1. Short title This Act may be cited as the Home Health Payment Innovation Act of 2018 . 2. Improvements to Medicare innovations and managed care related to home health services (a) Expanded waivers in shared savings programs Section 1899(f) of the Social Security Act ( 42 U.S.C. 395jjj(f) ), is amended by adding at the end the following: Beginning not later than January 1, 2020, the Secretary shall include a waiver of the confined to his home requirement under sections 1814(a)(2)(C) and 1835(a)(2)(A) in one or more programs under this section. . (b) Flexibility in Medicare advantage plans Section 1852 of the Social Security Act ( 42 U.S.C. 1395ww–2 ) is amended by adding at the end the following: (n) Flexibility if providing home health services Notwithstanding any other provision of law, any MA organization shall be permitted to waive the confined to his home requirement in the home health services benefit when the organization determines it is in the best interest of the enrollee. . 3. Improvements to home health payment reforms under Medicare (a) Application of budget neutrality Section 1895(b)(3) of the Social Security Act ( 42 U.S.C. 1395fff(b)(3) ), as amended by section 51001(a)(2) of the Bipartisan Budget Act of 2018 ( Public Law 115–123 ), is amended— (1) in subparagraph (A)(iv), in the fourth sentence— (A) by striking shall make and inserting shall not make ; and (B) by striking and shall provide a description and all that follows through the period and inserting a period; and (2) in subparagraph (D)— (A) in the subparagraph heading, by striking assumptions and inserting observed evidence ; (B) in clause (i)— (i) by striking differences between assumed and all that follows through and actual ; (ii) by inserting attributable to the implementation of paragraphs (2)(B) and (4)(B) after behavior changes