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muscular conditions (as described within the 
discharge classifications specified in clause (ii) 
of such section) who are receiving services from 
such hospitals. 
(2) REPORT.—Not later than October 1, 2018, 
the Comptroller General shall submit to Congress a 
report on the study conducted under paragraph (1), 
including recommendations for such legislation and 
administrative action as the Comptroller General de-
termines appropriate. 
SEC. 105. TEMPORARY EXTENSION TO THE APPLICATION 
OF THE MEDICARE LTCH SITE NEUTRAL PRO-
VISIONS FOR CERTAIN DISCHARGES WITH SE-
VERE WOUNDS. 
(a) IN GENERAL.—Section 1886(m)(6) of the Social 
Security Act (42 U.S.C. 1395ww(m)(6)), as amended by 
section 104, is further amended— 
(1) in subparagraph (A)(i) by striking ‘‘and 
(F)’’ and inserting ‘‘(F), and (G)’’; 
(2) in subparagraph (E)(i)(I)(aa), by striking 
‘‘the amendment made’’ and all that follows before 
the semicolon and inserting ‘‘the last sentence of 
subsection (d)(1)(B)’’; and 
(3) by adding at the end the following new sub-
paragraph: 
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‘‘(G) ADDITIONAL TEMPORARY EXCEPTION 
FOR
CERTAIN
SEVERE
WOUND
DISCHARGES 
FROM CERTAIN LONG-TERM CARE HOSPITALS.— 
‘‘(i) IN
GENERAL.—For a discharge 
occurring in a cost reporting period begin-
ning during fiscal year 2018, subpara-
graph (A)(i) shall not apply (and payment 
shall be made to a long-term care hospital 
without regard to this paragraph) if such 
discharge— 
‘‘(I) is from a long-term care 
hospital identified by the last sentence 
of subsection (d)(1)(B); 
‘‘(II) is classified under MS– 
LTCH–DRG 602, 603, 539, or 540; 
and 
‘‘(III) is with respect to an indi-
vidual treated by a long-term care 
hospital for a severe wound. 
‘‘(ii) SEVERE
WOUND
DEFINED.—In 
this subparagraph, the term ‘severe wound’ 
means a wound which is a stage 3 wound, 
stage 4 wound, unstageable wound, non- 
healing surgical wound, or fistula as identi-
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fied in the claim from the long-term care 
hospital. 
‘‘(iii) WOUND DEFINED.—In this sub-
paragraph, the term ‘wound’ means an in-
jury involving division of tissue or rupture 
of the integument or mucous membrane 
with exposure to the external environ-
ment.’’. 
(c) STUDY AND REPORT TO CONGRESS.— 
(1) STUDY.—The Comptroller General of the 
United States shall, in consultation with relevant 
stakeholders, conduct a study on the treatment 
needs of individuals entitled to benefits under part 
A of title XVIII of the Social Security Act or en-
rolled under part B of such title who require special-
ized wound care, and the cost, for such individuals 
and the Medicare program under such title, of treat-
ing severe wounds in rural and urban areas. Such 
study shall include an assessment of— 
(A) access of such individuals to appro-
priate levels of care for such cases; 
(B) the potential impact that section 
1886(m)(6)(A)(i) of such Act (42 U.S.C. 
1395ww(m)(6)(A)(i)) will have on the access, 
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quality, and cost of care for such individuals; 
and 
(C) how to appropriately pay for such care 
under the Medicare program under such title. 
(2) REPORT.—Not later than October 1, 2020, 
the Comptroller General shall submit to Congress a 
report on the study conducted under paragraph (1), 
including recommendations for such legislation and 
administrative action as the Comptroller General de-
termines appropriate. 
TITLE II—OTHER PROVISIONS 
SEC. 201. NO PAYMENT FOR ITEMS AND SERVICES FUR-
NISHED BY NEWLY ENROLLED PROVIDERS 
OR SUPPLIERS WITHIN A TEMPORARY MORA-
TORIUM AREA. 
(a) MEDICARE.—Section 1866(j)(7) of the Social Se-
curity Act (42 U.S.C. 1395cc(j)(7)) is amended— 
(1) in the paragraph heading, by inserting ‘‘; 
NONPAYMENT’’ before the period; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(C) NONPAYMENT.— 
‘‘(i) IN GENERAL.—No payment may 
be made under this title or under a pro-
gram described in subparagraph (A) with 
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respect to an item or service described in 
clause (ii) furnished on or after October 1, 
2017. 
‘‘(ii) ITEM OR SERVICE DESCRIBED.— 
An item or service described in this clause 
is an item or service furnished— 
‘‘(I) within a geographic area 
with respect to which a temporary 
moratorium imposed under subpara-
graph (A) is in effect; and 
‘‘(II) by a provider of services or 
supplier that meets the requirements 
of clause (iii). 
‘‘(iii) REQUIREMENTS.—For purposes 
of clause (ii), the requirements of this 
clause are that a provider of services or 
supplier— 
‘‘(I) enrolls under this title on or 
after the effective date of such tem-
porary moratorium; and 
‘‘(II) is within a category of pro-
viders of services and suppliers (as de-
scribed in subparagraph (A)) subject 
to such temporary moratorium. 
