Securing Access to Care for Seniors in Critical Condition Act of 2022

Bill: 117-hr-9658
Sponsor: full_name: Rep. Hern, Kevin [R-OK-1]
Introduced: 2022-12-21
Policy area: Health
Latest action: action_date: 2022-12-21
text: Referred to the House Committee on Ways and Means.

Summaries:
action_date: 2022-12-21
action_desc: Introduced in House
text: <p><b>Securing Access to Care for Seniors in Critical Condition Act of 2022</b></p> <p>This bill exempts discharges from long-term care hospitals from the Medicare site-neutral payment rate if the discharge meets specified high acuity criteria and occurs on or after October 1, 2025. </p>

tv_txt: I 117th CONGRESS 2d Session H. R. 9658 IN THE HOUSE OF REPRESENTATIVES December 21, 2022 Mr. Hern introduced the following bill; which was referred to the Committee on Ways and Means A BILL To amend title XVIII of the Social Security Act to establish a new criterion for the nonapplication of site-neutral payments to long-term care hospitals under the Medicare program.

1. Short title This Act may be cited as the Securing Access to Care for Seniors in Critical Condition Act of 2022 . 2. Establishing a new criterion for the nonapplication of site-neutral payments to long-term care hospitals under the Medicare program Section 1886(m)(6)(A) of the Social Security Act ( 42 U.S.C. 1395ww(m)(6)(A) ) is amended— (1) by striking or the ventilator criterion under clause (iv) and inserting , the ventilator criterion under clause (iv), or the high acuity criterion described in clause (v) ; and (2) by adding at the end the following new clause: (v) High acuity criterion (I) In general The criterion specified in this clause (in this paragraph referred to as the high acuity criterion ) for a discharge from a long-term care hospital in a fiscal year is that— (aa) the individual discharged had a primary diagnosis assigned to a Medicare-Severity-Long-Term-Care-Diagnosis-Related-Group (MS–LTC–DRG) with a relative weight for such fiscal year that was equal to or greater than the specified amount for such fiscal year; and (bb) the discharge occurred on or after October 1, 2025. (II) Specified amount defined For purposes of subclause (I), the term specified amount means, with respect to a fiscal year, an amount equal to the 80th percentile of the relative weights for Medicare-Severity-Long-Term-Care-Diagnosis-Related-Groups that were assigned to primary diagnoses for all discharges occurring in the preceding fiscal year. .