110th CONGRESS
1st Session
S. 321
To establish pilot projects under the Medicare program to provide
incentives for home health agencies to utilize home monitoring and communications
technologies.
IN THE SENATE OF THE UNITED STATES
January 17, 2007
Mr. THUNE (for himself and Ms. KLOBUCHAR) introduced the following bill;
which was read twice and referred to the Committee on Finance
A BILL
To establish pilot projects under the Medicare program to provide
incentives for home health agencies to utilize home monitoring and communications
technologies.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Fostering Independence Through Technology
Act of 2007'.
SEC. 2. REMOTE MONITORING PILOT PROJECTS.
(1) IN GENERAL- Not later than 9 months after the date of enactment of
this Act, the Secretary of Health and Human Services (in this section
referred to as the `Secretary') shall conduct pilot projects under title
XVIII of the Social Security Act for the purpose of providing incentives
to home health agencies to utilize home monitoring and communications
technologies that--
(A) enhance health outcomes for medicare beneficiaries; and
(B) reduce expenditures under such title.
(A) URBAN AND RURAL- The Secretary shall conduct the pilot projects
under this section in both urban and rural areas.
(B) SITE IN A SMALL STATE- The Secretary shall conduct at least 1 of
the pilot projects in a State with a population of less than 1,000,000.
(3) DEFINITION OF HOME HEALTH AGENCY- In this section, the term `home
health agency' has the meaning given that term in section 1861(o) of the
Social Security Act (42 U.S.C. 1395x(o)).
(b) Medicare Beneficiaries Within the Scope of Projects- The Secretary shall
specify the criteria for identifying those medicare beneficiaries who shall
be considered within the scope of the pilot projects under this section
for purposes of the application of subsection (c) and for the assessment
of the effectiveness of the home health agency in achieving the objectives
of this section. Such criteria may provide for the inclusion in the projects
of medicare beneficiaries who begin receiving home health services under
title XVIII of the Social Security Act after the date of the implementation
of the projects.
(1) PERFORMANCE TARGETS- The Secretary shall establish for each home health
agency participating in a pilot project under this section a performance
target using one of the following methodologies, as determined appropriate
by the Secretary:
(A) ADJUSTED HISTORICAL PERFORMANCE TARGET- The Secretary shall establish
for the agency--
(i) a base expenditure amount equal to the average total payments
made to the agency under parts A and B of title XVIII of the Social
Security Act for medicare beneficiaries determined to be within the
scope of the pilot project in a base period determined by the Secretary;
and
(ii) an annual per capita expenditure target for such beneficiaries,
reflecting the base expenditure amount adjusted for risk and adjusted
growth rates.
(B) COMPARATIVE PERFORMANCE TARGET- The Secretary shall establish for
the agency a comparative performance target equal to the average total
payments under such parts A and B during the pilot project for comparable
individuals in the same geographic area that are not determined to be
within the scope of the pilot project.
(2) INCENTIVE- Subject to paragraph (3), the Secretary shall pay to each
participating home care agency an incentive payment for each year under
the pilot project equal to a portion of the medicare savings realized
for such year relative to the performance target under paragraph (1).
(3) LIMITATION ON EXPENDITURES- The Secretary shall limit incentive payments
under this section in order to ensure that the aggregate expenditures
under title XVIII of the Social Security Act (including incentive payments
under this subsection) do not exceed the amount that the Secretary estimates
would have been expended if the pilot projects under this section had
not been implemented.
(d) Waiver Authority- The Secretary may waive such provisions of titles
XI and XVIII of the Social Security Act as the Secretary determines to be
appropriate for the conduct of the pilot projects under this section.
(e) Report to Congress- Not later than 5 years after the date that the first
pilot project under this section is implemented, the Secretary shall submit
to Congress a report on the pilot projects. Such report shall contain a
detailed description of issues related to the expansion of the projects
under subsection (f) and recommendations for such legislation and administrative
actions as the Secretary considers appropriate.
(f) Expansion- If the Secretary determines that any of the pilot projects
under this section enhance health outcomes for medicare beneficiaries and
reduce expenditures under title XVIII of the Social Security Act, the Secretary
may initiate comparable projects in additional areas.
(g) Incentive Payments Have No Effect on Other Medicare Payments to Agencies-
An incentive payment under this section--
(1) shall be in addition to the payments that a home health agency would
otherwise receive under title XVIII of the Social Security Act for the
provision of home health services; and
(2) shall have no effect on the amount of such payments.
END
