SEC. 2. ADDITIONAL PENALTIES FOR PSYCHIATRIC HOS-
PITAL OR UNIT FAILURE TO COMPLY WITH 
MEDICARE DISCHARGE PLANNING PROCESS 
REQUIREMENTS. 
Section 1861(ee) of the Social Security Act (42 
U.S.C. 1395x(ee)) is amended by adding at the end the 
following new paragraph: 
‘‘(4)(A) Beginning 1 year after the date of the enact-
ment of this paragraph, a psychiatric hospital or a psy-
chiatric unit (as described in the matter following clause 
(v) of section 1886(d)(1)(B)) that is determined by the 
Secretary not to have in place a discharge planning proc-
ess that meets the requirements of this subsection is sub-
ject to a civil money penalty of not more than $10,000. 
A civil money penalty under this subparagraph shall be 
imposed and collected in the same manner as civil money 
penalties under subsection (a) of section 1128A are im-
posed and collected under that section. 
‘‘(B) Beginning 1 year after the date of the enact-
ment of this paragraph, the Secretary may require a psy-
chiatric hospital or such a psychiatric unit that the Sec-
retary has determined on multiple occasions does not have 
in place a discharge planning process that meets the re-
quirements of this subsection to enter into an agreement 
with the Secretary, similar to a system improvement 
agreement applied pursuant to section 1866(b), to— 
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‘‘(i) obtain from a third party that is selected 
by the Secretary an independent review of policies 
and procedures of the hospital or unit for purposes 
of providing recommendations for establishing a suf-
ficient discharge planning process under this sub-
section; 
‘‘(ii) retain an independent compliance officer 
for a period specified in the agreement to monitor 
and assist the hospital or unit in establishing a suf-
ficient discharge planning process under this sub-
section; 
‘‘(iii) submit periodic reports to the Secretary 
detailing improvements made to the policies and pro-
cedures of the hospital or unit to have in place a 
sufficient discharge planning process under this sub-
section; and 
‘‘(iv) undertake such other actions as the Sec-
retary determines necessary in order to ensure that 
the hospital or unit will continue to have a sufficient 
discharge planning process under this subsection on 
an ongoing basis. 
‘‘(C) In the case that a psychiatric hospital or such 
a psychiatric unit has entered into an agreement under 
subparagraph (B) and does not have in place a sufficient 
discharge planning process by the date that is 45 days 
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after entering into such agreement, the Secretary may, in 
consultation with the State, appoint temporary manage-
ment to oversee the operation of the hospital or unit, as-
sure the health and safety of the hospital or unit’s inpa-
tients, and ensure compliance with requirements of such 
discharge planning process by the hospital or unit. The 
temporary management under this subparagraph shall be 
terminated when the Secretary has determined that the 
hospital or unit has the management capability to ensure 
continued compliance with all such requirements.’’. 
Æ 
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