Summary:
Hospice Commitment to Accurate and Relevant Encounters Act or the Hospice CARE [sic]

 Amends title XVIII (Medicare) of the Social Security Act with respect to the face-to-face encounter framework in hospice care. A clinical nurse specialist, physician assistant, or other health professional (in addition to a hospice physician or a nurse practitioner, as under current law) is allowed to conduct the face-to-face encounter with the individual to determine continued eligibility for hospice care before the first 60-day (currently 180-day) recertification period and each subsequent recertification.

accurate relevant act sic amends title xviii medicare social security act respect face face encounter framework hospice care clinical nurse specialist physician assistant health professional addition hospice physician nurse practitioner current law allowed conduct face face encounter individual determine continued eligibility hospice care day currently day recertification period subsequent recertification


Summary:
Preserving Rehabilitation Innovation Centers Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to study whether there should be an increase in the prospective payment rate for inpatient rehabilitation services that would otherwise be made to a rehabilitation innovation center to cover additional costs incurred in: (1) furnishing items and services to individuals conducting research, and (2) providing medical training.

Requires the study also to specify the amount of such an increase if the Secretary determines that it is recommended.

Directs the Secretary also to study the access by individuals to rehabilitation care in rural communities in states where there is no rehabilitation innovation center.

preserving rehabilitation innovation centers act amends title xviii medicare social security act direct secretary health_and_human_services study increase prospective payment rate inpatient rehabilitation services rehabilitation innovation center cover additional costs incurred furnishing items services individuals conducting research providing medical training requires study specify increase secretary determines recommended directs secretary study access individuals rehabilitation care rural communities states rehabilitation innovation center


Summary:
(This measure has not been amended since it was introduced. The summary has been expanded because action occurred on the measure.)

(Sec. 1) This bill directs the Department of Veterans Affairs (VA) to enter into an agreement or a contract with each state home to pay for adult day health care for a veteran eligible for, but not receiving, nursing home care.

The veteran must need such care either specifically for a service-connected disability, or, if not specifically for one, the veteran must have a service-connected disability rated 70% or more.

Payment under each agreement or contract between the VA and a state home must equal 65% of the payment that the VA would otherwise pay to the state home if the veteran were receiving nursing home care.

measure amended introduced summary expanded action occurred measure sec bill directs department_of_veterans_affairs enter agreement contract state home pay adult day health care veteran eligible receiving nursing home care veteran need care specifically service connected disability specifically veteran service connected disability rated payment agreement contract state home equal payment pay state home veteran receiving nursing home care


Summary:
Community Based Independence for Seniors Act of 2015

This bill amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to establish a Community-Based Institutional Special Needs Plan demonstration program to provide home and community-based care to eligible Medicare beneficiaries age 65 or older.

community based independence seniors act bill amends title xviii medicare social security act direct secretary health_and_human_services establish needs plan demonstration program provide home community based care eligible medicare beneficiaries age older


Summary:
Veterans Residential Care Choice Act

This bill authorizes the Department of Veterans Affairs (VA), at the request of an eligible veteran for whom the VA is required to provide domiciliary, nursing home, adult day health, or hospital care, or who is determined to be in need of such care, to place the veteran (at the expense of the United States) in a state licensed or certified residential care facility that meets VA standards if the cost of providing such care through the facility is less than the cost of providing the care through any other available option.

An eligible veteran is a veteran with a service-connected disability rated at 70% or more disabling.

veterans residential care choice act bill authorizes department_of_veterans_affairs request eligible veteran required provide domiciliary nursing home adult day health hospital care determined need care place veteran expense united_states state licensed certified residential care facility meets standards cost providing care facility cost providing care available option eligible veteran veteran service connected disability rated disabling


Summary:
Hospice Care Access Improvement Act of 2015

This bill directs the Department of Health and Human Services (HHS) to select one Medicare administrative contractor to conduct a one-year demonstration program during FY2016 in all hospice programs under the contractor's jurisdiction to test revisions to the methodology for determining hospice payment rates under title XVIII (Medicare) of the Social Security Act contained in the "Fiscal Year 2016 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements," published on May 5, 2015, by the Centers for Medicare & Medicaid Services.

No revisions to the hospice payment methodology may be made for FY2016-FY2017, except for demonstration program purposes. HHS shall implement the proposed hospice payment methodology revisions beginning with FY2018 after:

 taking into account an evaluation of the demonstration program, and making any necessary changes to the revisions. HHS shall implement a process for the medical review of hospice care furnished by a hospice program identified according to certain multiple factors, such as the percentage of patients discharged after receiving hospice care for between 120 and 180 days and who were alive upon discharge.

HHS shall also develop and publish guidance for hospice programs to develop interventions to reduce hospital admissions and visits to hospital emergency departments by hospice patients.

Medicare shall cover pre-hospice evaluation and counseling services performed by a registered nurse employed by a hospice program.

A skilled nursing facility (SNF) shall make a good faith effort to contract with more than one hospice program participating in the Medicare program that provides services in the area served by the SNF, if more than one hospice program is available to serve SNF residents.

SNF residents shall have the right to be fully informed of any financial interest the SNF has in any hospice program to which a resident is referred.

Any hospital discharge planning evaluation must evaluate, for an individual likely to need hospice care, the availability of such care through hospice programs that:

 participate in the Medicare program and serve the area in which the patient resides, and request to be listed by the hospital as available.

bill directs department_of_health_and_human_services hhs select medicare administrative contractor conduct year demonstration program fy2016 hospice programs contractor jurisdiction test revisions methodology determining hospice payment rates title xviii medicare social security act contained fiscal year hospice wage index published revisions hospice payment methodology fy2016 fy2017 demonstration program purposes hhs shall implement proposed hospice payment methodology revisions beginning fy2018 taking account evaluation demonstration program making necessary changes revisions hhs shall implement process medical review hospice care furnished hospice program identified according certain multiple factors percentage patients discharged receiving hospice care days alive discharge hhs shall develop publish guidance hospice programs develop interventions reduce hospital admissions visits hospital emergency departments hospice patients medicare shall cover pre hospice evaluation counseling services performed registered nurse employed hospice program skilled nursing facility snf shall good faith effort contract hospice program participating medicare program provides services area served snf hospice program available serve snf residents snf residents shall right fully informed financial interest snf hospice program resident referred hospital discharge planning evaluation evaluate individual likely need hospice care availability care hospice programs participate medicare program serve area patient resides request listed hospital available


Summary:
Missing Alzheimer's Disease Patient Alert Program Reauthorization Act of 2015

 Amends the Violent Crime Control and Law Enforcement Act of 1994 to revise provisions concerning the Missing Alzheimer's Disease Patient Alert Program to direct the Attorney General: (1) through the Bureau of Justice Assistance and in consultation with the Department of Health and Human Services, to award competitive grants to nonprofit organizations to assist in paying for the costs of planning, designing, establishing, and operating locally based, proactive programs to protect and locate missing patients with Alzheimer's disease and related dementias; and (2) in awarding grants, to give preference to national nonprofit organizations that have experience working with patients with Alzheimer's disease and related dementias and their families.

Authorizes appropriations for such grants for FY2016-FY2020.

missing alzheimer disease patient alert program reauthorization act amends violent_crime_control_and_law_enforcement_act revise provisions concerning missing alzheimer disease patient alert program direct attorney general bureau_of_justice_assistance consultation department_of_health_and_human_services award competitive grants nonprofit organizations assist paying costs planning designing establishing operating locally based proactive programs protect locate missing patients alzheimer disease related dementias awarding grants preference national nonprofit organizations experience working patients alzheimer disease related dementias families authorizes appropriations grants fy2016-fy2020


Summary:
Recognize, Assist, Include, Support, and Engage Family Caregivers Act of 2015 or the RAISE Family Caregivers Act

This bill directs the Department of Health and Human Services (HHS) to develop, maintain, and periodically update a National Family Caregiving Strategy.

 HHS shall convene a Family Caregiving Advisory Council to advise it on recognizing and supporting family caregivers.

Federal departments and agencies must share with HHS any data they maintain that HHS needs to prepare the initial and updated Strategies.

recognize assist engage family caregivers act raise family caregivers act bill directs department_of_health_and_human_services hhs develop maintain periodically update national family caregiving strategy hhs shall convene advise recognizing supporting family caregivers federal departments agencies share hhs data maintain hhs needs prepare initial updated strategies


Summary:
Safe Food for Seniors Act of 2015

This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act such that a Medicare skilled nursing facility or Medicaid nursing facility without a full-time qualified dietitian must require its director of food services to be: (1) a Certified Dietary Manager meeting the requirements of the Certifying Board for Dietary Managers; (2) a Dietetic Technician, Registered, meeting with the requirements published by the Commission on Dietetic Registration; or (3) an individual with equivalent military or academic qualifications.

safe food seniors act bill amends titles xviii medicare xix medicaid social security act medicare skilled nursing facility medicaid nursing facility time qualified require director food services certified dietary manager meeting requirements technician registered meeting requirements published commission registration individual equivalent military academic qualifications


Summary:
Medicaid and CHIP Territory Fraud Prevention Act

This bill amends part A (General Provisions) of title XI of the Social Security Act to exclude certain payments from ceilings on the amounts of Medicaid payments made to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. Specifically, the bill excludes certain payments made to these territories for the establishment and operation of Medicaid fraud control units.

