,,ii  #aahth ,,congress  #ast ,session  
,s4 #bacg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #bb1     
#bjbc,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 #bjbc4  #b4 ,ensuring stability 
in payments to home health agencies  7a7
 ,repeal of permanent and temporary     
adjustments ,section #ahie7;b77#c7 of   
the ,social ,security ,act 7#db         
,u4,s4,c4 #acie;fff7b77#c77 is amended  
by striking subparagraph 7,d74  7b7     
,effective date2 implementation  7#a7   
,effective date ,the amendment made by  
subsection 7a7 shall take effect as if  
included in the enactment of the        
,bipartisan ,budget ,act of #bjah       

7,public ,law #aae-abc74  7#b7          
,implementation ,the ,secretary of      
,health and ,human ,services 7in this   
section referred to as the ,secretary7  
shall implement such section            
#ahie7;b77#c7 for #bjbd and subsequent  
years as if the amendment made by       
section #eajja7;a77#b77;,b7 of division 
,e of the ,bipartisan ,budget ,act of   
#bjah 7,public ,law #aae-abc7 7adding   
such subparagraph 7,d77 had not been    
made4  7c7 ,construction ,nothing in    
this section shall be construed as      
signifying congressional approval or    
disapproval of the methodology          
promulgated by the ,secretary to        
implement section #ahie7;b77#c77;,d7 of 
the ,social ,security ,act in the final 
rule entitled1 ,medicare ,program2      
,calendar ,year 7,,cy7 #bjbc ,home      
,health ,prospective ,payment ,system   
,rate ,update2 ,home ,health ,quality   
,reporting ,program ,requirements2 ,home
 ,health ,value-,based ,purchasing      
,expanded ,model ,requirements2 and     

,home ,infusion ,therapy ,services      
,requirements published in the ,federal 
,register on ,november #d1 #bjbb 7#hg   
,fed4 ,reg4 #ffgij74  #c4 ,interaction  
of medicare payment policies with health
 care delivery generally ,section       
#ahje7;b77#b77;,c7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acie;b-#f7;b77#b77;,c77 is amended--   
7#a7 by striking                        
generally4--,specifically1 and inserting
 8generally4--  7i7 ,in general         
,specifically1  2 and  7#b7 by adding at
 the end the following new clause3  7ii7
 ,special rule for home health agencies 
7,i7 ,in general ,when conducting the   
review of home health agency financial  
performance and its impact on access to 
care under the original fee-for-service 
system1 the ,commission shall-- 7aa7    
review and report on aggregate trends in
 spending1 utilization1 and financial   
performance under the ,medicare         
,advantage program1 the ,medicaid       
program under title ,,xix 7both         

fee-for-service and managed care payment
 models71 and other payers for home     
health agency services2  7bb7 evaluate  
and consider the impact of all payers on
 access to care for ,medicare           
beneficiaries2 and  7cc7 comprehensively
 disclose the methodologies used to     
evaluate and calculate home health      
agency margins under this title and all 
other payers1 including the process for 
developing the data used4  ,where       
appropriate1 the ,commission shall      
conduct such reviews in consultation    
with the ,medicaid and ,,chip ,payment  
and ,access ,commission established     
under section #aijj4  7,,ii7 ,medicare  
home health cost report amendments ,for 
cost reporting periods beginning in     
#bjbe and subsequent years1 the         
,secretary shall have in effect an      
amended ,medicare home health cost      
report that collects data on visit      
utilization and total payments by payer 
source1 including original              
fee-for-service payments1 ,medicare     

,advantage1 the ,medicaid program under 
title ,,xix 7both fee-for-service and   
managed care payment models71 and other 
payers4 ,the ,secretary shall make such 
amended cost reports available to the   
,commission in the form and manner      
necessary to conduct the analysis       
described in subclause 7,i74  7,,iii7   
,financial data ,prior to the           
availability of cost report data as     
described in subclause 7,,ii71 the      
,commission shall utilize data on cost  
and revenues from sources it deems as   
reliable and valid for purposes of      
conducting the analysis described in    
subclause 7,i74  4