,,ii  #aai? ,,congress  #a/ ,session    
,s4 #aice  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #c1 #bjbe ,ms4   
,ros5 7= h]self1 ,mr4 ,b>rasso1 ,ms4    
,baldw91 & ,mrs4 ,fis*]7 introduc$ !    
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xi ( ! ,social         
,security ,act to provide = ! te/+ ( a  
community-bas$ palliative c>e model4    
#a4  ,%ort title  ,?is ,act may be cit$ 
z ! ,exp&+ ,access to ,palliative ,c>e  
,act4  #b4  ,community-bas$ palliative  
c>e model  ,section #aaae;,a ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #acae;a7 
is am5d$--  7#a7 9 subsection           
7b77#b77;,a71 by add+ at ! end ! foll[+ 
new s5t5ce3 ,! models select$ "u ?is    
subp>agraph %all include ! te/+ ( !     
model describ$ 9 subsection 7h742 &     
7#b7 by add+ at ! end ! foll[+ new      
subsection3  7h7  ,community-,bas$      
palliative c>e model  7#a7  ,9 g5]al  ,!
 ,,cmi %all develop & implem5t a model  
to provide community-bas$ palliative c>e

 & c>e coord9ation = high-risk          
b5efici>ies1 9 co-managem5t ) o!r       
provid]s ( s]vices & suppli]s1 aim$ at  
improv+ outcomes & exp]i5ce ( c>e &     
r$uc+ unnecess>y or unwant$ em]g5cy     
dep>tm5t visits & hospitalizations 79   
?is subsection ref]r$ to z ! model71 & t
 is int5d$ to replace ! ,m$ic>e ,c>e    
,*oices ,model4  7#b7  ,duration  ,!    
model %all be implem5t$ = a #e-ye>      
p]iod1 beg9n+ n lat] ?an "o ye> aft] !  
date ( ! enactm5t ( ?is subsection4     
7#c7  ,t>get population  7,a7  ,9 g5]al 
,! t>get population = ! model is an     
individual-- 7i7 entitl$ to1 or enroll$ 
=1 b5efits "u "p ,a ( title ,,xviii2 &  
7ii7 ) a diagnosis ( a s]i\s illness or 
injury1 :i* may include a diagnosis (   
canc]1 he>t & vascul> disease1 pulmon>y 
disease1 human immunodefici5cy          
virus_/acquir$ immunodefici5cy1         
,alzheim]'s & dem5tia1 /roke1 s]i\s     
injury requir+ rehabilitation includ+   
burns1 kidney disease1 liv] disease1    
,amyotrophic lat]al scl]osis1 any neuro 

deg5]ative disease1 or any o!r s]i\s    
illness or injury ! ,secret>y det]m9es  
appropriate4  7,b7  ,no exclusion =     
prior use ( hospice c>e b5efits  ,an    
individual %all n be exclud$ f          
p>ticipation 9 ! model bas$ on prior use
 ( hospice c>e b5efits dur+ any p]iod   
prior to su* p>ticipation1 reg>dless ( !
 s\rce ( cov]age = su* b5efits4  7#d7   
,p>ticipat+ provid]s  ,provid]s eligible
 to p>ticipate "u ! model may include   
palliative c>e teams work+ z an         
indep5d5t practice or associat$ ) a     
hospice program1 home heal? ag5cies1    
hospitals1 integrat$ heal? sy/ems1 & o!r
 facilities det]m9$ appropriate by !    
,secret>y4  7#e7  ,team-bas$ approa*    
,"u ! model1 at lea/ "o memb] ( !       
multi-discipl9>y palliative c>e team    
%all be c]tifi$ 9 hospice & palliative  
c>e4 ,?is is a co-managem5t model )     
palliative c>e align+ ) prim>y &        
speciali/ c>e = a team-bas$ approa*4    
,c>e mu/ be coord9at$ across provid]s & 
community s]vices = inclusion ( all pa91

 symptom managem5t1 disease-modify+ &   
curative treatm5ts1 & o!r palliative c>e
 s]vices4  7#f7  ,location  ,c>e may be 
furni%$ "u ! model 9 any b5efici>y home1
 includ+ a c>egiv]'s resid5ce1 an ext5d$
 c>e facility1 or a community sett+ z   
appropriate bas$ on ! individual's      
ability to access s]vices4 ,! model %all
 include access )9 an 9-pati5t /ay s    
long z ! pati5t beg9s receiv+ palliative
 c>e s]vices prior to admission4        
,s]vices %all n be disrupt$ solely due  
to *ange 9 location f a resid5ce to an  
9-pati5t sett+1 & %all be "p ( c>e      
coord9ation & c>e plann+ foll[+ hospital
 dis*>ge4  7#g7  ,s]vices  ,! model %all
 include items & s]vices bas$ on        
specific pati5t ne$s ) respect to pa91  
symptom managem5t1 education1 disease   
modify+ treatm5ts1 advance c>e plann+ & 
%>$ decision mak+1 goals cl>ification1  
m5tal heal? s]vices1 family & c>egiv]   
support s]vices1 spiritual support c>e1 
p]sonal c>e assi/ance1 & /ress r$uction 
!rapies4 ,?is includes a compreh5sive   

assessm5t ( symptoms & /ress factors t  
impact quality ( life4  7#h7  ,access   
,c>e %all be available "u ! model #bd   
h\rs a day1 #g days a week1 & #cfe days 
a ye>1 includ+ teleheal? s]vices4 ,!    
,,cmi %all specifically consid] ! ne$s (
 rural & und]s]v$ areas & adju/         
accord+ly to ensure equitable access to 
c>e4 ,a broad range ( provid]s mu/ be   
includ$ ) no geographic limitations4    
7#i7  ,metrics  ,! ,,cmi %all assess !  
model by comp>+ p>ticipants to o!r      
memb]s ( ! t>get population :o are      
receiv+ c>e outside ( ! model1 includ+ )
 respect to ! foll[+3  7,a7             
,demographics 7includ+ age1 diagnosis1  
resid5ce type1 m$ical enc\nt]s 9 prec$+ 
#ab mon?s lead+ to enrollm5t1 geographic
 location 7su* z urban or rural7 & o!rs 
z det]m9$ by ! ,,cmi74  7,b7 ,impact on 
utilization ( items & s]vices "u title  
,,xviii 7su* z em]g5cy dep>tm5t s]vices1
 hospital obs]vation s]vices1 inpati5t  
admissions1 & int5sive c>e unit 7,,icu7 
/ays74  7,c7 ,election ( hospice c>e4   

7,d7 ,duration ( hospice c>e4  7,e7 ,c>e
 ,exp]i5ce 7b5efici>y & c>egiv]74  4