[Congressional Record Volume 162, Number 142 (Tuesday, September 20, 2016)]
[House]
[Pages H5685-H5688]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     SUSTAINING HEALTHCARE INTEGRITY AND FAIR TREATMENT ACT OF 2016

  Mr. TIBERI. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 5713) to provide for the extension of certain long-term care 
hospital Medicare payment rules, clarify the application of rules on 
the calculation of hospital length of stay to certain moratorium-
excepted long-term care hospitals, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 5713

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Sustaining 
     Healthcare Integrity and Fair Treatment Act of 2016''.
       (b) Table of Contents.--This table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.

                  TITLE I--MEDICARE PART A PROVISIONS

Sec. 101. Extension of certain LTCH Medicare payment rules.
Sec. 102. Application of rules on the calculation of hospital length of 
              stay to all LTCHs.
Sec. 103. Change in Medicare classification for certain hospitals.
Sec. 104. Temporary exception to the application of the Medicare LTCH 
              site neutral provisions for certain spinal cord specialty 
              hospitals.
Sec. 105. Temporary extension to the application of the Medicare LTCH 
              site neutral provisions for certain discharges with 
              severe wounds.

                       TITLE II--OTHER PROVISIONS

Sec. 201. No payment for items and services furnished by newly enrolled 
              providers or suppliers within a temporary moratorium 
              area.

                  TITLE I--MEDICARE PART A PROVISIONS

     SEC. 101. EXTENSION OF CERTAIN LTCH MEDICARE PAYMENT RULES.

       (a) 25-Percent Patient Threshold Payment Adjustment.--
     Section 114(c)(1)(A) of the Medicare, Medicaid, and SCHIP 
     Extension Act of 2007 (42 U.S.C. 1395ww note), as amended by 
     section 4302(a) of division B of the American Recovery and 
     Reinvestment Act (Public Law 111-5), sections 3106(a) and 
     10312(a) of Public Law 111-148, and section 1206(b)(1)(B) of 
     the Pathway for SGR Reform Act of 2013 (division B of Public 
     Law 113-67), is amended by striking ``for a 9-year period'' 
     and inserting ``through June 30, 2016, and for discharges 
     occurring on or after October 1, 2016, and before July 1, 
     2017''.
       (b) Payment for Hospitals-within-hospitals.--Section 
     114(c)(2) of the Medicare, Medicaid, and SCHIP Extension Act 
     of 2007 (42 U.S.C. 1395ww note), as amended by section 
     4302(a) of division B of the American Recovery and 
     Reinvestment Act (Public Law 111-5), sections 3106(a) and 
     10312(a) of Public

[[Page H5686]]

     Law 111-148, and section 1206(b)(1)(A) of the Pathway for SGR 
     Reform Act of 2013 (division B of Public Law 113-67), is 
     amended--
       (1) in subparagraph (A), by inserting ``or any similar 
     provision,'' after ``Regulations,'';
       (2) in subparagraph (B)--
       (A) in clause (i), by inserting ``or any similar 
     provision,'' after ``Regulations,''; and
       (B) in clause (ii), by inserting ``, or any similar 
     provision,'' after ``Regulations''; and
       (3) in subparagraph (C), by striking ``for a 9-year 
     period'' and inserting ``through June 30, 2016, and for 
     discharges occurring on or after October 1, 2016, and before 
     July 1, 2017''.

     SEC. 102. APPLICATION OF RULES ON THE CALCULATION OF HOSPITAL 
                   LENGTH OF STAY TO ALL LTCHS.

       (a) In General.--Section 1206(a)(3) of the Pathway for SGR 
     Reform Act of 2013 (division B of Public Law 113-67; 42 
     U.S.C. 1395ww note) is amended--
       (1) by striking subparagraph (B);
       (2) by striking ``site neutral basis.--'' and all that 
     follows through ``For discharges occurring'' and inserting 
     ``site neutral basis.--For discharges occurring'';
       (3) by striking ``subject to subparagraph (B),''; and
       (4) by redesignating clauses (i) and (ii) as subparagraphs 
     (A) and (B), respectively, and moving each of such 
     subparagraphs (as so redesignated) 2 ems to the left.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall be effective as if included in the enactment of section 
     1206(a)(3) of the Pathway for SGR Reform Act of 2013 
     (division B of Public Law 113-67; 42 U.S.C. 1395ww note).

