,,ii  #aagth ,,congress  #b;d ,session  
,s4 #dfje  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,july #be1     
#bjbb,ms4 ,stabenow 7for herself and    
,ms4 ,collins7 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 ensure stability in  
payments to home health agencies under  
the ,medicare program4  #a4 ,short title
 ,this ,act may be cited as the         
,preserving ,access to ,home ,health    
,act of #bjbb4  #b4 ,ensuring stability 
in payments to home health agencies  7a7
 ,limitation on permanent and temporary 
adjustments ,section #ahie7;b77#c77;,d7 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acie;fff7b77#c77;,d77 is     
amended-- 7#a7 in each of clauses 7ii7  
and 7iii71 by striking ,the ,secretary  
shall and inserting ,subject to clause  
7iv71 the ,secretary shall2 and  7#b7 by
 adding at the end the following new    
clause3  7iv7 ,special rules for        

decreases in payments  7,i7             
,postponement ,no permanent decrease to 
the standard prospective payment amount 
7or amounts7 for a year under clause    
7ii7 and no temporary decrease to the   
payment amount for a unit of home health
 services for a year under clause 7iii7 
shall be made prior to #bjbf4  7,,ii7   
,sunset ,subject to subclause 7,i71 the 
,secretary shall ensure that all        
necessary permanent or temporary        
decreases described in subclause 7,i7   
are made prior to #bjcb4  4  7b7        
,implementation ,notwithstanding any    
other provision of law1 the ,secretary  
may implement the provisions of1 and the
 amendments made by1 this section by    
program instruction or otherwise4