Page:United States Statutes at Large Volume 124.djvu/453

 124 STAT. 427 PUBLIC LAW 111–148—MAR. 23, 2010 (1) in subparagraph (A), by inserting ‘‘and to assist such hospitals in participating in delivery system reforms under the provisions of and amendments made by the Patient Protec- tion and Affordable Care Act, such as value-based purchasing programs, accountable care organizations under section 1899, the National pilot program on payment bundling under section 1866D, and other delivery system reform programs determined appropriate by the Secretary’’ before the period at the end; and (2) in subparagraph (E)— (A) by striking ‘‘, and to offset’’ and inserting ‘‘, to offset’’; and (B) by inserting ‘‘and to participate in delivery system reforms under the provisions of and amendments made by the Patient Protection and Affordable Care Act, such as value-based purchasing programs, accountable care organizations under section 1899, the National pilot pro- gram on payment bundling under section 1866D, and other delivery system reform programs determined appropriate by the Secretary’’ before the period at the end. (c) EFFECTIVE DATE.—The amendments made by this section shall apply to grants made on or after January 1, 2010. PART III—IMPROVING PAYMENT ACCURACY SEC. 3131. PAYMENT ADJUSTMENTS FOR HOME HEALTH CARE. (a) REBASING HOME HEALTH PROSPECTIVE PAYMENT AMOUNT.— (1) IN GENERAL.—Section 1895(b)(3)(A) of the Social Secu- rity Act (42 U.S.C. 1395fff(b)(3)(A)) is amended— (A) in clause (i)(III), by striking ‘‘For periods’’ and inserting ‘‘Subject to clause (iii), for periods’’; and (B) by adding at the end the following new clause: ‘‘(iii) ADJUSTMENT FOR 2013 AND SUBSEQUENT YEARS.— ‘‘(I) IN GENERAL.—Subject to subclause (II), for 2013 and subsequent years, the amount (or amounts) that would otherwise be applicable under clause (i)(III) shall be adjusted by a percentage determined appropriate by the Secretary to reflect such factors as changes in the number of visits in an episode, the mix of services in an episode, the level of intensity of services in an episode, the average cost of providing care per episode, and other factors that the Secretary considers to be relevant. In conducting the analysis under the preceding sentence, the Secretary may consider differences between hospital-based and free- standing agencies, between for-profit and nonprofit agencies, and between the resource costs of urban and rural agencies. Such adjustment shall be made before the update under subparagraph (B) is applied for the year. ‘‘(II) TRANSITION.—The Secretary shall provide for a 4-year phase-in (in equal increments) of the adjustment under subclause (I), with such adjust- ment being fully implemented for 2016. During each year of such phase-in, the amount of any 42 USC 1395i–4 note.