     SEC. 103. CHANGE IN MEDICARE CLASSIFICATION FOR CERTAIN 
                   HOSPITALS.

       (a) In General.--Subsection (d)(1)(B) of section 1886 of 
     the Social Security Act (42 U.S.C. 1395ww) is amended--
       (1) in clause (iv)--
       (A) in subclause (I), by striking ``or'' at the end;
       (B) in subclause (II)--
       (i) by striking ``, or'' at the end and inserting a 
     semicolon; and
       (ii) by redesignating such subclause as clause (vi) and by 
     moving it to immediately follow clause (v); and
       (iii) in clause (v), by striking the semicolon at the end 
     and inserting ``, or''; and
       (C) by striking ``(iv)(I) a hospital'' and inserting ``(iv) 
     a hospital''.
       (b) Conforming Payment References.--The second sentence of 
     subsection (d)(1)(B) of such section is amended--
       (1) by inserting ``(as in effect as of such date)'' after 
     ``clause (iv)''; and
       (2) by inserting ``(or, in the case of a hospital described 
     in clause (iv)(II), as so in effect, shall be classified 
     under clause (vi) on and after the effective date of such 
     clause (vi) and for cost reporting periods beginning on or 
     after January 1, 2015, shall not be subject to subsection (m) 
     as of the date of such classification)'' after ``so 
     classified''.
       (c) Application.--
       (1) In general.--For cost reporting periods beginning on or 
     after January 1, 2015, in the case of an applicable hospital 
     (as defined in paragraph (3)), the following shall apply:
       (A) Payment for inpatient operating costs shall be made on 
     a reasonable cost basis in the manner provided in section 
     412.526(c)(3) of title 42, Code of Federal Regulations (as in 
     effect on January 1, 2015) and in any subsequent 
     modifications.
       (B) Payment for capital costs shall be made in the manner 
     provided by section 412.526(c)(4) of title 42, Code of 
     Federal Regulations (as in effect on such date).
       (C) Claims for payment for Medicare beneficiaries who are 
     discharged on or after January 1, 2017, shall be processed as 
     claims which are paid on a reasonable cost basis as described 
     in section 412.526(c) of title 42, Code of Federal 
     Regulations (as in effect on such date).
       (2) Applicable hospital defined.--In this subsection, the 
     term ``applicable hospital'' means a hospital that is 
     classified under clause (iv)(II) of section 1886(d)(1)(B) of 
     the Social Security Act (42 U.S.C. 1395ww(d)(1)(B)) on the 
     day before the date of the enactment of this Act and which is 
     classified under clause (vi) of such section, as redesignated 
     and moved by subsection (a), on or after such date of 
     enactment.
       (d) Conforming Technical Amendments.--
       (1) Section 1899B(a)(2)(A)(iv) of the Social Security Act 
     (42 U.S.C. 1395lll(a)(2)(A)(iv)) is amended by striking 
     ``1886(d)(1)(B)(iv)(II)'' and inserting 
     ``1886(d)(1)(B)(vi)''.
       (2) Section 1886(m)(5)(F) of such Act (42 U.S.C. 
     1395ww(m)(5)(F)) is amended in each of clauses (i) and (ii) 
     by striking ``(d)(1)(B)(iv)(II)'' and inserting 
     ``(d)(1)(B)(vi)''.

     SEC. 104. TEMPORARY EXCEPTION TO THE APPLICATION OF THE 
                   MEDICARE LTCH SITE NEUTRAL PROVISIONS FOR 
                   CERTAIN SPINAL CORD SPECIALTY HOSPITALS.

