Introduced in House Passed House Introduced in Senate Passed Senate To President Became Law
02/10/2020          

HOSPICE Act

Date Version PDF TXT
02/10/2020 Introduced in House Open

            I 

116TH CONGRESS 
2D SESSION H. R. 5821 

To amend title XVIII of the Social Security Act to establish hospice program 
survey and enforcement procedures under the Medicare program, and 
for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 10, 2020 
Mr. PANETTA (for himself, Mr. REED, and Mr. HIGGINS of New York) intro-

duced the following bill; which was referred to the Committee on Ways 
and Means, and in addition to the Committee on Energy and Commerce, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 

A BILL 
To amend title XVIII of the Social Security Act to establish 

hospice program survey and enforcement procedures 
under the Medicare program, and for other purposes. 

Be it enacted by the Senate and House of Representa-1

tives of the United States of America in Congress assembled, 2

SECTION 1. SHORT TITLE. 3

This Act may be cited as the ‘‘Helping Our Senior 4

Population in Comfort Environments Act’’ or the ‘‘HOS-5

PICE Act’’. 6

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SEC. 2. ESTABLISHING HOSPICE PROGRAM SURVEY AND 1

ENFORCEMENT PROCEDURES UNDER THE 2

MEDICARE PROGRAM. 3

(a) SURVEY AND ENFORCEMENT PROCEDURES.— 4

(1) IN GENERAL.—Part A of title XVIII of the 5

Social Security Act (42 U.S.C. 1395c et seq.) is 6

amended by adding at the end the following new sec-7

tion: 8

‘‘SEC. 1822. HOSPICE PROGRAM SURVEY AND ENFORCE-9

MENT PROCEDURES. 10

‘‘(a) SURVEYS.— 11

‘‘(1) FREQUENCY.—Any entity that is certified 12

as a hospice program shall be subject to a standard 13

survey by an appropriate State or local survey agen-14

cy, or an approved accreditation agency, as deter-15

mined by the Secretary, not less frequently than 16

once every 36 months (and not less frequently than 17

once every 24 months beginning October 1, 2021). 18

‘‘(2) PUBLIC TRANSPARENCY OF SURVEY AND 19

CERTIFICATION INFORMATION.— 20

‘‘(A) SUBMISSION OF INFORMATION TO 21

THE SECRETARY.— 22

‘‘(i) IN GENERAL.—Each State, and 23

each national accreditation body with re-24

spect to which the Secretary has made a 25

finding under section 1865(a) respecting 26

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•HR 5821 IH

the accreditation of a hospice program by 1

such body, shall submit, in a form and 2

manner, and at a time, specified by the 3

Secretary for purposes of this subpara-4

graph, information respecting any survey 5

or certification made with respect to a hos-6

pice program by such State or body, as ap-7

plicable. Such information shall include 8

any inspection report made by such State 9

or body with respect to such survey or cer-10

tification, any enforcement actions taken 11

as a result of such survey or certification, 12

and any other information determined ap-13

propriate by the Secretary. 14

‘‘(ii) REQUIRED INCLUSION OF SPECI-15

FIED FORM.—With respect to a survey 16

under this subsection carried out by a na-17

tional accreditation body described in 18

clause (i) on or after October 1, 2021, in-19

formation described in such clause shall in-20

clude Form 2567 (or a successor form), 21

along with such additional information de-22

termined appropriate by such body. 23

‘‘(B) PUBLIC DISCLOSURE OF INFORMA-24

TION.—Beginning not later than October 1, 25

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2022, the Secretary shall publish the informa-1

