instruction:
In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preserving Rehabilitation Innovation 
Centers Act of 2016''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) In the United States, there are an estimated 1,181 
        inpatient rehabilitation facilities. Among these facilities is 
        a small group of inpatient rehabilitation institutions that are 
        contributing to the future of rehabilitation care medicine, as 
        well as to patient recovery, scientific innovation, and quality 
        of life.
            (2) This unique category of inpatient rehabilitation 
        institutions treats the most complex patient conditions, such 
        as traumatic brain injury, stroke, spinal cord injury, 
        childhood disease, burns, and wartime injuries.
            (3) These leading inpatient rehabilitation institutions are 
        all not-for-profit or Government-owned institutions and serve a 
        high volume of Medicare or Medicaid beneficiaries.
            (4) These leading inpatient rehabilitation institutions 
        have been recognized by the Federal Government for their 
        contributions to cutting-edge research to develop solutions 
        that enhance quality of care, improve patient outcomes, and 
        reduce health care costs.
            (5) These leading inpatient rehabilitation institutions 
        help to improve the practice and standard of rehabilitation 
        medicine across the Nation in urban, suburban, and rural 
        communities by training physicians, medical students, and other 
        clinicians, and providing care to patients from all 50 States.
            (6) It is vital that these leading inpatient rehabilitation 
        institutions are supported so they can continue to lead the 
        Nation's efforts to--
                    (A) advance integrated, multidisciplinary 
                rehabilitation research;
                    (B) provide cutting-edge medical care to the most 
                complex rehabilitation patients;
                    (C) serve as education and training facilities for 
                the physicians, nurses, and other health professionals 
                who serve rehabilitation patients;
                    (D) ensure Medicare and Medicaid beneficiaries 
                receive state-of-the-art, high-quality rehabilitation 
                care by developing and disseminating best practices and 
                advancing the quality of care utilized by post-acute 
                providers in all 50 States; and
                    (E) support other inpatient rehabilitation 
                institutions in rural areas to help ensure access to 
                quality post-acute care for patients living in these 
                communities.

SEC. 3. STUDY AND REPORT RELATING TO THE COSTS INCURRED BY, AND THE 
              MEDICARE PAYMENTS MADE TO, REHABILITATION INNOVATION 
              CENTERS.