       (a) Exception.--Section 1886(m)(6) of the Social Security 
     Act (42 U.S.C. 1395ww(m)(6)) is amended--
       (1) in subparagraph (A)(i), by striking ``and (E)'' and 
     inserting ``, (E), and (F)''; and
       (2) by adding at the end the following new subparagraph:
       ``(F) Temporary exception for certain spinal cord specialty 
     hospitals.--For discharges in cost reporting periods 
     beginning during fiscal years 2018 and 2019, subparagraph 
     (A)(i) shall not apply (and payment shall be made to a long-
     term care hospital without regard to this paragraph) if such 
     discharge is from a long-term care hospital that meets each 
     of the following requirements:
       ``(i) Not-for-profit.--The long-term care hospital was a 
     not-for-profit long-term care hospital on June 1, 2014, as 
     determined by cost report data.
       ``(ii) Primarily providing treatment for catastrophic 
     spinal cord or acquired brain injuries or other paralyzing 
     neuromuscular conditions.--Of the discharges in calendar year 
     2013 from the long-term care hospital for which payment was 
     made under this section, at least 50 percent were classified 
     under MS-LTCH-DRGs 28, 29, 52, 57, 551, 573, and 963.
       ``(iii) Significant out-of-state admissions.--

       ``(I) In general.--The long-term care hospital discharged 
     inpatients (including both individuals entitled to, or 
     enrolled for, benefits under this title and individuals not 
     so entitled or enrolled) during fiscal year 2014 who had been 
     admitted from at least 20 of the 50 States, determined by the 
     States of residency of such inpatients and based on such data 
     submitted by the hospital to the Secretary as the Secretary 
     may require.
       ``(II) Implementation.--Notwithstanding any other provision 
     of law, the Secretary may implement subclause (I) by program 
     instruction or otherwise.
       ``(III) Non-application of paperwork reduction act.--
     Chapter 35 of title 44, United States Code, shall not apply 
     to data collected under this clause.''.

       (b) Study and Report on the Status and Viability of Certain 
     Spinal Cord Specialty Long-term Care Hospitals.--
       (1) Study.--The Comptroller General of the United States 
     shall conduct a study on long-term care hospitals described 
     in section 1886(m)(6)(F) of the Social Security Act, as added 
     by subsection (a). Such report shall include an analysis of 
     the following:
       (A) The impact on such hospitals of the classification and 
     facility licensure by State agencies of such hospitals.
       (B) The Medicare payment rates for such hospitals.
       (C) Data on the number and health care needs of Medicare 
     beneficiaries who have been diagnosed with catastrophic 
     spinal cord or acquired brain injuries or other paralyzing 
     neuromuscular conditions (as described within the discharge 
     classifications specified in clause (ii) of such section) who 
     are receiving services from such hospitals.
       (2) Report.--Not later than October 1, 2018, the 
     Comptroller General shall submit to Congress a report on the 
     study conducted under paragraph (1), including 
     recommendations for such legislation and administrative 
     action as the Comptroller General determines appropriate.

     SEC. 105. TEMPORARY EXTENSION TO THE APPLICATION OF THE 
                   MEDICARE LTCH SITE NEUTRAL PROVISIONS FOR 
                   CERTAIN DISCHARGES WITH SEVERE WOUNDS.

       (a) In General.--Section 1886(m)(6) of the Social Security 
     Act (42 U.S.C. 1395ww(m)(6)), as amended by section 104, is 
     further amended--
       (1) in subparagraph (A)(i) by striking ``and (F)'' and 
     inserting ``(F), and (G)'';
       (2) in subparagraph (E)(i)(I)(aa), by striking ``the 
     amendment made'' and all that follows before the semicolon 
     and inserting ``the last sentence of subsection (d)(1)(B)''; 
     and
       (3) by adding at the end the following new subparagraph:
       ``(G) Additional temporary exception for certain severe 
     wound discharges from certain long-term care hospitals.--
       ``(i) In general.--For a discharge occurring in a cost 
     reporting period beginning during fiscal year 2018, 
     subparagraph (A)(i) shall not apply (and payment shall be 
     made to a long-term care hospital without regard to this 
     paragraph) if such discharge--

       ``(I) is from a long-term care hospital identified by the 
     last sentence of subsection (d)(1)(B);
       ``(II) is classified under MS-LTCH-DRG 602, 603, 539, or 
     540; and
       ``(III) is with respect to an individual treated by a long-
     term care hospital for a severe wound.

