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Committee on Ways and MeansIntroducedNovember 21st, 2013
- house Committees
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To amend title XVIII of the Social Security Act with respect to payments to long-term care hospitals, and for other purposes.
Directs the Secretary of Health and Human Services (HHS), in implementing special payment requirements for certain long-term care hospitals (LTCHs) and LTCH satellites under title XVIII (Medicare) of the Social Security Act, for a 12-month cost reporting period beginning on or after October 1, 2013, to continue the same 25% rule patient threshold payment adjustment and exemptions as were established for the 12-month cost reporting periods beginning on or after October 1, 2012, in the same manner as provided for in a specified rule published on August 31, 2012, regarding hospital inpatient prospective payment systems (IPPSs) for acute care hospitals and theLTCH prospective payment system and FY2013 rates. Prohibits the Secretary from applying such special payment requirements to certain grandfathered LTCHs which are subsection (d) hospitals. (Generally, a subsection (d) hospital is an acute care hospital, particularly one that receives payments under the Medicare IPPS when providing covered inpatient services to eligible beneficiaries.) Excludes from the calculation of such special payment requirements any Medicare beneficiaries who: (1) were inpatients in a subsection (d) hospital within one day before their admission to a LTCH which has an average inpatient length of stay of more than 25 days, and (2) had a stay of more than seven days in an intensive care unit. Declares that, for discharges occurring on or after October 1, 2014, payments made to such hospitals at amounts comparable or equivalent to amounts payable to a subsection (d) hospital for short stay patients and under the 25% rule shall be at amounts not less than what would be paid to a subsection (d) hospital had it performed the same services. Declares that, for discharges occurring on or after enactment of this Act, in calculating the length of stay requirement applicable to a LTCH or satellite facility, the Secretary shall exclude any patient for whom payment is based on an amount comparable or equivalent to that payable to a subsection (d) hospital had such a hospital provided the same service.