tion submitted under subparagraph (A) on the 2

public website of the Centers for Medicare & 3

Medicaid Services in a manner that is promi-4

nent, easily accessible, readily understandable, 5

and searchable. The Secretary shall provide for 6

the timely update of such information so pub-7

lished. 8

‘‘(3) CONSISTENCY OF SURVEYS.—Each State 9

and the Secretary shall implement programs to 10

measure and reduce inconsistency in the application 11

of survey results among surveyors. 12

‘‘(4) SURVEY TEAMS.— 13

‘‘(A) IN GENERAL.—In the case of a sur-14

vey conducted under this subsection on or after 15

October 1, 2021, by more than 1 individual, 16

such survey shall be conducted by a multidisci-17

plinary team of professionals (including a reg-18

istered professional nurse). 19

‘‘(B) PROHIBITION OF CONFLICTS OF IN-20

TEREST.—Beginning October 1, 2021, a State 21

may not use as a member of a survey team 22

under this subsection an individual who is serv-23

ing (or has served within the previous 2 years) 24

as a member of the staff of, or as a consultant 25

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to, the program surveyed respecting compliance 1

with the requirements of section 1861(dd) or 2

who has a personal or familial financial interest 3

in the program being surveyed. 4

‘‘(C) TRAINING.—The Secretary shall pro-5

vide, not later than October 1, 2021, for the 6

comprehensive training of State and Federal 7

surveyors in the conduct of surveys under this 8

subsection, including training with respect to 9

the review of written plans for providing hospice 10

care (as described in section 1814(a)(7)(B)). 11

No individual shall serve as a member of a sur-12

vey team with respect to a survey conducted on 13

or after such date unless the individual has suc-14

cessfully completed a training and testing pro-15

gram in survey and certification techniques that 16

has been approved by the Secretary. 17

‘‘(5) FUNDING.—The Secretary shall provide 18

for the transfer, from the Federal Hospital Insur-19

ance Trust Fund under section 1817 to the Centers 20

for Medicare & Medicaid Program Management Ac-21

count, of $10,000,000 for each fiscal year (begin-22

ning with fiscal year 2022) for purposes of carrying 23

out surveys under this subsection. Sums so trans-24

ferred shall remain available until expended. Any 25

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transfer pursuant to this paragraph shall be in addi-1

tion to any transfer pursuant to section 3(a)(2) of 2

the Improving Medicare Post-Acute Care Trans-3

formation Act of 2014. 4

‘‘(b) SPECIAL FOCUS PROGRAM.— 5

‘‘(1) IN GENERAL.—The Secretary shall con-6

duct a special focus program for enforcement of re-7

quirements for hospice programs that the Secretary 8

has identified as having substantially failed to meet 9

applicable requirements of this Act. 10

‘‘(2) PERIODIC SURVEYS.—Under such special 11

focus program, the Secretary shall conduct surveys 12

of each hospice program in the special focus pro-13

gram not less than once every 6 months. 14

‘‘(c) ENFORCEMENT.— 15

‘‘(1) SITUATIONS INVOLVING IMMEDIATE JEOP-16

ARDY.—If the Secretary determines on the basis of 17

a standard survey or otherwise that a hospice pro-18

gram that is certified for participation under this 19

title is no longer in compliance with the require-20

ments specified in section 1861(dd) and determines 21

that the deficiencies involved immediately jeopardize 22

the health and safety of the individuals to whom the 23

program furnishes items and services, the Secretary 24

shall take immediate action to remove the jeopardy 25

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and correct the deficiencies through the remedy de-1

scribed in paragraph (5)(B)(iii) or terminate the cer-2

tification of the program, and may provide, in addi-3

tion, for one or more of the other remedies described 4

in paragraph (5)(B). 5

‘‘(2) SITUATIONS NOT INVOLVING IMMEDIATE 6

JEOPARDY.—If the Secretary determines on the 7

basis of a standard survey or otherwise that a hos-8

pice program that is certified for participation under 9

this title is no longer in compliance with the require-10

ments specified in section 1861(dd) and determines 11

that the deficiencies involved do not immediately 12

jeopardize the health and safety of the individuals to 13

whom the program furnishes items and services, the 14

Secretary may (for a period not to exceed 6 months) 15

impose remedies developed pursuant to paragraph 16

(5)(A), in lieu of terminating the certification of the 17

program. If, after such a period of remedies, the 18

program is still no longer in compliance with such 19

requirements, the Secretary shall terminate the cer-20

tification of the program. 21

‘‘(3) PENALTY FOR PREVIOUS NONCOMPLI-22

ANCE.—If the Secretary determines that a hospice 23

program that is certified for participation under this 24

title is in compliance with the requirements specified 25

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in section 1861(dd) but, as of a previous period, did 1