       ``(ii) Severe wound defined.--In this subparagraph, the 
     term `severe wound' means a wound which is a stage 3 wound, 
     stage 4 wound, unstageable wound, non-healing surgical wound, 
     or fistula as identified in the claim from the long-term care 
     hospital.
       ``(iii) Wound defined.--In this subparagraph, the term 
     `wound' means an injury involving division of tissue or 
     rupture of the integument or mucous membrane with exposure to 
     the external environment.''.
       (c) Study and Report to Congress.--
       (1) Study.--The Comptroller General of the United States 
     shall, in consultation with relevant stakeholders, conduct a 
     study on the treatment needs of individuals entitled to 
     benefits under part A of title XVIII of the Social Security 
     Act or enrolled under part B of such title who require 
     specialized wound care, and the cost, for such individuals 
     and the Medicare program under such title, of treating severe 
     wounds in rural and urban areas. Such study shall include an 
     assessment of--
       (A) access of such individuals to appropriate levels of 
     care for such cases;
       (B) the potential impact that section 1886(m)(6)(A)(i) of 
     such Act (42 U.S.C. 1395ww(m)(6)(A)(i)) will have on the 
     access, quality, and cost of care for such individuals; and
       (C) how to appropriately pay for such care under the 
     Medicare program under such title.
       (2) Report.--Not later than October 1, 2020, the 
     Comptroller General shall submit to Congress a report on the 
     study conducted

[[Page H5687]]

     under paragraph (1), including recommendations for such 
     legislation and administrative action as the Comptroller 
     General determines appropriate.

                       TITLE II--OTHER PROVISIONS

     SEC. 201. NO PAYMENT FOR ITEMS AND SERVICES FURNISHED BY 
                   NEWLY ENROLLED PROVIDERS OR SUPPLIERS WITHIN A 
                   TEMPORARY MORATORIUM AREA.

       (a) Medicare.--Section 1866(j)(7) of the Social Security 
     Act (42 U.S.C. 1395cc(j)(7)) is amended--
       (1) in the paragraph heading, by inserting ``; nonpayment'' 
     before the period; and
       (2) by adding at the end the following new subparagraph:
       ``(C) Nonpayment.--
       ``(i) In general.--No payment may be made under this title 
     or under a program described in subparagraph (A) with respect 
     to an item or service described in clause (ii) furnished on 
     or after October 1, 2017.
       ``(ii) Item or service described.--An item or service 
     described in this clause is an item or service furnished--

       ``(I) within a geographic area with respect to which a 
     temporary moratorium imposed under subparagraph (A) is in 
     effect; and
       ``(II) by a provider of services or supplier that meets the 
     requirements of clause (iii).

       ``(iii) Requirements.--For purposes of clause (ii), the 
     requirements of this clause are that a provider of services 
     or supplier--

       ``(I) enrolls under this title on or after the effective 
     date of such temporary moratorium; and
       ``(II) is within a category of providers of services and 
     suppliers (as described in subparagraph (A)) subject to such 
     temporary moratorium.

       ``(iv) Prohibition on charges for specified items or 
     services.--In no case shall a provider of services or 
     supplier described in clause (ii)(II) charge an individual or 
     other person for an item or service described in clause (ii) 
     furnished on or after October 1, 2017, to an individual 
     entitled to benefits under part A or enrolled under part B or 
     an individual under a program specified in subparagraph 
     (A).''.
       (b) Conforming Amendments.--
       (1) Medicaid.--
       (A) In general.--Section 1903(i)(2) of the Social Security 
     Act (42 U.S.C. 1396b(i)(2)) is amended--
       (i) in subparagraph (A), by striking the comma at the end 
     and inserting a semicolon;
       (ii) in subparagraph (B), by striking ``or'' at the end; 
     and
       (iii) by adding at the end the following new subparagraph:
       ``(D) with respect to any amount expended for such an item 
     or service furnished during calendar quarters beginning on or 
     after October 1, 2017, subject to section 
     1902(kk)(4)(A)(ii)(II), within a geographic area that is 
     subject to a moratorium imposed under section 1866(j)(7) by a 
     provider or supplier that meets the requirements specified in 
     subparagraph (C)(iii) of such section, during the period of 
     such moratorium; or''.
       (B) Exception with respect to access.--Section 
     1902(kk)(4)(A)(ii) of the Social Security Act (42 U.S.C. 
     1396a(kk)(4)(A)(ii)) is amended to read as follows:
       ``(ii) Exceptions.--

