I 
108TH CONGRESS 
1ST SESSION H. R. 2246
To direct the Secretary of Health and Human Services to modify treatment 
categories for qualification as a rehabilitation hospital or unit for pur-
poses of reimbursement under the Medicare prospective payment system 
for inpatient rehabilitation facilities. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 22, 2003
Mr. LOBIONDO (for himself, Mr. FROST, Mr. SAXTON, Mr. BRADLEY of New 
Hampshire, Mr. MCNULTY, Mr. PALLONE, Mr. PAYNE, Mr. SMITH of 
New Jersey, Mr. MENENDEZ, Mr. GARRETT of New Jersey, Mr. AN-
DREWS, and Mr. NEAL of Massachusetts) introduced the following bill; 
which was referred to the Committee on Ways and Means 
A BILL 
To direct the Secretary of Health and Human Services to 
modify treatment categories for qualification as a reha-
bilitation hospital or unit for purposes of reimbursement 
under the Medicare prospective payment system for inpa-
tient rehabilitation facilities.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. MODIFICATION OF TREATMENT CATEGORIES 
FOR QUALIFICATION AS A REHABILITATION 
HOSPITAL OR UNIT FOR PURPOSES OF REIM-
BURSEMENT UNDER THE MEDICARE PRO-
SPECTIVE PAYMENT SYSTEM FOR INPATIENT 
REHABILITATION FACILITIES. 
(a) REVISION OF REGULATIONS.—The Secretary of 
Health and Human Services shall revise, in accordance 
with subsection (b), the definition under medicare regula-
tions of the terms ‘‘rehabilitation hospital’’ and ‘‘rehabili-
tation unit’’ (as set forth under section 412.23(b) of title 
42 of the Code of Federal Regulations) for purposes of 
determining the applicable payment methodology under 
title XVIII of the Social Security Act (42 U.S.C. 1395 
et seq.). 
(b) MODIFICATION OF 75 PERCENT RULE.—In de-
termining whether a rehabilitation hospital or unit is eligi-
ble for reimbursement for services furnished to medicare 
beneficiaries under the prospective payment system for in-
patient rehabilitation facilities under section 1886(j) of 
the Social Security Act (42 U.S.C. 1395ww(j)), the Sec-
retary shall modify the list of treatment categories other-
wise applicable under paragraph (2) of such section 
412.23(b) (commonly referred to as the ‘‘75 Percent 
Rule’’) to include all rehabilitation impairment categories
(except miscellaneous) established by the Secretary for 
purposes of such prospective payment system. 
(c) PERIODIC UPDATE REQUIRED.—The Secretary 
shall update the regulations described in subsection (a) pe-
riodically to ensure that the definitions of the terms ‘‘reha-
bilitation hospital’’ and ‘‘rehabilitation unit’’ remain whol-
ly consistent with all rehabilitation impairment categories 
(except miscellaneous) on which payment under such sec-
tion 1886(j) is based. 
(d) ENFORCEMENT.—Notwithstanding any other 
provision of law, during the period beginning on the date 
of enactment of this Act and ending no earlier than the 
date that is six months after the date on which the Sec-
retary issues final regulations to comply with subsection 
(a), the Secretary shall not commence any enforcement ac-
tion or impose any sanction or penalty pertaining to retro-
active enforcement of the 75 Percent Rule on a hospital 
or unit for failure to meet the definition of rehabilitation 
hospital set forth at 42 CFR 412.23(b) as of April 30, 
2003.
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