    (a) In General.--Section 1886(j) of the Social Security Act (42 
U.S.C. 1395ww(j)) is amended--
            (1) by redesignating paragraph (8) as paragraph (9); and
            (2) by inserting after paragraph (7) the following new 
        paragraph:
            ``(8) Study and report relating to the costs incurred by, 
        and the medicare payments made to, rehabilitation innovation 
        centers.--
                    ``(A) Study.--The Secretary shall conduct a study 
                to assess the costs incurred by rehabilitation 
                innovation centers (as defined in subparagraph (C)) 
                that are beyond the prospective rate for each of the 
                following activities:
                            ``(i) Furnishing items and services to 
                        individuals under this title.
                            ``(ii) Conducting research.
                            ``(iii) Providing medical training.
                    ``(B) Report.--Not later than July 1, 2019, the 
                Secretary shall submit to Congress a report containing 
                the results of the study under subparagraph (A), 
                together with recommendations for such legislation and 
                administrative action as the Secretary determines 
                appropriate.
                    ``(C) Rehabilitation innovation center defined.--
                            ``(i) In general.--In this paragraph, the 
                        term `rehabilitation innovation center' means a 
                        rehabilitation facility that, determined as of 
                        the date of the enactment of this paragraph, is 
                        described in clause (ii) or clause (iii).
                            ``(ii) Not-for-profit.--A rehabilitation 
                        facility described in this clause is a facility 
                        that--
                                    ``(I) is classified as a not-for-
                                profit entity under the IRF Rate 
                                Setting File for the Correction Notice 
                                for the Inpatient Rehabilitation 
                                Facility Prospective Payment System for 
                                Federal Fiscal Year 2012 (78 Fed. Reg. 
                                59256);
                                    ``(II) holds at least one Federal 
                                rehabilitation research and training 
                                designation for research projects on 
                                traumatic brain injury, spinal cord 
                                injury, or stroke rehabilitation 
                                research from the Rehabilitation 
                                Research and Training Centers or the 
                                Rehabilitation Engineering Research 
                                Center at the National Institute on 
                                Disability and Rehabilitation Research 
                                at the Department of Education, based 
                                on such data submitted to the Secretary 
                                by a facility, in a form, manner, and 
                                time frame specified by the Secretary;
                                    ``(III) has a minimum Medicare case 
                                mix index of 1.1144 for fiscal year 
                                2012 according to the IRF Rate Setting 
                                File described in subclause (I); and
                                    ``(IV) had at least 300 Medicare 
                                discharges or at least 200 Medicaid 
                                discharges in a prior year as 
                                determined by the Secretary.
                            ``(iii) Government-owned.--A rehabilitation 
                        facility described in this clause is a facility 
                        that--
                                    ``(I) is classified as a 
                                Government-owned institution under the 
                                IRF Rate Setting File described in 
                                clause (ii)(I);
                                    ``(II) holds at least one Federal 
                                rehabilitation research and training 
                                designation for research projects on 
                                traumatic brain injury, spinal cord 
                                injury, or stroke rehabilitation 
                                research from the Rehabilitation 
                                Research and Training Centers, the 
                                Rehabilitation Engineering Research 
                                Center, or the Model Spinal Cord Injury 
                                Systems at the National Institute on 
                                Disability and Rehabilitation Research 
                                at the Department of Education, based 
                                on such data submitted to the Secretary 
                                by a facility, in a form, manner, and 
                                time frame specified by the Secretary;
                                    ``(III) has a minimum Medicare case 
                                mix index of 1.1144 for 2012 according 
                                to the IRF Rate Setting File described 
                                in clause (ii)(I); and
                                    ``(IV) has a Medicare 
                                disproportionate share hospital (DSH) 
                                percentage of at least 0.6300 according 
                                to the IRF Rate Setting File described 
                                in clause (ii)(I)).''.

            Passed the Senate December 10 (legislative day, December 
      9), 2016.

            Attest:

                                                             Secretary.
114th CONGRESS

  2d Session

                                S. 1168

_______________________________________________________________________

                                 AN ACT

 To amend title XVIII of the Social Security Act to preserve access to 
     rehabilitation innovation centers under the Medicare program.
answer:
Preserving Rehabilitation Innovation Centers Act of 2016 This bill amends title XVIII (Medicare) of the Social Security Act to direct the Department of Health and Human Services to conduct a study to assess the costs incurred by rehabilitation innovation centers that are beyond the prospective rates for each of the following activities: (1) furnishing items and services to individuals under Medicare; (2) conducting research; and (3) providing medical training.


question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Emergency Room Relief Act 
of 2017''.

SEC. 2. COVERAGE OF URGENT CARE AND EMERGENCY ROOM TREATMENT OF 
              VETERANS BY THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) Payment of Reasonable Costs of Urgent Care.--
            (1) In general.--Subchapter III of chapter 17 of title 38, 
        United States Code, is amended by inserting after section 1725 
        the following new section:
``Sec. 1725A. Payment of reasonable costs of urgent care
    ``(a) In General.--The Secretary shall enter into contracts with 
urgent care providers under which the Secretary pays the urgent care 
provider the reasonable costs of urgent care provided to eligible 
veterans by the urgent care provider.
    ``(b) Eligible Veterans.--A veteran is an eligible veteran for 
purposes of this section if the veteran--
            ``(1) is enrolled in the system of annual patient 
        enrollment established and operated under section 1705(a) of 
        this title; and
            ``(2) has received health care under this chapter during 
        the two-year period preceding the date on which the veteran 
        receives urgent care under this section.
    ``(c) Cost Sharing.--(1) Except as provided in paragraph (2), the 
Secretary shall establish a cost-sharing amount that eligible veterans 
shall pay to the Secretary to receive urgent care from an urgent care 
provider under this section.
    ``(2) The cost-sharing amount established under paragraph (1) shall 
not apply to an eligible veteran--
            ``(A) if the eligible veteran is admitted to a hospital for 
        treatment or observation after receiving urgent care under this 
        section; or
            ``(B) if the eligible veteran is receiving urgent care 
        under this section for the treatment of a service-connected 
        disability or condition.
    ``(d) Treatment of Department.--Notwithstanding the coverage of an 
eligible veteran under a health-plan contract, the Secretary shall be 
considered the primary payer for any urgent care provided to the 
eligible veteran under this section.
    ``(e) Types of Providers.--The Secretary shall ensure that all 
types of urgent care providers, including local urgent care providers, 
have an opportunity to enter into a contract with the Secretary under 
this section.
    ``(f) Definitions.--In this section:
            ``(1) The term `health-plan contract' has the meaning given 
        that term in section 1725(f) of this title.
            ``(2) The term `urgent care' has the meaning given that 
        term by the Secretary.
            ``(3) The term `urgent care provider' means a health care 
        provider that provides urgent care at a non-Department 
        facility.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 17 of such title is amended by inserting 
        after the item relating to section 1725 the following new item:

``1725A. Payment of reasonable costs of urgent care.''.
            (3) Sense of congress.--It is the sense of Congress that 
        the Secretary of Veterans Affairs is encouraged to contract 
        with urgent care centers that are accredited by a nationally 
        recognized accrediting body or organization to carry out 
        section 1725A of title 38, United States Code, as added by 
        paragraph (1).
    (b) Establishment of Cost-Sharing Amount for Veterans Receiving 
Emergency Room Care From Department.--
            (1) In general.--Except as provided in paragraph (2), the 
        Secretary of Veterans Affairs shall establish a cost-sharing 
        amount that veterans shall pay to the Secretary to receive care 
        at an emergency room of the Department of Veterans Affairs.
            (2) Exception.--The cost-sharing amount established under 
        paragraph (1) shall not apply to a veteran if the veteran--
                    (A) receives care for a service-connected (as 
                defined in section 101 of title 38, United States Code) 
                disability or condition;
                    (B) meets a hardship exception established by the 
                Secretary for purposes of this subsection; or
                    (C) is admitted to a hospital for treatment or 
                observation after receiving care at an emergency room 
                of the Department.
    (c) Limitation on Cost-Sharing Amounts.--The Secretary of Veterans 
Affairs may not require a veteran to pay multiple cost-sharing amounts 
if the veteran seeks urgent care under section 1725A of title 38, 
United States Code, as added by subsection (a)(1), and care at an 
emergency room of the Department of Veterans Affairs for the same 
condition during a period determined by the Secretary for purposes of 
this subsection.
    (d) Report on Use by Veterans of Urgent and Emergency Room Care.--
Not later than two years after the date of the enactment of this Act, 
and not less frequently than once every two years thereafter, the 
Secretary of Veterans Affairs shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report on the use by veterans 
eligible for health care under the laws administered by the Secretary 
of--
            (1) urgent care facilities; and
            (2) emergency room facilities of the Department of Veterans 
        Affairs.
answer:
Veterans Emergency Room Relief Act of 2017 This bill directs the Department of Veterans Affairs (VA) to enter into contracts under which the VA pays health care providers the reasonable costs of urgent care provided to eligible veterans at non-VA facilities. An &quot;eligible veteran&quot; is one who: (1) is enrolled in the VA health care system, and (2) has received health care through the VA during the two years preceding the date on which the veteran receives urgent care. The VA shall establish a cost-sharing amount that a veteran shall pay to the VA to receive such urgent care. Such amount shall not apply to a veteran who: (1) is admitted to a hospital for treatment or observation after receiving urgent care, or (2) is receiving urgent care for the treatment of a service-connected disability or condition.  The VA shall: (1) be considered the primary payer for the urgent care provided, and (2) ensure that all types of urgent care providers have an opportunity to enter into such a contract.  The VA also shall establish a cost-sharing amount that veterans shall pay to receive care at a VA emergency room. Such amount shall not apply to a veteran who: (1) is receiving care for a service-connected disability or condition, (2) meets a hardship exception, or (3) is admitted to a hospital for treatment or observation after receiving care at a VA emergency room.  The VA may not require a veteran to pay multiple cost-sharing amounts if the veteran seeks urgent care under this bill and care at a VA emergency room for the same condition during a period determined by the VA.  The VA shall report every two years on the use by veterans of urgent care facilities and of VA emergency room facilities.


question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Fuel Efficiency Energy Act of 
2007''.

