I 
109TH CONGRESS 
1ST SESSION H. R. 3373 
To extend the 50 percent compliance threshold used to determine whether 
a hospital or unit of a hospital is an inpatient rehabilitation facility 
and to establish the National Advisory Council on Medical Rehabilitation. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 21, 2005 
Mr. LOBIONDO (for himself, Mrs. LOWEY, Mr. TANNER, Mr. WAMP, Mr. SIM-
MONS, Mr. REYES, Mr. HOLT, Mr. HOLDEN, Mr. SAXTON, Mr. 
PASCRELL, Mr. LYNCH, Mr. ACKERMAN, Mr. ROTHMAN, Mr. BRADY of 
Pennsylvania, Mr. EHLERS, Mr. HINCHEY, Mr. MENENDEZ, Mr. DAVIS 
of Alabama, Mr. SHUSTER, Mr. MCNULTY, Mr. BONNER, Mr. CHAN-
DLER, Mr. HIGGINS, Mr. BERRY, Ms. SCHWARTZ of Pennsylvania, Mr. 
WALSH, Mr. PLATTS, Mr. ENGEL, Mr. KANJORSKI, Mr. DELAHUNT, Mr. 
MORAN of Virginia, Mr. MCHUGH, Mr. MCINTYRE, Mr. GRAVES, Mr. 
PORTER, Mr. GERLACH, Mr. LARSON of Connecticut, Mr. PAUL, Mr. 
PALLONE, Mr. BOEHLERT, Mr. KILDEE, Mr. CAPUANO, Mr. DENT, Mr. 
FITZPATRICK of Pennsylvania, and Mr. SMITH of New Jersey) 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 com-
mittee concerned 
A BILL 
To extend the 50 percent compliance threshold used to deter-
mine whether a hospital or unit of a hospital is an 
inpatient rehabilitation facility and to establish the Na-
tional Advisory Council on Medical Rehabilitation.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Preserving Patient Ac-
cess to Inpatient Rehabilitation Hospitals Act of 2005’’. 
SEC. 2. EFFECT ON ENFORCEMENT OF REGULATIONS. 
(a) 
IN
GENERAL.—Notwithstanding 
section 
412.23(b)(2) of title 42, Code of Federal Regulations, dur-
ing the period beginning on July 1, 2005, and ending on 
the date that is 2 years after the date of enactment of 
this Act, the Secretary of Health and Human Services (re-
ferred to in this Act as the ‘‘Secretary’’) shall not— 
(1) require a compliance rate, pursuant to the 
criterion (commonly known as the ‘‘75 percent 
rule’’) that is used to determine whether a hospital 
or unit of a hospital is an inpatient rehabilitation fa-
cility (as defined in the rule published in the Federal 
Register on May 7, 2004, entitled ‘‘Medicare Pro-
gram; Final Rule; Changes to the Criteria for Being 
Classified as an Inpatient Rehabilitation Facility’’ 
(69 Fed. Reg. 25752)), that is greater than the 50 
percent compliance threshold that became effective 
on July 1, 2004;
(2) change the designation of an inpatient reha-
bilitation facility that is in compliance with the 50 
percent threshhold; or 
(3) conduct medical necessity review of inpa-
tient rehabilitation facilities using any guidelines, 
such as fiscal intermediary Local Coverage Deter-
minations, other than the national criteria estab-
lished in chapter 1, section 110 of the Medicare 
Benefits Policy Manual. 
(b) RETROACTIVE STATUS AS AN INPATIENT REHA-
BILITATION
FACILITY; PAYMENTS; EXPEDITED
RE-
VIEW.—The Secretary shall establish procedures for— 
(1) making any necessary retroactive adjust-
ment to restore the status of a facility as an inpa-
tient rehabilitation facility as a result of subsection 
(a); 
(2) making any necessary payments to inpatient 
rehabilitation facilities based on such adjustment for 
discharges occurring on or after July 1, 2005 and 
before the date of enactment of this Act; and 
(3) developing and implementing an appeals 
process that provides for expedited review of any ad-
justment to the status of a facility as an inpatient 
rehabilitation facility made during the period begin-
ning on July 1, 2005 and ending on the date that 
is 2 years after the date of enactment of this Act. 
SEC. 3. NATIONAL ADVISORY COUNCIL ON MEDICAL REHA-
BILITATION. 
(a) DEFINITIONS.—In this section: 
(1) ADVISORY COUNCIL.—The term ‘‘Advisory 
Council’’ means the National Advisory Council on 
Medical Rehabilitation established under subsection 
(b). 
(2) APPROPRIATE
FEDERAL
AGENCIES.—The 
term ‘‘appropriate Federal agencies’’ means— 
(A) the Agency for Healthcare Research 
and Quality; 
(B) the Centers for Medicare & Medicaid 
Services; 
(C) the National Institute on Disability 
and Rehabilitation Research; and 
(D) the National Center for Medical Reha-
bilitation Research. 
(b) ESTABLISHMENT.—Pursuant to section 222 of 
the Public Health Service Act (42 U.S.C. 217a), the Sec-
retary shall establish an advisory panel to be known as 
the ‘‘National Advisory Council on Medical Rehabilita-
tion’’. 
(c) MEMBERSHIP.—
(1) APPOINTMENT.—The Advisory Council shall 
be composed of 17 members, of whom— 
(A) 9 members shall be appointed by the 
Secretary, in consultation with the medical re-
habilitation community, from a diversity of 
backgrounds, including— 
(i) physicians; 
(ii) medicare beneficiaries; 
(iii) representatives of inpatient reha-
bilitation facilities; and 
(iv) other practitioners experienced in 
rehabilitative care; and 
(B) 8 members, not more than 4 of whom 
are members of the same political party, shall 
be appointed jointly by— 
(i) the Majority Leader of the Senate; 
(ii) the Minority Leader of the Senate; 
(iii) the Speaker of the House of Rep-
resentatives; 
(iv) the Minority Leader of the House 
of Representatives; 
(v) the Chairman and the Ranking 
Member of the Committee on Finance of 
the Senate; and