       ``(I) Compliance with moratorium.--A State shall not be 
     required to comply with a temporary moratorium described in 
     clause (i) if the State determines that the imposition of 
     such temporary moratorium would adversely impact 
     beneficiaries' access to medical assistance.
       ``(II) FFP available.--Notwithstanding section 
     1903(i)(2)(D), payment may be made to a State under this 
     title with respect to amounts expended for items and services 
     described in such section if the Secretary, in consultation 
     with the State agency administering the State plan under this 
     title (or a waiver of the plan), determines that denying 
     payment to the State pursuant to such section would adversely 
     impact beneficiaries' access to medical assistance. ''.

       (C) State plan requirement with respect to limitation on 
     charges to beneficiaries.--Section 1902(kk)(4)(A) of the 
     Social Security Act (42 U.S.C. 1396a(kk)(4)(A)) is amended by 
     adding at the end the following new clause:
       ``(iii) Limitation on charges to beneficiaries.--With 
     respect to any amount expended for items or services 
     furnished during calendar quarters beginning on or after 
     October 1, 2017, the State prohibits, during the period of a 
     temporary moratorium described in clause (i), a provider 
     meeting the requirements specified in subparagraph (C)(iii) 
     of section 1866(j)(7) from charging an individual or other 
     person eligible to receive medical assistance under the State 
     plan under this title (or a waiver of the plan) for an item 
     or service described in section 1903(i)(2)(D) furnished to 
     such an individual.''.
       (2) Correcting amendments to related provisions.--
       (A) Section 1866(j).--Section 1866(j) of the Social 
     Security Act (42 U.S.C. 1395cc(j)) is amended--
       (i) in paragraph (1)(A)--

       (I) by striking ``paragraph (4)'' and inserting ``paragraph 
     (5)'';
       (II) by striking ``moratoria in accordance with paragraph 
     (5)'' and inserting ``moratoria in accordance with paragraph 
     (7)''; and
       (III) by striking ``paragraph (6)'' and inserting 
     ``paragraph (9)''; and

       (ii) by redesignating the second paragraph (8) (added by 
     section 1304(1) of Public Law 111-152) as paragraph (9).
       (B) Section 1902(kk).--Section 1902(kk) of such Act (42 
     U.S.C. 1396a(kk)) is amended--
       (i) in paragraph (1), by striking ``section 1886(j)(2)'' 
     and inserting ``section 1866(j)(2)'';
       (ii) in paragraph (2), by striking ``section 1886(j)(3)'' 
     and inserting ``section 1866(j)(3)'';
       (iii) in paragraph (3), by striking ``section 1886(j)(4)'' 
     and inserting ``section 1866(j)(5)''; and
       (iv) in paragraph (4)(A), by striking ``section 
     1886(j)(6)'' and inserting ``section 1866(j)(7)''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Ohio (Mr. Tiberi) and the gentleman from New Jersey (Mr. Pascrell) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Ohio.