SEC. 2. DEFINITIONS.

    (a) Automobile.--Section 32901(a)(3) of title 49, United States 
Code, is amended--
            (1) by striking ``4-wheeled''; and
            (2) by striking ``, and rated at--'' and all that follows 
        and inserting a period.
    (b) Medium-Duty Truck.--Section 32901(a) of such title is amended--
            (1) by redesignating paragraphs (14), (15), and (16) as 
        paragraphs (15), (16), and (17), respectively; and
            (2) by inserting after paragraph (13) the following:
            ``(14) `medium-duty truck' means a truck (as defined in 
        section 30127) with a gross vehicle weight between 10,000 and 
        26,000 pounds.''.
    (c) Passenger Automobile.--Section 32901(a)(17) of such title, as 
redesignated by subsection (b)(1), is amended by striking ``decides by 
regulation--'' and all that follows through the period and inserting 
``determines by regulation, to have a significant feature (except 4-
wheel drive) designed for off-highway operation.''.
    (d) Fuel Economy Information.--Section 32908(a) of such title is 
amended--
            (1) in the subsection heading, by striking ``Definitions'' 
        and inserting ``Definition''; and
            (2) by striking ``section--'' and all that follows through 
        ``(2)'' and inserting ``section, the term''.

SEC. 3. ANNUAL INCREASE IN AVERAGE FUEL ECONOMY STANDARDS.

