Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies".
- Bill Number
- H.J.Res. 58
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-02-12: 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.
- Last Updated
- 2025-06-13T20:35:59Z
AI-Generated Summary
Purpose
This joint resolution (H.J. Res. 58) aims to block a specific rule issued by the Centers for Medicare & Medicaid Services (CMS), a federal agency that administers Medicare health insurance programs for older and disabled Americans. The rule updates payment systems and policies for home health services under Medicare for calendar year 2025. By disapproving the rule, Congress seeks to prevent these changes from taking effect, using a process called the Congressional Review Act (CRA), which allows lawmakers to overturn certain agency regulations.
Key Provisions
- Disapproval of the Rule: The resolution explicitly disapproves the CMS rule titled "Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies," published in the Federal Register on November 7, 2024 (89 Fed. Reg. 88354).
- No Force or Effect: If enacted, the rule would be nullified, meaning its provisions could not be implemented.
- Legislative Process: Introduced in the House of Representatives on February 12, 2025, by Representative Clyde, and referred to the Committees on Ways and Means and Energy and Commerce for review.
The resolution does not introduce new policies; it solely targets the reversal of the CMS rule.
Significant Changes to Existing Law
- This resolution invokes the CRA (chapter 8 of title 5, U.S. Code), a 1996 law that empowers Congress to review and disapprove major agency rules within a set timeframe after issuance.
- It would override the CMS rule without altering the underlying Medicare laws (like the Social Security Act), effectively maintaining the status quo from prior years' policies on home health payments and requirements.
- No new statutory changes are proposed; the focus is on halting administrative updates to payment rates (how much Medicare pays home health providers) and program requirements (such as quality reporting and value-based purchasing, where payments are tied to performance metrics).
Potential Impacts
- On Government Agencies: CMS would be unable to enforce the 2025 updates, potentially requiring it to delay or revise policies, which could strain administrative resources and lead to legal challenges or new rulemaking.
- On Citizens: Medicare beneficiaries relying on home health services (e.g., nursing or therapy at home) might face unchanged or potentially outdated payment structures, affecting access to care if providers adjust services due to frozen rates. Patients needing home intravenous immune globulin (IVIG) treatments for immune disorders could see no updates to coverage or payments.
- On Providers and Economy: Home health agencies might experience financial stability from avoiding rate changes but could miss out on incentives for quality improvements. This could indirectly impact healthcare costs and workforce in the home health sector.
- International Relations: No direct impacts, as this is a domestic healthcare policy matter.
Main Stakeholders Affected
- Home Health Providers: Agencies and organizations delivering Medicare-covered home health services, directly impacted by payment rates and quality requirements.
- Medicare Beneficiaries: Elderly, disabled, or chronically ill individuals using home health care, who could see effects on service availability and costs.
- CMS and Federal Government: The agency responsible for Medicare administration, facing operational disruptions.
- Congress and Taxpayers: Lawmakers exercising oversight, with broader implications for federal spending on Medicare (a major part of the U.S. budget).
Notable Legal, Constitutional, or Political Implications
- Legal: Relies on the CRA, which has a "lookback" window for Congress to act on rules, ensuring quick reversal without needing presidential approval if passed by both chambers (though the President can veto). This upholds separation of powers by checking executive agency actions but could invite lawsuits if seen as interfering with routine healthcare administration.
- Constitutional: Reinforces Congress's authority under Article I to regulate commerce and spending, particularly in healthcare, without raising major constitutional challenges.
- Political: Demonstrates congressional intervention in executive rulemaking, often used in partisan contexts to influence healthcare policy. It highlights tensions between legislative oversight and agency expertise in implementing laws like Medicare, potentially setting a precedent for future disapprovals of similar rules.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Clyde, Andrew S. [R-GA-9]
Recent Actions
- 2025-02-12: 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.
- 2025-02-12: 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.
- 2025-02-12: Introduced in House
- 2025-02-12: Introduced in House
Bill Versions
- Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies". — issued 2025-02-12 — PDF (2 pages)