I 

109TH CONGRESS 

1ST SESSION H. R. 3373 

To extend the 50 percent compliance threshold used to determine whether 

a hospital or unit of a hospital is an inpatient rehabilitation facility 

and to establish the National Advisory Council on Medical Rehabilitation. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 21, 2005 

Mr. LOBIONDO (for himself, Mrs. LOWEY, Mr. TANNER, Mr. WAMP, Mr. SIMMONS, Mr. REYES, Mr. HOLT, Mr. HOLDEN, Mr. SAXTON, Mr. 

PASCRELL, Mr. LYNCH, Mr. ACKERMAN, Mr. ROTHMAN, Mr. BRADY of 

Pennsylvania, Mr. EHLERS, Mr. HINCHEY, Mr. MENENDEZ, Mr. DAVIS

of Alabama, Mr. SHUSTER, Mr. MCNULTY, Mr. BONNER, Mr. CHANDLER, Mr. HIGGINS, Mr. BERRY, Ms. SCHWARTZ of Pennsylvania, Mr. 

WALSH, Mr. PLATTS, Mr. ENGEL, Mr. KANJORSKI, Mr. DELAHUNT, Mr. 

MORAN of Virginia, Mr. MCHUGH, Mr. MCINTYRE, Mr. GRAVES, Mr. 

PORTER, Mr. GERLACH, Mr. LARSON of Connecticut, Mr. PAUL, Mr. 

PALLONE, Mr. BOEHLERT, Mr. KILDEE, Mr. CAPUANO, Mr. DENT, Mr. 

FITZPATRICK of Pennsylvania, and Mr. SMITH of New Jersey) introduced 

the following bill; which was 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 

A BILL 

To extend the 50 percent compliance threshold used to determine whether a hospital or unit of a hospital is an 

inpatient rehabilitation facility and to establish the National Advisory Council on Medical Rehabilitation. 
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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Preserving Patient Ac5 cess to Inpatient Rehabilitation Hospitals Act of 2005’’. 

6 SEC. 2. EFFECT ON ENFORCEMENT OF REGULATIONS. 

7 (a) IN GENERAL.—Notwithstanding section 

8 412.23(b)(2) of title 42, Code of Federal Regulations, dur9 ing the period beginning on July 1, 2005, and ending on 

10 the date that is 2 years after the date of enactment of 

11 this Act, the Secretary of Health and Human Services (re12 ferred to in this Act as the ‘‘Secretary’’) shall not— 

13 (1) require a compliance rate, pursuant to the 

14 criterion (commonly known as the ‘‘75 percent 

15 rule’’) that is used to determine whether a hospital 

16 or unit of a hospital is an inpatient rehabilitation fa17 cility (as defined in the rule published in the Federal 

18 Register on May 7, 2004, entitled ‘‘Medicare Pro19 gram; Final Rule; Changes to the Criteria for Being 

20 Classified as an Inpatient Rehabilitation Facility’’ 

21 (69 Fed. Reg. 25752)), that is greater than the 50 

22 percent compliance threshold that became effective 

23 on July 1, 2004; 
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1 (2) change the designation of an inpatient reha2 bilitation facility that is in compliance with the 50 

3 percent threshhold; or 

4 (3) conduct medical necessity review of inpa5 tient rehabilitation facilities using any guidelines, 

6 such as fiscal intermediary Local Coverage Deter7 minations, other than the national criteria estab8 lished in chapter 1, section 110 of the Medicare 

9 Benefits Policy Manual. 

10 (b) RETROACTIVE STATUS AS AN INPATIENT REHA11 BILITATION FACILITY; PAYMENTS; EXPEDITED RE12 VIEW.—The Secretary shall establish procedures for— 

13 (1) making any necessary retroactive adjust14 ment to restore the status of a facility as an inpa15 tient rehabilitation facility as a result of subsection 

16 (a); 

17 (2) making any necessary payments to inpatient 

18 rehabilitation facilities based on such adjustment for 

19 discharges occurring on or after July 1, 2005 and 

20 before the date of enactment of this Act; and 

21 (3) developing and implementing an appeals 

22 process that provides for expedited review of any ad23 justment to the status of a facility as an inpatient 

24 rehabilitation facility made during the period begin-
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1 ning on July 1, 2005 and ending on the date that 

2 is 2 years after the date of enactment of this Act. 

3 SEC. 3. NATIONAL ADVISORY COUNCIL ON MEDICAL REHA4 BILITATION. 

5 (a) DEFINITIONS.—In this section: 

6 (1) ADVISORY COUNCIL.—The term ‘‘Advisory 

7 Council’’ means the National Advisory Council on 

8 Medical Rehabilitation established under subsection 

9 (b). 

