II 

113TH CONGRESS 

1ST SESSION S. 1220 

To amend title XVIII of the Social Security Act to preserve access to 

rehabilitation innovation centers under the Medicare program. 

IN THE SENATE OF THE UNITED STATES 

JUNE 25, 2013 

Mr. KIRK (for himself and Mr. DURBIN) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to preserve 

access to rehabilitation innovation centers under the 

Medicare program. 

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 Rehabilita5 tion Innovation Centers Act of 2013’’. 

6 SEC. 2. FINDING. 

7 Congress makes the following findings: 

8 (1) In the United States, there are an esti9 mated 1,181 inpatient rehabilitation facilities. 

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1 tion institutions that are important for the future of 

2 rehabilitation care and medicine, as well as to pa3 tient recovery. 

4 (2) This unique category of inpatient rehabilita5 tion institutions treat the most complex conditions, 

6 such as traumatic brain injury, stroke, spinal cord 

7 injury, childhood disease, burns, and wartime inju8 ries. 

9 (3) These leading inpatient rehabilitation insti10 tutions are all not-for-profit or Government-owned 

11 institutions and serve a high volume of Medicare or 

12 Medicaid beneficiaries. 

13 (4) Each member of this small group of inpa14 tient rehabilitation institutions has been recognized 

15 by the Federal Government for its contributions to 

16 cutting-edge research to develop solutions that en17 hance quality of care, improve patient outcomes, and 

18 reduce health care costs. 

19 (5) This cohort of inpatient rehabilitation insti20 tutions helps to improve the practice and standard 

21 of rehabilitation medicine across the Nation by 

22 training physicians, medical students, and other cli23 nicians. 


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1 (6) It is vital that these unique inpatient reha2 bilitation institutions are supported so they can con3 tinue to lead the Nation’s efforts to— 

4 (A) advance integrated, multidisciplinary 

5 rehabilitation research; 

6 (B) provide cutting-edge medical care to 

7 the most complex rehabilitation patients; 

8 (C) serve as education and training facili9 ties for the physicians, nurses, and other health 

10 professionals who serve rehabilitation patients; 

11 and 

12 (D) ensure Medicare and Medicaid bene13 ficiaries receive state-of-the-art, high-quality re14 habilitation care. 

15 SEC. 3. INDIRECT COSTS PAYMENT FOR REHABILITATION 

16 INNOVATION CENTERS. 

17 Section 1886(j) of the Social Security Act (42 U.S.C. 

18 1395ww(j)) is amended— 

19 (1) by redesignating paragraph (8) as para20 graph (9); and 

21 (2) by inserting after paragraph (7) the fol22 lowing new paragraph: 

23 ‘‘(8) INDIRECT COSTS PAYMENT FOR REHABILI24 TATION INNOVATION CENTERS.— 


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1 ‘‘(A) STUDY RELATING TO ADDITIONAL

2 PAYMENTS TO REHABILITATION INNOVATION

3 CENTERS TO ACCOUNT FOR HIGHER COSTS; AU4 THORITY TO INCREASE PAYMENTS.— 

5 ‘‘(i) STUDY.—Not later than July 1, 

6 2015, the Secretary shall conduct a study 

7 to determine whether there should be an 

8 increase in the prospective payment rate 

9 that would otherwise be made to a rehabili10 tation innovation center under this sub11 section for purposes of covering the addi12 tional costs that are incurred by such cen13 ters in furnishing items and services to in14 dividuals under this title, conducting re15 search, and providing medical training, 

16 and if the Secretary determines that such 

17 an increase is recommended, the amount of 

18 such increase that is needed to cover such 

19 additional costs. 

20 ‘‘(ii) AUTHORITY TO INCREASE PAY21 MENTS.—Insofar as the Secretary deter22 mines under clause (i) that there should be 

23 an increase in the prospective payment 

24 rate to rehabilitation innovation centers, 

25 the Secretary may provide on a prospective 


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1 basis for an appropriate percentage in2 crease in such rate. 

3 ‘‘(B) REHABILITATION INNOVATION CEN4 TER DEFINED.— 

5 ‘‘(i) IN GENERAL.—Subject to clause 

6 (iv), in this paragraph, the term ‘rehabili7 tation innovation center’ means a rehabili8 tation facility that, determined as of the 

9 date of the enactment of this paragraph, is 

10 described in clause (ii) or clause (iii). 

11 ‘‘(ii) NOT-FOR-PROFIT.—A rehabilita12 tion facility described in this clause is a fa13 cility that— 

14 ‘‘(I) is classified as a not-for15 profit entity under the Centers for 

16 Medicare & Medicaid Services 2010 

17 Provider of Services file; 

18 ‘‘(II) holds at least one Federal 

19 rehabilitation research and training 

20 designation for research projects on 

21 traumatic brain injury, spinal cord in22 jury, or stroke rehabilitation research 

23 from the Rehabilitation Research and 

24 Training Centers or the Rehabilitation 

25 Engineering Research Center at the 


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1 National Institute on Disability and 

2 Rehabilitation Research at the De3 partment of Education; 

4 ‘‘(III) has a minimum Medicare 

5 case mix index of 1.1144 according to 

6 the IRF Rate Setting File for the 

7 Correction Notice for the Inpatient 

8 Rehabilitation Facility Prospective 

9 Payment System for Federal Fiscal 

10 Year 2012 (78 Fed. Reg. 59256); and 

11 ‘‘(IV) has at least 300 Medicare 

12 discharges per year or at least 200 

13 Medicaid discharges per year. 

14 ‘‘(iii) GOVERNMENT-OWNED.—A reha15 bilitation facility described in this clause is 

16 a facility that— 

17 ‘‘(I) is classified as a Govern18 ment-owned institution under the 

19 Centers for Medicare & Medicaid 

20 Services 2010 Provider of Services 

21 file; 

22 ‘‘(II) holds at least one Federal 

23 rehabilitation research and training 

24 designation for research projects on 

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1 jury, or stroke rehabilitation research 

2 from the Rehabilitation Research and 

3 Training Centers, the Rehabilitation 

4 Engineering Research Center, or the 

5 Model Spinal Cord Injury Systems at 

6 the National Institute on Disability 

7 and Rehabilitation Research at the 

8 Department of Education; 

9 ‘‘(III) has a minimum Medicare 

10 case mix index of 1.1144 according to 

11 the IRF Rate Setting File for the 

12 Correction Notice for the Inpatient 

13 Rehabilitation Facility Prospective 

14 Payment System for Federal Fiscal 

15 Year 2012 (78 Fed. Reg. 59256); and 

16 ‘‘(IV) has a disproportionate 

17 share hospital (DSH) percentage of at 

18 least 0.6300 according to the IRF 

19 Rate Setting File for the Correction 

20 Notice for the Inpatient Rehabilitation 

21 Facility Prospective Payment System 

22 for Federal Fiscal Year 2012 (78 

23 Fed. Reg. 59256). 

24 ‘‘(iv) AUTHORITY.—The Secretary 

25 may consider applications from inpatient 


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1 rehabilitation facilities that are not de2 scribed in clause (ii) or (iii) as of the date 

3 of the enactment of this paragraph but 

4 who are subsequently so described.’’. 

Æ 


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