    (a) Fuel Efficiency Standards.--
            (1) In general.--Section 32902 of title 49, United States 
        Code, is amended by striking subsections (a) through (c) and 
        inserting the following:
    ``(a) In General.--Not later than 18 months before the beginning of 
each model year beginning with model year 2012, the Secretary of 
Transportation, shall prescribe, by regulation, average fuel economy 
standards for automobiles manufactured by a manufacturer for that model 
year in accordance with subsection (b). The Secretary of Transportation 
shall prescribe separate average fuel economy standards for different 
classes of automobiles. The Secretary shall establish average fuel 
economy standards for medium-duty trucks that are consistent with the 
projected benefits of hybridization.
    ``(b) Annual Increases in Fuel Economy Standards.--
            ``(1) For model year 2012.--For model year 2012, the 
        average fuel economy standard for each class of automobiles 
        shall be the average combined highway and city miles per gallon 
        performance of all automobiles within that class of automobiles 
        in 2011 (rounded to the nearest \1/10\ mile per gallon).
            ``(2) For model years after model year 2012.--For each 
        model year beginning with model year 2013 and ending with model 
        year 2030, the average fuel economy attained by the fleet of 
        automobiles manufactured or sold in the United States shall be 
        at least 4 percent greater than the average fuel economy 
        standard for the fleet in the previous model year (rounded to 
        the nearest \1/10\ mile per gallon).
    ``(c) Amending Fuel Economy Standards.--
            ``(1) In general.--Notwithstanding subsections (a) and (b), 
        the Secretary of Transportation may prescribe an average fuel 
        economy standard for a class of automobiles in a model year 
        that is lower than the standard required under subsection (b) 
        if the Secretary of Transportation, in consultation with the 
        National Academy of Sciences, determines that the average fuel 
        economy standard prescribed in accordance with subsections (a) 
        and (b) for that class of automobiles in that model year--
                    ``(A) is not technologically achievable;
                    ``(B) cannot be achieved without materially 
                reducing the overall safety of automobiles manufactured 
                or sold in the United States and no offsetting safety 
                improvements can be practicably implemented for that 
                model year; or
                    ``(C) is shown not to be cost effective.
            ``(2) Maximum standard.--Any average fuel economy standard 
        prescribed for a class of automobiles in a model year under 
        paragraph (1) shall be the maximum standard that--
                    ``(A) is technologically achievable;
                    ``(B) can be achieved without materially reducing 
                the overall safety of automobiles manufactured or sold 
                in the United States; and
                    ``(C) is cost effective.
            ``(3) Considerations in determination of cost 
        effectiveness.--In determining cost effectiveness under 
        paragraph (1)(C), the Secretary of Transportation shall take 
        into account the total value to the United States of reduced 
        petroleum use, including the value of reducing external costs 
        of petroleum use, using a value for such costs equal to 50 
        percent of the value of 1 gallon of gasoline saved or the 
        amount determined in an analysis of the external costs of 
        petroleum use that considers--
                    ``(A) value to consumers;
                    ``(B) economic security;
                    ``(C) national security;
                    ``(D) foreign policy;
                    ``(E) the impact of oil use--
                            ``(i) on sustained cartel rents paid to 
                        foreign suppliers;
                            ``(ii) on long-run potential gross domestic 
                        product due to higher normal-market oil price 
                        levels, including inflationary impacts;
                            ``(iii) on import costs, wealth transfers, 
                        and potential gross domestic product due to 
                        increased trade imbalances;
                            ``(iv) on import costs and wealth transfers 
                        during oil shocks;
                            ``(v) on macroeconomic dislocation and 
                        adjustment costs during oil shocks;
                            ``(vi) on the cost of existing energy 
                        security policies, including the management of 
                        the Strategic Petroleum Reserve;
                            ``(vii) on the timing and severity of the 
                        oil peaking problem;
                            ``(viii) on the risk, probability, size, 
                        and duration of oil supply disruptions;
                            ``(ix) on the strategic behavior of the 
                        Organization of the Petroleum Exporting 
                        Countries and long-run oil pricing;
                            ``(x) on the short term elasticity of 
                        energy demand and the magnitude of price 
                        increases resulting from a supply shock;
                            ``(xi) on oil imports, military costs, and 
                        related security costs, including intelligence, 
                        homeland security, sea lane security and 
                        infrastructure, and other military activities;
                            ``(xii) on oil imports, diplomatic and 
                        foreign policy flexibility, and connections to 
                        geopolitical strife, terrorism, and 
                        international development activities;
                            ``(xiii) all relevant environmental hazards 
                        under the jurisdiction of the Environmental 
                        Protection Agency; and
                            ``(xiv) on well-to-wheels urban and local 
                        air emissions of pollutants and their 
                        uninternalized costs;
                    ``(F) the impact of the oil or energy intensity of 
                the United States economy on the sensitivity of the 
                economy to oil price changes, including the magnitude 
                of gross domestic product losses in response to short 
                term price shocks or long term price increases;
                    ``(G) the impact of United States payments for oil 
                imports on political, economic, and military 
                developments in unstable or unfriendly oil-exporting 
                countries;
                    ``(H) the uninternalized costs of pipeline and 
                storage oil seepage, and for risk of oil spills from 
                production, handling, and transport, and related 
                landscape damage; and
                    ``(I) additional relevant factors, as determined by 
                the Secretary.
            ``(4) Minimum valuation.--When considering the value to 
        consumers of a gallon of gasoline saved, the Secretary of 
        Transportation may not use a value less than the greatest of--
                    ``(A) the average national cost of a gallon of 
                gasoline sold in the United States during the 12-month 
                period ending on the date on which the new fuel economy 
                standard is proposed;
                    ``(B) the most recent weekly estimate by the Energy 
                Information Administration of the Department of Energy 
                of the average national cost of a gallon of gasoline 
                (all grades) sold in the United States; and
                    ``(C) the gasoline prices projected by the Energy 
                Information Administration for the 20-year period 
                beginning in the year following the year in which the 
                standards are established.''.
            (2) Conforming amendments.--Title 49, United States Code, 
        is amended--
                    (A) in section 32902--
                            (i) in subsection (d) by striking 
                        ``subsection (b) or (c) of this section'' and 
                        inserting ``subsection (a), (b), or (c)'';
                            (ii) by striking subsection (f);
                            (iii) in subsection (g)--
                                    (I) by striking ``subsection (a) or 
                                (d)'' and inserting ``this section''; 
                                and
                                    (II) by striking ``(and submit the 
                                amendment to Congress when required 
                                under subsection (c)(2) of this 
                                section)''; and
                            (iv) in subsection (h) by striking 
                        ``subsections (c), (f), and (g) of this 
                        section'' and inserting ``subsections (c) and 
                        (g)'';
                    (B) in section 32903--
                            (i) by striking ``section 32902(b)-(d) of 
                        this title'' each place it occurs and inserting 
                        ``subsections (a) through (d) of section 
                        32902''; and
                            (ii) in subsection (e), by striking 
                        ``section 32902(a) of this title'' and 
                        inserting ``subsections (a) through (d) of 
                        section 32902''; and
                    (C) in section 32904--
                            (i) in subsection (a)--
                                    (I) by striking ``subject to--'' 
                                and all that follows through ``(B) 
                                section 32902(a)-(d) of this title'' 
                                and inserting ``subject to subsections 
                                (a) through (d) of section 32902''; and
                                    (II) by redesignating clauses (i) 
                                and (ii) as subparagraphs (A) and (B), 
                                respectively.
    (b) Repeal of Credit for Dual Fueled Automobiles.--
            (1) In general.--Section 32905 of title 49, United States 
        Code, is amended--
                    (A) by amending subsection (b) to read as follows:
    ``(b) Dual Fueled Automobiles.--The Administrator of the 
Environmental Protection Agency shall measure the fuel economy for any 
model of dual fueled automobile manufactured in model year 2012 and any 
model year thereafter, in accordance with section 32904.''; and
                    (B) by amending subsection (d) to read as follows:
    ``(d) Gaseous Fuel Dual Fueled Automobiles.--The Administrator of 
the Environmental Protection Agency shall measure the fuel economy for 
any model of gaseous fuel dual fueled automobile manufactured in model 
year 2012 and any model year thereafter, in accordance with section 
32904.''.
            (2) Conforming amendments.--Section 32905 of such title is 
        further amended--
                    (A) by striking subsection (f); and
                    (B) redesignating subsections (g) and (h) as 
                subsections (f) and (g), respectively.