10 (2) APPROPRIATE FEDERAL AGENCIES.—The 

11 term ‘‘appropriate Federal agencies’’ means— 

12 (A) the Agency for Healthcare Research 

13 and Quality; 

14 (B) the Centers for Medicare & Medicaid 

15 Services; 

16 (C) the National Institute on Disability 

17 and Rehabilitation Research; and 

18 (D) the National Center for Medical Reha19 bilitation Research. 

20 (b) ESTABLISHMENT.—Pursuant to section 222 of 

21 the Public Health Service Act (42 U.S.C. 217a), the Sec22 retary shall establish an advisory panel to be known as 

23 the ‘‘National Advisory Council on Medical Rehabilita24 tion’’. 

25 (c) MEMBERSHIP.— 
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1 (1) APPOINTMENT.—The Advisory Council shall 

2 be composed of 17 members, of whom— 

3 (A) 9 members shall be appointed by the 

4 Secretary, in consultation with the medical re5 habilitation community, from a diversity of 

6 backgrounds, including— 

7 (i) physicians; 

8 (ii) medicare beneficiaries; 

9 (iii) representatives of inpatient reha10 bilitation facilities; and 

11 (iv) other practitioners experienced in 

12 rehabilitative care; and 

13 (B) 8 members, not more than 4 of whom 

14 are members of the same political party, shall 

15 be appointed jointly by— 

16 (i) the Majority Leader of the Senate; 

17 (ii) the Minority Leader of the Senate; 

18 (iii) the Speaker of the House of Rep19 resentatives; 

20 (iv) the Minority Leader of the House 

21 of Representatives; 

22 (v) the Chairman and the Ranking 

23 Member of the Committee on Finance of 

24 the Senate; and 
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1 (vi) the Chairman and the Ranking 

2 Member of the Committee on Ways and 

3 Means of the House of Representatives. 

4 (2) DATE.—Members of the Advisory Council 

5 shall be appointed not later than 30 days after the 

6 date of enactment of this Act. 

7 (3) PERIOD OF APPOINTMENT; VACANCIES.— 

8 Members shall be appointed for the life of the Coun9 cil. A vacancy on the Advisory Council shall be filled 

10 not later than 30 days after the date on which the 

11 Advisory Council is given notice of the vacancy, in 

12 the same manner as the original appointment. 

13 (4) MEETINGS.— 

14 (A) INITIAL MEETING.—The Advisory 

15 Council shall conduct an initial meeting not 

16 later than 120 days after the date of enactment 

17 of this Act. 

18 (B) MEETINGS.—The Advisory Council 

19 shall conduct such meetings as the Council de20 termines to be necessary to carry out its duties 

21 but shall meet not less frequently than 2 times 

22 during each calendar year. 

23 (d) DUTIES.—The duties of the Advisory Council 

24 shall include providing advice and recommendations to— 
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1 (1) Congress and the Secretary concerning the 

2 coverage of rehabilitation services under the medi3 care program, including— 

4 (A) policy issues related to rehabilitative 

5 treatment and reimbursement for rehabilitative 

6 care, such as issues relating to any rulemaking 

7 relating to, or impacting, rehabilitation hos8 pitals and units; 

9 (B) the appropriate criteria for— 

10 (i) determining clinical appropriate11 ness of inpatient rehabilitation facility ad12 missions; and 

13 (ii) distinguishing an inpatient reha14 bilitation facility from an acute care hos15 pital and other providers of intensive med16 ical rehabilitation; 

17 (C) the efficacy of inpatient rehabilitation 

18 services, as opposed to other post-acute inpa19 tient settings, through a comparison of quality 

20 and cost, controlling for patient characteristics 

21 (such as medical severity and motor and cog22 nitive function) and discharge destination; 

23 (D) the effect of any medicare regulations 

24 on access to inpatient rehabilitation care by 

25 medicare beneficiaries and the clinical effective-
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1 ness of care available to such beneficiaries in 

2 other health care settings; and 

3 (E) any other topic or issue that the Sec4 retary or Congress requests the Advisory Coun5 cil to provide advice and recommendations on; 

6 and 

7 (2) appropriate Federal agencies (as defined in 

8 subsection (a)) on how to best utilize available re9 search funds and authorities focused on medical re10 habilitation research, including post-acute care site 

11 of service and outcomes research. 

12 (e) PERIODIC REPORTS.—The Advisory Council shall 

13 provide the Secretary with periodic reports that summa14 rize— 

15 (1) the Council’s activities; and 

16 (2) any recommendations for legislation or ad17 ministrative action the Council considers to be ap18 propriate. 

19 (f) TERMINATION.—The Advisory Council shall ter20 minate on September 30, 2010. 

21 (g) AUTHORIZATION OF APPROPRIATIONS.—There 

22 are authorized to be appropriated such sums as may be 

23 necessary to carry out the purposes of this section. 
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1 (h) EFFECTIVE DATE.—This section shall take effect 

2 on the date of enactment of this Act. 

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