not meet such requirements, the Secretary may pro-2

vide for a civil monetary penalty under paragraph 3

(5)(B)(i) for the days in which the Secretary finds 4

that the program was not in compliance with such 5

requirements. 6

‘‘(4) OPTION TO CONTINUE PAYMENTS FOR 7

NONCOMPLIANT HOSPICE PROGRAMS.—The Sec-8

retary may continue payments under this title with 9

respect to a hospice program not in compliance with 10

the requirements specified in section 1861(dd) over 11

a period of not longer than 6 months, if— 12

‘‘(A) the State or local survey agency finds 13

that it is more appropriate to take alternative 14

action to assure compliance of the program with 15

such requirements than to terminate the certifi-16

cation of the program; 17

‘‘(B) the program has submitted a plan 18

and timetable for corrective action to the Sec-19

retary for approval and the Secretary approves 20

the plan of corrective action; and 21

‘‘(C) the program agrees to repay to the 22

Federal Government payments received under 23

this title during such period if the corrective ac-24

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•HR 5821 IH

tion is not taken in accordance with the ap-1

proved plan and timetable. 2

The Secretary shall establish guidelines for approval 3

of corrective actions requested by hospice programs 4

under this paragraph. 5

‘‘(5) REMEDIES.— 6

‘‘(A) DEVELOPMENT.— 7

‘‘(i) IN GENERAL.—Not later than Oc-8

tober 1, 2021, the Secretary shall develop 9

and implement— 10

‘‘(I) a range of remedies to apply 11

to hospice programs under the condi-12

tions described in paragraphs (1) 13

through (4); and 14

‘‘(II) appropriate procedures for 15

appealing determinations relating to 16

the imposition of such remedies. 17

Remedies developed pursuant to the pre-18

ceding sentence shall include the remedies 19

specified in subparagraph (B). 20

‘‘(ii) CONDITIONS OF IMPOSITION OF 21

REMEDIES.—Not later than October 1, 22

2021, the Secretary shall develop and im-23

plement specific procedures with respect to 24

the conditions under which each of the 25

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remedies developed under clause (i) is to 1

