To amend title XVIII of the Social Security Act to provide for a temporary exception to the application of the Medicare long-term care hospital site neutral provisions for certain spinal cord specialty hospitals.

This bill amends title XVIII (Medicare) of the Social Security Act to establish, with respect to certain spinal cord specialty hospitals, a temporary exemption from specified Medicare payment limits applicable to long-term care hospital (LTCH) inpatient services. Current law generally applies payment limits to inpatient services for LTCHs that do not meet certain discharge requirements.

[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5688 Introduced in House (IH)]

<DOC>






114th CONGRESS
  2d Session
                                H. R. 5688

   To amend title XVIII of the Social Security Act to provide for a 
 temporary exception to the application of the Medicare long-term care 
  hospital site neutral provisions for certain spinal cord specialty 
                               hospitals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              July 8, 2016

 Mr. Tom Price of Georgia (for himself, Ms. DeGette, Mr. Coffman, and 
  Mr. Lewis) introduced the following bill; which was referred to the 
                      Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
   To amend title XVIII of the Social Security Act to provide for a 
 temporary exception to the application of the Medicare long-term care 
  hospital site neutral provisions for certain spinal cord specialty 
                               hospitals.

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

SECTION 1. TEMPORARY EXCEPTION TO THE APPLICATION OF THE MEDICARE LTCH 
              SITE NEUTRAL PROVISIONS FOR CERTAIN SPINAL CORD SPECIALTY 
              HOSPITALS.

    (a) Exception.--Section 1886(m)(6) of the Social Security Act (42 
U.S.C. 1395ww(m)(6)) is amended--
            (1) in subparagraph (A)(i) by striking ``and (E)'' and 
        inserting ``, (E), and (F)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(F) Temporary exception for certain spinal cord 
                specialty hospitals.--For discharges in cost reporting 
                periods beginning during fiscal years 2018 through 
                2023, subparagraph (A)(i) shall not apply (and payment 
                shall be made to a long-term care hospital without 
                regard to this paragraph) if such discharge is from a 
                long-term care hospital that meets each of the 
                following requirements:
                            ``(i) Not-for-profit.--The long-term care 
                        hospital is a not-for-profit long-term care 
                        hospital June 1, 2016.
                            ``(ii) Primarily providing treatment for 
                        catastrophic spinal cord or acquired brain 
                        injuries or other paralyzing neuromuscular 
                        conditions.--At least 50 percent of the 
                        discharges in 2013 from the long-term care 
                        hospital were classified under MS-LTCH-DRGs 28, 
                        29, 52, 57, 551, 573, or 963.
                            ``(iii) Significant out-of-state 
                        admissions.--The long-term care hospital 
                        admitted inpatients (including both individuals 
                        entitled to, or enrolled for benefits under 
                        this title and individuals not so entitled or 
                        enrolled) during fiscal year 2014 from at least 
                        20 of the 50 States, determined based on such 
                        data, submitted by the hospital to the 
                        Secretary, as the Secretary may require. 
                        Notwithstanding any other provision of law, the 
                        Secretary may implement the previous sentence 
                        by program instruction or otherwise.''.
    (b) Study and Report on the Status and Viability of Certain Spinal 
Cord Specialty Long-Term Care Hospitals.--
            (1) Study.--The Comptroller General of the United States 
        shall conduct a study on long-term care hospitals described in 
        section 1886(m)(6)(F) of the Social Security Act, as added by 
        subsection (a). Such report shall include an analysis of the 
        following:
                    (A) The impact on such hospitals of the 
                classification and facility licensure by State agencies 
                of such hospitals.
                    (B) The Medicare payment rates for such hospitals.
                    (C) Data on the number and health care needs of 
                Medicare beneficiaries who have been diagnosed with 
                catastrophic spinal cord or acquired brain injuries or 
                other paralyzing neuromuscular conditions (as described 
                within the discharge classifications specified in 
                clause (ii) of such section) who are receiving services 
                from such hospitals.
            (2) Report.--Not later than June 30, 2022, the Comptroller 
        General shall submit to Congress a report on the study 
        conducted under paragraph (1), together with recommendations 
        for such legislation and administrative action as the 
        Comptroller General determines appropriate.
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