Medicare Long-Term Care Hospital Improvement Act of 2009

Medicare Long-Term Care Hospital Improvement Act of 2009 - Amends the Medicare, Medicaid, and SCHIP Extension Act of 2007, as amended by the American Recovery and Reinvestment Act of 2009, to extend from three years to five years the delay in application of: (1) the 25% patient threshold payment adjustment to freestanding and grandfathered long-term care hospitals (LTCHs); (2) any payment adjustment, in certain circumstances, to any applicable LTCH or satellite facility located in a rural area or co-located with an urban single or metropolitan statistical area (MSA) dominant hospital; (3) the very short-stay outlier policy; and (4) a specified one-time prospective adjustment to LTCH prospective payment rates.

Extends from three years to five years the moratorium on: (1) the establishment and classification of a LTCH or satellite facility, other than an existing one; and (2) an increase of LTCH beds in existing LTCHs or satellite facilities.

Establishes a formula for annual adjustment of the base prospective payment rate for LTCHs for rate years 2011 through 2015 in order to implement a budget neutrality offset of the costs of implementing this Act.

[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2124 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 2124

   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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 27, 2009

 Mr. Pomeroy (for himself, Mr. Larson of Connecticut, Mr. Doggett, and 
 Mr. Yarmuth) introduced the following bill; which was referred to the 
                      Committee on Ways and Means

_______________________________________________________________________

                                 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.

    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 ``Medicare Long-Term Care Hospital 
Improvement Act of 2009''.

SEC. 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.

SEC. 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.

SEC. 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.''.
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