II 111th CONGRESS 1st Session S. 935 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.

1.

Short title

This Act may be cited as the Medicare Long-Term Care Hospital Improvement Act of 2009.

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.

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.

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. .