To direct the Secretary of Health and Human Services to modify treatment categories for qualification as a rehabilitation hospital or unit for purposes of reimbursement under the Medicare prospective payment system for inpatient rehabilitation facilities.

Directs the Secretary of Health and Human Services to revise the definitions under Medicare regulations of "rehabilitation hospital" and "rehabilitation unit" for purposes of determining the applicable payment methodology under title XVIII (Medicare) of the Social Security Act.

Requires the Secretary, in determining whether a rehabilitation hospital or unit is eligible for reimbursement for services furnished to Medicare beneficiaries under the prospective payment system (PPS) for inpatient rehabilitation facilities, to modify the list of treatment categories otherwise applicable (commonly referred to as the "75 Percent Rule") to include all rehabilitation impairment categories (except miscellaneous) established by the Secretary for purposes of such prospective payment system.

(The "75 Percent Rule" requires that a rehabilitation hospital or unit show that during its most recent 12-month cost reporting period it served an inpatient population of whom at least 75 percent required intensive rehabilitative services for treatment of one or more of specified conditions.)

[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2246 Introduced in House (IH)]







108th CONGRESS
  1st Session
                                H. R. 2246

    To direct the Secretary of Health and Human Services to modify 
treatment categories for qualification as a rehabilitation hospital or 
   unit for purposes of reimbursement under the Medicare prospective 
        payment system for inpatient rehabilitation facilities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 22, 2003

 Mr. LoBiondo (for himself, Mr. Frost, Mr. Saxton, Mr. Bradley of New 
   Hampshire, Mr. McNulty, Mr. Pallone, Mr. Payne, Mr. Smith of New 
 Jersey, Mr. Menendez, Mr. Garrett of New Jersey, Mr. Andrews, and Mr. 
    Neal of Massachusetts) introduced the following bill; which was 
              referred to the Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
    To direct the Secretary of Health and Human Services to modify 
treatment categories for qualification as a rehabilitation hospital or 
   unit for purposes of reimbursement under the Medicare prospective 
        payment system for inpatient rehabilitation facilities.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. MODIFICATION OF TREATMENT CATEGORIES FOR QUALIFICATION AS A 
              REHABILITATION HOSPITAL OR UNIT FOR PURPOSES OF 
              REIMBURSEMENT UNDER THE MEDICARE PROSPECTIVE PAYMENT 
              SYSTEM FOR INPATIENT REHABILITATION FACILITIES.

    (a) Revision of Regulations.--The Secretary of Health and Human 
Services shall revise, in accordance with subsection (b), the 
definition under medicare regulations of the terms ``rehabilitation 
hospital'' and ``rehabilitation unit'' (as set forth under section 
412.23(b) of title 42 of the Code of Federal Regulations) for purposes 
of determining the applicable payment methodology under title XVIII of 
the Social Security Act (42 U.S.C. 1395 et seq.).
    (b) Modification of 75 Percent Rule.--In determining whether a 
rehabilitation hospital or unit is eligible for reimbursement for 
services furnished to medicare beneficiaries under the prospective 
payment system for inpatient rehabilitation facilities under section 
1886(j) of the Social Security Act (42 U.S.C. 1395ww(j)), the Secretary 
shall modify the list of treatment categories otherwise applicable 
under paragraph (2) of such section 412.23(b) (commonly referred to as 
the ``75 Percent Rule'') to include all rehabilitation impairment 
categories (except miscellaneous) established by the Secretary for 
purposes of such prospective payment system.
    (c) Periodic Update Required.--The Secretary shall update the 
regulations described in subsection (a) periodically to ensure that the 
definitions of the terms ``rehabilitation hospital'' and 
``rehabilitation unit'' remain wholly consistent with all 
rehabilitation impairment categories (except miscellaneous) on which 
payment under such section 1886(j) is based.
    (d) Enforcement.--Notwithstanding any other provision of law, 
during the period beginning on the date of enactment of this Act and 
ending no earlier than the date that is six months after the date on 
which the Secretary issues final regulations to comply with subsection 
(a), the Secretary shall not commence any enforcement action or impose 
any sanction or penalty pertaining to retroactive enforcement of the 75 
Percent Rule on a hospital or unit for failure to meet the definition 
of rehabilitation hospital set forth at 42 CFR 412.23(b) as of April 
30, 2003.
                                 <all>