I 

114TH CONGRESS 

1ST SESSION H. R. 2292 

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

rehabilitation innovation centers under the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 13, 2015 

Mr. OLSON (for himself, Mr. GENE GREEN of Texas, Mr. DOLD, and Mr. 

DANNY K. DAVIS of Illinois) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the 

Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions 

as fall within the jurisdiction of the committee concerned 

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: 


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1 (1) In the United States, there are an esti2 mated 1,181 inpatient rehabilitation facilities. 

3 Among these facilities is a small group of inpatient 

4 rehabilitation institutions that are contributing to 

5 the future of rehabilitation care medicine, as well as 

6 to patient recovery, scientific innovation, and quality 

7 of life. 

8 (2) This unique category of inpatient rehabilita9 tion institutions treats the most complex patient 

10 conditions, such as traumatic brain injury, stroke, 

11 spinal cord injury, childhood disease, burns, and 

12 wartime injuries. 

13 (3) These leading inpatient rehabilitation insti14 tutions are all not-for-profit or Government-owned 

15 institutions and serve a high volume of Medicare or 

16 Medicaid beneficiaries. 

17 (4) These leading inpatient rehabilitation insti18 tutions have been recognized by the Federal Govern19 ment for their contributions to cutting-edge research 

20 to develop solutions that enhance quality of care, im21 prove patient outcomes, and reduce health care 

22 costs. 

23 (5) These leading inpatient rehabilitation insti24 tutions help to improve the practice and standard of 

25 rehabilitation medicine across the Nation in urban, 


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1 suburban, and rural communities by training physi2 cians, medical students, and other clinicians, and 

3 providing care to patients from all 50 States. 

4 (6) It is vital that these leading inpatient reha5 bilitation institutions are supported so they can con6 tinue to lead the Nation’s efforts to— 

7 (A) advance integrated, multidisciplinary 

8 rehabilitation research; 

9 (B) provide cutting-edge medical care to 

10 the most complex rehabilitation patients; 

11 (C) serve as education and training facili12 ties for the physicians, nurses, and other health 

13 professionals who serve rehabilitation patients; 

14 (D) ensure Medicare and Medicaid bene15 ficiaries receive state-of-the-art, high-quality re16 habilitation care by developing and dissemi17 nating best practices and advancing the quality 

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

19 States; and 

20 (E) support other inpatient rehabilitation 

21 institutions in rural areas to help ensure access 

22 to quality post-acute care for patients living in 

23 these communities. 


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1 SEC. 3. INDIRECT COSTS PAYMENT FOR REHABILITATION 

2 INNOVATION CENTERS. 

3 (a) IN GENERAL.—Section 1886(j) of the Social Se4 curity Act (42 U.S.C. 1395ww(j)) is amended— 

5 (1) by redesignating paragraph (8) as para6 graph (9); and 

7 (2) by inserting after paragraph (7) the fol8 lowing new paragraph: 

9 ‘‘(8) INDIRECT COSTS PAYMENT FOR REHABILI10 TATION INNOVATION CENTERS.— 

11 ‘‘(A) STUDY RELATING TO ADDITIONAL

12 PAYMENTS TO REHABILITATION INNOVATION

13 CENTERS TO ACCOUNT FOR HIGHER COSTS; AU14 THORITY TO INCREASE PAYMENTS.— 

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

16 2017, the Secretary shall conduct a study 

17 to determine whether there should be an 

18 increase in the prospective payment rate 

19 that would otherwise be made to a rehabili20 tation innovation center under this sub21 section for purposes of covering the addi22 tional costs that are incurred by such cen23 ters in furnishing items and services to in24 dividuals under this title, conducting re25 search, and providing medical training, 

26 and if the Secretary determines that such 


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1 an increase is recommended, the amount of 

2 such increase that is needed to cover such 

3 additional costs. 

