Medicare Rural Home Health Preservation Act of 2009 - Amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, as amended by the Deficit Reduction Act of 2005, to require for episodes and visits ending on or after January 1, 2010, and before January 1, 2015, a 5% increase in the rate of payment under title XVIII (Medicare) of the Social Security Act for home health services furnished in a rural area.