[Congressional Record Volume 162, Number 178 (Friday, December 9, 2016)]
[Senate]
[Pages S7074-S7075]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 5181. Mr. PORTMAN (for Mr. Kirk) proposed an amendment to the bill 
S. 1168, to amend title XVIII of the Social Security Act to preserve 
access to rehabilitation innovation centers under the Medicare program; 
as follows:

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Preserving Rehabilitation 
     Innovation Centers Act of 2016''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) In the United States, there are an estimated 1,181 
     inpatient rehabilitation facilities. Among these facilities 
     is a small group of inpatient rehabilitation institutions 
     that are contributing to the future of rehabilitation care 
     medicine, as well as to patient recovery, scientific 
     innovation, and quality of life.
       (2) This unique category of inpatient rehabilitation 
     institutions treats the most complex patient conditions, such 
     as traumatic brain injury, stroke, spinal cord injury, 
     childhood disease, burns, and wartime injuries.
       (3) These leading inpatient rehabilitation institutions are 
     all not-for-profit or Government-owned institutions and serve 
     a high volume of Medicare or Medicaid beneficiaries.
       (4) These leading inpatient rehabilitation institutions 
     have been recognized by the Federal Government for their 
     contributions to cutting-edge research to develop solutions 
     that enhance quality of care, improve patient outcomes, and 
     reduce health care costs.
       (5) These leading inpatient rehabilitation institutions 
     help to improve the practice and standard of rehabilitation 
     medicine across the Nation in urban, suburban, and rural 
     communities by training physicians, medical students, and 
     other clinicians, and providing care to patients from all 50 
     States.
       (6) It is vital that these leading inpatient rehabilitation 
     institutions are supported so they can continue to lead the 
     Nation's efforts to--
       (A) advance integrated, multidisciplinary rehabilitation 
     research;
       (B) provide cutting-edge medical care to the most complex 
     rehabilitation patients;
       (C) serve as education and training facilities for the 
     physicians, nurses, and other health professionals who serve 
     rehabilitation patients;
       (D) ensure Medicare and Medicaid beneficiaries receive 
     state-of-the-art, high-quality rehabilitation care by 
     developing and disseminating best practices and advancing the 
     quality of care utilized by post-acute providers in all 50 
     States; and
       (E) support other inpatient rehabilitation institutions in 
     rural areas to help ensure access to quality post-acute care 
     for patients living in these communities.

     SEC. 3. STUDY AND REPORT RELATING TO THE COSTS INCURRED BY, 
                   AND THE MEDICARE PAYMENTS MADE TO, 
                   REHABILITATION INNOVATION CENTERS.

       (a) In General.--Section 1886(j) of the Social Security Act 
     (42 U.S.C. 1395ww(j)) is amended--
       (1) by redesignating paragraph (8) as paragraph (9); and
       (2) by inserting after paragraph (7) the following new 
     paragraph:
       ``(8) Study and report relating to the costs incurred by, 
     and the medicare payments made to, rehabilitation innovation 
     centers.--
       ``(A) Study.--The Secretary shall conduct a study to assess 
     the costs incurred by rehabilitation innovation centers (as 
     defined in subparagraph (C)) that are beyond the prospective 
     rate for each of the following activities:
       ``(i) Furnishing items and services to individuals under 
     this title.
       ``(ii) Conducting research.
       ``(iii) Providing medical training.
       ``(B) Report.--Not later than July 1, 2019, the Secretary 
     shall submit to Congress a report containing the results of 
     the study under subparagraph (A), together with 
     recommendations for such legislation and administrative 
     action as the Secretary determines appropriate.
       ``(C) Rehabilitation innovation center defined.--
       ``(i) In general.--In this paragraph, the term 
     `rehabilitation innovation center'

[[Page S7075]]

     means a rehabilitation facility that, determined as of the 
     date of the enactment of this paragraph, is described in 
     clause (ii) or clause (iii).
       ``(ii) Not-for-profit.--A rehabilitation facility described 
     in this clause is a facility that--

       ``(I) is classified as a not-for-profit entity under the 
     IRF Rate Setting File for the Correction Notice for the 
     Inpatient Rehabilitation Facility Prospective Payment System 
     for Federal Fiscal Year 2012 (78 Fed. Reg. 59256);
       ``(II) holds at least one Federal rehabilitation research 
     and training designation for research projects on traumatic 
     brain injury, spinal cord injury, or stroke rehabilitation 
     research from the Rehabilitation Research and Training 
     Centers or the Rehabilitation Engineering Research Center at 
     the National Institute on Disability and Rehabilitation 
     Research at the Department of Education, based on such data 
     submitted to the Secretary by a facility, in a form, manner, 
     and time frame specified by the Secretary;
       ``(III) has a minimum Medicare case mix index of 1.1144 for 
     fiscal year 2012 according to the IRF Rate Setting File 
     described in subclause (I); and
       ``(IV) had at least 300 Medicare discharges or at least 200 
     Medicaid discharges in a prior year as determined by the 
     Secretary.

       ``(iii) Government-owned.--A rehabilitation facility 
     described in this clause is a facility that--

       ``(I) is classified as a Government-owned institution under 
     the IRF Rate Setting File described in clause (ii)(I);
       ``(II) holds at least one Federal rehabilitation research 
     and training designation for research projects on traumatic 
     brain injury, spinal cord injury, or stroke rehabilitation 
     research from the Rehabilitation Research and Training 
     Centers, the Rehabilitation Engineering Research Center, or 
     the Model Spinal Cord Injury Systems at the National 
     Institute on Disability and Rehabilitation Research at the 
     Department of Education, based on such data submitted to the 
     Secretary by a facility, in a form, manner, and time frame 
     specified by the Secretary;
       ``(III) has a minimum Medicare case mix index of 1.1144 for 
     2012 according to the IRF Rate Setting File described in 
     clause (ii)(I); and
       ``(IV) has a Medicare disproportionate share hospital (DSH) 
     percentage of at least 0.6300 according to the IRF Rate 
     Setting File described in clause (ii)(I)).''.

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