The bill also makes a technical amendment.

medicaid fraud prevention act bill amends general provisions title social security act exclude certain payments ceilings amounts medicaid payments puerto_rico virgin_islands guam northern_mariana islands american_samoa specifically bill excludes certain payments territories establishment operation medicaid fraud control units bill makes technical amendment


Summary:
Nursing Home Accountability Act of 2015

This bill amends the National Housing Act to condition a nursing home's eligibility for a Section 232 loan upon its quality rating. (A Section 232 loan is insured by the Federal Housing Administration and may be used to finance or refinance the purchase, construction, or renovation of a nursing home or assisted living facility.)

A nursing home becomes ineligible for a Section 232 loan if, for any period of 30 or more consecutive months, the home achieves two or fewer stars under the five-star quality rating system established pursuant to the Social Security Act for purposes of the Medicare and Medicaid programs. However, a nursing home's eligibility shall be renewed if the home subsequently maintains a rating of three or more stars for a period of at least 30 consecutive months.

The bill does not affect existing mortgages.

nursing home accountability act bill amends national housing act condition nursing home eligibility section loan quality rating section loan insured federal_housing_administration finance refinance purchase construction renovation nursing home assisted living facility nursing home ineligible section loan period consecutive months home achieves fewer stars star quality rating system established pursuant social security act purposes medicare medicaid programs nursing home eligibility shall renewed home subsequently maintains rating stars period consecutive months bill affect existing mortgages


Summary:
Lifespan Respite Care Reauthorization Act of 2015

This bill amends the Public Health Service Act to extend lifespan respite care programs (services for family caregivers of children and adults with special needs) through FY2020.

Each state agency awarded a grant or cooperative agreement for lifespan respite care must collect, maintain, and report to the Department of Health and Human Services data and records to enable monitoring and evaluation of the lifespan programs and activities.

bill amends public_health_service_act extend lifespan respite care programs services family caregivers children adults special needs fy2020 state agency awarded grant cooperative agreement lifespan respite care collect maintain report department_of_health_and_human_services data records enable monitoring evaluation lifespan programs activities


Summary:
Community-Based Independence for Seniors Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to establish a Community-Based Institutional Special Needs Plan demonstration program through which up to five eligible Medicare Advantage (MA) organizations shall provide home and community-based care to eligible Medicare beneficiaries. For purposes of the demonstration program, an eligible Medicare beneficiary is ineligible for Medicaid and unable to perform two or more activities of daily living.

The Centers for Medicare & Medicaid Services (CMS) shall establish payment rates for eligible MA plans under the demonstration program. Such payment rates are capped but shall be in addition to payments otherwise made to MA organizations with respect to such plans.

CMS shall also: (1) help to educate eligible Medicare beneficiaries on the availability of the program, and (2) provide for program evaluation by an independent third party.

bill amends title xviii medicare social security act establish needs plan demonstration program eligible medicare_advantage organizations shall provide home community based care eligible medicare beneficiaries purposes demonstration program eligible medicare beneficiary ineligible medicaid unable perform activities daily living centers cms shall establish payment rates eligible plans demonstration program payment rates capped shall addition payments organizations respect plans cms shall help educate eligible medicare beneficiaries availability program provide program evaluation independent party


Summary:
Medicare and Medicaid Improvements and Adjustments Act of 2015

This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify payment rules and other provisions related to the Medicare and Medicaid programs.

The bill includes off-campus outpatient department (OPD) services in Medicare's prospective payment system (in which predetermined amounts form the basis of payment) with respect to departments that are under development.

The existing Medicare payment adjustment for cancer hospitals shall apply to off-campus OPDs.

The bill temporarily prohibits specified Medicare payment adjustments related to competitive acquisition programs for certain wheelchair accessories.

In addition, the bill modifies provisions related to: (1) reimbursement under Medicare for certain drugs furnished through durable medical equipment (DME), (2) Medicare payment rules for certain radiation therapy services, and (3) the treatment of Medicaid supplemental needs trusts.

The bill expands criminal penalties and civil monetary penalties for certain acts involving federal health care programs.

With respect to negative Medicare payment adjustments for physicians and hospitals that fail to comply with certain requirements related to electronic health records (EHR), the bill authorizes a temporary blanket exception.

A patient encounter occurring at an ambulatory surgical center shall not be used to determine whether an eligible professional qualifies as a meaningful EHR user. This prohibition applies until a specified period has passed following a determination by the Department of Health and Human Services that certified EHR technology is applicable to that setting.

Current law limits state reimbursement for DME under Medicaid to Medicare payment rates beginning January 1, 2019. The bill accelerates this limitation such that it begins October 1, 2018.

medicare adjustments act bill amends titles xviii medicare xix medicaid social security act modify payment rules provisions related medicare medicaid programs bill includes campus outpatient department opd services medicare prospective payment system predetermined amounts form basis payment respect departments development existing medicare payment adjustment cancer hospitals shall apply campus bill temporarily prohibits specified medicare payment adjustments related competitive acquisition programs certain wheelchair accessories addition bill modifies provisions related reimbursement medicare certain drugs furnished durable medical equipment dme medicare payment rules certain radiation therapy services treatment medicaid supplemental needs trusts bill expands criminal penalties civil monetary penalties certain acts involving federal health care programs respect negative medicare payment adjustments physicians hospitals fail comply certain requirements related electronic health records ehr bill authorizes temporary blanket exception patient encounter occurring ambulatory surgical center shall determine eligible professional qualifies meaningful ehr user prohibition applies specified period passed following determination department_of_health_and_human_services certified ehr technology applicable setting current law limits state reimbursement dme medicaid medicare payment rates beginning january bill accelerates limitation begins october


Summary:
Return to Work Awareness Act of 2016

 This bill authorizes the Department of Labor, acting through the Job Accommodation Network, to disseminate information and promote awareness among survivors of stroke and other debilitating health occurrences, such as traumatic brain injury and heart attack, and survivors' families, as well as among employers, government agencies, employee representatives, and service providers in order to: (1) assist survivors of stroke and such other debilitating health occurrences in returning to work, (2) improve a survivor's employability and demonstrate to employers ways to capitalize on the value and talent that survivors add to the workplace, and (3) enhance self-employment and entrepreneurship options for survivors.

return work awareness act bill authorizes department_of_labor acting disseminate information promote awareness survivors stroke debilitating health occurrences traumatic brain injury heart attack survivors families employers government agencies employee representatives service providers order assist survivors stroke debilitating health occurrences returning work improve survivor employability demonstrate employers ways capitalize value talent survivors add workplace enhance self employment entrepreneurship options survivors


Summary:
Preserving Patient Access to Post-Acute Hospital Care Act of 2016

This bill amends title XVIII (Medicare) of the Social Security Act to delay by two additional years the application of negative payment adjustments under the "25-percent rule" to certain long-term care hospitals and satellite facilities. This rule reduces payments to a long-term care facility that admits proportionately more patients from any single hospital.

preserving patient access bill amends title xviii medicare social security act delay additional years application negative payment adjustments percent rule certain long term care hospitals satellite facilities rule reduces payments long term care facility proportionately patients single hospital


Summary:
Housing Opportunities for Persons With AIDS Modernization Act of 2016

This bill amends the AIDS Housing Opportunity Act to revise the formula and requirements for distributing funds under the Housing Opportunities for Persons With Aids (HOPWA) Program.

 A grantee that received an allocation in FY2016 shall continue to be eligible for such allocations in subsequent fiscal years, subject to approval by the Department of Housing and Urban Development (HUD) and the amounts available from appropriations Acts.

HUD shall:

 redetermine a grantee's eligibility at least once every 10 years, and ensure that a grantee that received an allocation in the prior fiscal year does not receive an allocation 5% less than or 10% greater than the share of total available formula funds allocated to that grantee in the preceding fiscal year. HUD may also award such funds to an alternative grantee if the original grantee agrees in a written document meeting HUD approval.

