,i  #aah? ,,congress  #b;d ,session  ,h4
 ,r4 #iagc  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #be1 #bjbd ,mr4 
,smuck] 7= himself1 ,mr4 ,boyle (       
,p5nsylvania1 & ,mr4 ,joyce (           
,p5nsylvania7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,ways & 
,means  ,a ,,bill  ,to am5d title       
,,xviii ( ! ,social ,security ,act to   
/abilize paym5ts to long-t]m c>e        
hospitals "u ! ,m$ic>e program & improve
 pati5t access4  #a4 ,%ort title ,?is   
,act may be cit$ z ! ,long ,t]m ,c>e    
,/abilization ,act4  #b4 ,tempor>y cap  
on fix$ loss am\nt = sett+ paym5ts =    
high-co/ long-t]m c>e hospital pati5ts  
7a7 ,m$ic>e high co/ outli] paym5ts to  
long-,t]m c>e hospitals ,section        
#ahhf7m77#g7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acieww7m77#g77 is       
am5d$--  7#a7 by r$esignat+ subp>agraphs
 7,c7 & 7,d7 z subp>agraph 7,d7 & 7,e71 
respectively2  7#b7 by ins]t+ aft]      
subp>agraph 7,b7 ! foll[+ new           
subp>agraph3  7,c7 ,tempor>y cap on fix$

 loss am\nt ,not)/&+ subp>agraphs 7,a7 &
 7,b71 ! fix$ loss am\nt = high co/     
outli] paym5ts made = /&>d ,f$]al paym5t
 rate dis*>ges 9 fiscal ye>s #bjbe &    
#bjbf may n exce$ #ej1jjj4  2 &  7#c7 9 
subp>agraph 7,d71 z s r$esignat$ by     
p>agraph 7#a71 by ins]t+ 1 & any        
increase 9 paym5ts result+ f !          
application ( subp>agraph 7,c71 aft]    
subp>agraph 7,b74  7b7 ,/udy & report on
 high co/ outli] paym5ts to long-,t]m   
c>e hospitals  7#a7 ,/udy ,! ,secret>y (
 ,heal? & ,human ,s]vices 79 ?is section
 ref]r$ to z ! ,secret>y7 %all conduct a
 /udy on ! curr5t me?odology = mak+ high
 co/ outli] paym5ts to long-t]m c>e     
hospitals "u ! paym5t sy/em describ$ 9  
section #ahhf7m77l7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acieww7m77#a774 ,su* /udy %all include 
an analysis ( ! foll[+3 7,a7 ,pot5tial  
legislative *anges to re=m ! me?odology 
= mak+ high co/ outli] paym5ts to       
long-t]m c>e hospitals to ensure t su*  
hospitals are inc5tiviz$ to treat       

,m$ic>e b5efici>ies ) high res\rce ne$s4
  7,b7 ,! effect ( ! site neutral paym5t
 rate & pati5t crit]ia "u section       
l#hhf7m77#f7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acieww7m77#f77 on ! data
 t ! ,secret>y uses to calculate ! fix$ 
loss am\nt = high co/ outli] paym5ts to 
long-t]m c>e hospitals4  7,c7 ,! *anges 
to long-t]m c>e hospital utilization    
dur+ ! ,,covid-#ai p&emic & ! impact t  
su* *anges _h on ! data t ! ,secret>y   
uses to calculate ! fix$ loss am\nt =   
high co/ outli] paym5ts to long-t]m c>e 
hospitals4  7,d7 ,! effect ( inflation &
 increas+ labor co/s on ! data t !      
,secret>y uses to calculate ! fix$ loss 
am\nt = high co/ outli] paym5ts to      
long-t]m c>e hospitals4  7,e7 ,! h>ms to
 long-t]m c>e hospitals & b5efici>ies1  
includ+ pati5t access to c>e1 z a result
 ( ! increases to ! fix$ loss am\nts    
adopt$ by ! ,secret>y 9 fiscal ye>s     
#bjbc & #bjbd4  7,f7 ,! pot5tial b5efits
 to long-t]m c>e hospitals & b5efici>ies
 t may result f increas+ ! #ii4fhge     

p]c5t ( #h p]c5t t>get = high co/ outli]
 paym5ts set by section                 
#ahhf7m77#g77;,b7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4                     
#acieww7m77#g77;,b774  7#b7 ,report ,n  
lat] ?an #a ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 ! ,secret>y %all submit to 
,congress a report on ! /udy conduct$ "u
 p>agraph 7#a71 includ+ recomm5dations  
on *anges to ! me?odology = mak+ high   
co/ outli] paym5ts to longt]m c>e       
hospitals "u ! paym5t sy/em describ$ 9  
section #ahhf7m77l7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acieww7m77#a774  #c4 ,tempor>y paym5t  
at ! /&>d ,f$]al rate = c]ta9 long-t]m  
c>e hospital dis*>ges ) sev]e w\nds  7a7
 ,9 g5]al ,section #ahhf7m77#f7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7m77#f77 is am5d$-- 7#a7 9       
subp>agraph 7,a77i71 by /rik+ & 7,g7 &  
ins]t+ 7,g71 & 7,h72 &  7#b7 by add+ at 
! end ! foll[+ new subp>agraph3  7,h7   
,tempor>y exception = c]ta9 sev]e w\nd  
dis*>ges f long-t]m c>e hospitals 9     

