[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4188 Introduced in House (IH)]

113th CONGRESS
  2d Session
                                H. R. 4188

To amend title XVIII of the Social Security Act to adjust the Medicare 
     hospital readmission reduction program to respond to patient 
                  disparities, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 11, 2014

 Mr. Renacci (for himself, Mr. Heck of Nevada, Mr. Joyce, Mr. Ryan of 
  Ohio, Mr. Fitzpatrick, Mr. Turner, Mr. Kelly of Pennsylvania, Mrs. 
   Capito, Mr. Stivers, Mr. Tiberi, Mr. LaMalfa, Mr. Perry, Mr. Sam 
  Johnson of Texas, Mr. Gibbs, Mr. Chabot, Mr. Meehan, Mr. Johnson of 
 Ohio, Mr. Carney, Mr. Johnson of Georgia, Mr. Engel, Ms. Kaptur, Mr. 
    David Scott of Georgia, and Ms. Eddie Bernice Johnson of Texas) 
 introduced the following bill; which was referred to the Committee on 
                             Ways and Means

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to adjust the Medicare 
     hospital readmission reduction program to respond to patient 
                  disparities, 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 ``Establishing Beneficiary Equity in 
the Hospital Readmission Program Act''.

SEC. 2. ADJUSTING THE MEDICARE HOSPITAL READMISSION REDUCTION PROGRAM 
              TO RESPOND TO PATIENT DISPARITIES.

    (a) Removal of Certain Readmissions.--Section 1886(q)(5)(E) of the 
Social Security Act (42 U.S.C. 1395ww(q)(5)(E)) is amended by adding at 
the end the following: ``Such term does not include an admission that 
is classified within one or more of the following: transplants, end-
stage renal disease, burns, trauma, psychosis, or substance abuse.''.
    (b) Adjustment for Dual Eligible Population.--Section 1886(q)(4)(C) 
of the Social Security Act (42 U.S.C. 1395ww(q)(4)(C)) is amended by 
adding at the end the following new clause:
                            ``(iii) Adjustment for dual eligibles.--In 
                        applying clause (i), the Secretary shall 
                        provide for such risk adjustment as will take 
                        into account a hospital's proportion of 
                        inpatients who are full-benefit dual eligible 
                        individuals (as defined in section 1935(c)(6)) 
                        in order to ensure that hospitals that treat 
                        the most vulnerable populations are not 
                        unfairly penalized by the program under this 
                        subsection.''.
    (c) MedPAC Study on 30-Day Readmission Threshold.--The Medicare 
Payment Advisory Commission shall conduct a study on the 
appropriateness of using a threshold of 30 days for readmissions under 
section 1886(q)(5)(E) of the Social Security Act (42 U.S.C. 
1395ww(q)(5)(E)). The Commission shall submit to Congress a report on 
such study in its report to Congress in June 2014.
    (d) Addressing Issue of Noncompliant Patients.--Section 
1886(q)(4)(C) of the Social Security Act (42 U.S.C. 1395ww(q)(4)(C)), 
as amended by subsection (b), is further amended by adding at the end 
the following new clause:
                            ``(iv) Consideration of exclusion of 
                        noncompliant patient cases based on v codes.--
                        In promulgating regulations to carry out this 
                        subsection for the applicable period with 
                        respect to fiscal year 2015, the Secretary 
                        shall consider the use of V codes for potential 
                        exclusions of cases in order to address the 
                        issue of noncompliant patients.''.
    (e) Effective Date; Budget Neutral Implementation.--
            (1) The amendments made by this section shall be effective 
        for applicable periods with respect to fiscal year 2015 and 
        each succeeding fiscal year.
            (2) The Secretary of Health and Human Services shall make 
        such payment adjustment to subsection (d) hospitals under the 
        inpatient prospective payment system under section 1886 of the 
        Social Security Act (42 U.S.C. 1395ww) as may be necessary to 
        ensure that the implementation of the amendments made by this 
        section do not result in an increase in aggregate expenditures 
        under such section.
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