,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #ceii  ,,in ,,the ,,house ,,of  
,,representatives  ,november #ba1       
#bjac,mr4 ,fortenberry 7for himself and 
,mr4 ,hall7 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 with respect to  
payments to long-term care hospitals1   
and for other purposes4  #a4 ,relief for
 ,medicare payments to long-term care   
hospitals  7a7 ,application of #be      
percent rule patient threshold payment  
adjustment  7#a7 ,extension of relief   
,in implementing sections #dab4ecd and  
#dab4ecf of title #db1 ,code of ,federal
 ,regulations1 for a #ab-month cost     
reporting period beginning on or after  
,october #a1 #bjac1 the ,secretary of   
,health and ,human ,services shall      
continue the same threshold payment     
adjustment percentages and exemptions as
 were established for the #ab-month cost
 reporting periods beginning on or after

 ,october #a1 #bjab1 in the same manner 
as was provided for in the rule         
published on ,august #ca1 #bjab 7#gg    
,federal ,register #ecbeh74  7#b7 ,no   
application of rule to grandfathered    
,l,t,c,hs ,the ,secretary of ,health and
 ,human ,services shall not apply       
sections #dab4ecd and #dab4ecf of title 
#db1 ,code of ,federal ,regulations1 or 
any similar provisions to a long-term   
care hospital described in the second   
sentence of section #ahhf7;d77#a77;,b7  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acieww7d77#a77;,b774  7#c7   
,new exclusion from calculation of the  
#be percent rule ,medicare beneficiaries
 who were inpatients in a subsection 7d7
 hospital within #a day prior to their  
admission to a long-term care hospital  
described in section                    
#ahhf7;d77#a77;,b77iv77,i7 of the       
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7d77#a77;,b77iv77,i77 and who had
 a stay of more than #g days in an      
intensive care unit identified in       

section #dac4ec7;d7 of title #db1 ,code 
of ,federal ,regulations1 shall be      
excluded from the numerator of the #be  
percent threshold applied under sections
 #dab4ecd and #dab4ecf of such title4   
7#d7 ,effective date ,this subsection   
shall be effective on ,october #a1      
#bjac4  7b7 ,clarification of payments  
paid to long-,term care hospitals on an 
,,ipps basis  7#a7 ,site neutral        
payments ,for discharges occurring on or
 after ,october #a1 #bjad1 payments made
 to long-term care hospitals described  
in section #ahhf7;d77#a77;,b77iv77,i7 of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acieww7d77#a77;,b77iv77,i77  
at amounts that are comparable or       
equivalent to amounts that are payable  
to a subsection 7d7 hospital1 for short 
stay patients and under the #be percent 
rules established under sections        
#dab4ebi7;d77#d71 #dab4ecd1 and #dab4ecf
 of title #db1 ,code of ,federal        
,regulations1 shall be at amounts that  
are not less than would be paid to a    

subsection 7d7 hospital had it performed
 the same services4  7#b7 ,calculation  
of length of stay excluding cases paid  
on an ,,ipps basis ,for discharges      
occurring on or after the date of the   
enactment of this ,act1 in calculating  
the length of stay requirement          
applicable to a long-term care hospital 
or satellite facility under section     
#ahhf7;d77#a77;,b77iv77,i7 of the       
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7d77#a77;,b77iv77,i77 and section
 #ahfa7;ccc77#b7 of such ,act 7#db      
,u4,s4,c4 #aciex7ccc77#b771 the         
,secretary of ,health and ,human        
,services shall exclude any patient for 
whom payment is based on an amount that 
is comparable or equivalent to the      
amount payable to a subsection 7d7      
hospital had such a hospital provided   
the same services4  7#c7 ,subsection 7d7
 hospital defined ,in this subsection1  
the term subsection 7d7 hospital has the
 meaning given such term in section     
#ahhf7;d77#a77;,b7 of the ,social       

,security ,act 7#db ,u4,s4,c4           
#acieww7d77#a77;,b774