                             General Leave

  Mr. TIBERI. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days within which to revise and extend their remarks 
and include extraneous material on H.R. 5713, currently under 
consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Ohio?
  There was no objection.
  Mr. TIBERI. Mr. Speaker, I yield myself such time as I may consume. 
This bill provides needed regulatory relief for our hospitals, 
specifically long-term care hospitals.
  I am happy that the Ways and Means Committee has come together in a 
bipartisan effort on this bill, and I want to thank my colleague and 
dear friend from the Garden State, Bill Pascrell, for cosponsoring this 
bill with me today.
  H.R. 5713, the Sustaining Healthcare Integrity and Fair Treatment 
Act, or the SHIFT Act, will give relief to all long-term care 
hospitals, or LTCHs, from the 25 percent rule before it fully goes into 
effect next month on October 1 of this year.
  This CMS rule, which has been delayed for 10 years, allows for no 
more than 25 percent of patients to come from one inpatient acute care 
hospital in one quarter. My bill will reinstate the 50 percent 
threshold that was in effect prior to July 1, 2016, and delay the rule 
for 9 months.
  During a time when patients and healthcare providers are facing 
increasing burdens and higher costs, I am pleased that we could come to 
an agreement that will help over 400 hospitals across America. This 
bill will also provide relief for four specific groups of LTCHs that 
treat highly unique groups of patients.
  I was glad to work with a number of my colleagues to incorporate 
their bills within this bill, including Mr. Buchanan's and Mr. 
Pascrell's bill, H.R. 4650; Mr. Jason Smith's bill, H.R. 5559; Mr. 
Crowley's bill, H.R. 5614; Dr. Price's and Mr. Lewis' bill, H.R. 5688; 
and finally, Mr. Levin's bill, H.R. 5723.
  The SHIFT Act also allows the Medicare, Medicaid, and Children's 
Health Insurance Program to limit reimbursement for providers or 
suppliers who may be exploiting program integrity loopholes and 
engaging in waste, fraud, or abuse. This will prevent hard-earned 
taxpayer dollars from going to bad actors.
  Mr. Speaker, I reserve the balance of my time.
                                         House of Representatives,


                             Committee on Energy and Commerce,

                               Washington, DC, September 20, 2016.
     Hon. Kevin Brady,
     Chairman, Committee on Ways and Means,
     Washington, DC.
       Dear Chairman Brady: I write in regard to the following 
     bills:
       H.R. 5713, Sustaining Healthcare Integrity and Fair 
     Treatment Act of 2016;
       H.R. 5659, Expanding Seniors Receiving Dialysis Choice Act 
     of 2016; and,
       H.R. 5613, To provide for the extension of the enforcement 
     instruction on supervision requirements for outpatient 
     therapeutic services in critical access and small rural 
     hospitals through 2016.
       As you know, H.R. 5716, H.R. 5659, and H.R. 5613 were each 
     referred to both the Committee on Energy and Commerce and the 
     Committee on Ways and Means. I wanted to notify you that the 
     Committee on Energy and Commerce will forgo action on each of 
     these bills so that they may proceed expeditiously to the 
     House floor for consideration.
       This is done with the understanding that the Committee on 
     Energy and Commerce's jurisdictional interests over these 
     bills and similar legislation are in no way diminished or 
     altered and that the Committee will be appropriately 
     consulted and involved as these bills or similar legislation 
     move forward. In addition, the Committee reserves the right 
     to seek conferees each of these bills and requests your 
     support when such a request is made.
       I would appreciate your response confirming this 
     understanding with respect to

[[Page H5688]]

     H.R. 5716, H.R. 5659, and H.R. 5613 and ask that a copy of 
     our exchange of letters on this matter be included in the 
     Congressional Record during consideration of these bills on 
     the House floor.
           Sincerely,
                                                       Fred Upton,
     Chairman.
                                  ____

                                      Committee on Ways and Means,


                                     House of Representatives,

                               Washington, DC, September 20, 2016.
     Hon. Fred Upton,
     Chairman, Committee on Energy and Commerce,
     Washington, DC.
       Dear Chairman Upton: Thank you for your letter regarding 
     the following bills:
       H.R. 5713, the ``Sustaining Healthcare Integrity and Fair 
     Treatment Act of 2016;''
       H.R. 5659, the ``Expanding Seniors Receiving Dialysis 
     Choice Act of 2016;'' and
       H.R. 5613, to provide for the extension of the enforcement 
     instruction on supervision requirements for outpatient 
     therapeutic services in critical access and small rural 
     hospitals through 2016.
       I am most appreciative of your decision to waive formal 
     consideration of these measures so that they may proceed 
     expeditiously to the House floor. I acknowledge that although 
     you waived formal consideration of these bills, the Committee 
     on Energy and Commerce is in no way waiving its jurisdiction 
     over the subject matter contained in those provisions of the 
     bills that fall within your Rule X jurisdiction. I would 
     support your effort to seek appointment of an appropriate 
     number of conferees on any House-Senate conference involving 
     this legislation.
       I will include a copy of our letters in the Congressional 
     Record during consideration of these measures on the House 
     floor.
           Sincerely,
                                                      Kevin Brady,
                                                         Chairman.

