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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. 104

Sec. 104. Temporary exception to the application of the Medicare LTCH site neutral provisions for certain spinal cord specialty hospitals

391 words·~2 min read·/bill/114/hr/5713/rfs/section-104

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Section 1886(m)(6) of the Social Security Act ( 42 U.S.C. 1395ww(m)(6) ) is amended— in subparagraph (A)(i), by striking and
(E)and inserting , (E), and
(F); and by adding at the end the following new subparagraph: For discharges in cost reporting periods beginning during fiscal years 2018 and 2019, subparagraph (A)(i) shall not apply (and payment shall be made to a long-term care hospital without regard to this paragraph) if such discharge is from a long-term care hospital that meets each of the following requirements: The long-term care hospital was a not-for-profit long-term care hospital on June 1, 2014, as determined by cost report data. Of the discharges in calendar year 2013 from the long-term care hospital for which payment was made under this section, at least 50 percent were classified under MS–LTCH–DRGs 28, 29, 52, 57, 551, 573, and 963. The long-term care hospital discharged inpatients (including both individuals entitled to, or enrolled for, benefits under this title and individuals not so entitled or enrolled) during fiscal year 2014 who had been admitted from at least 20 of the 50 States, determined by the States of residency of such inpatients and based on such data submitted by the hospital to the Secretary as the Secretary may require. Notwithstanding any other provision of law, the Secretary may implement subclause
(I)by program instruction or otherwise. Chapter 35 of title 44, United States Code, shall not apply to data collected under this clause. . The Comptroller General of the United States shall conduct a study on long-term care hospitals described in section 1886(m)(6)(F) of the Social Security Act, as added by subsection (a). Such report shall include an analysis of the following: The impact on such hospitals of the classification and facility licensure by State agencies of such hospitals. The Medicare payment rates for such hospitals. Data on the number and health care needs of Medicare beneficiaries who have been diagnosed with catastrophic spinal cord or acquired brain injuries or other paralyzing neuromuscular conditions (as described within the discharge classifications specified in clause
(ii)of such section) who are receiving services from such hospitals. Not later than October 1, 2018, the Comptroller General shall submit to Congress a report on the study conducted under paragraph (1), including recommendations for such legislation and administrative action as the Comptroller General determines appropriate.
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Sec. 104
Temporary exception to the application of the Medicare LTCH site neutral provisions for certain spinal cord specialty hospitals
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