117 HR 9658 IH: Securing Access to Care for Seniors in Critical Condition Act of 2022 U.S. House of Representatives 2022-12-21 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.

I117th CONGRESS2d SessionH. R. 9658IN THE HOUSE OF REPRESENTATIVESDecember 21, 2022Mr. Hern introduced the following bill; which was referred to the Committee on Ways and MeansA BILLTo amend title XVIII of the Social Security Act to establish a new criterion for the nonapplication of site-neutral payments to long-term care hospitals under the Medicare program.

1.

Short title

This Act may be cited as the Securing Access to Care for Seniors in Critical Condition Act of 2022.

2.

Establishing a new criterion for the nonapplication of site-neutral payments to long-term care hospitals under the Medicare program

Section 1886(m)(6)(A) of the Social Security Act (42 U.S.C. 1395ww(m)(6)(A)) is amended—(1)by striking or the ventilator criterion under clause (iv) and inserting , the ventilator criterion under clause (iv), or the high acuity criterion described in clause (v); and(2)by adding at the end the following new clause:(v)

High acuity criterion

(I)

In general

The criterion specified in this clause (in this paragraph referred to as the high acuity criterion) for a discharge from a long-term care hospital in a fiscal year is that—(aa)the individual discharged had a primary diagnosis assigned to a Medicare-Severity-Long-Term-Care-Diagnosis-Related-Group (MS–LTC–DRG) with a relative weight for such fiscal year that was equal to or greater than the specified amount for such fiscal year; and(bb)the discharge occurred on or after October 1, 2025.(II)

Specified amount defined

For purposes of subclause (I), the term specified amount means, with respect to a fiscal year, an amount equal to the 80th percentile of the relative weights for Medicare-Severity-Long-Term-Care-Diagnosis-Related-Groups that were assigned to primary diagnoses for all discharges occurring in the preceding fiscal year..