  Mr. PASCRELL. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I am proud to introduce H.R. 5713 with Mr. Tiberi, 
Sustaining Healthcare Integrity and Fair Treatment Act. I think this is 
good legislation, not because my name is on it but because I thought a 
lot of thought came into this, and staff helped tremendously.
  This is one of the areas I have tried to concentrate on since being 
in Congress: long-term and acute care. As the cofounder and co-chair of 
the Congressional Brain Injury Task Force, I understand the important 
role that long-term care hospitals play in the recovery of many 
individuals who suffer moderate to severe traumatic brain injuries, or 
TBIs.
  I use this as one example, the area of TBI. If there is one thing I 
have learned about TBI in the 18 years I have been working on this 
issue, it is that recovery looks different for everyone, whether you 
are on the battlefield or you fall off a ladder trying to fix your 
roof.
  I understand the important role that long-term care hospitals play. I 
want to repeat that. That is why we must, I believe, preserve access to 
all post-acute care options, so that patients can receive the 
individualized care they need, and we don't tell them: get out, because 
your time is up, in the middle of their treatment. And that is what the 
gentleman from Ohio (Mr. Tiberi) has talked about many times.

                              {time}  1730

  This is the right legislation, I believe, for this particular 
problem. H.R. 5713 would provide an additional 9 months of relief from 
the full implementation of the 25 percent rule for long-term care 
hospitals, which Mr. Tiberi mentioned. This bill includes technical 
changes for long-term hospitals.
  H.R. 5713 would, first, clarify the application of rules on the 
calculation of the hospital length to certain moratorium-excepted 
LTCHs, the long-term care hospitals.
  Second, it would correct the status of Calvary Hospital in New York 
City that has led to secondary-payer issues, big issues.
  Third, it would provide a temporary exception to the application of 
the Medicare long-term care hospital site-neutral provisions for 
certain spinal cord specialty hospitals.
  Fourth, it would exempt four payment codes for severe wounds from 
site-neutral payments.
  This is a bipartisan piece of legislation. We can do this. We could 
do it, without exception, if you put people in the room who want to 
compromise, who don't know all the answers, and I don't. We could come 
to a conclusion.
  This bill would offset the cost of this extension by implementing an 
important program integrity policy that would allow the Secretary to 
reject Medicare claims from new Medicare suppliers and providers 
located just outside of the moratorium areas.
  While this bill is an important step forward, it is just a temporary 
Band-Aid on the 25 percent rule. I say to the gentleman, I don't 
believe it is a permanent solution, but I think it helps us. We need to 
work together to find a long-term solution to the issue.
  I urge my colleagues to support this bill before us today.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TIBERI. Mr. Speaker, I don't think I have any more speakers and 
am ready to close.
  I reserve the balance of my time.
  Mr. PASCRELL. Mr. Speaker, long-term hospitals are an important part 
of our post-acute care system. This bill will help preserve access and 
maintain fairness for these hospitals and their patients.
  I urge my colleagues to support H.R. 5713, and it is my hope that 
this bill is taken up expeditiously on the other side of the building 
in the Senate.
  Mr. Speaker, I yield back the balance of my time.
  Mr. TIBERI. Mr. Speaker, I yield myself such time as I may consume.
  I thank the Speaker for allowing me the opportunity to present this 
bill today, this bipartisan bill that came out of the Ways and Means 
Committee.
  I really can't add much to what Mr. Pascrell said, and I really 
appreciate his leadership, not only on this issue, but on the issue of 
traumatic brain injury. There has been nobody in the Congress who has 
talked more, spent more time in educating folks and trying to come up 
with solutions to traumatic brain injury, and I appreciate his 
leadership.
  I thank the Speaker for allowing us to present and advance this 
package, this healthcare package through the process today.
  I ask all my colleagues to vote for it. We must help those 
beneficiaries that suffer from acute, long-term illness and injuries, 
and I believe this bill will do just that.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Ohio (Mr. Tiberi) that the House suspend the rules and 
pass the bill, H.R. 5713, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. HUELSKAMP. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

                          ____________________