date of enactment of the ,improving ,medicare ,post-,acute ,care ,transformation ,act of #bjad1 any entity that is certified as a hospice program shall be subject to a standard survey by an appropriate ,state or local survey agency1 or an approved accreditation agency1 as determined by the ,secretary1 not less frequently than once every #cf months4 7ii7 ,any entity that is first certified as a hospice program after the date of enactment of the ,hospice ,care ,improvement ,act of #bjai shall be subject to a standard survey described in clause 7i7 within #ab months of such certification4 ,after such standard survey1 such entity shall be subject to standard surveys in accordance with clause 7i74 7iii7 ,any entity that is subject to an intermediate sanction under paragraph 7#f7 shall be subject to a standard survey described in clause 7i7 not less than once every #ab months until such time that the entity is found by the ,state or local survey agency or approved accreditation agency to be in compliance with the requirements under this title for a period of #bd months4 7iv7 ,if a ,state and local survey agency or an approved accreditation agency identifies a deficiency of an entity as part of a standard survey conducted pursuant to this subparagraph1 the agency shall notify the entity of the finding and provide the entity with 7or provide access to7 educational information on how to address the deficiency and prevent future deficiencies4 ,such educational information 7or access to such information7 shall be provided to the entity upon the completion of the site visit performed as part of the survey4 ,such educational information shall be standardized for purposes of both educating hospice programs and surveyors from local survey agencies and approved accreditation agencies4 7v7 ,the ,secretary shall establish a process for joint training and education of ,state and local survey agencies1 approved accreditation agencies1 and hospice programs on a regular basis as changes to regulations1 guidelines1 and policies governing hospice program operations are implemented and used in standard surveys of participating hospice programs4 4 7c7 ,annual report of deficiencies 7#a7 ,study ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall conduct an annual study on deficiencies by a hospice programs under the ,medicare program4 ,such study shall include an analysis of ways to address such deficiencies4 7#b7 ,report ,not later than ,january #a1 #bjba1 the ,secretary shall submit to ,congress a report on the study conducted under paragraph 7#a71 together with recommendations for such legislation and administrative action as the ,secretary determines appropriate4 #c4 ,increasing compliance of quality standards for hospice care 7a7 ,increasing payment reductions for failing ,to report quality measures ,section #ahad7;i77#e77;,a77i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;f7i77#e77;,a77i77 is amended by inserting or1 for fiscal year #bjba and subsequent fiscal years1 #d percentage points before the period at the end4 7b7 ,authority ,to impose intermediate sanctions ,section #ahfa7;dd7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7dd77 is amended by adding at the end the following paragraph3 7#f7 ,beginning #a year after the date of enactment of the ,hospice ,care ,improvement ,act of #bjai1 if the ,secretary determines based on the results of a survey that a hospice program no longer meets the applicable requirements of this ,act1 the ,secretary-- 7,a7 shall issue guidance on ways to determine the mechanisms for imposing a range of intermediate sanctions on hospice programs2 and 7,b7 may impose an intermediate sanction on the hospice program1 including but not limited to1 the following3 7i7 ,suspension of all or part of the payments to which a hospice program would otherwise be entitled under this title for all new admissions on or after the date on which the ,secretary determines that intermediate sanctions should be imposed4 7ii7 ,the appointment of temporary management to oversee the operation of the hospice program and to protect and assure the health and safety of individuals under the care of the hospice program while improvements are made in order to bring the hospice program into compliance with all the requirements specified in this section4 7iii7 ,implementation of a directed plan of correction under which the ,secretary or the temporary manager may direct the hospice program to take specific corrective action to achieve specific outcomes within specific timeframes4 7iv7 ,if the ,secretary determines that education is likely to correct the deficiencies1 imposition of a requirement that all hospice program staff attend in-service training programs deemed acceptable by the ,secretary4 4