II 

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. 

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 2015’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

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

10 Among these facilities is a small group of inpatient 


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1 rehabilitation institutions that are contributing to 

2 the future of rehabilitation care medicine, as well as 

3 to patient recovery, scientific innovation, and quality 

4 of life. 

5 (2) This unique category of inpatient rehabilita6 tion institutions treats the most complex patient 

7 conditions, such as traumatic brain injury, stroke, 

8 spinal cord injury, childhood disease, burns, and 

9 wartime injuries. 

10 (3) These leading inpatient rehabilitation insti11 tutions are all not-for-profit or Government-owned 

12 institutions and serve a high volume of Medicare or 

13 Medicaid beneficiaries. 

14 (4) These leading inpatient rehabilitation insti15 tutions have been recognized by the Federal Govern16 ment for their contributions to cutting-edge research 

17 to develop solutions that enhance quality of care, im18 prove patient outcomes, and reduce health care 

19 costs. 

20 (5) These leading inpatient rehabilitation insti21 tutions help to improve the practice and standard of 

22 rehabilitation medicine across the Nation in urban, 

23 suburban, and rural communities by training physi24 cians, medical students, and other clinicians, and 

25 providing care to patients from all 50 States. 


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1 (6) It is vital that these leading 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 (D) ensure Medicare and Medicaid bene12 ficiaries receive state-of-the-art, high-quality re13 habilitation care by developing and dissemi14 nating best practices and advancing the quality 

15 of care utilized by post-acute providers in all 50 

16 States; and 

17 (E) support other inpatient rehabilitation 

18 institutions in rural areas to help ensure access 

19 to quality post-acute care for patients living in 

20 these communities. 

21 SEC. 3. INDIRECT COSTS PAYMENT FOR REHABILITATION 

22 INNOVATION CENTERS. 

23 (a) IN GENERAL.—Section 1886(j) of the Social Se24 curity Act (42 U.S.C. 1395ww(j)) is amended— 


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1 (1) by redesignating paragraph (8) as para2 graph (9); and 

3 (2) by inserting after paragraph (7) the fol4 lowing new paragraph: 

5 ‘‘(8) INDIRECT COSTS PAYMENT FOR REHABILI6 TATION INNOVATION CENTERS.— 

7 ‘‘(A) STUDY RELATING TO ADDITIONAL

8 PAYMENTS TO REHABILITATION INNOVATION

9 CENTERS TO ACCOUNT FOR HIGHER COSTS; AU10 THORITY TO INCREASE PAYMENTS.— 

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

12 2017, the Secretary shall conduct a study 

13 to determine whether there should be an 

14 increase in the prospective payment rate 

15 that would otherwise be made to a rehabili16 tation innovation center under this sub17 section for purposes of covering the addi18 tional costs that are incurred by such cen19 ters in furnishing items and services to in20 dividuals under this title, conducting re21 search, and providing medical training, 

22 and if the Secretary determines that such 

23 an increase is recommended, the amount of 

24 such increase that is needed to cover such 

25 additional costs. 


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1 ‘‘(ii) AUTHORITY TO INCREASE PAY2 MENTS.—Insofar as the Secretary deter3 mines under clause (i) that there should be 

4 an increase in the prospective payment 

5 rate to rehabilitation innovation centers, 

6 the Secretary may provide on a prospective 

7 basis for an appropriate percentage in8 crease in such rate. 

9 ‘‘(B) REHABILITATION INNOVATION CEN10 TER DEFINED.— 

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

12 (iv), in this paragraph, the term ‘rehabili13 tation innovation center’ means a rehabili14 tation facility that, determined as of the 

15 date of the enactment of this paragraph, is 

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

17 ‘‘(ii) NOT-FOR-PROFIT.—A rehabilita18 tion facility described in this clause is a fa19 cility that— 

20 ‘‘(I) is classified as a not-for21 profit entity under the Centers for 

22 Medicare & Medicaid Services 2010 

23 Provider of Services file; 

24 ‘‘(II) holds at least one Federal 

25 rehabilitation research and training 


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1 designation for research projects on 

2 traumatic brain injury, spinal cord in3 jury, or stroke rehabilitation research 

4 from the Rehabilitation Research and 

5 Training Centers or the Rehabilitation 

6 Engineering Research Center at the 

7 National Institute on Disability and 

8 Rehabilitation Research at the De9 partment of Education; 

10 ‘‘(III) has a minimum Medicare 

11 case mix index of 1.1144 according to 

12 the IRF Rate Setting File for the 

13 Correction Notice for the Inpatient 

14 Rehabilitation Facility Prospective 

15 Payment System for Federal Fiscal 

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

17 ‘‘(IV) has at least 300 Medicare 

18 discharges per year or at least 200 

19 Medicaid discharges per year. 

20 ‘‘(iii) GOVERNMENT-OWNED.—A reha21 bilitation facility described in this clause is 

22 a facility that— 

23 ‘‘(I) is classified as a Govern24 ment-owned institution under the 

25 Centers for Medicare & Medicaid 


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1 Services 2010 Provider of Services 

2 file; 

3 ‘‘(II) holds at least one Federal 

4 rehabilitation research and training 

5 designation for research projects on 

6 traumatic brain injury, spinal cord in7 jury, or stroke rehabilitation research 

8 from the Rehabilitation Research and 

9 Training Centers, the Rehabilitation 

10 Engineering Research Center, or the 

11 Model Spinal Cord Injury Systems at 

12 the National Institute on Disability 

13 and Rehabilitation Research at the 

14 Department of Education; 

15 ‘‘(III) has a minimum Medicare 

16 case mix index of 1.1144 according to 

17 the IRF Rate Setting File for the 

18 Correction Notice for the Inpatient 

19 Rehabilitation Facility Prospective 

20 Payment System for Federal Fiscal 

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

22 ‘‘(IV) has a disproportionate 

23 share hospital (DSH) percentage of at 

24 least 0.6300 according to the IRF 

25 Rate Setting File for the Correction 


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1 Notice for the Inpatient Rehabilitation 

2 Facility Prospective Payment System 

3 for Federal Fiscal Year 2012 (78 

4 Fed. Reg. 59256). 

5 ‘‘(iv) AUTHORITY.—The Secretary 

6 may consider applications from inpatient 

7 rehabilitation facilities that are not de8 scribed in clause (ii) or (iii) as of the date 

9 of the enactment of this paragraph but 

10 who are subsequently so described.’’. 

11 (b) STUDY AND REPORT TO CONGRESS ON ACCESS

12 TO REHABILITATION CARE IN RURAL COMMUNITIES IN

13 STATES THAT DO NOT HAVE A REHABILITATION INNO14 VATION CENTER.— 

15 (1) STUDY.—The Secretary of Health and 

16 Human Services shall conduct a study on access by 

17 individuals (including, but not limited to, Medicare 

18 beneficiaries) to rehabilitation care in rural commu19 nities in States in which there is no rehabilitation in20 novation center (as defined in section 1886(j)(8)(B) 

21 of the Social Security Act, as added by subsection 

22 (a)). 

23 (2) REPORT.—Not later than July 1, 2017, the 

24 Secretary of Health and Human Services shall sub25 mit to Congress a report on the study conducted 


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1 under paragraph (1), together with recommenda2 tions for such legislation and administrative action 

3 as the Secretary determines appropriate. 

Æ 


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