```

[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3599 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 3599

    To amend title XVIII of the Social Security Act with respect to 
     payments to long-term care hospitals, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           November 21, 2013

  Mr. Fortenberry (for himself and Mr. Hall) 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 with respect to 
     payments to long-term care hospitals, and for other purposes.

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

SECTION 1. RELIEF FOR MEDICARE PAYMENTS TO LONG-TERM CARE HOSPITALS.

    (a) Application of 25 Percent Rule Patient Threshold Payment 
Adjustment.--
            (1) Extension of relief.--In implementing sections 412.534 
        and 412.536 of title 42, Code of Federal Regulations, for a 12-
        month cost reporting period beginning on or after October 1, 
        2013, the Secretary of Health and Human Services shall continue 
        the same threshold payment adjustment percentages and 
        exemptions as were established for the 12-month cost reporting 
        periods beginning on or after October 1, 2012, in the same 
        manner as was provided for in the rule published on August 31, 
        2012 (77 Federal Register 53258).
            (2) No application of rule to grandfathered ltchs.--The 
        Secretary of Health and Human Services shall not apply sections 
        412.534 and 412.536 of title 42, Code of Federal Regulations, 
        or any similar provisions to a long-term care hospital 
        described in the second sentence of section 1886(d)(1)(B) of 
        the Social Security Act (42 U.S.C. 1395ww(d)(1)(B)).
            (3) New exclusion from calculation of the 25 percent 
        rule.--Medicare beneficiaries who were inpatients in a 
        subsection (d) hospital within 1 day prior to their admission 
        to a long-term care hospital described in section 
        1886(d)(1)(B)(iv)(I) of the Social Security Act (42 U.S.C. 
        1395ww(d)(1)(B)(iv)(I)) and who had a stay of more than 7 days 
        in an intensive care unit identified in section 413.53(d) of 
        title 42, Code of Federal Regulations, shall be excluded from 
        the numerator of the 25 percent threshold applied under 
        sections 412.534 and 412.536 of such title.
            (4) Effective date.--This subsection shall be effective on 
        October 1, 2013.
    (b) Clarification of Payments Paid to Long-Term Care Hospitals on 
an IPPS Basis.--
            (1) Site neutral payments.--For discharges occurring on or 
        after October 1, 2014, payments made to long-term care 
        hospitals described in section 1886(d)(1)(B)(iv)(I) of the 
        Social Security Act (42 U.S.C. 1395ww(d)(1)(B)(iv)(I)) at 
        amounts that are comparable or equivalent to amounts that are 
        payable to a subsection (d) hospital, for short stay patients 
        and under the 25 percent rules established under sections 
        412.529(d)(4), 412.534, and 412.536 of title 42, Code of 
        Federal Regulations, shall be at amounts that are not less than 
        would be paid to a subsection (d) hospital had it performed the 
        same services.
            (2) Calculation of length of stay excluding cases paid on 
        an ipps basis.--For discharges occurring on or after the date 
        of the enactment of this Act, in calculating the length of stay 
        requirement applicable to a long-term care hospital or 
        satellite facility under section 1886(d)(1)(B)(iv)(I) of the 
        Social Security Act (42 U.S.C. 1395ww(d)(1)(B)(iv)(I)) and 
        section 1861(ccc)(2) of such Act (42 U.S.C. 1395x(ccc)(2)), the 
        Secretary of Health and Human Services shall exclude any 
        patient for whom payment is based on an amount that is 
        comparable or equivalent to the amount payable to a subsection 
        (d) hospital had such a hospital provided the same services.
            (3) Subsection (d) hospital defined.--In this subsection, 
        the term ``subsection (d) hospital'' has the meaning given such 
        term in section 1886(d)(1)(B) of the Social Security Act (42 
        U.S.C. 1395ww(d)(1)(B)).
                                 <all>
```