,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #cadd  ,,in ,,the ,,house ,,of  
,,representatives  ,september #ai1      
#bjac,mr4 ,mc,dermott introduced the    
following bill2 which was referred to   
the ,committee on ,ways and ,means  ,a  
,,bill  ,to amend title ,,xviii of the  
,social ,security ,act to provide       
,medicare coverage of extended care     
services without regard to a requirement
 for a #c-;day prior hospitalization1   
and for other purposes4  #a4 ,short     
title ,this ,act may be cited as the    
,fairness for ,beneficiaries ,act of    
#bjac4  #b4 ,medicare coverage of       
extended care services without a #c-;day
 prior hospitalization  7a7 ,in general 
,subsection 7f7 of section #ahab of the 
,social ,security ,act 7#db ,u4,s4,c4   
#acie;d7 is amended to read as follows3 
7f7 ,coverage of extended care services 
without a #c-;,day prior hospitalization
  7#a7 ,in general ,coverage shall be   
provided under this part for an         
individual for extended care services in

 a skilled nursing facility that are not
 post-hospital extended care services   
if1 before the individual is admitted to
 the skilled nursing facility1 a        
physician or other qualified health care
 practitioner described in section      
#ahad7;a77#b7 makes a determination that
 the provision of extended care services
 to the individual is medically         
necessary and has made the certification
 described in subparagraph 7,b7 of such 
section with respect to such services   
7and continues to have such a           
certification made in the same manner as
 for post-hospital extended care        
services74  7#b7 ,continued application 
of certification and other requirements 
and provisions ,the requirements of     
paragraphs 7#b7 and 7#f7 of section     
#ahad7;a7 and the provisions of         
subsections 7b77#b7 and 7e7 and sections
 #aheb7l71 #ahfa7v77#a77;,g77i71        
#ahfa7v77#b77;,a71 #ahfa7v77#c71        
#ahfa7y71 #ahfa7tt77#a77;,b71           
#ahfb7;a77#ah71                         

#ahff7;a77#a77;,h77ii77,i71 #ahhc7;d71  
#ahhc7;f71 and #ahhh7;e7 shall apply to 
extended care services provided under   
this subsection in the same manner as   
they apply to post-hospital extended    
care services4  7#c7 ,,mac              
determinations  7,a7 ,publication of    
requirements for determinations ,not    
later than #f months after the date of  
the enactment of this paragraph1 the    
,secretary shall publish a set of       
uniform requirements that will enable   
the medicare administrative contractors 
to make determinations as to whether an 
admission described in paragraph 7#a7 is
 medically necessary4  7,b7 ,,mac audits
 ,a medicare administrative contractor  
may audit determinations described in   
paragraph 7#a7 based on the uniform     
requirements established under          
subparagraph 7,a74 ,in any              
administrative proceeding to review such
 determinations1 the uniform            
requirements established by the         
,secretary shall be binding on          

administrative law judges4  4  7b7      
,effective date ,the amendment made by  
subsection 7a7 shall apply to extended  
care services furnished on or after the 
date that is #a year after the date of  
the enactment of this ,act4