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Problem:SECTION 1. SHORT TITLE.

This Act may be cited as the ''MRSA Infection Prevention and
Patient Protection Act''.

SEC. 2. DEFINITIONS.

In this Act:
(1) Acute care hospital.--The term ''acute care hospital''
means a hospital that maintains and operates an emergency room
(including a trauma or burn center), surgical unit, birthing
facility, and such other unit that is highly susceptible to
acquiring or transmitting infections, as determined by the
Secretary through regulations.
(2) Hospital.--The term ''hospital'' has the meaning given
such term in section 1861(e) of the Social Security Act (42
U.S.C. 1395x(e)) and includes critical access hospitals (as
defined in section 1861(mm) of such Act) and other entities
determined to be hospitals by the Secretary.
(3) MRSA.--The term ''MRSA'' means Methicillin-resistant
Staphylococcus aureus.
(4) Other infection.--The term ''other infection'' means an
infection that the Secretary, after consultation with the
Director of the Centers for Disease Control and Prevention and
other public health officials, as appropriate, and after public
hearing, determines to be, or to have the potential to become,
a serious source of morbidity and mortality in health care
facilities.
(5) Secretary.--The term ''Secretary'' means the Secretary
of Health and Human Services.

SEC. 3. HOSPITAL INFECTION PREVENTION PROGRAMS.