References to "cases of AIDS" and "AIDS cases" shall be replaced by "individuals living with HIV or AIDS," which means, with respect to the counting of cases in a geographic area during a period of time, the sum of:

 the number of living non-AIDS cases of HIV in the area, and the number of living cases of AIDS in the area.

bill amends aids housing opportunity act revise formula requirements distributing funds grantee received allocation fy2016 shall continue eligible allocations subsequent fiscal years subject approval department_of_housing_and_urban_development hud amounts available appropriations acts hud shall redetermine grantee eligibility years ensure grantee received allocation prior fiscal year receive allocation greater share total available formula funds allocated grantee preceding fiscal year hud award funds alternative grantee original grantee agrees written document meeting hud approval references cases aids aids cases shall replaced individuals living hiv aids means respect counting cases geographic area period time sum number living non aids cases hiv area number living cases aids area


Summary:
Protecting Families with Disabilities Act of 2016

This bill amends the Patient Protection and Affordable Care Act with respect to how a state that had an approved home- and community-based Medicaid waiver as of January 1, 2014, may treat spousal income and assets for purposes of determining an individual's financial eligibility for services under the waiver.

With respect to such a state that disregarded an individual's spousal income and assets for those purposes, specified provisions of current law shall not prohibit the state from continuing to do so.

protecting families disabilities act bill amends patient_protection affordable care act respect state approved home- community based medicaid waiver january treat spousal income assets purposes determining individual financial eligibility services waiver respect state disregarded individual spousal income assets purposes specified provisions current law shall prohibit state continuing


Summary:
Personalize Your Care Act 2.0

This bill amends title XVIII (Medicare) of the Social Security Act to establish several new programs and requirements related to end-of-life care and advance care planning.

The bill establishes a demonstration program to test the use of advanced illness management and early use of palliative care under Medicare.

The Department of Health and Human Services (HHS) must make grants to eligible entities for the purpose of developing, expanding, and enhancing programs for orders for life-sustaining treatment.

The Centers for Medicare & Medicaid Services (CMS) shall adopt standards for electronic health records with respect to providing one-click access to specified advance care planning documentation.

Under Medicare, an advance directive shall be portable across state lines and may be presumed valid regardless of where it was executed. In the absence of a validly executed advance directive, any authentic expression of a person's wishes with regard to health care shall be honored.

The Government Accountability Office must study and report on the portability, electronic storage, use, and barriers to use of advance directives.

The bill applies specified quality measures to end-of-life care under Medicare.

CMS must report annually on specified information related to Medicare decedents.

HHS shall award grants to increase public awareness of advance care planning. In addition, HHS shall award grants to eligible entities for the development and implementation of training and education programs related to advance care planning, hospice care, and palliative care.

HHS must establish an advisory committee on advance care planning.

personalize care act bill amends title xviii medicare social security act establish new programs requirements related end life care advance care planning bill establishes demonstration program test use advanced illness management early use palliative care medicare human services hhs grants eligible entities purpose developing expanding enhancing programs orders life sustaining treatment centers cms shall adopt standards electronic health records respect providing access specified advance care planning documentation medicare advance directive shall portable state lines presumed valid regardless executed absence validly executed advance directive authentic expression person wishes regard health care shall honored government_accountability_office study report portability electronic storage use barriers use advance directives bill applies specified quality measures end life care medicare cms report annually specified information related medicare decedents hhs shall award grants increase public awareness advance care planning addition hhs shall award grants eligible entities development implementation training education programs related advance care planning hospice care palliative care hhs establish advisory committee advance care planning


Summary:
Alzheimer's Beneficiary and Caregiver Support Act

This bill amends title XI (General Provisions) of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test the efficacy of coverage and payment for Alzheimer's Disease caregiver support services in delaying or reducing the use of institutionalized care for Medicare beneficiaries.

The Centers for Medicare & Medicaid Services shall establish payment amounts for such services.

alzheimer beneficiary caregiver support act bill amends title general provisions social security act require center medicare medicaid_innovation test efficacy coverage payment alzheimer disease caregiver support services delaying reducing use institutionalized care medicare beneficiaries centers shall establish payment amounts services


Summary: This bill amends title XVIII (Medicare) of the Social Security Act to establish, with respect to certain spinal cord specialty hospitals, a temporary exemption from specified Medicare payment limits applicable to long-term care hospital (LTCH) inpatient services. Current law generally applies payment limits to inpatient services for LTCHs that do not meet certain discharge requirements.

bill amends title xviii medicare social security act establish respect certain spinal cord specialty hospitals temporary exemption specified medicare payment limits applicable long term care hospital ltch inpatient services current law generally applies payment limits inpatient services ltchs meet certain discharge requirements


Summary: This bill amends title XVIII (Medicare) of the Social Security Act to, with respect to certain discharges involving severe wounds, extend and expand a temporary exception from certain Medicare payment limits for long-term care hospital (LTCH) inpatient services. Current law generally applies payment limits to inpatient services for LTCHs that do not meet specified discharge requirements.

bill amends title xviii medicare social security act respect certain discharges involving severe wounds extend expand temporary exception certain medicare payment limits long term care hospital ltch inpatient services current law generally applies payment limits inpatient services ltchs meet specified discharge requirements


Summary:
Rural Access to Hospice Act of 2016

This bill amends title XVIII (Medicare) of the Social Security Act to allow payment under Medicare for certain services furnished to hospice patients by rural health clinics and federally qualified health centers (FQHCs).

With respect to a patient who elects to receive hospice care under Medicare, current law generally limits payment for services that are either duplicative of such care or related to the treatment of the individual's terminal illness. However, current law exempts from this limitation: (1) physicians' services furnished by the individual's attending physician, if not an employee of the hospice program; and (2) services provided or arranged by the hospice program.

The bill expands this exemption with regard to rural health clinic and FQHC services. Specifically, the Medicare payment limitation shall not apply to such services that: (1) would otherwise be physicians' services if furnished by an individual unaffiliated with a rural health clinic or FQHC; and (2) are either arranged by the hospice program or furnished by the individual's attending physician, if not an employee of the hospice program.

hospice act bill amends title xviii medicare social security act allow payment medicare certain services furnished hospice patients rural health clinics federally qualified health centers fqhcs respect patient elects receive hospice care medicare current law generally limits payment services duplicative care related treatment individual terminal illness current law exempts limitation physicians services furnished individual attending physician employee hospice program services provided arranged hospice program bill expands exemption regard rural health clinic fqhc services specifically medicare payment limitation shall apply services physicians services furnished individual unaffiliated rural health clinic fqhc arranged hospice program furnished individual attending physician employee hospice program


Summary:
Community Integration Act of 2016

This bill amends title XIX (Medicaid) of the Social Security Act to require a state Medicaid program to, with respect to an individual who requires a level of care provided in a nursing facility, intermediate care facility for the developmentally disabled, institution for mental disease, or other similar setting: (1) provide the individual with the choice and equal opportunity to receive such care in a home- and community-based setting; and (2) meet specified requirements relating to the provision and availability of care in such a setting, including a requirement to develop a statewide plan to increase affordable and accessible housing for individuals with disabilities.

community integration act bill amends title xix medicaid social security act require state medicaid program respect individual requires level care provided nursing facility intermediate care facility developmentally disabled institution mental disease similar setting provide individual choice equal opportunity receive care home- community based setting meet specified requirements relating provision availability care setting including requirement develop statewide plan increase affordable accessible housing individuals disabilities


Summary:
Pre-Claims Undermine Seniors' Health Act of 2016 or the PUSH Act of 2016

This bill delays the Medicare demonstration for pre-claim review of home health services and requires the Centers for Medicare & Medicaid Services (CMS) to report on such pre-claim review. Specifically, CMS shall delay or suspend the demonstration by the later of: (1) one year after either the bill's enactment or the demonstration's scheduled start-date, as applicable; or (2) six months after CMS submits its report.

act bill delays medicare demonstration pre claim review home health services requires centers cms report pre claim review specifically cms shall delay suspend demonstration later year bill enactment demonstration scheduled start date applicable months cms submits report


Summary:
Medicare Home Health Flexibility Act of 2016

This bill establishes circumstances under which an occupational therapist may conduct the initial assessment visit for an individual who is eligible for home health services under Medicare. Specifically, an occupational therapist may conduct the assessment if the physician's referral order does not include skilled nursing care but does include: (1) occupational therapy, and (2) physical therapy or speech language pathology.

medicare_home_health flexibility act bill establishes circumstances occupational therapist conduct initial assessment visit individual eligible home health services medicare specifically occupational therapist conduct assessment physician referral order include skilled nursing care include occupational therapy physical therapy speech language pathology


Summary:
Improving Care for Vulnerable Older Citizens through Workforce Advancement Act of 2016

 This bill amends the Older Americans Act of 1965 to direct the Administration on Aging to carry out a program awarding grants to eligible entities to carry out six separate demonstration projects that focus on care coordination and service delivery for older individuals with chronic illness or at risk of institutional placement by: (1) designing and testing new models of care coordination and service delivery that thoughtfully and effectively deploy advanced aides to improve efficiency and quality of care for frail older individuals; and (2) giving direct-care workers opportunities for career advancement through additional training, an expanded role, and increased compensation.

improving care vulnerable older citizens workforce advancement act bill amends older americans act direct administration_on_aging carry program awarding grants eligible entities carry separate demonstration projects focus care coordination service delivery older individuals chronic illness risk institutional placement designing testing new models care coordination service delivery effectively deploy advanced aides improve efficiency quality care frail older individuals giving direct care workers opportunities career advancement additional training expanded role increased compensation


Summary:
Younger-Onset Alzheimer's Disease Parity Act of 2016

This bill amends the Older Americans Act of 1965 to authorize services to be provided to individuals with Alzheimer's disease or a related disorder with neurological and organic brain dysfunction who have not attained 60 years of age.

disease parity act bill amends older americans act authorize services provided individuals alzheimer disease related disorder neurological organic brain dysfunction attained years age


Summary:
Authorizes payment under the Department of Veterans Affairs (VA) beneficiary travel program of travel expenses in connection with the medical examination, treatment, or care of a veteran with vision impairment, a spinal cord injury or disorder, or double or multiple amputations whose travel is in connection with care provided through a VA special disabilities rehabilitation program, if such care is provided: (1) on an inpatient basis, or (2) while a veteran is provided temporary lodging at a VA facility in order to make such care more accessible.