4 ‘‘(ii) AUTHORITY TO INCREASE PAY5 MENTS.—Insofar as the Secretary deter6 mines under clause (i) that there should be 

7 an increase in the prospective payment 

8 rate to rehabilitation innovation centers, 

9 the Secretary may provide on a prospective 

10 basis for an appropriate percentage in11 crease in such rate. 

12 ‘‘(B) REHABILITATION INNOVATION CEN13 TER DEFINED.— 

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

15 (iv), in this paragraph, the term ‘rehabili16 tation innovation center’ means a rehabili17 tation facility that, determined as of the 

18 date of the enactment of this paragraph, is 

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

20 ‘‘(ii) NOT-FOR-PROFIT.—A rehabilita21 tion facility described in this clause is a fa22 cility that— 

23 ‘‘(I) is classified as a not-for24 profit entity under the Centers for 


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1 Medicare & Medicaid Services 2010 

2 Provider of Services 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 or the Rehabilitation 

10 Engineering Research Center at the 

11 National Institute on Disability and 

12 Rehabilitation Research at the De13 partment of Education; 

14 ‘‘(III) has a minimum Medicare 

15 case mix index of 1.1144 according to 

16 the IRF Rate Setting File for the 

17 Correction Notice for the Inpatient 

18 Rehabilitation Facility Prospective 

19 Payment System for Federal Fiscal 

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

21 ‘‘(IV) has at least 300 Medicare 

22 discharges per year or at least 200 

23 Medicaid discharges per year. 


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1 ‘‘(iii) GOVERNMENT-OWNED.—A reha2 bilitation facility described in this clause is 

3 a facility that— 

4 ‘‘(I) is classified as a Govern5 ment-owned institution under the 

6 Centers for Medicare & Medicaid 

7 Services 2010 Provider of Services 

8 file; 

9 ‘‘(II) holds at least one Federal 

10 rehabilitation research and training 

11 designation for research projects on 

12 traumatic brain injury, spinal cord in13 jury, or stroke rehabilitation research 

14 from the Rehabilitation Research and 

15 Training Centers, the Rehabilitation 

16 Engineering Research Center, or the 

17 Model Spinal Cord Injury Systems at 

18 the National Institute on Disability 

19 and Rehabilitation Research at the 

20 Department of Education; 

21 ‘‘(III) has a minimum Medicare 

22 case mix index of 1.1144 according to 

23 the IRF Rate Setting File for the 

24 Correction Notice for the Inpatient 

25 Rehabilitation Facility Prospective 


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1 Payment System for Federal Fiscal 

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

3 ‘‘(IV) has a disproportionate 

4 share hospital (DSH) percentage of at 

5 least 0.6300 according to the IRF 

6 Rate Setting File for the Correction 

7 Notice for the Inpatient Rehabilitation 

8 Facility Prospective Payment System 

9 for Federal Fiscal Year 2012 (78 

10 Fed. Reg. 59256). 

11 ‘‘(iv) AUTHORITY.—The Secretary 

12 may consider applications from inpatient 

13 rehabilitation facilities that are not de14 scribed in clause (ii) or (iii) as of the date 

15 of the enactment of this paragraph but 

16 who are subsequently so described.’’. 

17 (b) STUDY AND REPORT TO CONGRESS ON ACCESS

18 TO REHABILITATION CARE IN RURAL COMMUNITIES IN

19 STATES THAT DO NOT HAVE A REHABILITATION INNO20 VATION CENTER.— 

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

22 Human Services shall conduct a study on access by 

23 individuals (including, but not limited to, Medicare 

24 beneficiaries) to rehabilitation care in rural commu25 nities in States in which there is no rehabilitation inVerDate Sep 11 2014 06:01 May 15, 2015 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2292.IH H2292

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1 novation center (as defined in section 1886(j)(8)(B) 

2 of the Social Security Act, as added by subsection 

3 (a)). 

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

5 Secretary of Health and Human Services shall sub6 mit to Congress a report on the study conducted 

7 under paragraph (1), together with recommenda8 tions for such legislation and administrative action 

9 as the Secretary determines appropriate. 

Æ 


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