(a) Regulations.--
(1) In general.--Not later than 150 days after the date of
enactment of this Act, the Secretary, in consultation with the
Director of the Centers for Disease Control and Prevention and
such independent experts as the Secretary determines
appropriate, shall promulgate regulations that--
(A) provide a list of best practices for preventing
MRSA infections and such other antibiotic resistant
pathogens as the Secretary determines appropriate;
(B) define the term ''high risk hospital
departments'' for purposes of applying the best
practices provided for under subparagraph (A), which
may include surgical, burn, neonatal, and such other
departments as the Secretary determines;
(C) define the term ''serious source of morbidity
and mortality'' in quantitative terms for purposes of
determining the applicability of this Act to other
infections, except that such definition shall not
require morbidity and mortality rates of more than 1
percent of the estimated patient population at risk for
a particular infection in order for an infection to
qualify as a serious source of morbidity and mortality;
and
(D) provide screening, recordkeeping, and other
requirements as they relate to reductions in MRSA
infections.
(2) Consistency.--The regulations promulgated under this
subsection shall be consistent with the requirements of this
Act.
(3) Effective date.--The regulations promulgated under
paragraph (1) shall take effect on the date that is 30 days
after the date on which such regulations are published in the
Federal Register, but in no case later than 180 days after the
date of enactment of this Act.
(b) Screening Requirements.--
(1) In general.--Not later than 180 days after the date of
enactment of this Act, each acute care hospital shall screen
each patient entering an intensive care unit or other high risk
hospital department (as defined in the regulations promulgated
under subsection (a)(1)(B)).
(2) Extension of requirements.--
(A) In general.--The Secretary, in consultation
with the Director of the Centers for Disease Control
and Prevention, shall establish a process and a
timetable for extending the screening requirements of
paragraph (1) to all patients admitted to all
hospitals.
(B) Requirements fully applied.--The timetable
established under subparagraph (A), shall require that
all patients be covered by the screening requirements
under paragraph (1) by not later than January 1, 2014.
(C) Waiver.--The Secretary may waive the
requirements of this paragraph if the Secretary
determines, at the recommendation of the Director of
the Centers for Disease Control and Prevention and
after public hearing, that the rate of MRSA infections
or other infections has declined to a level at which
further screening is no longer needed.
(3) Medicare.--
(A) Requirement.--
(i) In general.--Section 1866(a)(1) of the
Social Security Act (42 U.S.C. 1395cc(a)(1)) is
amended--
(I) by striking ''and'' at the end
of subparagraph (U);
(II) by striking the period at the
end of subparagraph (V) and inserting
'', and''; and
(III) by inserting after
subparagraph (V) the following:
''(W) in the case of an acute care hospital (as defined in
section 2(1) of the MRSA Infection Prevention and Patient
Protection Act), to comply with the screening requirements
described in section 3 of such Act.''.
(ii) Effective date.--The amendments made
by clause (i) shall apply to agreements entered
into or renewed on or after the date that is
180 days after the enactment of this Act.
(B) Medicare payment adjustments.--Not later than
January 1, 2011, the Secretary shall submit to the
appropriate committees of Congress, a report on whether
payment adjustments should be made under title XVIII of
the Social Security Act (42 U.S.C. 1395 et seq.) to
assist certain hospitals in defraying the cost of
screening for, and the subsequent treatment of, MRSA
infections (or other infections). In preparing such
report, the Secretary shall give special consideration
to the needs of rural, critical access, sole community,
and Medicare dependent hospitals, and disproportionate
share hospitals and other hospitals with a
disproportionate share of immune compromised patients.
(c) Best Practices.--In addition to any other best practices
contained in the regulations promulgated under subsection (a)(1)(A),
each hospital shall comply with the following:
(1) A hospital shall require contact (barrier) precautions,
as determined by the Secretary, be taken when treating patients
who test positive for MRSA colonization (as defined by the
Centers for Disease Control and Prevention).
(2) Where possible, a hospital shall--
(A)(i) isolate, with the same staffing ratio per
bed as in the non-isolated beds of the hospital, or
cohort patients colonized or infected with MRSA; or
(ii) notify any patients with whom the
infected patient may room that such patient has
tested positive for MRSA;
(B) control and monitor the movements of such
patients within the hospital; and
(C) take whatever steps are needed to stop the
transmission of MRSA bacteria to patients who did not
come into the hospital infected or colonized with such
bacteria.
The Secretary may suspend the application of this paragraph in
the case of an emergency.
(3) All patients who test positive for MRSA shall be
informed of the results. All MRSA test results shall be noted
in the patient's medical record.
(4) Each hospital shall, by January 1, 2010, adopt a policy
requiring any patient who has a MRSA infection to receive oral
and written instructions regarding aftercare and precautions to
prevent the spread of the infection to others.
(5) Patients being discharged from intensive care units
shall be tested again for MRSA, and those patients testing
positive shall be informed of their status, and that status
shall be noted in the patient's medical records in case of
readmittance to a hospital.
(6) A hospital shall educate its staff concerning modes of
transmission of MRSA, use of protective equipment, disinfection
policies and procedures, and other preventive measures.
(7) A hospital shall provide other interventions, as the
Secretary determines to be necessary, for control of MRSA
infection.
(d) Reporting.--
(1) In general.--Not later than January 1, 2011, each
hospital shall, using the National Healthcare Safety Network of
the Centers for Disease Control and Prevention, report
hospital-acquired MRSA and other infections that occur in the
hospital facility. The Secretary shall develop a process for
the risk adjustment of such reports by hospitals.
(2) Publication.--The Secretary shall develop a system for
the publication of hospital-specific infection rates, including
the rate of MRSA infections.
(e) Non-Hospital Medicare Providers.--
(1) MRSA infection reporting.--The Secretary, using the
MRSA infection and other infection information identified under
subsection (b) and such other billing and coding information as
necessary, shall promulgate regulations to--
(A) define the term ''infected transferred
patient'', to describe a patient who, after discharge
from, or treatment at, a non-hospital Medicare
provider, is admitted to the hospital with MRSA
infection (or other infection);
(B) establish a system for identifying infected
transferred patients;
(C) establish a system to promptly inform any
facility that has transferred an infected patient; and
(D) establish requirements that any non-hospital
Medicare provider that treats an infected transferred
patient described under subparagraph (A) and that
cannot provide a reasonable explanation that the
infection was not acquired in the facility, submit to
the Secretary an action plan describing how such
provider plans to reduce the incidence of such
infections.
(2) Assistance.--The Secretary shall promulgate regulations
to develop a program to provide technical assistance and
educational materials to non-hospital Medicare providers
described in paragraph (1)(A) in order to assist in preventing
subsequent MRSA infections.
(3) Publication of certain information.--If a non-hospital
Medicare provider identified using the system established under
paragraph (1) fails to take steps, as required by the
regulations promulgated under subparagraph (1)(D), to combat
MRSA infections, the Secretary shall publish the name of the
provider and the number of MRSA infections from such provider
in the previous year.
(f) Assistance.--
(1) In general.--To provide for the rapid implementation of
MRSA screening programs and initiatives through the
installation of certified MRSA screening equipment and the
provision of necessary support services, a hospital may submit
an application to the Secretary for a 1-year increase in the
amount of the capital-related costs payment made to the
hospital under the prospective payment system under section
1886(g) of the Social Security Act (42 U.S.C. 1395ww(g)). The
Secretary shall approve all requests that the Secretary
determines are reasonable and necessary.
(2) Repayment.--A hospital that receives an increase under
paragraph (1) shall, not later than 4 years after the date of
receipt of such increase, reimburse the Secretary for the costs
of such increase. Such costs shall include the accrual of
interest at the rate payable for Federal Treasury notes. Such
reimbursement may be in the form of reduced capital-related
costs payments to the hospital under the system described in
paragraph (1) for the years following the year in which the
increase was received.
(3) Certification system.--Not later than 180 days after
the date of enactment of this Act, the Secretary shall
promulgate regulations for the development of a system to
certify appropriate MRSA screening and support services for
purposes of this subsection.