Requires a report from the Secretary to the congressional veterans committees on the travel program.

authorizes payment department_of_veterans_affairs beneficiary travel program travel expenses connection medical examination treatment care veteran vision impairment spinal cord injury disorder double multiple travel connection care provided special disabilities rehabilitation program care provided inpatient basis veteran provided temporary lodging facility order care accessible requires report secretary congressional veterans committees travel program


Summary:
This bill amends the Medicare, Medicaid, and SCHIP Extension Act of 2007, as amended by other specified federal law, with respect to the five-year moratorium begining April 1, 2014, on the establishment of long-term care (LTC) hospitals and LTC satellite facilities and on the increase of LTC hospital beds in existing LTC hospitals or satellite facilities for purposes of title XVIII (Medicare) of the Social Security Act.

A technical correction is made to an exception to this moratorium for certain LTC hospitals that:

 began their qualifying period for Medicare payment on or before April 1, 2014; have a binding written agreement as of that date with an outside, unrelated party for the actual construction, renovation, lease, or demolition for an LTC hospital, and have expended, before that date, at least 10% of the project's estimated cost (or, if less, $ 2.5 million); or have obtained on or before that date an approved certificate of need in a state where one is required. This bill applies the exception to any similar moratorium.

bill amends medicare medicaid schip extension act amended specified federal law respect year moratorium april establishment long term care ltc hospitals ltc satellite facilities increase ltc hospital beds existing ltc hospitals satellite facilities purposes title xviii medicare social security act technical correction exception moratorium certain ltc hospitals began qualifying period medicare payment april binding written agreement date outside unrelated party actual construction renovation lease demolition ltc hospital expended date project estimated cost million obtained date approved certificate need state required bill applies exception similar moratorium


Summary:
Protecting Access to Rural Therapy Services (PARTS) Act

 Amends title XVIII (Medicare) of the Social Security Act to state that, except with respect to high-risk or complex medical services requiring direct levels of supervision, if the Secretary of Health and Human Services requires supervision by a physician or non-physician practitioner for Medicare payment for therapeutic hospital outpatient services, that requirement is met if such services are furnished under the physician's or non-physician practitioner's general supervision.

Directs the Secretary to establish a process for designating therapeutic hospital outpatient services for which direct supervision may be required for the entire service or direct supervision during the initiation of the service followed by general supervision for the remainder of the service.

Declares without force or effect in law regarding Medicare requirements for direct supervision by physicians for therapeutic hospital outpatient services a specified restatement and clarification under the final rulemaking changes to the Medicare hospital outpatient prospective payment system and calendar year 2009 payment rates, which was published in the Federal Register on November 18, 2008.

protecting_access rural therapy services parts act amends title xviii medicare social security act state respect high risk complex medical services requiring direct levels supervision secretary health_and_human_services requires supervision physician non physician practitioner medicare payment therapeutic hospital outpatient services requirement met services furnished physician non physician practitioner general supervision directs secretary establish process designating therapeutic hospital outpatient services direct supervision required entire service direct supervision initiation service followed general supervision remainder service declares force effect law medicare requirements direct supervision physicians therapeutic hospital outpatient services specified restatement clarification final rulemaking changes medicare hospital outpatient prospective payment system calendar year payment rates published federal_register november


Summary:
Medicare Home Infusion Site of Care Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to authorize Medicare coverage of home infusion therapy and home infusion drugs.

Directs the Secretary of Health and Human Services to implement the Medicare home infusion therapy benefit in a manner that ensures that: (1) Medicare beneficiaries have timely and appropriate access to infusion therapy in their homes, and (2) there is rapid and seamless coordination between drug coverage under Medicare part D (Voluntary Prescription Drug Benefit Program) and home infusion therapy services coverage under Medicare part B (Supplemental Security Income) (SSI) to avoid the filing of duplicative or otherwise improper claims.

amends title xviii medicare social security act authorize medicare coverage home infusion therapy home infusion drugs directs secretary health_and_human_services implement medicare home infusion therapy benefit manner ensures medicare beneficiaries timely appropriate access infusion therapy homes rapid seamless coordination drug coverage medicare voluntary prescription drug benefit program home infusion therapy services coverage medicare supplemental security income ssi avoid filing duplicative improper claims


Summary:
Medicare Access to Rehabilitation Services Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to repeal the existing caps on physical therapy, occupational therapy, and speech-language pathology services.

medicare_access_to_rehabilitation_services_act bill amends title xviii medicare social security act repeal existing caps physical therapy occupational therapy speech language pathology services


Summary:
Home Health Care Planning Improvement Act of 2015

 Amends title XVIII (Medicare) of the Social Security Act to revise conditions of and limitations on payment for home health care services.

Allows payment for home health services to Medicare beneficiaries by: (1) a nurse practitioner, (2) a clinical nurse specialist working in collaboration with a physician in accordance with state law, (3) a certified nurse-midwife, or (4) a physician assistant under a physician's supervision.

home_health_care_planning_improvement_act amends title xviii medicare social security act revise conditions limitations payment home health care services allows payment home health services medicare beneficiaries nurse practitioner clinical nurse specialist working collaboration physician accordance state law certified nurse midwife physician assistant physician supervision


Summary:
Rural Veterans Travel Enhancement Act of 2015

Makes permanent the authority of the Department of Veterans Affairs (VA) to transport individuals to and from VA facilities in connection with vocational rehabilitation, counseling, examination, treatment, or care.

Treats Vet Centers (centers for readjustment counseling and related mental health services for veterans) as VA facilities for purposes of providing payment of actual expenses of travel or allowance for travel to or from a VA facility.

Amends the Caregivers and Veterans Omnibus Health Services Act of 2010 to reauthorize through FY2020 a grant program to provide innovative transportation options to veterans in highly rural areas.

enhancement act makes permanent authority department_of_veterans_affairs transport individuals facilities connection vocational rehabilitation counseling examination treatment care centers readjustment counseling related mental health services veterans facilities purposes providing payment actual expenses travel allowance travel facility amends caregivers veterans_omnibus_health_services act reauthorize fy2020 grant program provide innovative transportation options veterans highly rural areas


Summary:
Caregivers Expansion and Improvement Act of 2015

Extends to all veterans with a serious service-connected injury the eligibility to participate in the Department of Veterans Affairs program of comprehensive assistance to family caregivers of such veterans. (Under current law, such eligibility is limited to those veterans who incurred such an injury on or after September 11, 2001.)

improvement act extends veterans service connected injury eligibility participate department_of_veterans_affairs program comprehensive assistance family caregivers veterans current law eligibility limited veterans incurred injury september


Summary:
Community Based Independence for Seniors Act

(Sec. 3) This bill directs the Department of Health and Human Services (HHS) to establish a five-year Community-Based Institutional Special Needs Plan demonstration program to prevent and delay institutionalization under title XIX (Medicaid) of the Social Security Act (SSAct) among eligible low-income Medicare beneficiaries age 65 or older.

HHS shall enter into agreements with up to five eligible Medicare Advantage (MA) plans under part C (Medicare+Choice) of SSAct title XVIII (Medicare) to conduct the demonstration program. Each eligible MA plan may enroll up to 1,000 eligible low-income Medicare beneficiaries in such program.

A participating MA plan shall use the rebate the plan must provide to eligible low-income Medicare enrollees to furnish certain benefits, including homemaker services, home delivered meals, transportation services, respite care, adult day care services, and non-Medicare-covered safety and other equipment.

HHS shall help to educate eligible Medicare beneficiaries about the availability of the demonstration program through State Health Insurance Assistance Programs and other organizations dedicated to assisting seniors with Medicare benefits and enrollment.

The demonstration program shall be implemented by January 1, 2018.

HHS shall arrange for an independent third party evaluation of the demonstration program, on the basis of which its duration and scope may be expanded.