be applied, including the amount of any 2

fines and the severity of each of these rem-3

edies. Such procedures shall be designed so 4

as to minimize the time between identifica-5

tion of deficiencies and imposition of these 6

remedies and shall provide for the imposi-7

tion of incrementally more severe fines for 8

repeated or uncorrected deficiencies. 9

‘‘(B) SPECIFIED REMEDIES.—The rem-10

edies specified in this subparagraph are the fol-11

lowing: 12

‘‘(i) Civil monetary penalties in an 13

amount not to exceed $10,000 for each day 14

of noncompliance by a hospice program 15

with the requirements specified in section 16

1861(dd). 17

‘‘(ii) Suspension of all or part of the 18

payments to which a hospice program 19

would otherwise be entitled under this title 20

with respect to items and services fur-21

nished by a hospice program on or after 22

the date on which the Secretary determines 23

that remedies should be imposed pursuant 24

to paragraph (2). 25

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•HR 5821 IH

‘‘(iii) The appointment of temporary 1

management to oversee the operation of 2

the hospice program and to protect and as-3

sure the health and safety of the individ-4

uals under the care of the program while 5

improvements are made in order to bring 6

the program into compliance with all such 7

requirements. 8

‘‘(C) PROCEDURES.— 9

‘‘(i) CIVIL MONETARY PENALTIES.— 10

‘‘(I) IN GENERAL.—Subject to 11

subclause (II), the provisions of sec-12

tion 1128A (other than subsections 13

(a) and (b)) shall apply to a civil mon-14

etary penalty under this subsection in 15

the same manner as such provisions 16

apply to a penalty or proceeding 17

under section 1128A(a). 18

‘‘(II) RETENTION OF AMOUNTS 19

FOR HOSPICE PROGRAM IMPROVE-20

MENTS.—The Secretary may provide 21

that any portion of civil monetary 22

penalties collected under this sub-23

section may be used to support activi-24

ties that benefit individuals receiving 25

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hospice care, including education and 1

training programs to ensure hospice 2

program compliance with the require-3

ments of section 1861(dd). 4

‘‘(ii) SUSPENSION OF PAYMENT.—A 5

finding to suspend payment under sub-6

paragraph (B)(ii) shall terminate when the 7

Secretary finds that the program is in sub-8

stantial compliance with all such require-9

ments. 10

‘‘(iii) TEMPORARY MANAGEMENT.— 11

The temporary management under sub-12

paragraph (B)(iii) shall not be terminated 13

until the Secretary has determined that the 14

program has the management capability to 15

ensure continued compliance with all the 16

requirements referred to in such subpara-17

graph. 18

‘‘(D) RELATIONSHIP TO OTHER REM-19

EDIES.—The remedies developed under sub-20

paragraph (A) are in addition to sanctions oth-21

erwise available under State or Federal law and 22

shall not be construed as limiting other rem-23

edies, including any remedy available to an indi-24

vidual at common law.’’. 25

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(2) AVAILABILITY OF HOSPICE ACCREDITATION 1

SURVEYS.—Section 1865(b) of the Social Security 2

Act (42 U.S.C. 1395bb(b)) is amended by inserting 3

‘‘or, beginning on the date of the enactment of the 4

HOSPICE Act, a hospice program’’ after ‘‘home 5

health agency’’. 6

(3) STATE PROVISION OF HOSPICE PROGRAM 7

INFORMATION.— 8

(A) IN GENERAL.—Section 1864(a) of the 9

Social Security Act (42 U.S.C. 1395aa(a)) is 10

amended in the sixth sentence— 11

(i) by inserting ‘‘and hospice pro-12

grams’’ after ‘‘information on home health 13

agencies’’; 14

(ii) by inserting ‘‘or the hospice pro-15

gram’’ after ‘‘the home health agency’’; 16

(iii) by inserting ‘‘or the hospice pro-17

gram’’ after ‘‘with respect to the agency’’; 18

and 19

(iv) by inserting ‘‘and hospice pro-20

grams’’ after ‘‘with respect to home health 21

agencies’’. 22

(B) EFFECTIVE DATE.—The amendments 23

made by subparagraph (A) shall apply with re-24

spect to agreements entered into on or after, or 25

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in effect as of, the date that is 1 year after the 1

