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 re-
ferred to the Committee on Ways and Means, and in addition to the 
Committee on Energy and Commerce, for a period to be subsequently de-
termined 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. 
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 Rehabilita-
tion Innovation Centers Act of 2015’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
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(1) In the United States, there are an esti-
mated 
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 rehabilita-
tion 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 insti-
tutions are all not-for-profit or Government-owned 
institutions and serve a high volume of Medicare or 
Medicaid beneficiaries. 
(4) These leading inpatient rehabilitation insti-
tutions have been recognized by the Federal Govern-
ment for their contributions to cutting-edge research 
to develop solutions that enhance quality of care, im-
prove patient outcomes, and reduce health care 
costs. 
(5) These leading inpatient rehabilitation insti-
tutions help to improve the practice and standard of 
rehabilitation medicine across the Nation in urban, 
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suburban, and rural communities by training physi-
cians, medical students, and other clinicians, and 
providing care to patients from all 50 States. 
(6) It is vital that these leading inpatient reha-
bilitation institutions are supported so they can con-
tinue 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 facili-
ties for the physicians, nurses, and other health 
professionals who serve rehabilitation patients; 
(D) ensure Medicare and Medicaid bene-
ficiaries receive state-of-the-art, high-quality re-
habilitation care by developing and dissemi-
nating 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. 
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SEC. 3. INDIRECT COSTS PAYMENT FOR REHABILITATION 
INNOVATION CENTERS. 
(a) IN GENERAL.—Section 1886(j) of the Social Se-
curity Act (42 U.S.C. 1395ww(j)) is amended— 
(1) by redesignating paragraph (8) as para-
graph (9); and 
(2) by inserting after paragraph (7) the fol-
lowing new paragraph: 
‘‘(8) INDIRECT COSTS PAYMENT FOR REHABILI-
TATION INNOVATION CENTERS.— 
‘‘(A) STUDY
RELATING
TO
ADDITIONAL 
PAYMENTS
TO
REHABILITATION
INNOVATION 
CENTERS TO ACCOUNT FOR HIGHER COSTS; AU-
THORITY 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 rehabili-
tation innovation center under this sub-
section for purposes of covering the addi-
tional costs that are incurred by such cen-
ters in furnishing items and services to in-
dividuals under this title, conducting re-
search, and providing medical training, 
and if the Secretary determines that such 
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an increase is recommended, the amount of 
such increase that is needed to cover such 
additional costs. 
‘‘(ii) AUTHORITY TO INCREASE PAY-
MENTS.—Insofar as the Secretary deter-
mines 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 in-
crease in such rate. 
‘‘(B) REHABILITATION INNOVATION CEN-
TER DEFINED.— 
‘‘(i) IN GENERAL.—Subject to clause 
(iv), in this paragraph, the term ‘rehabili-
tation innovation center’ means a rehabili-
tation 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 rehabilita-
tion facility described in this clause is a fa-
cility that— 
‘‘(I) is classified as a not-for- 
profit entity under the Centers for 
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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 in-
jury, 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 De-
partment 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. 
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‘‘(iii) GOVERNMENT-OWNED.—A reha-
bilitation facility described in this clause is 
a facility that— 
‘‘(I) is classified as a Govern-
ment-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 in-
jury, 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 
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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 de-
scribed 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 INNO-
VATION 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 commu-
nities in States in which there is no rehabilitation in-
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novation 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 sub-
mit to Congress a report on the study conducted 
under paragraph (1), together with recommenda-
tions for such legislation and administrative action 
as the Secretary determines appropriate. 
Æ 
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