Funding for the demonstration program shall come out of the Medicare trust funds.

community based independence seniors act sec bill directs department_of_health_and_human_services hhs establish year needs plan demonstration program prevent delay institutionalization title xix medicaid social security act ssact eligible low income medicare beneficiaries age older hhs shall enter agreements eligible medicare_advantage plans ssact title xviii medicare conduct demonstration program eligible plan enroll eligible low income medicare beneficiaries program participating plan shall use rebate plan provide eligible low income medicare enrollees furnish certain benefits including services home delivered meals transportation services respite care adult day care services non medicare covered safety equipment hhs shall help educate eligible medicare beneficiaries availability demonstration program organizations dedicated assisting seniors medicare benefits enrollment demonstration program shall implemented january hhs shall arrange independent party evaluation demonstration program basis duration scope expanded funding demonstration program shall come medicare trust funds


Summary:
Veterans Access to Extended Care Act of 2015

This bill modifies the treatment of Department of Veterans Affairs (VA) agreements with service providers to furnish veterans with nursing home care, adult day health care, or other extended care services.

Any such agreement shall:

 not be treated as a federal contract for the acquisition of goods or services and shall be not subject to any provision of law governing federal contracts for the acquisition of goods or services, and include specified requirements (such as for medical licensing and VA review of staff and facilities) to ensure the safety and quality of care furnished to veterans pursuant to such agreement. The failure of a provider to comply with a provision of the agreement may result in VA termination of the agreement.

Such agreements are exempted from the application of certain public contract labor laws.

bill modifies treatment department_of_veterans_affairs agreements service providers furnish veterans nursing home care adult day health care extended care services agreement shall treated federal contract acquisition goods services shall subject provision law governing federal contracts acquisition goods services include specified requirements medical licensing review staff facilities ensure safety quality care furnished veterans pursuant agreement failure provider comply provision agreement result termination agreement agreements exempted application certain public contract labor laws


Summary:
Preserve Access to Medicare Rural Home Health Services Act of 2015

This bill amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend through calendar 2020 the payment increase (add-on) for Medicare home health services in rural areas.

 The ceiling on the total amount of the additional payments or payment adjustments otherwise made in the case of home health outliers with respect to a fiscal year or year is lowered, in the case of each of 2016 through 2020, from 2.5% to 2.25% of the total payments projected or estimated to be made under the prospective payment system for home health services.

preserve access act bill amends medicare_prescription_drug improvement modernization act extend calendar payment increase add medicare home health services rural areas ceiling total additional payments payment adjustments case home health respect fiscal year year case total payments projected estimated prospective payment system home health services


Summary:
Improving Access to Medicare Coverage Act of 2015

Amends title XVIII (Medicare) of the Social Security Act to deem an individual receiving outpatient observation services in a hospital to be an inpatient with respect to satisfying the three-day inpatient hospital requirement in order to entitle the individual to Medicare coverage of any post-hospital extended care services in a skilled nursing facility.

medicare coverage act amends title xviii medicare social security act deem individual receiving outpatient observation services hospital inpatient respect satisfying day inpatient hospital requirement order entitle individual medicare coverage post hospital extended care services skilled nursing facility


Summary:
Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to cover comprehensive Alzheimer's disease care planning services.

education hope alzheimer act bill amends title xviii medicare social security act cover comprehensive alzheimer disease care planning services


Summary:
(This measure has not been amended since it passed the Senate on April 22, 2015. The summary of that version is repeated here.)

Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015

(Sec. 2) Amends title XVIII (Medicare) of the Social Security Act to increase from a three-year to a five-year period the length of an agreement with an independence at home medical practice under the Medicare Independence at Home Medical Practice Demonstration Program.

measure amended passed senate april summary version repeated medicare independence sec amends title xviii medicare social security act increase year year period length agreement independence home medical practice


Summary:
Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015

Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs.

Directs the Secretary of Health and Human Services to: (1) designate CRT items (excluding adaptive equipment to operate motor vehicles or certain prosthetic devices and orthotics), and (2) establish eligibility criteria for them.

Prescribes requirements for payments for CRT items.

Directs the Secretary to establish standards for clinical conditions for CRT item payment as well as quality standards for suppliers of such items.

Directs the Secretary to establish a formal process to allow submission of CRT code set modification requests by stakeholder groups for comprehensive coding changes related to entire policy groups.

Requires payment for replacement of a CRT item (or any part of one), without regard to certain continuous use or useful lifetime restrictions established for items of durable medical equipment, if a qualified ordering practitioner determines that a replacement item (or part) is necessary.

ensuring access quality complex rehabilitation technology act amends title xviii medicare social security act cover medical health services complex rehabilitation technology crt items designed individually configured specific qualified individual meet individual unique medical physical functional needs related medical condition capacities basic activities daily living adls instrumental adls directs secretary health_and_human_services designate crt items excluding adaptive equipment operate motor vehicles certain prosthetic devices orthotics establish eligibility criteria prescribes requirements payments crt items directs secretary establish standards clinical conditions crt item payment quality standards suppliers items directs secretary establish formal process allow submission crt code set modification requests stakeholder groups comprehensive coding changes related entire policy groups requires payment replacement crt item regard certain continuous use useful lifetime restrictions established items durable medical equipment qualified ordering practitioner determines replacement item necessary


Summary:
Preserving Rehabilitation Innovation Centers Act of 2016

This bill amends title XVIII (Medicare) of the Social Security Act to direct the Department of Health and Human Services to conduct a study to assess the costs incurred by rehabilitation innovation centers that are beyond the prospective rates for each of the following activities: (1) furnishing items and services to individuals under Medicare; (2) conducting research; and (3) providing medical training.

preserving rehabilitation innovation centers act bill amends title xviii medicare social security act direct department_of_health_and_human_services conduct study assess costs incurred rehabilitation innovation centers prospective rates following activities furnishing items services individuals medicare conducting research providing medical training


Summary:
This bill amends title XVIII (Medicare) of the Social Security Act to prohibit payment at the applicable site neutral payment rate for discharges in a cost reporting period beginning before October 1, 2017, from subsection (d) hospitals and certain long-term care hospitals that involve certain severe wounds.

(Generally, a subsection [d] hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system when providing covered inpatient services to eligible beneficiaries.)

The Secretary of Health and Human Services shall study the treatment needs of individuals entitled to benefits under Medicare part A (Hospital Insurance), or enrolled under Medicare part B (Supplementary Medical Insurance), requiring specialized wound care, and the cost, for such individual, and the Medicare program of treating severe wounds in rural and urban areas.

bill amends title xviii medicare social security act prohibit payment applicable site neutral payment rate discharges cost reporting period beginning october subsection hospitals certain long term care hospitals involve certain severe wounds generally subsection hospital acute care hospital particularly receives payments medicare inpatient prospective payment system providing covered inpatient services eligible beneficiaries secretary health_and_human_services shall study treatment needs individuals entitled benefits medicare enrolled medicare supplementary_medical_insurance requiring specialized wound care cost individual medicare program treating severe wounds rural urban areas


Summary:
(This measure has not been amended since it was reported to the Senate on July 30, 2015. The summary of that version is repeated here.)

This bill amends part A (General Provisions) of title XI of the Social Security Act to authorize the Department of Health and Human Services (HHS) to waive applicable general and Medicaid requirements of the Program of All-Inclusive Care for the Elderly (PACE) in order to conduct demonstration projects through the Center for Medicare and Medicaid Innovation (CMS Innovation Center) that involve PACE.

 HHS may not, as part of a CMS Innovation Center demonstration, waive: (1) the requirement to offer items and services under Medicare and Medicaid without limitation to PACE program enrollees, and (2) certain requirements regarding enrollment in and disenrollment from PACE programs.

measure amended reported senate july summary version repeated bill amends general provisions title social security act authorize department_of_health_and_human_services hhs waive applicable general medicaid requirements pace order conduct demonstration projects center medicare medicaid_innovation cms innovation center involve pace hhs demonstration waive requirement offer items services medicare medicaid limitation pace program enrollees certain requirements enrollment disenrollment pace programs


Summary:
Older Americans Community Access Revitalization and Education Act or the CARE Act

Amends the Older Americans Act of 1965 to direct the Administration on Aging (AoA) of the Administration for Community Living of the Department of Health and Human Services to establish a community care wrap-around support demonstration program of grants to enable eligible entities to: (1) establish community care wrap-around support partnerships; and (2) carry out specified activities, including longitudinal care plans for each eligible older individual as well as medication management and medical nutrition therapy.

Directs the AoA to provide funding through area agencies on aging, and other approved entities, to not-for-profit owners or managers of housing for a pilot project service packaged and targeted for residents of federally assisted housing.