SEC. 4. REQUIREMENT TO INCREASE PERCENTAGE OF DUAL FUELED AUTOMOBILES.

    Section 32902 of title 49, United States Code, as amended by 
section 3, is further amended by inserting after subsection (e) the 
following:
    ``(f) Requirement for Annual Increase in Duel Fueled Automobiles.--
Each manufacturer shall ensure that the percentage of automobiles 
manufactured by such manufacturer in each of model years 2012 through 
2022 that are dual fueled automobiles is not less than 10 percent 
greater than the percentage of automobiles manufactured by such 
manufacturer in the previous model year that are dual fueled 
automobiles.''.

SEC. 5. EFFECTIVE DATE.

    The amendments made by this Act shall--
            (1) take effect on January 1, 2010; and
            (2) apply to automobiles manufactured for model year 2012 
        and for each subsequent model year.
answer:

Fuel Efficiency Energy Act of 2007 - Amends corporate average fuel economy (CAFE) provisions to revise the definition of: (1) "automobile" to mean any vehicle that is propelled by fuel, or by alternative fuel, and is manufactured primarily for use on public streets, roads, and highways (currently, four-wheeled vehicles that are so propelled and manufactured for such use and that are up to 6,000 pounds and certain vehicles between 6,000 and 10,000 pounds); and (2) "passenger automobile" to eliminate the exception for 4-wheel drive automobiles and vehicles weighing more than 6,000 pounds. Defines "medium-duty truck" as a truck with a gross vehicle weight between 10,000 and 26,000 pounds.

Requires the Secretary of Transportation to: (1) prescribe separate increased minimum CAFE standards for different classes of automobiles manufactured beginning for model year 2012, but adds an increase of 4% per year in such standard for model years 2013 through 2030; and (2) establish CAFE standards for medium-duty trucks that are consistent with hybridization beginning for model year 2012.

Revises the calculation of fuel economy standards for dual fueled automobiles and gaseous fuel dual fueled automobiles manufactured in model year 2012 and beyond to require using the same calculation provisions as used for gas or diesel fueled vehicles. Repeals provisions allowing the Department of Transportation (DOT) to extend manufacturing credits for such automobiles.