I 

111TH CONGRESS 

1ST SESSION H. R. 2124 

To extend subsections (c) and (d) of section 114 of the Medicare, Medicaid, 

and SCHIP Extension Act of 2007 (Public Law 110–173) to provide 

for regulatory stability during the development of facility and patient 

criteria for long-term care hospitals under the Medicare Program, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 27, 2009 

Mr. POMEROY (for himself, Mr. LARSON of Connecticut, Mr. DOGGETT, and 

Mr. YARMUTH) introduced the following bill; which was referred to the 

Committee on Ways and Means 

A BILL 

To extend subsections (c) and (d) of section 114 of the 

Medicare, Medicaid, and SCHIP Extension Act of 2007 

(Public Law 110–173) to provide for regulatory stability 

during the development of facility and patient criteria 

for long-term care hospitals under the Medicare Program, and for other purposes. 

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 ‘‘Medicare Long-Term 

5 Care Hospital Improvement Act of 2009’’. 


wwoods2 on PRODPC68 with BILLS
2 

•HR 2124 IH

1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) Long-term care hospitals (in this section re4 ferred to as ‘‘LTCHs’’) serve a valuable role in the 

5 post-acute care continuum by providing care to 

6 medically complex patients needing long hospital 

7 stays. 

8 (2) The Medicare program should ensure that 

9 patients receive post-acute care in the most appro10 priate setting. The use of additional certification cri11 teria for LTCHs, including facility and patient cri12 teria, will promote the appropriate placement of 

13 medically complex patients into LTCHs. 

14 (3) Subsections (c) and (d) of section 114 of 

15 the Medicare, Medicaid, and SCHIP Extension Act 

16 of 2007 (Public Law 110–173) provide necessary 

17 regulatory stability and temporary limits on the 

18 growth of new hospitals during the development of 

19 facility and patient criteria for LTCHs. An exten20 sion of section 114 is warranted to allow for addi21 tional time to develop facility and patient criteria for 

22 LTCHs. 


wwoods2 on PRODPC68 with BILLS
3 

•HR 2124 IH

1 SEC. 3. EXTENSION OF CERTAIN PROVISIONS UNDER SEC2 TION 114 OF THE MEDICARE, MEDICAID, AND 

3 SCHIP EXTENSION ACT OF 2007. 

4 Subsections (c) and (d) of section 114 of the Medi5 care, Medicaid, and SCHIP Extension Act of 2007 (Public 

6 Law 110–173), as amended by section 4302 of division 

7 B of the American Recovery and Reinvestment Act of 

8 2009 (Public Law 111–5), are amended by striking ‘‘3- 

9 year period’’ and inserting ‘‘5-year period’’ each place it 

10 appears. 

11 SEC. 4. LONG-TERM CARE HOSPITAL BUDGET NEUTRALITY 

12 OFFSET. 

13 Section 1886(m) of the Social Security Act (42 

14 U.S.C. 1395ww(m)) is amended by adding at the end the 

15 following new paragraph: 

16 ‘‘(3) BUDGET NEUTRALITY OFFSET FOR RATE

17 YEARS 2011 THROUGH 2015.—In implementing the 

18 system described in paragraph (1) for discharges oc19 curring during each of the rate years ending in 2011 

20 through 2015 for a hospital, the base rate shall be 

21 adjusted annually by the market basket update 

22 amount allowed by the Secretary less an amount de23 termined by the Secretary, in advance of each rate 

24 year, to implement a budget neutrality offset of the 

25 cost of implementation of section 3 of the Medicare 

26 Long-Term Care Hospital Improvement Act of 2009 


wwoods2 on PRODPC68 with BILLS
4 

•HR 2124 IH

1 for such year, not to exceed a maximum percentage 

2 reduction of 1.5 percent per rate year. Each such 

3 budget neutrality offset shall apply only with respect 

4 to the single rate year involved. The Secretary shall 

5 not reflect, or take into account, any such budget 

6 neutrality offset in computing and establishing the 

7 applicable market basket update percentage increase 

8 to the base rate for a subsequent rate year.’’. 

Æ 


wwoods2 on PRODPC68 with BILLS