,i  #aag? ,,congress  #b;d ,session  ,h4
 ,r4 #hhgi  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,septemb] #ai1        
#bjbb,mr4 ,evans 7= himself & ,mr4      
,arr+ton7 introduc$ ! foll[+ bill2 :i* 0
 ref]r$ to ! ,committee on ,ways &      
,means  ,a ,,bill  ,to am5d title       
,,xviii ( ! ,social ,security ,act to   
provide = improvem5ts to ! ,m$ic>e      
prospective paym5t sy/em = psy*iatric   
hospitals & psy*iatric units4  #a4 ,%ort
 title ,?is ,act may be cit$ z !        
,inpati5t ,psy*iatric ,facility         
,improvem5t ,act4  #b4 ,improvem5ts to  
,m$ic>e prospective paym5t sy/em =      
psy*iatric hospitals & psy*iatric units 
7a7 ,improvem5ts ?r\gh additional claims
 data in=mation ,section #ahhf7s7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7s77 is am5d$ by add+ at ! end ! 
foll[+ new p>agraph3  7#e7 ,additional  
data & in=mation  7,a7 ,9 g5]al ,!      
,secret>y %all collect data & in=mation 
z ! ,secret>y det]m9es appropriate to   
revise paym5ts "u ! sy/em describ$ 9    

p>agraph 7#a7 = psy*iatric hospitals &  
psy*iatric units pursuant to subp>agraph
 7,d7 & = o!r purposes z det]m9$        
appropriate by ! ,secret>y4 ,! ,secret>y
 %all beg9 to collect su* data by n lat]
 ?an ,octob] #a1 #bjbc4  7,b7 ,data &   
in=mation ,! data & in=mation to be     
collect$ "u subp>agraph 7,a7 may        
include-- 7i7 *>ges1 includ+ ^? relat$  
to ancill>y s]vices2  7ii7 ! requir$    
int5sity ( behavioral monitor+1 su* z   
cognitive deficit1 suicide ideations1   
viol5t behavior1 & ne$ = physical       
re/ra9t2 &  7iii7 int]v5tions1 su* z    
detoxification s]vices = sub/ance abuse1
 dep5d5ce on respirator1 total p>5t]al  
nutritional support1 dep5d5ce on r5al   
dialysis1 & burn c>e4  7,c7 ,me?od (    
collection ,! ,secret>y may collect !   
additional data & in=mation "u          
subp>agraph 7,a7 on co/ reports or      
claims4  7,d7 ,revisions to paym5t rates
  7i7 ,9 g5]al ,not)/&+ ! prec$+        
p>agraphs ( ?is subsection or section   
#abd ( ! ,m$ic>e1 ,m$icaid1 & ,,s*ip    

,balanc$ ,budget ,ref9em5t ,act ( #aiii1
 = rate ye> #bjbe 7& = any subsequ5t    
rate ye>1 if det]m9$ appropriate by !   
,secret>y71 ! ,secret>y %all1 by        
regulation1 implem5t revisions to !     
me?odology = det]m9+ ! paym5t rates "u !
 sy/em describ$ 9 p>agraph 7#a7 =       
psy*iatric hospitals & psy*iatric units1
 z ! ,secret>y det]m9es to be           
appropriate4 ,su* revisions may be bas$ 
on a review ( data & in=mation collect$ 
"u subp>agraph 7,a74  7ii7 ,review ,!   
,secret>y may make revisions to !       
diagnosis-relat$ gr\p classifications1 9
 accordance ) subsection 7d77#d77;,c71  
to reflect nurs+ & /aff res\rce use &   
co/s involv$ 9 furni%+ s]vices at su*   
hospitals & units1 includ+ consid]ations
 = pati5t complexity & prior admission  
to an inpati5t psy*iatric facility1 :i* 
may be bas$ on review ( data & in=mation
 collect$ "u subp>agraph 7,a71 z !      
,secret>y det]m9es to be appropriate4   
7iii7 ,budget neutrality ,revisions 9   
paym5t implem5t$ pursuant to clause 7i7 

= a rate ye> %all result 9 ! same       
e/imat$ am\nt ( aggregate exp5ditures "u
 ?is title = psy*iatric hospitals &     
psy*iatric units furni%$ 9 ! rate ye> z 
w\ld h be5 made "u ?is title = su* c>e 9
 su* rate ye> if su* revisions _h n be5 
implem5t$4  4  7b7 ,improvem5ts ?r\gh   
/&>diz$ pati5t assessm5t data ,section  
#ahhf7s7 ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #acieww7s771 z am5d$ by      
subsection 7a71 is fur!r am5d$-- 7#a7 9 
p>agraph 7#d7-- 7,a7 9 subp>agraph      
7,a77i71 by /rik+ subp>agraph 7,c7 &    
ins]t+ subp>agraphs 7,c7 & 7,e72  7,b7  
by r$esignat+ subp>agraph 7,e7 z        
subp>agraph 7,f72  7,c7 by ins]t+ aft]  
subp>agraph 7,d7 ! foll[+ new           
subp>agraph3  7,e7 ,/&>diz$ pati5t      
assessm5t data  7i7 ,9 g5]al ,= rate ye>
 #bjbh & ea* subsequ5t rate ye>1 9      
addition to su* data on ! quality       
measures describ$ 9 subp>agraph 7,c71   
ea* psy*iatric hospital & psy*iatric    
unit %all submit to ! ,secret>y1 ?r\gh !
 use ( a /&>diz$ assessm5t in/rum5t     

