S. 2829: Preventive Home Visit Act

This bill, known as the Preventive Home Visit Act, proposes to amend the Social Security Act to include coverage for preventive home visits under Medicare. Here’s a breakdown of what the bill entails:

Coverage of Preventive Home Visits

The bill stipulates that Medicare will cover preventive home visits, which are defined as visits to a person's home by qualified professionals. These visits can occur once every two years or less frequently, depending on the needs of the individual. The purpose of these visits is to:

• Assess the home environment
• Identify health risks
• Provide referrals for interventions or home modifications
• Improve physical function, balance, strength, and mobility
• Reduce factors that increase the risk of falls
• Enhance nutritional support

The visits can be conducted in person, remotely, or using a combination of both methods.

Payment Provisions

The bill outlines specific payment provisions for these preventive home visits. The payment structure is proposed to work as follows:

• The amount that Medicare would pay for a preventive home visit will be equal to 100% of the lesser of the actual charge for the service or a predetermined amount set by the Secretary of Health and Human Services.
• Additionally, a bundled payment amount will be established for preventive home visits, which includes any referrals made during the visit.

Frequency Limitations

The bill modifies frequency limitations related to these visits. It adds preventive home visits to a list in the Social Security Act that are considered when assessing the frequency of services covered by Medicare. This means that visits that occur more frequently than allowed under these new provisions could be excluded from coverage.

Effective Date

The provisions of this bill are set to take effect for services rendered on or after January 1, 2027.

Relevant Companies

• HUM - Humana Inc.: As a provider of health insurance, Humana may see changes in demand for certain types of home health services if preventive home visits become more common under Medicare.
• UNH - UnitedHealth Group Incorporated: UnitedHealth could potentially experience increased service costs as more beneficiaries utilize preventive home visits, affecting their Medicare Advantage plans.
• ANTM - Anthem, Inc.: As a major health insurance provider, Anthem may have to adapt to the changes in Medicare coverage and could influence their own plans and reimbursements for similar services.