```

[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 1168 Introduced in Senate (IS)]

114th CONGRESS
  1st Session
                                S. 1168

 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

                             April 30, 2015

 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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preserving Rehabilitation Innovation 
Centers Act of 2015''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) In the United States, there are an estimated 1,181 
        inpatient rehabilitation facilities. Among these facilities is 
        a small group of inpatient rehabilitation institutions that are 
        contributing to the future of rehabilitation care medicine, as 
        well as to patient recovery, scientific innovation, and quality 
        of life.
            (2) This unique category of inpatient rehabilitation 
        institutions treats the most complex patient conditions, such 
        as traumatic brain injury, stroke, spinal cord injury, 
        childhood disease, burns, and wartime injuries.
            (3) These leading inpatient rehabilitation institutions are 
        all not-for-profit or Government-owned institutions and serve a 
        high volume of Medicare or Medicaid beneficiaries.
            (4) These leading inpatient rehabilitation institutions 
        have been recognized by the Federal Government for their 
        contributions to cutting-edge research to develop solutions 
        that enhance quality of care, improve patient outcomes, and 
        reduce health care costs.
            (5) These leading inpatient rehabilitation institutions 
        help to improve the practice and standard of rehabilitation 
        medicine across the Nation in urban, suburban, and rural 
        communities by training physicians, medical students, and other 
        clinicians, and providing care to patients from all 50 States.
            (6) It is vital that these leading inpatient rehabilitation 
        institutions are supported so they can continue to lead the 
        Nation's efforts to--
                    (A) advance integrated, multidisciplinary 
                rehabilitation research;
                    (B) provide cutting-edge medical care to the most 
                complex rehabilitation patients;
                    (C) serve as education and training facilities for 
                the physicians, nurses, and other health professionals 
                who serve rehabilitation patients;
                    (D) ensure Medicare and Medicaid beneficiaries 
                receive state-of-the-art, high-quality rehabilitation 
                care by developing and disseminating best practices and 
                advancing the quality of care utilized by post-acute 
                providers in all 50 States; and
                    (E) support other inpatient rehabilitation 
                institutions in rural areas to help ensure access to 
                quality post-acute care for patients living in these 
                communities.

SEC. 3. INDIRECT COSTS PAYMENT FOR REHABILITATION INNOVATION CENTERS.

    (a) In General.--Section 1886(j) of the Social Security Act (42 
U.S.C. 1395ww(j)) is amended--
            (1) by redesignating paragraph (8) as paragraph (9); and
            (2) by inserting after paragraph (7) the following new 
        paragraph:
            ``(8) Indirect costs payment for rehabilitation innovation 
        centers.--
                    ``(A) Study relating to additional payments to 
                rehabilitation innovation centers to account for higher 
                costs; authority to increase payments.--
                            ``(i) Study.--Not later than July 1, 2017, 
                        the Secretary shall conduct a study to 
                        determine whether there should be an increase 
                        in the prospective payment rate that would 
                        otherwise be made to a rehabilitation 
                        innovation center under this subsection for 
                        purposes of covering the additional costs that 
                        are incurred by such centers in furnishing 
                        items and services to individuals under this 
                        title, conducting research, and providing 
                        medical training, and if the Secretary 
                        determines that such an increase is 
                        recommended, the amount of such increase that 
                        is needed to cover such additional costs.
                            ``(ii) Authority to increase payments.--
                        Insofar as the Secretary determines under 
                        clause (i) that there should be an increase in 
                        the prospective payment rate to rehabilitation 
                        innovation centers, the Secretary may provide 
                        on a prospective basis for an appropriate 
                        percentage increase in such rate.
                    ``(B) Rehabilitation innovation center defined.--
                            ``(i) In general.--Subject to clause (iv), 
                        in this paragraph, the term `rehabilitation 
                        innovation center' means a rehabilitation 
                        facility that, determined as of the date of the 
                        enactment of this paragraph, is described in 
                        clause (ii) or clause (iii).
                            ``(ii) Not-for-profit.--A rehabilitation 
                        facility described in this clause is a facility 
                        that--
                                    ``(I) is classified as a not-for-
                                profit entity under the Centers for 
                                Medicare & Medicaid Services 2010 
                                Provider of Services file;
                                    ``(II) holds at least one Federal 
                                rehabilitation research and training 
                                designation for research projects on 
                                traumatic brain injury, spinal cord 
                                injury, or stroke rehabilitation 
                                research from the Rehabilitation 
                                Research and Training Centers or the 
                                Rehabilitation Engineering Research 
                                Center at the National Institute on 
                                Disability and Rehabilitation Research 
                                at the Department of Education;
                                    ``(III) has a minimum Medicare case 
                                mix index of 1.1144 according to the 
                                IRF Rate Setting File for the 
                                Correction Notice for the Inpatient 
                                Rehabilitation Facility Prospective 
                                Payment System for Federal Fiscal Year 
                                2012 (78 Fed. Reg. 59256); and
                                    ``(IV) has at least 300 Medicare 
                                discharges per year or at least 200 
                                Medicaid discharges per year.
                            ``(iii) Government-owned.--A rehabilitation 
                        facility described in this clause is a facility 
                        that--
                                    ``(I) is classified as a 
                                Government-owned institution under the 
                                Centers for Medicare & Medicaid 
                                Services 2010 Provider of Services 
                                file;
                                    ``(II) holds at least one Federal 
                                rehabilitation research and training 
                                designation for research projects on 
                                traumatic brain injury, spinal cord 
                                injury, or stroke rehabilitation 
                                research from the Rehabilitation 
                                Research and Training Centers, the 
                                Rehabilitation Engineering Research 
                                Center, or the Model Spinal Cord Injury 
                                Systems at the National Institute on 
                                Disability and Rehabilitation Research 
                                at the Department of Education;
                                    ``(III) has a minimum Medicare case 
                                mix index of 1.1144 according to the 
                                IRF Rate Setting File for the 
                                Correction Notice for the Inpatient 
                                Rehabilitation Facility Prospective 
                                Payment System for Federal Fiscal Year 
                                2012 (78 Fed. Reg. 59256); and
                                    ``(IV) has a disproportionate share 
                                hospital (DSH) percentage of at least 
                                0.6300 according to the IRF Rate 
                                Setting File for the Correction Notice 
                                for the Inpatient Rehabilitation 
                                Facility Prospective Payment System for 
                                Federal Fiscal Year 2012 (78 Fed. Reg. 
                                59256).
                            ``(iv) Authority.--The Secretary may 
                        consider applications from inpatient 
                        rehabilitation facilities that are not 
                        described in clause (ii) or (iii) as of the 
                        date of the enactment of this paragraph but who 
                        are subsequently so described.''.
    (b) Study and Report to Congress on Access to Rehabilitation Care 
in Rural Communities in States That Do Not Have a Rehabilitation 
Innovation Center.--
            (1) Study.--The Secretary of Health and Human Services 
        shall conduct a study on access by individuals (including, but 
        not limited to, Medicare beneficiaries) to rehabilitation care 
        in rural communities in States in which there is no 
        rehabilitation innovation center (as defined in section 
        1886(j)(8)(B) of the Social Security Act, as added by 
        subsection (a)).
            (2) Report.--Not later than July 1, 2017, the Secretary of 
        Health and Human Services shall submit to Congress a report on 
        the study conducted under paragraph (1), together with 
        recommendations for such legislation and administrative action 
        as the Secretary determines appropriate.
                                 <all>
```