data and information collected under sub-
paragraph (A). 
‘‘(ii) REVIEW.—The Secretary may 
make revisions to the diagnosis-related 
group classifications, in accordance with 
subsection (d)(4)(C), to reflect nursing and 
staff resource use and costs involved in 
furnishing services at such hospitals and 
units, including considerations for patient 
complexity and prior admission to an inpa-
tient psychiatric facility, which may be 
based on review of data and information 
collected under subparagraph (A), as the 
Secretary determines to be appropriate. 
‘‘(iii) BUDGET
NEUTRALITY.—Revi-
sions in payment implemented pursuant to 
clause (i) for a rate year shall result in the 
same estimated amount of aggregate ex-
penditures under this title for psychiatric 
hospitals and psychiatric units furnished in 
the rate year as would have been made 
under this title for such care in such rate 
year if such revisions had not been imple-
mented.’’. 
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(b) IMPROVEMENTS THROUGH STANDARDIZED PA-
TIENT ASSESSMENT DATA.—Section 1886(s) of the Social 
Security Act (42 U.S.C. 1395ww(s)), as amended by sub-
section (a), is further amended— 
(1) in paragraph (4)— 
(A) in subparagraph (A)(i), by striking 
‘‘subparagraph (C)’’ and inserting ‘‘subpara-
graphs (C) and (E)’’; 
(B) by redesignating subparagraph (E) as 
subparagraph (F); 
(C) by inserting after subparagraph (D) 
the following new subparagraph: 
‘‘(E) STANDARDIZED
PATIENT
ASSESS-
MENT DATA.— 
‘‘(i) IN
GENERAL.—For rate year 
2028 and each subsequent rate year, in ad-
dition to such data on the quality measures 
described in subparagraph (C), each psy-
chiatric hospital and psychiatric unit shall 
submit to the Secretary, through the use of 
a standardized assessment instrument im-
plemented under clause (iii), the standard-
ized patient assessment data described in 
clause (ii). Such data shall be submitted 
with respect to admission and discharge of 
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an individual (and may be submitted more 
frequently as the Secretary determines ap-
propriate). 
‘‘(ii) STANDARDIZED
PATIENT
AS-
SESSMENT
DATA
DESCRIBED.—For pur-
poses of clause (i), the standardized pa-
tient assessment data described in this 
clause, with respect to a psychiatric hos-
pital or psychiatric unit, is data with re-
spect to the following categories: 
‘‘(I) Functional status, such as 
mobility and self-care at admission to 
a psychiatric hospital or unit and be-
fore discharge from a psychiatric hos-
pital or unit. 
‘‘(II) Cognitive function, such as 
ability to express ideas and to under-
stand, and mental status, such as de-
pression and dementia. 
‘‘(III) Special services, treat-
ments, and interventions for psy-
chiatric conditions. 
‘‘(IV) Medical conditions and co- 
morbidities, such as diabetes, conges-
tive heart failure, and pressure ulcers. 
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‘‘(V) Impairments, such as incon-
tinence and an impaired ability to 
hear, see, or swallow. 
‘‘(VI) Other categories as deter-
mined appropriate by the Secretary. 
‘‘(iii) STANDARDIZED ASSESSMENT IN-
STRUMENT.— 
‘‘(I) IN GENERAL.—For purposes 
of clause (i), the Secretary shall im-
plement a standardized assessment in-
strument that provides for the sub-
mission of standardized patient as-
sessment data under this title with re-
spect to psychiatric hospitals and psy-
chiatric units which enables compari-
son of such assessment data across all 
such hospitals and units to which such 
data are applicable. 
‘‘(II) FUNDING.—The Secretary 
shall provide for the transfer, from 
the Federal Hospital Insurance Trust 
Fund under section 1817 to the Cen-
ters for Medicare & Medicaid Services 
Program Management Account, of 
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$10,000,000 for purposes of carrying 
out subclause (I).’’; and 
(D) in subparagraph (F), as redesignated 
by subparagraph (B) of this paragraph, by 
striking ‘‘subparagraph (C)’’ and inserting 
‘‘subparagraphs (C) and (F)’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(6) ADDITIONAL CONSIDERATIONS FOR DIAG-
NOSIS-RELATED GROUP CLASSIFICATIONS.— 
‘‘(A) IN
GENERAL.—Notwithstanding the 
preceding paragraphs of this subsection (other 
than paragraph (5)) or section 124 of the Medi-
care, Medicaid, and SCHIP Balanced Budget 
Refinement Act of 1999, beginning not later 
than rate year 2031, in addition to any revi-
sions pursuant to paragraph (5), the Secretary 
shall, by regulation, implement revisions to the 
methodology for determining the payment rates 
under the system described in paragraph (1) for 
psychiatric hospitals and psychiatric units, as 
the Secretary determines to be appropriate, to 
take into account the patient assessment data 
described in paragraph (4)(E)(ii). 
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‘‘(B) BUDGET NEUTRALITY.—Revisions in 
payment implemented pursuant to subpara-
graph (A) for a rate year shall result in the 
same estimated amount of aggregate expendi-
tures under this title for psychiatric hospitals 
and psychiatric units furnished in the rate year 
as would have been made under this title for 
such care in such rate year if such revisions 
had not been implemented.’’. 
Æ 
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