DETERMINING ELIGIBILITY OF HOME HEALTH AGENCIES FOR WAIVER OF LIABILITY FOR DENIED CLAIMS.

SEC. 6214. DETERMINING ELIGIBILITY OF HOME HEALTH AGENCIES FOR WAIVER OF LIABILITY FOR DENIED CLAIMS. (a) Scope of Waiver and Determination of Denied Claim.—Section 1879(f) of the Social Security Act (42 U.S.C. 1395pp(f)) is amended— (1) in paragraph (1), by striking “with respect to” and all that follows and inserting a period; and (2) in paragraph (4), by striking “(4) The requirement” and inserting “(4)(A) The requirement”, and by adding at the end the following new subparagraph: “(B) For purposes of determining the rate of denial of bills for a home health agency under subparagraph (A), a bill shall not be considered to be denied until the expiration of the 60-day period that begins on the date such bill is denied by the fiscal intermediary, or, with respect to such a denial for which the agency requests reconsideration, until the fiscal intermediary issues a decision denying payment for such bill.”. (b) Monitoring of Denied Claims.—Section 1879(f) of such Act (42 U.S.C. 1395pp(f)) is amended by adding at the end the following new paragraph: “(6) The Secretary shall monitor the proportion of denied bills submitted by home health agencies for which reconsideration is requested, and shall notify Congress if the proportion of denials reversed upon reconsideration increases significantly.”. (c) Effective Date.—The amendments made by subsection (a) shall apply to determinations for quarters beginning on or after the date of the enactment of this Act.