SEC. 4. MRSA TESTING PILOT PROGRAM.

(a) In General.--The Director of the Centers for Disease Control
and Prevention (referred to in this section as the ''Director'') shall
award a grant to 1 collaborative project involving an eligible hospital
and qualified testing corporation on a competitive basis to carry out a
pilot program designed to develop a rapid, cost-effective method for
testing for MRSA using the polymerase chain reaction (referred to in
this section as ''PCR'') or other molecular testing methods.
(b) Purpose.--The pilot program described in subsection (a) shall
be designed to--
(1) develop a low-cost, nationally adoptable PCR-based
analytical system for timely MRSA testing and results;
(2) develop the system described in paragraph (1) so that
it is affordable to hospitals, thereby enabling compliance with
mandated MRSA testing requirements;
(3) develop a system for centralized reporting of results
receiving through such testing to appropriate governmental
agencies for the purpose of disease reporting and surveillance;
and
(4) develop a technology platform that may be extended to
other infections that the Director identifies as priorities for
detection, treatment, and surveillance.
(c) Eligibility.--The Secretary shall establish requirements
regarding eligibility to receive a grant under this section, which
shall include the following requirements:
(1) The collaborate project shall be between a nonprofit
hospital organized for charitable purposes under section
501(c)(3) of the Internal Revenue Code of 1986 and a qualified
testing corporation.
(2) The hospital shall serve as the beta test site for any
MRSA screening methods developed through the pilot program.
Solution:
MRSA Infection Prevention and Patient Protection Act - Directs the Secretary of Health and Human Services (HHS) to promulgate regulations relating to MRSA (methicillin-resistant Staphylococcus aureus), including regulations that provide a list of best practices for preventing MRSA infections and such other antibiotic resistant pathogens as the Secretary determines appropriate.

Requires each acute care hospital to screen each patient entering an intensive care unit or other high-risk hospital department. Directs the Secretary to: (1) establish a process and a timetable for extending the screening requirements to patients admitted to all hospitals by January 1, 2014; and (2) report to Congress on whether payment adjustments should be made under Medicare to assist certain hospitals in defraying the cost of screening for, and the subsequent treatment of, MRSA or other infections.

Requires all hospitals to: (1) comply with specified MRSA best practices, including contact precautions and patient notification; and (2) report hospital-acquired MRSA and other infections that occur in the facility.

Requires the Secretary to: (1) establish systems for identifying infected transferred patients and for promptly informing any facility that has transferred an infected patient; and (2) publish the names of providers who fail to take steps to reduce the incidence of MRSA infections.

Permits a hospital to apply to the Secretary for a one-year increase in the amount of the capital-related costs payment made to the hospital under the prospective payment system to provide for the rapid implementation of MRSA screening programs and initiatives.

Requires the Director of the Centers for Disease Control and Prevention (CDC) to award a grant for a pilot program to develop a rapid, cost-effective method for testing for MRSA using a molecular testing method. .