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‘‘(iv) PROHIBITION ON CHARGES FOR 
SPECIFIED
ITEMS
OR
SERVICES.—In no 
case shall a provider of services or supplier 
described in clause (ii)(II) charge an indi-
vidual or other person for an item or serv-
ice described in clause (ii) furnished on or 
after October 1, 2017, to an individual en-
titled to benefits under part A or enrolled 
under part B or an individual under a pro-
gram specified in subparagraph (A).’’. 
(b) CONFORMING AMENDMENTS.— 
(1) MEDICAID.— 
(A) IN GENERAL.—Section 1903(i)(2) of 
the Social Security Act (42 U.S.C. 1396b(i)(2)) 
is amended— 
(i) in subparagraph (A), by striking 
the comma at the end and inserting a 
semicolon; 
(ii) in subparagraph (B), by striking 
‘‘or’’ at the end; and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(D) with respect to any amount expended 
for such an item or service furnished during 
calendar quarters beginning on or after October 
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1, 
2017, 
subject 
to 
section 
1902(kk)(4)(A)(ii)(II), within a geographic area 
that is subject to a moratorium imposed under 
section 1866(j)(7) by a provider or supplier 
that meets the requirements specified in sub-
paragraph (C)(iii) of such section, during the 
period of such moratorium; or’’. 
(B) EXCEPTION
WITH
RESPECT
TO
AC-
CESS.—Section 1902(kk)(4)(A)(ii) of the Social 
Security Act (42 U.S.C. 1396a(kk)(4)(A)(ii)) is 
amended to read as follows: 
‘‘(ii) EXCEPTIONS.— 
‘‘(I) COMPLIANCE WITH MORATO-
RIUM.—A State shall not be required 
to comply with a temporary morato-
rium described in clause (i) if the 
State determines that the imposition 
of such temporary moratorium would 
adversely impact beneficiaries’ access 
to medical assistance. 
‘‘(II) 
FFP 
AVAILABLE.—Not-
withstanding section 1903(i)(2)(D), 
payment may be made to a State 
under this title with respect to 
amounts expended for items and serv-
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ices described in such section if the 
Secretary, in consultation with the 
State agency administering the State 
plan under this title (or a waiver of 
the plan), determines that denying 
payment to the State pursuant to 
such section would adversely impact 
beneficiaries’ access to medical assist-
ance. ’’. 
(C) STATE PLAN REQUIREMENT WITH RE-
SPECT TO LIMITATION ON CHARGES TO BENE-
FICIARIES.—Section 1902(kk)(4)(A) of the So-
cial Security Act (42 U.S.C. 1396a(kk)(4)(A)) 
is amended by adding at the end the following 
new clause: 
‘‘(iii) LIMITATION
ON
CHARGES
TO 
BENEFICIARIES.—With 
respect 
to 
any 
amount expended for items or services fur-
nished during calendar quarters beginning 
on or after October 1, 2017, the State pro-
hibits, during the period of a temporary 
moratorium described in clause (i), a pro-
vider meeting the requirements specified in 
subparagraph (C)(iii) of section 1866(j)(7) 
from charging an individual or other per-
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son eligible to receive medical assistance 
under the State plan under this title (or a 
waiver of the plan) for an item or service 
described in section 1903(i)(2)(D) fur-
nished to such an individual.’’. 
(2) CORRECTING
AMENDMENTS
TO
RELATED 
PROVISIONS.— 
(A) SECTION 1866(J).—Section 1866(j) of 
the Social Security Act (42 U.S.C. 1395cc(j)) is 
amended— 
(i) in paragraph (1)(A)— 
(I) by striking ‘‘paragraph (4)’’ 
and inserting ‘‘paragraph (5)’’; 
(II) by striking ‘‘moratoria in ac-
cordance with paragraph (5)’’ and in-
serting ‘‘moratoria in accordance with 
paragraph (7)’’; and 
(III) by striking ‘‘paragraph (6)’’ 
and inserting ‘‘paragraph (9)’’; and 
(ii) by redesignating the second para-
graph (8) (added by section 1304(1) of 
Public Law 111–152) as paragraph (9). 
(B) SECTION 1902(KK).—Section 1902(kk) 
of such Act (42 U.S.C. 1396a(kk)) is amend-
ed— 
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(i) in paragraph (1), by striking ‘‘sec-
tion 1886(j)(2)’’ and inserting ‘‘section 
1866(j)(2)’’; 
(ii) in paragraph (2), by striking ‘‘sec-
tion 1886(j)(3)’’ and inserting ‘‘section 
1866(j)(3)’’; 
(iii) in paragraph (3), by striking 
‘‘section 1886(j)(4)’’ and inserting ‘‘section 
1866(j)(5)’’; and 
(iv) in paragraph (4)(A), by striking 
‘‘section 1886(j)(6)’’ and inserting ‘‘section 
1866(j)(7)’’. 
Passed the House of Representatives September 21, 
2016. 
Attest: 
KAREN L. HAAS, 
Clerk. 
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