date of the enactment of this Act. 2

(4) CONFORMING AMENDMENTS.— 3

(A) DEFINITION OF A HOSPICE PRO-4

GRAM.—Section 1861(dd)(4) of the Social Secu-5

rity Act (42 U.S.C. 1395x(dd)(4)) is amended 6

by striking subparagraph (C). 7

(B) CONTINUATION OF FUNDING.—Section 8

3(a)(2) of the Improving Medicare Post-Acute 9

Care Transformation Act of 2014 is amended 10

by inserting ‘‘and section 1822(a)(1) of such 11

Act,’’ after ‘‘as added by paragraph (1),’’. 12

(b) INCREASING PAYMENT REDUCTIONS FOR FAIL-13

URE TO MEET QUALITY DATA REPORTING REQUIRE-14

MENTS.—Section 1814(i)(5)(A)(i) of the Social Security 15

Act (42 U.S.C. 1395f(i)(5)(A)(i)) is amended by inserting 16

‘‘(or, for fiscal year 2023 and each subsequent fiscal year, 17

4 percentage points)’’ before the period. 18

(c) REPORT.—Not later than October 1, 2024, the 19

Comptroller General of the United States shall submit to 20

the Committee on Ways and Means of the House of Rep-21

resentatives and the Committee on Finance of the Senate 22

a report containing an analysis of the effects of the 23

amendments made by subsection (a), including the fre-24

quency of application of remedies specified in section 25

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•HR 5821 IH

1822(c)(5)(B) of the Social Security Act (as added by 1

such subsection), on access to, and quality of, care fur-2

nished by hospice programs under part A of title XVIII 3

of the Social Security Act (42 U.S.C. 1395c et seq.). 4

Æ 

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  >>
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>> setdistillerparams
<<
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>> setpagedevice



		Superintendent of Documents
	2020-02-11T05:56:42-0500
	US GPO, Washington, DC 20401
	Superintendent of Documents
	GPO attests that this document has not been altered since it was disseminated by GPO
        

Picture Name From Date Type
Jimmy Panetta D-CA 02/10/2020 Sponsor
Tom Rice R-SC 02/11/2020 Cosponsor
Tom Reed R-NY 02/10/2020 Cosponsor
Daniel Kildee D-MI 02/11/2020 Cosponsor
Brian Higgins D-NY 02/10/2020 Cosponsor
Date Branch Action
02/12/2020 President Ordered to be Reported in the Nature of a Substitute (Amended) by Voice Vote.Action By: Committee on Ways and Means
02/12/2020 President Committee Consideration and Mark-up Session Held.Action By: Committee on Ways and Means
02/10/2020 President Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.Action By: House of Representatives
02/10/2020 President Introduced in HouseAction By: House of Representatives
Summary
There is one summary for H.R.5821. View summaries Shown Here:Introduced in House (02/10/2020) Helping Our Senior Population in Comfort Environments Act or the HOSPICE Act This bill establishes survey requirements for, and enforcement mechanisms against, certified hospice programs under Medicare. Specifically, certified programs must undergo periodic surveys by a state, local, or approved accreditation agency, as specified; the Centers for Medicare &amp; Medicaid Services (CMS) must provide appropriate training for surveyors and publish information relating to survey results on its website. The CMS must also (1) conduct more frequent surveys of programs that are found to be noncompliant with applicable standards; and (2) take specified enforcement actions against such programs, based on the severity of the deficiencies. Enforcement actions include civil penalties, suspended Medicare payments, and termination of program certification.
Shown Here:Introduced in House (02/10/2020) Helping Our Senior Population in Comfort Environments Act or the HOSPICE Act This bill establishes survey requirements for, and enforcement mechanisms against, certified hospice programs under Medicare. Specifically, certified programs must undergo periodic surveys by a state, local, or approved accreditation agency, as specified; the Centers for Medicare &amp; Medicaid Services (CMS) must provide appropriate training for surveyors and publish information relating to survey results on its website. The CMS must also (1) conduct more frequent surveys of programs that are found to be noncompliant with applicable standards; and (2) take specified enforcement actions against such programs, based on the severity of the deficiencies. Enforcement actions include civil penalties, suspended Medicare payments, and termination of program certification.
Congress - Bill Number Major Title
Branch Vote Date Yes No Not Voting
Wiki







Bill TEXT Points.
This Bill has been listed with the following Subjects from Texts:
Commerce
Higgins of New York) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedA BILLTo amend title XVIII of the Social Security Act to establish hospice program survey and enforcement procedures under the Medicare program, and for other p

Congress


Energy
Higgins of New York) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedA BILLTo amend title XVIII of the Social Security Act to establish hospice program survey and enforcement procedures under the Medicare program, and for other p

Environment
116 HR 5821 IH: Helping Our Senior Population in Comfort Environments Act U


End Bill TEXT Points.
Date Bill Major Title
Committee Name
Subject Type