fiscal ye>s #bjbe ?r\gh #bjbg  7i7 ,9   
g5]al ,= a dis*>ge 9 a co/ report+ p]iod
 beg9n+ on or aft] ,octob] #a1 #bjbd1 & 
be=e ,octob] #a1 #bjbg1 subp>agraph     
7,a77i7 %all n apply 7& paym5t %all be  
made to a long-t]m c>e hospital )\t     
reg>d to ?is p>agraph7 if su* dis*>ge is
 ) respect to an individual treat$ by a 
long-t]m c>e hospital = a sev]e w\nd4   
7ii7 ,sev]e w\nd def9$ ,9 ?is           
subp>agraph1 ! t]m sev]e w\nd means a   
/age #c w\nd1 /age #d w\nd1 un/ageable  
w\nd1 non-heal+ surgical w\nd1 infect$  
w\nd1 fi/ula1 o/eomyelitis1 or a w\nd ) 
morbid obesity1 z id5tifi$ by !         
applicable code on ! claim f ! long-t]m 
c>e hospital4  7iii7 ,w\nd def9$ ,9 ?is 
subp>agraph1 ! t]m w\nd means an injury 
involv+ division ( tissue or rupture or 
! integum5t or muc\s membrane ) exposure
 to ! ext]nal environm5t4  4  7b7 ,/udy 
& report on an exception to ! long-,t]m 
c>e hospital site neutral paym5t rate = 
c]ta9 sev]e w\nd dis*>ges  7#a7 ,/udy ,!
 ,secret>y ( ,heal? & ,human ,s]vices 79

 ?is section ref]r$ to z ! ,secret>y7   
%all conduct a /udy t exam9es :e!r !    
tempor>y exception to ! site neutral    
paym5t rate = long-t]m c>e hospitals =  
c]ta9 sev]e w\nd dis*>ges "u section    
#ahhf7m77#f77;,h7 ( ! ,social ,security 
,act1 z add$ by subsection 7a77#b7 79   
?is p>agraph ref]r$ to z ! sev]e w\nd   
tempor>y exception71 %\ld be made       
p]man5t4 ,su* report %all include an    
analysis ( ! foll[+3 7,a7 ,! co/s &     
b5efits ( ! sev]e w\nd tempor>y         
exception1 includ+ ! impact on pati5t   
outcomes & hospital readmissions =      
pati5ts ) sev]e w\nds4  7,b7 ,a m9imum (
 #ah mon?s ( claims data to det]m9e h[ !
 sev]e w\nd tempor>y exception affects  
paym5ts to long-t]m c>e hospitals "u !  
paym5t sy/em describ$ 9 section         
#ahhf7m77l7 ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acieww7m77#a774  7,c7   
,tak+ into acc\nt data collect$ be=e !  
effective date ( ! sev]e w\nd tempor>y  
exception & dur+ ! p]iod :5 su*         
exception is 9 effect1 ! impact ( !     

sev]e w\nd tempor>y exception on ! co/s 
( an episode ( c>e = pati5ts ) qualify+ 
sev]e w\nds treat$ 9 long-t]m c>e       
hospitals1 includ+ ! diff]5ce 9 co/s (  
sev]e w\nd pati5t episodes ( c>e t      
include admissions to long-t]m c>e      
hospitals pursuant to a sev]e w\nd      
tempor>y exception comp>$ to simil>     
episodes ( c>e = pati5ts ) sev]e w\nds  
:o are n admitt$ to long-t]m c>e        
hospitals4  7,d7 ,pot5tial sav+s to !   
program "u title ,,xviii ( ! ,social    
,security ,act t may result f mak+      
p]man5t ! sev]e w\nd tempor>y exception4
  7,e7 ,a review ( comm5ts & o!r fe$back
 t ! ,secret>y %all obta9 f long-t]m c>e
 hospitals & o!r /akehold]s pursuant to 
a reque/ = in=mation publi%$ 9 ! ,f$]al 
,regi/] reg>d+ ! sev]e w\nd tempor>y    
exception & ! b5efici>ies :o are treat$ 
9 long-t]m c>e hospitals pursuant to su*
 exception4  7#b7 ,report ,n lat] ?an   
,octob] #a1 #bjbf1 ! ,secret>y %all     
submit to ,congress a report on ! /udy  
conduct$ "u p>agraph 7#a71 includ+ a    

recomm5dation on :e!r ! sev]e w\nd      
tempor>y exception %\ld be made p]man5t4
  7#c7 ,def9ition ,= purposes ( ?is     
subsection1 ! t]m episode ( c>e means ! 
l5g? ( /ay ( ! applicable b5efici>y 9 ! 
longt]m c>e hospital or subsection 7d7  
hospital1 plus ! #ij days foll[+ !      
dis*>ge ( ! b5efici>y f ! hospital4