[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 935 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 935

   To extend subsections (c) and (d) of section 114 of the Medicare, 
   Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to 
provide for regulatory stability during the development of facility and 
   patient criteria for long-term care hospitals under the Medicare 
                    program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 30, 2009

Mr. Conrad (for himself, Mr. Hatch, Mr. Crapo, Mr. Roberts, Mr. Wicker, 
Mr. Vitter, Mr. Voinovich, Mr. Chambliss, Mr. Isakson, Mr. Cochran, Mr. 
 Bunning, Mr. Kerry, Ms. Stabenow, Mr. Harkin, Mr. Wyden, Mr. Specter, 
and Mr. Alexander) introduced the following bill; which was read twice 
                and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
   To extend subsections (c) and (d) of section 114 of the Medicare, 
   Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) to 
provide for regulatory stability during the development of facility and 
   patient criteria for long-term care hospitals under the Medicare 
                    program, and for other purposes.

    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 ``Medicare Long-Term Care Hospital 
Improvement Act of 2009''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Long-term care hospitals (in this section referred to 
        as ``LTCHs'') serve a valuable role in the post-acute care 
        continuum by providing care to medically complex patients 
        needing long hospital stays.
            (2) The Medicare program should ensure that patients 
        receive post-acute care in the most appropriate setting. The 
        use of additional certification criteria for LTCHs, including 
        facility and patient criteria, will promote the appropriate 
        placement of medically complex patients into LTCHs.
            (3) Subsections (c) and (d) of section 114 of the Medicare, 
        Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) 
        provide necessary regulatory stability and temporary limits on 
        the growth of new hospitals during the development of facility 
        and patient criteria for LTCHs. An extension of section 114 is 
        warranted to allow for additional time to develop facility and 
        patient criteria for LTCHs.

SEC. 3. EXTENSION OF CERTAIN PROVISIONS UNDER SECTION 114 OF THE 
              MEDICARE, MEDICAID, AND SCHIP EXTENSION ACT OF 2007.

    Subsections (c) and (d) of section 114 of the Medicare, Medicaid, 
and SCHIP Extension Act of 2007 (Public Law 110-173), as amended by 
section 4302 of division B of the American Recovery and Reinvestment 
Act of 2009 (Public Law 111-5), are amended by striking ``3-year 
period'' and inserting ``5-year period'' each place it appears.

SEC. 4. LONG-TERM CARE HOSPITAL BUDGET NEUTRALITY OFFSET.

    Section 1886(m) of the Social Security Act (42 U.S.C. 1395ww(m)) is 
amended by adding at the end the following new paragraph:
            ``(3) Budget neutrality offset for rate years 2011 through 
        2015.--In implementing the system described in paragraph (1) 
        for discharges occurring during each of the rate years ending 
        in 2011 through 2015 for a hospital, the base rate shall be 
        adjusted annually by the market basket update amount allowed by 
        the Secretary less an amount determined by the Secretary, in 
        advance of each rate year, to implement a budget neutrality 
        offset of the cost of implementation of section 3 of the 
        Medicare Long-Term Care Hospital Improvement Act of 2009 for 
        such year, not to exceed a maximum percentage reduction of 1.5 
        percent per rate year. Each such budget neutrality offset shall 
        apply only with respect to the single rate year involved. The 
        Secretary shall not reflect, or take into account, any such 
        budget neutrality offset in computing and establishing the 
        applicable market basket update percentage increase to the base 
        rate for a subsequent rate year.''.
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