Directs the AoA, through a coordinated public education and outreach campaign carried out by the National Eldercare Locator Service, and in coordination with other appropriate federal agencies, to promote: (1) enhanced public awareness of the importance of advance planning for integrated long-term care; and (2) the availability of national, state, and local information and resources to assist in such planning, as well as the existence of area agencies and aging service providers to give direct assistance with it.

care act amends older americans act direct administration_on_aging aoa establish community care support demonstration program grants enable eligible entities establish community care support partnerships carry specified activities including longitudinal care plans eligible older individual medication management medical nutrition therapy directs aoa provide funding area agencies aging approved entities profit owners managers housing pilot project service packaged targeted residents federally assisted housing directs aoa coordinated public education outreach campaign carried national_eldercare_locator_service coordination appropriate federal agencies promote enhanced public awareness importance advance planning integrated long term care availability national state local information resources assist planning existence area agencies aging service providers direct assistance


Summary:
Home Health Documentation and Program Improvement Act of 2015

This bill amends title XVIII (Medicare) of the Social Security Act to direct the Department of Health and Human Services (HHS) to:

 develop a single form or document to be used by a physician to satisfy the documentation requirements necessary to fulfill the requirement of a face-to-face encounter and other criteria for home health eligibility (otherwise known as the certification for home health services); and notify and provide guidance and education to Medicare administrative contractors, recovery audit contractors, and any other appropriate entity regarding application of the form or document to such documentation requirements. HHS shall also:

 develop and implement processes to open and review claims denied on or after January 1, 2011, and before enactment of this Act, due solely to the face-to-face documentation requirements; issue revised decisions of such denials as if the requirements of related regulations did not apply at the time such services were furnished; and establish a voluntary process for home health agencies to enter into a settlement agreement with HHS in lieu of reprocessing claims whose payment this bill now requires.

bill amends title xviii medicare social security act direct department_of_health_and_human_services hhs develop single form document physician satisfy documentation requirements necessary fulfill requirement face face encounter criteria home health eligibility known certification home health services notify provide guidance education medicare administrative contractors recovery audit contractors appropriate entity application form document documentation requirements hhs shall develop implement processes open review claims denied january enactment act solely face face documentation requirements issue revised decisions denials requirements related regulations apply time services furnished establish voluntary process home health agencies enter settlement agreement hhs lieu reprocessing claims payment bill requires


Summary: This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.)

bill amends title xviii medicare social security act prohibit application medicare competitive acquisition rates complex rehabilitative wheelchairs accessories competitive bidding program replaced use established fee schedule amounts determine payments medicare certain durable medical equipment wheelchairs


Summary:
Medicare Choices Empowerment and Protection Act

This bill amends title XVIII (Medicare) of the Social Security Act to establish an Advance Directive Certification Program. Under the program, the Centers for Medicare & Medicaid Services (CMS) shall grant accreditation to advance directive vendors that meet specified accreditation criteria.

CMS shall establish procedures for an eligible beneficiary to register the adoption of a certified advance directive under the program. Beneficiary registration in the program shall be optional, but each eligible beneficiary who adopts and registers a certified advance directive shall receive a one-time incentive payment.

CMS shall provide for related education and outreach.

medicare choices empowerment protection act bill amends title xviii medicare social security act establish program cms shall grant accreditation advance directive vendors meet specified accreditation criteria cms shall establish procedures eligible beneficiary register adoption certified advance directive program beneficiary registration program shall optional eligible beneficiary adopts registers certified advance directive shall receive time incentive payment cms shall provide related education outreach


Summary:
Living Independently for Extended Time Act or the LIFETIME Act

This bill requires the Department of Health and Human Services to award grants to enable eligible states to develop innovative programs to meet the unique need for long-term services and supports in the state.

living independently extended time act lifetime act bill requires department_of_health_and_human_services award grants enable eligible states develop innovative programs meet unique need long term services supports state


Summary:
Preserve Access to Medicare Rural Home Health Services Act of 2015

This bill amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend through 2021 the rural add-on, which is a payment increase for Medicare home health services furnished to patients in rural areas.

The bill also amends title XVIII (Medicare) of the Social Security Act to lower, for FY2018-FY2022, the annual ceiling on the home health outlier adjustment, which is a payment increase for home health services furnished to the costliest Medicare beneficiaries, from 2.5% to 2.25% of the total Medicare payments projected to be made under the prospective payment system for home health services. (Under the Medicare prospective payment system, payment is made according to a predetermined, fixed amount.)

preserve access act bill amends medicare_prescription_drug improvement modernization act extend rural add payment increase medicare home health services furnished patients rural areas bill amends title xviii medicare social security act lower fy2018 fy2022 annual ceiling home health outlier adjustment payment increase home health services furnished medicare beneficiaries total medicare payments projected prospective payment system home health services medicare prospective payment system payment according predetermined fixed


Summary:
Medicare and Medicaid Improvements and Adjustments Act of 2015

This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify payment rules and other provisions related to the Medicare and Medicaid programs.

The bill includes off-campus outpatient department (OPD) services in Medicare's prospective payment system (in which predetermined amounts form the basis of payment) with respect to departments that are under development.

The existing Medicare payment adjustment for cancer hospitals shall apply to off-campus OPDs.

The bill temporarily prohibits specified Medicare payment adjustments related to competitive acquisition programs for certain wheelchair accessories.

In addition, the bill modifies provisions related to: (1) reimbursement under Medicare for certain drugs furnished through durable medical equipment (DME), (2) Medicare payment rules for certain radiation therapy services, and (3) the treatment of Medicaid supplemental needs trusts.

The bill expands criminal penalties and civil monetary penalties for certain acts involving federal health care programs.

With respect to negative Medicare payment adjustments for physicians and hospitals that fail to comply with certain requirements related to electronic health records (EHR), the bill authorizes a temporary blanket exception.

A patient encounter occurring at an ambulatory surgical center shall not be used to determine whether an eligible professional qualifies as a meaningful EHR user. This prohibition applies until a specified period has passed following a determination by the Department of Health and Human Services that certified EHR technology is applicable to that setting.

Current law limits state reimbursement for DME under Medicaid to Medicare payment rates beginning January 1, 2019. The bill accelerates this limitation such that it begins October 1, 2018.

medicare adjustments act bill amends titles xviii medicare xix medicaid social security act modify payment rules provisions related medicare medicaid programs bill includes campus outpatient department opd services medicare prospective payment system predetermined amounts form basis payment respect departments development existing medicare payment adjustment cancer hospitals shall apply campus bill temporarily prohibits specified medicare payment adjustments related competitive acquisition programs certain wheelchair accessories addition bill modifies provisions related reimbursement medicare certain drugs furnished durable medical equipment dme medicare payment rules certain radiation therapy services treatment medicaid supplemental needs trusts bill expands criminal penalties civil monetary penalties certain acts involving federal health care programs respect negative medicare payment adjustments physicians hospitals fail comply certain requirements related electronic health records ehr bill authorizes temporary blanket exception patient encounter occurring ambulatory surgical center shall determine eligible professional qualifies meaningful ehr user prohibition applies specified period passed following determination department_of_health_and_human_services certified ehr technology applicable setting current law limits state reimbursement dme medicaid medicare payment rates beginning january bill accelerates limitation begins october


Summary:
Verifying Electronically the Receipt of In-Home Care For Individuals Act or the VERIFI Act

This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require the use of electronic visit verification systems for certain services under the Medicare and Medicaid programs. An "electronic visit verification system" is a system under which care-related visits are electronically verified with regard to: (1) the type and date of service, (2) the individual receiving the service, (3) the individual providing the service, (4) the location of service delivery, and (5) the time the service begins and ends.

With respect to the Medicare program, a home health agency must have such a system in place for home health services as a condition of participation.

In the case of a state Medicaid program that does not require the use of such a system for both personal care services and home health services, the federal medical assistance percentage for medical assistance expended on such services shall be reduced beginning in 2019. These reductions increase incrementally from 0.25% to 1.00% through 2023.

With respect to the Medicare program, the Centers for Medicare & Medicaid Services shall establish standards for the systems and must consult with agencies to ensure that such standards: (1) are minimally burdensome, (2) account for existing best practices and electronic visit verifications systems already in use, and (3) require that the systems are conducted in accordance with specified legal requirements related to privacy and security. In regard to a state Medicaid program, a state shall do the same.

verifying electronically receipt home care individuals act act bill amends titles xviii medicare xix medicaid social security act require use electronic visit verification systems certain services medicare medicaid programs electronic visit verification system system care related visits electronically verified regard type date service individual receiving service individual providing service location service delivery time service begins ends respect medicare program home health agency system place home health services condition participation case state medicaid program require use system personal care services home health services federal medical assistance percentage medical assistance expended services shall reduced beginning reductions increase incrementally respect medicare program shall establish standards systems consult agencies ensure standards minimally burdensome account existing best practices electronic visit systems use require systems conducted accordance specified legal requirements related privacy security regard state medicaid program state shall


Summary:
(This measure has not been amended since it was introduced. The summary has been expanded because action occurred on the measure.)

