text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Access to Inpatient Rehabilitation 
  Therapy Act of 2017''.
  
  SEC. 2. FINDINGS AND PURPOSE.
  
      (a) Findings.--Congress finds the following:
              (1) Intensive, coordinated medical rehabilitation provided 
          in inpatient rehabilitation hospitals and units is critical to 
          Medicare beneficiaries with injuries, illnesses, disabilities, 
          and chronic conditions in order to return to health, full 
          function, independent living, and a high quality of life.
              (2) The Centers for Medicare & Medicaid Services (in this 
          section referred to as ``CMS'') uses an ``intensity of 
          therapy'' requirement to help determine which Medicare 
          beneficiaries are appropriate for treatment in an inpatient 
          rehabilitation hospital or unit. CMS has interpreted the 
          intensity of therapy requirement through application of the so-
          called ``Three Hour Rule'' (42 C.F.R. 412.622(a)(3)(ii)) which 
          requires the patient to be able to participate in three hours 
          of rehabilitation therapy per day, five days per week, or 15 
          hours of rehabilitation therapy over a one-week period.
              (3) Before 2010, CMS regulations explicitly stated that 
          physical therapy, occupational therapy, speech therapy, and/or 
          orthotics and prosthetics were counted toward the Three Hour 
          Rule on an as-needed basis. In addition, CMS regulations stated 
          that ``other therapeutic modalities'' that were determined by 
          the physician and the rehabilitation team to be needed by the 
          patient ``on a priority basis'' would qualify toward 
          satisfaction of the rule (HCFA Ruling 85-2).
              (4) This language allowed recreational therapy to count 
          toward satisfaction of the Three Hour Rule for patients who 
          required this mix of therapies on a priority basis in the 
          inpatient rehabilitation hospital or unit setting.
              (5) CMS by regulation (74 Fed. Reg. 39811 (August 7, 2009)) 
          revised these prior regulations, effective January 1, 2010, by 
          limiting the Three Hour Rule to recognize only four services 
          (namely, physical, occupational, and speech therapy as well as 
          orthotics and prosthetics) and removing the discretion of the 
          physician and the rehabilitation team to count other 
          therapeutic services needed by the patient toward satisfaction 
          of the Three Hour Rule. As a result, recreational therapy 
          services are often not available to patients who require 
          medically necessary recreational therapy as part of their plan 
          of care.
              (6) Recreational therapy is a treatment service designed to 
          restore, remediate, and rehabilitate a patient's level of 
          functioning and independence in life activities, to promote 
          health and wellness as well as to reduce or eliminate the 
          activity limitations and restrictions to participation in life 
          situations caused by an illness or disabling condition. 
          Recreational therapy in the inpatient rehabilitation hospital 
          and unit setting is provided by qualified recreational 
          therapists when required by the patient's condition and 
          prescribed by a physician as part of a patient's plan of care.
      (b) Purpose.--It is the purpose of this Act to restore reliance on 
  the professional judgment of the treating physician and the 
  rehabilitation team when determining whether a Medicare patient meets 
  the intensity of therapy requirement of an inpatient rehabilitation 
  hospital or unit in order for that patient to gain access to the 
  appropriate mix of medically necessary therapeutic rehabilitation 
  services in that setting, including physical therapy, occupational 
  therapy, and, as needed, speech therapy, orthotics and prosthetics, and 
  recreational therapy.
  
  SEC. 3. INCLUDING RECREATIONAL THERAPY AMONG THE THERAPY MODALITIES 
                THAT CONSTITUTE AN INTENSIVE REHABILITATION THERAPY 
                PROGRAM IN DETERMINING THE MEDICAL NECESSITY OF SERVICES 
                IN AN INPATIENT REHABILITATION FACILITY (IRF).
  
      (a) In General.--Section 1886(j) of the Social Security Act (42 
  U.S.C. 1395ww(j)) is amended by adding at the end the following new 
  paragraph:
              ``(9) Including recreational therapy among therapy 
          modalities that constitute an intensive rehabilitation therapy 
          program in a rehabilitation facility.--The Secretary shall 
          include recreational therapy services among the therapeutic 
          modalities that constitute an intensive rehabilitation program 
          in determining (pursuant to applicable regulations) whether 
          inpatient services in a rehabilitation facility are reasonable 
          and necessary under section 1862(a)(1)(A).''.
      (b) Effective Date.--The amendment made by section (a) shall apply 
  to services furnished on or after January 1, 2018.
target: Access to Inpatient Rehabilitation Therapy Act of 2017 This bill amends title XVIII (Medicare) of the Social Security Act to require the Centers for Medicare &amp; Medicaid Services,&nbsp;for purposes of&nbsp;determining whether inpatient rehabilitation-facility services are reasonable and necessary under Medicare,&nbsp;to include recreational-therapy services among the therapeutic modalities that constitute an intensive rehabilitation-therapy program. 
feat_title: Access to Inpatient Rehabilitation Therapy Act of 2017