I 
108TH CONGRESS 
2D SESSION 
H. R. 3790
To impose a moratorium on payments for inpatient hospital services in 
additional long-term care hospital beds under the Medicare Program. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 10, 2004
Mr. STARK introduced the following bill; which was referred to the Committee 
on Ways and Means 
A BILL 
To impose a moratorium on payments for inpatient hospital 
services in additional long-term care hospital beds 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 ‘‘Long-term Care Hos-
pital Moratorium Act of 2004’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Long-term care hospitals are one of four 
types of post-acute care settings that are reimbursed 
under the Medicare program.
(B) the appropriateness of the current 
Medicare payment system for long-term care 
hospital services; and 
(C) the extent to which clinical admissions 
criteria for long-term care hospital patients can 
be modified so as to minimize the acceptance of 
patients into these settings that can be appro-
priately treated in alternative, less costly post-
acute settings. 
(7) A temporary moratorium on recognizing ad-
ditional long-term care hospital beds is appropriate 
until these questions are answered, in order to en-
sure that beneficiaries are receiving the treatment 
they require and that Medicare funds are being pru-
dently spent. 
SEC. 3. MORATORIUM ON MEDICARE PAYMENT FOR INPA-
TIENT HOSPITAL SERVICES IN ADDITIONAL 
LONG-TERM CARE HOSPITAL BEDS. 
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, except as provided in subsection (b), no pay-
ment shall be made under section 1886 of the Social Secu-
rity Act (42 U.S.C. 1395ww) for inpatient hospital serv-
ices provided in a long-term care hospital unless such serv-
ices were provided for services furnished for a patient in 
a bed which was either in operation or in development (as
determined by the Secretary) as of the date of the intro-
duction of the Long-term Care Hospital Moratorium Act 
of 2004. 
(b) TERMINATION OF MORATORIUM.—
(1) IN GENERAL.—The Secretary may termi-
nate the moratorium under subsection (a) if the Sec-
retary determines that adequate information is ob-
tained and any appropriate interventions are imple-
mented to ensure that beneficiaries within long-term 
care hospitals are receiving the treatment they re-
quire and that Medicare funds allocated to these 
hospitals are being prudently spent. 
(2) CONDITION.— The Secretary shall only 
make such determination based on the Secretary 
judgment that there is adequate evidence—
(A) of a clinical need for a growth in the 
number of beds in long-term care hospitals; 
(B) that an appropriate reimbursement 
system and rate is in place for Medicare pay-
ment for inpatient hospital services in such hos-
pitals; and 
(C) of a clinical admission policy for such 
hospitals that minimizes the acceptance of pa-
tients into these settings that can be appro-
priately treated in alternative, less costly post 
acute settings. 
(c) PRIOR REPORT TO CONGRESS.—If the Secretary 
intends to terminate the moratorium under subsection (b), 
the Secretary shall submit to Congress a report at least 
1 month before the date of such termination. Such report 
shall include the rationale for the termination and shall 
specify the evidence described in subsection (b)(2) that 
supports the termination of the moratorium. 
(d) DEFINITIONS.—For purposes of this section: 
(1) The term ‘‘long-term care hospital’’ means 
a hospital described in section 1886(d)(1)(B)(iv) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395ww(d)(1)(B)(iv)). 
(2) The term ‘‘Secretary ’’ means the Secretary 
of Health and Human Services.
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