Patient Access and Medicare Protection Act

(Sec. 2) This bill temporarily exempts from certain Medicare payment adjustments wheelchair accessories and seat and back cushions furnished in connection with Group 3 complex rehabilitative power wheelchairs. (Group 3 power wheelchairs are those that meet the highest performance requirements with regard to speed, range, and climbing capability.)

The Government Accountability Office must study wheelchair accessories and seat and back cushions furnished in connection with Group 3 complex rehabilitative power wheelchairs.

(Sec. 3) The bill amends title XVIII (Medicare) of the Social Security Act (SSAct) to prohibit specified adjustments to the Medicare fee schedule for certain radiation therapy services in 2017 or 2018.

Under current law, the Centers for Medicare & Medicaid Services (CMS) must periodically identify, review, and make adjustments to potentially misvalued services under Medicare. The bill specifies that certain radiation therapy services shall not be considered as potentially misvalued services for these purposes in 2017 or 2018.

(Sec. 4) For 2017, CMS may exempt categories of eligible professionals from requirements for meaningful use of electronic health records (EHR) technology. Under current law, CMS may, on a case-by-case basis, exempt an eligible professional from certain negative payment adjustments that would otherwise apply due to the professional's failure to comply with those requirements.

(Sec. 5) The bill eliminates funding for the Medicare Improvement Fund. (The fund was established to make improvements under the original Medicare fee-for-service program.)

(Sec. 6) The bill amends title XIX (Medicaid) of the SSAct to make changes related to the Medicaid Integrity Program (MIP). The bill: (1) specifies that program appropriations may cover the costs of equipment, travel, training, and salaries and benefits; and (2) allows CMS flexibility in determining the number of additional staff necessary to carry out the program. (MIP is a federal program aimed at preventing and reducing provider fraud, waste, and abuse in the Medicaid program.)

(Sec. 7) Under current law, CMS may contract with Medicare administrative contractors (MACs), which are private insurers that process Medicare claims within specified geographic jurisdictions. The bill requires CMS to provide specified incentives for MACs to reduce improper payment error rates within their jurisdictions.

(Sec. 8) The bill establishes criminal penalties of up to 10 years imprisonment and up to $500,000 ($1,000,000 for corporations) in fines for illegally purchasing or distributing Medicare, Medicaid, or Children's Health Insurance Program (CHIP) beneficiary identification or billing privileges.

(Sec. 9) The bill increases the scope of the Medicare-Medicaid Data Match Program (Medi-Medi Program), an existing program through which contractors and participating governmental agencies collaboratively analyze Medicare and Medicaid billing trends. CMS must establish a plan to encourage states to participate in the Medi-Medi Program.

 CMS shall implement a plan to allow states to access relevant data on improper or fraudulent payments made under the Medicare program on behalf of individuals dually eligible for both Medicare and Medicaid.

measure amended introduced summary expanded action occurred measure patient access medicare protection act sec bill temporarily exempts certain medicare payment adjustments wheelchair accessories seat furnished connection group complex rehabilitative power wheelchairs group power wheelchairs meet highest performance requirements regard speed range capability government_accountability_office study wheelchair accessories seat furnished connection group complex rehabilitative power wheelchairs sec bill amends title xviii medicare social security act ssact prohibit specified adjustments medicare fee schedule certain radiation therapy services current law cms periodically identify review adjustments potentially misvalued services medicare bill specifies certain radiation therapy services shall considered potentially misvalued services purposes sec cms exempt categories eligible professionals requirements meaningful use electronic health records ehr technology current law cms case case basis exempt eligible professional certain negative payment adjustments apply professional failure comply requirements sec bill eliminates funding medicare_improvement_fund fund established improvements original medicare fee service program sec bill amends title xix medicaid ssact changes related medicaid_integrity_program mip bill specifies program appropriations cover costs equipment travel training salaries benefits allows cms flexibility determining number additional staff necessary carry program mip federal program aimed preventing reducing provider fraud waste abuse medicaid program sec current law cms contract medicare administrative contractors macs private insurers process medicare claims specified geographic jurisdictions bill requires cms provide specified incentives macs reduce improper payment error rates jurisdictions sec bill establishes criminal penalties years imprisonment corporations fines illegally purchasing distributing medicare medicaid beneficiary identification billing privileges sec bill increases scope medicare-medicaid data_match_program medi-medi_program existing program contractors participating governmental agencies collaboratively analyze medicare medicaid billing trends cms establish plan encourage states participate program cms shall implement plan allow states access relevant data improper fraudulent payments medicare program behalf individuals dually eligible medicare medicaid


Summary:
This bill amends the AIDS Housing Opportunity Act to revise the formula and requirements for distributing funds under the Housing Opportunities for Persons With Aids (HOPWA) Program.

 A grantee that received an allocation in FY2016 shall continue to be eligible for such allocations in subsequent fiscal years, subject to approval by the Department of Housing and Urban Development (HUD) and the amounts available from appropriations Acts.

HUD shall:

 redetermine a grantee's eligibility at least once every 10 years, and ensure that a grantee that received an allocation in the prior fiscal year does not receive an allocation 5% less than or 10% greater than the share of total available formula funds allocated to that grantee in the preceding fiscal year. HUD may also award such funds to an alternative grantee if the original grantee agrees in a written document meeting HUD approval.

References to "cases of AIDS" and "AIDS cases" shall be replaced by "individuals living with HIV or AIDS," which means, with respect to the counting of cases in a geographic area during a period of time, the sum of:

 the number of living non-AIDS cases of HIV in the area, and the number of living cases of AIDS in the area.

bill amends aids housing opportunity act revise formula requirements distributing funds grantee received allocation fy2016 shall continue eligible allocations subsequent fiscal years subject approval department_of_housing_and_urban_development hud amounts available appropriations acts hud shall redetermine grantee eligibility years ensure grantee received allocation prior fiscal year receive allocation greater share total available formula funds allocated grantee preceding fiscal year hud award funds alternative grantee original grantee agrees written document meeting hud approval references cases aids aids cases shall replaced individuals living hiv aids means respect counting cases geographic area period time sum number living non aids cases hiv area number living cases aids area


Summary:
Rural Access to Hospice Act of 2016

This bill amends title XVIII (Medicare) of the Social Security Act to allow payment under Medicare for certain services furnished to hospice patients by rural health clinics and federally qualified health centers (FQHCs).

With respect to a patient who elects to receive hospice care under Medicare, current law generally limits payment for services that are either duplicative of such care or related to the treatment of the individual's terminal illness. However, current law exempts from this limitation: (1) physicians' services furnished by the individual's attending physician, if not an employee of the hospice program; and (2) services provided or arranged by the hospice program.

The bill expands this exemption with regard to rural health clinic and FQHC services. Specifically, the Medicare payment limitation shall not apply to such services that: (1) would otherwise be physicians' services if furnished by an individual unaffiliated with a rural health clinic or FQHC; and (2) are either arranged by the hospice program or furnished by the individual's attending physician, if not an employee of the hospice program.

hospice act bill amends title xviii medicare social security act allow payment medicare certain services furnished hospice patients rural health clinics federally qualified health centers fqhcs respect patient elects receive hospice care medicare current law generally limits payment services duplicative care related treatment individual terminal illness current law exempts limitation physicians services furnished individual attending physician employee hospice program services provided arranged hospice program bill expands exemption regard rural health clinic fqhc services specifically medicare payment limitation shall apply services physicians services furnished individual unaffiliated rural health clinic fqhc arranged hospice program furnished individual attending physician employee hospice program


Summary:
Protecting Families with Disabilities Act of 2016

This bill amends the Patient Protection and Affordable Care Act with respect to how a state that had an approved home- and community-based Medicaid waiver as of January 1, 2014, may treat spousal income and assets for purposes of determining an individual's financial eligibility for services under the waiver.

With respect to such a state that disregarded an individual's spousal income and assets for those purposes, specified provisions of current law shall not prohibit the state from continuing to do so.

protecting families disabilities act bill amends patient_protection affordable care act respect state approved home- community based medicaid waiver january treat spousal income assets purposes determining individual financial eligibility services waiver respect state disregarded individual spousal income assets purposes specified provisions current law shall prohibit state continuing


Summary:
Compassionate Care Act

This bill requires the Centers for Disease Control and Prevention to develop and implement a national campaign that informs the public of the importance of end-of-life or advanced care planning and of an individual's right to direct and participate in health care decisions.

The Centers for Medicare & Medicaid Services and the Agency for Healthcare Research and Quality (AHRQ) must establish a website for qualified health care providers about those rights and advance care planning.

The Department of Health and Human Services (HHS) must establish a pilot grant program for end-of-life training in certain medical and health education schools.

The AHRQ must develop quality measures for end-of-life care in each relevant qualified health care provider setting. Health care providers must begin reporting on their performance relating to such measures on April 1, 2018.

The Health Resources and Services Administration must approve existing and develop new curricula on advance care planning and end-of-life care for continuing education that states may adopt for qualified health care providers.

