Page:United States Statutes at Large Volume 124.djvu/455

 124 STAT. 429 PUBLIC LAW 111–148—MAR. 23, 2010 (A) by striking ‘‘, and episodes’’ and inserting ‘‘, epi- sodes’’; (B) by inserting ‘‘and episodes and visits ending on or after April 1, 2010, and before January 1, 2016,’’ after ‘‘January 1, 2007,’’; and (C) by inserting ‘‘(or, in the case of episodes and visits ending on or after April 1, 2010, and before January 1, 2016, 3 percent)’’ before the period at the end. (d) STUDY AND REPORT ON THE DEVELOPMENT OF HOME HEALTH PAYMENT REFORMS IN ORDER TO ENSURE ACCESS TO CARE AND QUALITY SERVICES.— (1) IN GENERAL.—The Secretary of Health and Human Services (in this section referred to as the ‘‘Secretary’’) shall conduct a study to evaluate the costs and quality of care among efficient home health agencies relative to other such agencies in providing ongoing access to care and in treating Medicare beneficiaries with varying severity levels of illness. Such study shall include an analysis of the following: (A) Methods to revise the home health prospective payment system under section 1895 of the Social Security Act (42 U.S.C. 1395fff) to more accurately account for the costs related to patient severity of illness or to improving beneficiary access to care, including— (i) payment adjustments for services that may be under- or over-valued; (ii) necessary changes to reflect the resource use relative to providing home health services to low- income Medicare beneficiaries or Medicare bene- ficiaries living in medically underserved areas; (iii) ways the outlier payment may be improved to more accurately reflect the cost of treating Medicare beneficiaries with high severity levels of illness; (iv) the role of quality of care incentives and pen- alties in driving provider and patient behavior; (v) improvements in the application of a wage index; and (vi) other areas determined appropriate by the Sec- retary. (B) The validity and reliability of responses on the OASIS instrument with particular emphasis on questions that relate to higher payment under the home health prospective payment system and higher outcome scores under Home Care Compare. (C) Additional research or payment revisions under the home health prospective payment system that may be necessary to set the payment rates for home health services based on costs of high-quality and efficient home health agencies or to improve Medicare beneficiary access to care. (D) A timetable for implementation of any appropriate changes based on the analysis of the matters described in subparagraphs (A), (B), and (C). (E) Other areas determined appropriate by the Sec- retary. (2) CONSIDERATIONS.—In conducting the study under para- graph (1), the Secretary shall consider whether certain factors 42 USC 1395fff note.