implem5t$ "u clause 7iii71 ! /&>diz$    
pati5t assessm5t data describ$ 9 clause 
7ii74 ,su* data %all be submitt$ )      
respect to admission & dis*>ge ( an     
individual 7& may be submitt$ m         
frequ5tly z ! ,secret>y det]m9es        
appropriate74  7ii7 ,/&>diz$ pati5t     
assessm5t data describ$ ,= purposes (   
clause 7i71 ! /&>diz$ pati5t assessm5t  
data describ$ 9 ?is clause1 ) respect to
 a psy*iatric hospital or psy*iatric    
unit1 is data ) respect to ! foll[+     
categories3 7,i7 ,functional /atus1 su* 
z mobility & self-c>e at admission to a 
psy*iatric hospital or unit & be=e      
dis*>ge f a psy*iatric hospital or unit4
  7,,ii7 ,cognitive function1 su* z     
ability to express ideas & to und]/&1 & 
m5tal /atus1 su* z depression & dem5tia4
  7,,iii7 ,special s]vices1 treatm5ts1 &
 int]v5tions = psy*iatric conditions4   
7,,iv7 ,m$ical conditions &             
co-morbidities1 su* z diabetes1         
conge/ive he>t failure1 & pressure      
ulc]s4  7,v7 ,impairm5ts1 su* z         

incont95ce & an impair$ ability to he>1 
see1 or swall[4  7,,vi7 ,o!r categories 
z det]m9$ appropriate by ! ,secret>y4   
7iii7 ,/&>diz$ assessm5t in/rum5t  7,i7 
,9 g5]al ,= purposes ( clause 7i71 !    
,secret>y %all implem5t a /&>diz$       
assessm5t in/rum5t t provides = !       
submission ( /&>diz$ pati5t assessm5t   
data "u ?is title ) respect to          
psy*iatric hospitals & psy*iatric units 
:i* enables comp>ison ( su* assessm5t   
data across all su* hospitals & units to
 :i* su* data are applicable4  7,,ii7   
,fund+ ,! ,secret>y %all provide = !    
transf]1 f ! ,f$]al ,hospital ,insurance
 ,tru/ ,fund "u section #ahag to !      
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices     
,program ,managem5t ,acc\nt1 (          
#aj1jjj1jjj = purposes ( c>ry+ out      
subclause 7,i74  2 &  7,d7 9 subp>agraph
 7,f71 z r$esignat$ by subp>agraph 7,b7 
( ?is p>agraph1 by /rik+ subp>agraph    
7,c7 & ins]t+ subp>agraphs 7,c7 & 7,f72 
&  7#b7 by add+ at ! end ! foll[+ new   
p>agraph3  7#f7 ,additional             

consid]ations = diagnosis-relat$ gr\p   
classifications  7,a7 ,9 g5]al ,not)/&+ 
! prec$+ p>agraphs ( ?is subsection 7o!r
 ?an p>agraph 7#e77 or section #abd ( ! 
,m$ic>e1 ,m$icaid1 & ,,s*ip ,balanc$    
,budget ,ref9em5t ,act ( #aiii1 beg9n+ n
 lat] ?an rate ye> #bjca1 9 addition to 
any revisions pursuant to p>agraph 7#e71
 ! ,secret>y %all1 by regulation1       
implem5t revisions to ! me?odology =    
det]m9+ ! paym5t rates "u ! sy/em       
describ$ 9 p>agraph 7#a7 = psy*iatric   
hospitals & psy*iatric units1 z !       
,secret>y det]m9es to be appropriate1 to
 take into acc\nt ! pati5t assessm5t    
data describ$ 9 p>agraph 7#d77;,e77ii74 
7,b7 ,budget neutrality ,revisions 9    
paym5t implem5t$ pursuant to subp>agraph
 7,a7 = a rate ye> %all result 9 ! same 
e/imat$ am\nt ( aggregate exp5ditures "u
 ?is title = psy*iatric hospitals &     
psy*iatric units furni%$ 9 ! rate ye> z 
w\ld h be5 made "u ?is title = su* c>e 9
 su* rate ye> if su* revisions _h n be5 
implem5t$4  4