[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 543 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                 S. 543

  To improve Medicare beneficiary access by extending the 60 percent 
compliance threshold used to determine whether a hospital or unit of a 
  hospital is an inpatient rehabilitation facility under the Medicare 
                                program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 12, 2007

  Mr. Nelson of Nebraska (for himself, Mr. Bunning, Ms. Stabenow, Ms. 
    Snowe, Mr. Kerry, Ms. Collins, Mr. Reed, Mrs. Clinton, and Mr. 
   Menendez) introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To improve Medicare beneficiary access by extending the 60 percent 
compliance threshold used to determine whether a hospital or unit of a 
  hospital is an inpatient rehabilitation facility under the Medicare 
                                program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preserving Patient Access to 
Inpatient Rehabilitation Hospitals Act of 2007''.

SEC. 2. EXTENSION OF THE 60 PERCENT COMPLIANCE THRESHOLD USED TO 
              DETERMINE WHETHER A HOSPITAL OR UNIT OF A HOSPITAL IS AN 
              INPATIENT REHABILITATION FACILITY UNDER THE MEDICARE 
              PROGRAM.

    (a) In General.--Section 5005 of the Deficit Reduction Act of 2005 
(42 U.S.C. 1395ww note) is amended--
            (1) in subsection (a), by striking ``apply the applicable 
        percent specified in subsection (b)'' and inserting ``require a 
        compliance rate that is no greater than the 60 percent 
        compliance rate that became effective for cost reporting 
        periods beginning on or after July 1, 2005''; and
            (2) by striking subsection (b) and inserting the following 
        new subsection:
    ``(b) Continued Use of Comorbidities.--For cost reporting periods 
beginning on or after July 1, 2007, the Secretary shall include 
patients with comorbidity as described in section 412.23(b)(2)(i) of 
title 42, Code of Federal Regulations, in the inpatient population that 
counts towards the percent specified in subsection (a).''.
    (b) Effective Date.--The amendment made by subsection (a)(1) shall 
take effect on June 30, 2007.

SEC. 3. MEDICAL NECESSITY CRITERIA FOR BENEFICIARIES SERVED IN 
              REHABILITATION HOSPITALS AND UNITS.

    On and after June 30, 2007, the Secretary of Health and Human 
Services, the Centers for Medicare & Medicaid Services, fiscal 
intermediaries under section 1816 of the Social Security Act (42 U.S.C. 
1395h), medicare administrative contractors under section 1874A of such 
Act (42 U.S.C. 1395kk), recovery audit contractors under section 
1893(h) of such Act (42 U.S.C. 1395ddd(h)) or section 306 of the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003, 
and other government agents shall use and apply the criteria 
established in HCFA Ruling 85-2, as issued on July 31, 1985 (50 Fed. 
Reg. 31040), as the sole standard for determining the medical necessity 
of services provided by inpatient rehabilitation hospitals and units to 
beneficiaries under the Medicare program under title XVIII of the 
Social Security Act.
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