I 
114TH CONGRESS 
2D SESSION 
H. R. 5688 
To amend title XVIII of the Social Security Act to provide for a temporary 
exception to the application of the Medicare long-term care hospital 
site neutral provisions for certain spinal cord specialty hospitals. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 8, 2016 
Mr. TOM PRICE of Georgia (for himself, Ms. DEGETTE, Mr. COFFMAN, and 
Mr. LEWIS) introduced the following bill; which was referred to the Com-
mittee on Ways and Means 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for a temporary exception to the application of the Medi-
care long-term care hospital site neutral provisions for 
certain spinal cord specialty hospitals. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. TEMPORARY EXCEPTION TO THE APPLICATION 
OF THE MEDICARE LTCH SITE NEUTRAL PRO-
VISIONS FOR CERTAIN SPINAL CORD SPE-
CIALTY HOSPITALS. 
(a) EXCEPTION.—Section 1886(m)(6) of the Social 
Security Act (42 U.S.C. 1395ww(m)(6)) is amended— 
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(1) in subparagraph (A)(i) by striking ‘‘and 
(E)’’ and inserting ‘‘, (E), and (F)’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(F) TEMPORARY
EXCEPTION
FOR
CER-
TAIN
SPINAL
CORD
SPECIALTY
HOSPITALS.— 
For discharges in cost reporting periods begin-
ning during fiscal years 2018 through 2023, 
subparagraph (A)(i) shall not apply (and pay-
ment shall be made to a long-term care hospital 
without regard to this paragraph) if such dis-
charge is from a long-term care hospital that 
meets each of the following requirements: 
‘‘(i) 
NOT-FOR-PROFIT.—The 
long- 
term care hospital is a not-for-profit long- 
term care hospital June 1, 2016. 
‘‘(ii) PRIMARILY
PROVIDING
TREAT-
MENT
FOR
CATASTROPHIC
SPINAL
CORD 
OR ACQUIRED BRAIN INJURIES OR OTHER 
PARALYZING
NEUROMUSCULAR
CONDI-
TIONS.—At least 50 percent of the dis-
charges in 2013 from the long-term care 
hospital were classified under MS–LTCH– 
DRGs 28, 29, 52, 57, 551, 573, or 963. 
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‘‘(iii) SIGNIFICANT OUT-OF-STATE AD-
MISSIONS.—The long-term care hospital 
admitted inpatients (including both indi-
viduals entitled to, or enrolled for benefits 
under this title and individuals not so enti-
tled or enrolled) during fiscal year 2014 
from at least 20 of the 50 States, deter-
mined based on such data, submitted by 
the hospital to the Secretary, as the Sec-
retary may require. Notwithstanding any 
other provision of law, the Secretary may 
implement the previous sentence by pro-
gram instruction or otherwise.’’. 
(b) STUDY AND REPORT ON THE STATUS AND VIA-
BILITY
OF CERTAIN SPINAL CORD SPECIALTY LONG- 
TERM CARE HOSPITALS.— 
(1) STUDY.—The Comptroller General of the 
United States shall conduct a study on long-term 
care hospitals described in section 1886(m)(6)(F) of 
the Social Security Act, as added by subsection (a). 
Such report shall include an analysis of the fol-
lowing: 
(A) The impact on such hospitals of the 
classification and facility licensure by State 
agencies of such hospitals. 
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(B) The Medicare payment rates for such 
hospitals. 
(C) Data on the number and health care 
needs of Medicare beneficiaries who have been 
diagnosed with catastrophic spinal cord or ac-
quired brain injuries or other paralyzing neuro-
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 June 30, 2022, 
the Comptroller General shall submit to Congress a 
report on the study conducted under paragraph (1), 
together with recommendations for such legislation 
and administrative action as the Comptroller Gen-
eral determines appropriate. 
Æ 
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