,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #dgee  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #bi1 #bjad ,mr4  
,?ompson ( ,p5nsylvania 7= himself &    
,mr4 ,butt]field7 introduc$ ! foll[+    
bill2 :i* 0 ref]r$ to ! ,committee on   
,ways & ,means  ,a ,,bill  ,to am5d     
title ,,xviii ( ! ,social ,security ,act
 to include recreational !rapy among !  
!rapy modalities t con/itute an int5sive
 rehabilitation !rapy program 9 an      
inpati5t rehabilitation hospital or     
unit4  #a4 ,%ort title ,?is ,act may be 
cit$ z ! ,access to ,inpati5t           
,rehabilitation ,!rapy ,act ( #bjad4    
#b4 ,f9d+s & purpose  7a7 ,f9d+s        
,congress f9ds ! foll[+3  7#a7          
,int5sive1 coord9at$ m$ical             
rehabilitation provid$ 9 inpati5t       
rehabilitation hospitals & units is     
critical to ,m$ic>e b5efici>ies )       
injuries1 illnesses1 disabilities1 &    
*ronic conditions 9 ord] to return to   
heal?1 full function1 indep5d5t liv+1 & 
a high quality ( life4  7#b7 ,! ,c5t]s =

 ,m$ic>e  ,m$icaid ,s]vices 79 ?is      
section ref]r$ to z ,,cms7 uses an      
int5sity ( !rapy requirem5t to help     
det]m9e :i* ,m$ic>e b5efici>ies are     
appropriate = treatm5t 9 an inpati5t    
rehabilitation hospital or unit4 ,,cms  
has int]pret$ ! int5sity ( !rapy        
requirem5t ?r\gh application ( ! s-call$
 ,?ree ,h\r ,rule 7#db ,c4,f4,r4        
#dab4fbb7;a77#c77;ii77 :i* requires !   
pati5t to be able to p>ticipate 9 ?ree  
h\rs ( rehabilitation !rapy p] day1 five
 days p] week1 or #ae h\rs (            
rehabilitation !rapy ov] a "o-week      
p]iod4  7#c7 ,be=e #bjaj1 ,,cms         
regulations explicitly /at$ t physical  
!rapy1 occupational !rapy1 spee* !rapy1 
&_/or or?otics & pro/hetics 7 c\nt$ t[>d
 ! ,?ree ,h\r ,rule on an z-ne$$ basis4 
,9 addition1 ,,cms regulations /at$ t   
o!r !rapeutic modalities t 7 det]m9$ by 
! physician & ! rehabilitation team to  
be ne$$ by ! pati5t on a priority basis 
w\ld qualify t[>d satisfaction ( ! rule 
7,,hcfa ,rul+ #he-b74  7#d7 ,?is        

language all[$ recreational !rapy to    
c\nt t[>d satisfaction ( ! ,?ree ,h\r   
,rule = pati5ts :o requir$ ?is mix (    
!rapies on a priority basis 9 ! inpati5t
 rehabilitation hospital or unit sett+4 
7#e7 ,,cms by regulation 7#gd ,f$4 ,reg4
 #cihaa 7,augu/ #g1 #bjji77 revis$ ^!   
prior regulations1 effective ,janu>y #a1
 #bjaj1 by limit+ ! ,?ree ,h\r ,rule to 
recognize only f\r s]vices 7namely1     
physical1 occupational1 & spee* !rapy z 
well z or?otics & pro/hetics7 & remov+ !
 discretion ( ! physician & !           
rehabilitation team to c\nt o!r         
!rapeutic s]vices ne$$ by ! pati5t t[>d 
satisfaction ( ! ,?ree ,h\r ,rule4 ,z a 
result1 recreational !rapy s]vices are  
(t5 n available to pati5ts :o require   
m$ically necess>y recreational !rapy z  
"p ( _! plan ( c>e4  7#f7 ,recreational 
!rapy is a treatm5t s]vice design$ to   
re/ore1 rem$iate1 & rehabilitate a      
pati5t's level ( function+ & indep5d5ce 
9 life activities1 to promote heal? &   
wellness z well z to r$uce or elim9ate !

 activity limitations & re/rictions to  
p>ticipation 9 life situations caus$ by 
an illness or disabl+ condition4        
,recreational !rapy 9 ! inpati5t        
rehabilitation hospital & unit sett+ is 
provid$ by qualifi$ recreational !rapi/s
 :5 requir$ by ! pati5t's condition &   
prescrib$ by a physician z "p ( a       
pati5t's plan ( c>e4  7b7 ,purpose ,x is
 ! purpose ( ?is ,act to re/ore reliance
 on ! pr(essional judgm5t ( ! treat+    
physician & ! rehabilitation team :5    
det]m9+ :e!r a ,m$ic>e pati5t meets !   
int5sity ( !rapy requirem5t ( an        
inpati5t rehabilitation hospital or unit
 9 ord] = t pati5t to ga9 access to !   
appropriate mix ( m$ically necess>y     
!rapeutic rehabilitation s]vices 9 t    
sett+1 includ+ physical !rapy1          
occupational !rapy1 &1 z ne$$1 spee*    
!rapy1 or?otics & pro/hetics1 &         
recreational !rapy4  #c4 ,includ+       
recreational !rapy among ! !rapy        
modalities t con/itute an int5sive      
rehabilitation !rapy program 9 det]m9+ !

 m$ical necessity ( s]vices 9 an        
inpati5t rehabilitation facility 7,,irf7
  7a7 ,9 g5]al ,section #ahhf7;j7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7j77 is am5d$ by add+ at ! end ! 
foll[+ new p>agraph3  7#i7 ,includ+     
recreational !rapy among !rapy          
modalities t con/itute an int5sive      
rehabilitation !rapy program 9 a        
rehabilitation facility ,! ,secret>y    
%all include recreational !rapy s]vices 
among ! !rapeutic modalities t con/itute
 an int5sive rehabilitation program 9   
det]m9+ 7pursuant to applicable         
regulations7 :e!r inpati5t s]vices 9 a  
rehabilitation facility are reasonable &
 necess>y "u section #ahfb7;a77#a77;,a74
  4  7b7 ,effective date ,! am5dm5t made
 by section 7a7 %all apply to s]vices   
furni%$ on or aft] ,janu>y #a1 #bjae4