3.0.0 3516 2019-11-15T21:43:19Z 2019-11-15T21:43:19Z House H HR 2011-11-29 112 From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]By Mr. MURPHY of Connecticut:H.R. 3516.Congress has the power to enact this legislation pursuantto the following:Article I, Section 8.[Page H7928]]]> hswm00 Ways and Means Committee House Standing hswm02 Health Subcommittee Referred to 2011-12-07T22:31:17Z Referred to 2011-11-29T19:02:35Z 2011-12-07 hswm02 Health Subcommittee 1 House committee actions Referred to the Subcommittee on Health. Committee 2011-11-29 Referred to the House Committee on Ways and Means. IntroReferral H11100 2 House floor actions hswm00 Ways and Means Committee 2011-11-29 Introduced in House IntroReferral Intro-H 9 Library of Congress 2011-11-29 Introduced in House IntroReferral 1000 9 Library of Congress M001169 Rep. Murphy, Christopher [D-CT-5] Christopher Murphy D CT S. 5 N L000557 Rep. Larson, John B. [D-CT-1] JOHN LARSON D CT B. 1 2011-11-29 True D000216 Rep. DeLauro, Rosa L. [D-CT-3] ROSA DELAURO D CT 3 2011-12-07 False M001143 Rep. McCollum, Betty [D-MN-4] BETTY MCCOLLUM D MN 4 2011-12-12 False Health Health facilities and institutions Hospital care Long-term, rehabilitative, and terminal care Medicare Health 00 2011-11-29 Introduced in House 2012-01-27T19:48:20Z Amends title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services (HHS), in making payment under the prospective payment system (PPS) to certain long-term care (LTC) hospitals for discharges in rate years beginning on and after October 1, 2011, to make payment adjustments for cases identified as: (1) meeting or exceeding the fixed high episode efficient case threshold, and (2) meeting or below the episode outlier case threshold.

Directs the Secretary to adopt rules which identify the predicted probability of those Medicare beneficiaries admitted as inpatients to LTC hospitals from a subsection (d) hospital for whom the payment for services received during an episode of hospital care is predicted to be less than if they had remained in the subsection (d) hospital (episode efficient cases).

(Generally, a subsection [d] hospital is an acute care hospital particularly one that receives payments under Medicare's inpatient PPS when providing covered inpatient services to eligible beneficiaries.)

Directs the Secretary to: (1) establish separate thresholds for high episode efficient cases (Medicare beneficiary discharges with the highest 10% probability of being episode efficient cases) and episode outlier cases (Medicare beneficiary discharges with the lowest 10% probability of being episode efficient cases) for LTC hospitals located in a rural area, and (2) establish separate high episode efficient case and episode outlier case thresholds for LTC hospitals located in urban areas for beneficiaries discharged from a subsection (d) hospital which accounts for more than 25% of the Medicare beneficiaries discharged from subsection (d) hospitals in a Metropolitan Statistical Area.

Establishes a two-year moratorium, beginning December 29, 2012, on the establishment of new LTC hospitals and LTC satellite facilities and on the increase in beds in existing LTC hospitals or satellite facilities.

]]> To amend title XVIII of the Social Security Act with respect to Medicare payment for long-term care hospital services. Display Title To amend title XVIII of the Social Security Act with respect to Medicare payment for long-term care hospital services. Official Title as Introduced To amend title XVIII of the Social Security Act with respect to Medicare payment for long-term care hospital services. Introduced in House 2011-11-29T05:00:00Z https://www.govinfo.gov/content/pkg/BILLS-112hr3516ih/xml/BILLS-112hr3516ih.xml 2011-12-07 Referred to the Subcommittee on Health. text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Congressional Research Service, Library of Congress This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.