Home Health Payment Innovation Act of 2019

Home Health Payment Innovation Act of 2019

This bill makes a series of changes relating to payment and coverage of home health services under Medicare and Medicare Advantage (MA).

Specifically, the bill allows the home-confinement requirement (also known as the homebound requirement) for home health services to be waived under Medicare and MA. Currently, as a condition of eligibility for such services, a physician must certify that an individual has difficulty leaving home without assistance (e.g., a wheelchair, special transportation, or help from another person) due to an illness or injury.

The bill also alters the payment methodology under the Medicare prospective payment system for home health services, including by eliminating the requirement that such methodology include certain behavioral assumptions regarding the implementation of specified changes to units of payment and case-mix adjustment factors.