HHS must establish a demonstration program for supporting the provision of advance care planning through videoconferencing for patients who live far from their health care provider.

compassionate care act bill requires centers_for_disease_control_and_prevention develop implement national campaign informs public importance end life advanced care planning individual right direct participate health care decisions centers agency healthcare_research_and_quality ahrq establish website qualified health care providers rights advance care planning department_of_health_and_human_services hhs establish pilot grant program end life training certain medical health education schools ahrq develop quality measures end life care relevant qualified health care provider setting health care providers begin reporting performance relating measures april health_resources_and_services_administration approve existing develop new curricula advance care planning end life care continuing education states adopt qualified health care providers hhs establish demonstration program supporting provision advance care planning videoconferencing patients live far health care provider


Summary: This bill amends title XVIII (Medicare) of the Social Security Act to establish, with respect to certain spinal cord specialty hospitals, a temporary exemption from specified Medicare payment limits applicable to long-term care hospital (LTCH) inpatient services. Current law generally applies payment limits to inpatient services for LTCHs that do not meet certain discharge requirements.

bill amends title xviii medicare social security act establish respect certain spinal cord specialty hospitals temporary exemption specified medicare payment limits applicable long term care hospital ltch inpatient services current law generally applies payment limits inpatient services ltchs meet certain discharge requirements


Summary:
Alzheimer's Caregiver Support Act

This bill amends the Public Health Service Act to authorize the Department of Health and Human Services to make grants to public and nonprofit private health care providers to expand training and support services for families and caregivers of individuals living with Alzheimer's disease or a related dementia.

alzheimer caregiver support act bill amends public_health_service_act authorize department_of_health_and_human_services grants public nonprofit private health care providers expand training support services families caregivers individuals living alzheimer disease related dementia


Summary:
Independence at Home Act of 2016

This bill amends title XVIII (Medicare) of the Social Security Act to establish a permanent Independence at Home Medical Practice Program, under which a primary care practice shall be accountable for: (1) providing comprehensive, coordinated, continuous, and accessible care to applicable Medicare beneficiaries at home; and (2) coordinating health care across all treatment settings.

Subject to meeting specified quality performance standards, a participating practice is eligible to receive an incentive payment under the program if actual expenditures for applicable beneficiaries are less than the estimated spending target established by the Centers for Medicare & Medicaid Services (CMS).

CMS shall terminate a program agreement with a participating practice if the practice: (1) for the third of three consecutive years under the program, will not receive an incentive payment; or (2) fails to meet a minimum number of quality performance standards established by CMS.

The bill extends the existing Independence at Home Medical Practice Demonstration Program pending implementation of the permanent program. In addition, the bill removes the limit on the number of beneficiaries that may participate in the demonstration program.

independence home act bill amends title xviii medicare social security act establish permanent primary care practice shall accountable providing comprehensive coordinated continuous accessible care applicable medicare beneficiaries home coordinating health care treatment settings subject meeting specified quality performance standards participating practice eligible receive incentive payment program actual expenditures applicable beneficiaries estimated spending target established cms cms shall terminate program agreement participating practice practice consecutive years program receive incentive payment fails meet minimum number quality performance standards established cms bill extends existing independence pending implementation permanent program addition bill removes limit number beneficiaries participate demonstration program


Summary:
Alzheimer's Beneficiary and Caregiver Support Act

This bill amends title XI (General Provisions) of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test the efficacy of coverage and payment for Alzheimer's Disease caregiver support services in delaying or reducing the use of institutionalized care for Medicare beneficiaries.

The Centers for Medicare & Medicaid Services shall establish payment amounts for such services.

alzheimer beneficiary caregiver support act bill amends title general provisions social security act require center medicare medicaid_innovation test efficacy coverage payment alzheimer disease caregiver support services delaying reducing use institutionalized care medicare beneficiaries centers shall establish payment amounts services


Summary:
Verifying Electronically the Receipt of In-Home Care For Individuals Act or the VERIFI Act

This bill amends title XVIII (Medicare) of the Social Security Act to require the use of electronic visit verification systems for certain services under the Medicare program. An "electronic visit verification system" is a system under which care-related visits are electronically verified with regard to: (1) the type and date of service, (2) the individual receiving the service, (3) the individual providing the service, (4) the location of service delivery, and (5) the time the service begins and ends.

A home health agency must have such a system in place for home health services as a condition of participation in the Medicare program.

The Centers for Medicare & Medicaid Services shall establish standards for the systems and must consult with agencies to ensure that such standards: (1) are minimally burdensome, (2) account for existing best practices and electronic visit verifications systems already in use, and (3) require that the systems are conducted in accordance with specified legal requirements related to privacy and security.

verifying electronically receipt home care individuals act act bill amends title xviii medicare social security act require use electronic visit verification systems certain services medicare program electronic visit verification system system care related visits electronically verified regard type date service individual receiving service individual providing service location service delivery time service begins ends home health agency system place home health services condition participation medicare program centers shall establish standards systems consult agencies ensure standards minimally burdensome account existing best practices electronic visit systems use require systems conducted accordance specified legal requirements related privacy security


Summary: Currency Harmonization Initiative through Neutralizing Action Act of 2005 - Directs the Secretary of the Treasury to analyze annually the exchange rate policies of the People's Republic of China, and to impose additional tariffs, if necessary, to equalize any currency manipulations.

currency harmonization initiative action act directs secretary treasury analyze annually exchange rate policies impose additional tariffs necessary equalize currency


Summary: Fair Currency Act of 2007 - Amends the Tariff Act of 1930 to expand the authority of the administering authority or the International Trade Commission (ITC) to impose countervailing duties on products from a nonmarket economy country that have been provided a countervailable subsidy. Includes exchange-rate misalignment (undervaluation of a foreign currency) by a country as a countervailable subsidy. Requires the administering authority to use methodologies that measure certain benchmarks outside of a nonmarket economy country where exchange-rate misalignment exists when measuring the benefit of a countervailable subsidy bestowed on a product by such country in a countervailing duty proceeding. Amends the Trade Act of 1974 to include exchange-rate misalignment by the People's Republic of China as a condition in determining market disruption to the domestic producers of a like or directly competitive product from products imported from China. Prohibits the Department of Defense (DOD) from procuring defense articles imported from China if such articles are competitive with domestic industry articles critical to the defense industrial base of the United States. Applies provisions of this Act to goods from Canada and Mexico. Amends the Exchange Rates and International Economic Policy Coordination Act of 1988 to direct the Secretary of the Treasury to consider in the annual analysis of foreign exchange rate policies whether countries have a currency that is in fundamental misalignment, and if so, to initiate bilateral corrective negotiations. Directs the Secretary, prior to U.S. approval of a change in an international financial institution's governance, to determine whether a member who would benefit from such change has a currency that is manipulated or in fundamental misalignment, and if so, oppose such change. Amends the Tariff Act of 1930 to require the administering authority, in determining whether a country is a nonmarket economy country, to consider whether such country's manipulation or fundamental misalignment of its currency adversely affects the U.S. economy.

fair currency act amends tariff act expand authority administering authority international_trade_commission itc impose countervailing duties products nonmarket economy country provided countervailable subsidy includes exchange rate misalignment undervaluation foreign currency country countervailable subsidy requires administering authority use methodologies measure certain benchmarks outside nonmarket economy country exchange rate misalignment exists measuring benefit countervailable subsidy product country countervailing duty proceeding amends trade act include exchange rate misalignment condition determining market disruption domestic producers like directly competitive product products imported china prohibits department_of_defense dod procuring defense articles imported china articles competitive domestic industry articles critical defense industrial base united_states applies provisions act goods canada mexico amends international_economic_policy_coordination_act direct secretary treasury consider annual analysis foreign exchange rate policies countries currency fundamental misalignment initiate bilateral corrective negotiations directs secretary prior approval change international financial institution governance determine member benefit change currency manipulated fundamental misalignment oppose change amends tariff act require administering authority determining country nonmarket economy country consider country manipulation fundamental misalignment currency adversely affects economy


Summary: Imposes an additional duty rate of 27.5 % ad valorem on any article imported into the United States that is the growth, product, or manufacture of the People's Republic of China (PRC) unless the President certifies to Congress that: (1) the PRC is no longer manipulating the exchange rate between its currency and the U.S. dollar in order to prevent an effective balance of payments and gain an unfair international trade advantage; and (2) the PRC's currency is valued in accordance with accepted market-based trading policies. Directs the Secretary of the Treasury to begin negotiations with the PRC for adoption of a market-based currency valuation.

imposes additional duty rate valorem article imported united_states growth product manufacture prc president certifies congress prc longer manipulating exchange rate currency dollar order prevent effective balance payments gain unfair international trade advantage prc currency valued accordance accepted market based trading policies directs secretary treasury begin negotiations prc adoption market based currency valuation