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Code · BILL · 114th Congress · H.R. 5713 (Referred in Senate) — To provide for the extension of certain long-term care hospital Medicare payment rules, clarify the application of ru... · Sec. 103

Sec. 103. Change in Medicare classification for certain hospitals

427 words·~2 min read·/bill/114/hr/5713/rfs/section-103

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Subsection (d)(1)(B) of section 1886 of the Social Security Act ( 42 U.S.C. 1395ww ) is amended— in clause (iv)— in subclause (I), by striking or at the end; in subclause (II)— by striking , or at the end and inserting a semicolon; by redesignating such subclause as clause
(vi)and by moving it to immediately follow clause (v); and in clause (v), by striking the semicolon at the end and inserting , or ; and by striking and inserting a hospital
(I). a hospital
(iv)The second sentence of subsection (d)(1)(B) of such section is amended— by inserting (as in effect as of such date) after clause
(iv); and by inserting (or, in the case of a hospital described in clause (iv)(II), as so in effect, shall be classified under clause
(vi)on and after the effective date of such clause
(vi)and for cost reporting periods beginning on or after January 1, 2015, shall not be subject to subsection
(m)as of the date of such classification) after so classified . For cost reporting periods beginning on or after January 1, 2015, in the case of an applicable hospital (as defined in paragraph (3)), the following shall apply: Payment for inpatient operating costs shall be made on a reasonable cost basis in the manner provided in section 412.526(c)(3) of title 42, Code of Federal Regulations (as in effect on January 1, 2015) and in any subsequent modifications. Payment for capital costs shall be made in the manner provided by section 412.526(c)(4) of title 42, Code of Federal Regulations (as in effect on such date). Claims for payment for Medicare beneficiaries who are discharged on or after January 1, 2017, shall be processed as claims which are paid on a reasonable cost basis as described in section 412.526(c) of title 42, Code of Federal Regulations (as in effect on such date). In this subsection, the term applicable hospital means a hospital that is classified under clause (iv)(II) of section 1886(d)(1)(B) of the Social Security Act ( 42 U.S.C. 1395ww(d)(1)(B) ) on the day before the date of the enactment of this Act and which is classified under clause
(vi)of such section, as redesignated and moved by subsection (a), on or after such date of enactment. Section 1899B(a)(2)(A)(iv) of the Social Security Act ( 42 U.S.C. 1395lll(a)(2)(A)(iv) ) is amended by striking 1886(d)(1)(B)(iv)(II) and inserting 1886(d)(1)(B)(vi) . Section 1886(m)(5)(F) of such Act ( 42 U.S.C. 1395ww(m)(5)(F) ) is amended in each of clauses
(i)and
(ii)by striking (d)(1)(B)(iv)(II) and inserting (d)(1)(B)(vi) .
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Sec. 103
Change in Medicare classification for certain hospitals
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