SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preserving Patient Access to 
Inpatient Rehabilitation Hospitals Act of 2005''.

SEC. 2. EFFECT ON ENFORCEMENT OF REGULATIONS.

    (a) In General.--Notwithstanding section 412.23(b)(2) of title 42, 
Code of Federal Regulations, during the period beginning on July 1, 
2005, and ending on the date that is 2 years after the date of 
enactment of this Act, the Secretary of Health and Human Services 
(referred to in this Act as the ``Secretary'') shall not--
            (1) require a compliance rate, pursuant to the criterion 
        (commonly known as the ``75 percent rule'') that is used to 
        determine whether a hospital or unit of a hospital is an 
        inpatient rehabilitation facility (as defined in the rule 
        published in the Federal Register on May 7, 2004, entitled 
        ``Medicare Program; Final Rule; Changes to the Criteria for 
        Being Classified as an Inpatient Rehabilitation Facility'' (69 
        Fed. Reg. 25752)), that is greater than the 50 percent 
        compliance threshold that became effective on July 1, 2004;
            (2) change the designation of an inpatient rehabilitation 
        facility that is in compliance with the 50 percent threshhold; 
        or
            (3) conduct medical necessity review of inpatient 
        rehabilitation facilities using any guidelines, such as fiscal 
        intermediary Local Coverage Determinations, other than the 
        national criteria established in chapter 1, section 110 of the 
        Medicare Benefits Policy Manual.
    (b) Retroactive Status as an Inpatient Rehabilitation Facility; 
Payments; Expedited Review.--The Secretary shall establish procedures 
for--
            (1) making any necessary retroactive adjustment to restore 
        the status of a facility as an inpatient rehabilitation 
        facility as a result of subsection (a);
            (2) making any necessary payments to inpatient 
        rehabilitation facilities based on such adjustment for 
        discharges occurring on or after July 1, 2005 and before the 
        date of enactment of this Act; and
            (3) developing and implementing an appeals process that 
        provides for expedited review of any adjustment to the status 
        of a facility as an inpatient rehabilitation facility made 
        during the period beginning on July 1, 2005 and ending on the 
        date that is 2 years after the date of enactment of this Act.

SEC. 3. NATIONAL ADVISORY COUNCIL ON MEDICAL REHABILITATION.

    (a) Definitions.--In this section:
            (1) Advisory council.--The term ``Advisory Council'' means 
        the National Advisory Council on Medical Rehabilitation 
        established under subsection (b).
            (2) Appropriate federal agencies.--The term ``appropriate 
        Federal agencies'' means--
                    (A) the Agency for Healthcare Research and Quality;
                    (B) the Centers for Medicare & Medicaid Services;
                    (C) the National Institute on Disability and 
                Rehabilitation Research; and
                    (D) the National Center for Medical Rehabilitation 
                Research.
    (b) Establishment.--Pursuant to section 222 of the Public Health 
Service Act (42 U.S.C. 217a), the Secretary shall establish an advisory 
panel to be known as the ``National Advisory Council on Medical 
Rehabilitation''.
    (c) Membership.--
            (1) Appointment.--The Advisory Council shall be composed of 
        17 members, of whom--
                    (A) 9 members shall be appointed by the Secretary, 
                in consultation with the medical rehabilitation 
                community, from a diversity of backgrounds, including--
                            (i) physicians;
                            (ii) medicare beneficiaries;
                            (iii) representatives of inpatient 
                        rehabilitation facilities; and
                            (iv) other practitioners experienced in 
                        rehabilitative care; and
                    (B) 8 members, not more than 4 of whom are members 
                of the same political party, shall be appointed jointly 
                by--
                            (i) the Majority Leader of the Senate;
                            (ii) the Minority Leader of the Senate;
                            (iii) the Speaker of the House of 
                        Representatives;
                            (iv) the Minority Leader of the House of 
                        Representatives;
                            (v) the Chairman and the Ranking Member of 
                        the Committee on Finance of the Senate; and
                            (vi) the Chairman and the Ranking Member of 
                        the Committee on Ways and Means of the House of 
                        Representatives.
            (2) Date.--Members of the Advisory Council shall be 
        appointed not later than 30 days after the date of enactment of 
        this Act.
            (3) Period of appointment; vacancies.--Members shall be 
        appointed for the life of the Council. A vacancy on the 
        Advisory Council shall be filled not later than 30 days after 
        the date on which the Advisory Council is given notice of the 
        vacancy, in the same manner as the original appointment.
            (4) Meetings.--
                    (A) Initial meeting.--The Advisory Council shall 
                conduct an initial meeting not later than 120 days 
                after the date of enactment of this Act.
                    (B) Meetings.--The Advisory Council shall conduct 
                such meetings as the Council determines to be necessary 
                to carry out its duties but shall meet not less 
                frequently than 2 times during each calendar year.
    (d) Duties.--The duties of the Advisory Council shall include 
providing advice and recommendations to--
            (1) Congress and the Secretary concerning the coverage of 
        rehabilitation services under the medicare program, including--
                    (A) policy issues related to rehabilitative 
                treatment and reimbursement for rehabilitative care, 
                such as issues relating to any rulemaking relating to, 
                or impacting, rehabilitation hospitals and units;
                    (B) the appropriate criteria for--
                            (i) determining clinical appropriateness of 
                        inpatient rehabilitation facility admissions; 
                        and
                            (ii) distinguishing an inpatient 
                        rehabilitation facility from an acute care 
                        hospital and other providers of intensive 
                        medical rehabilitation;
                    (C) the efficacy of inpatient rehabilitation 
                services, as opposed to other post-acute inpatient 
                settings, through a comparison of quality and cost, 
                controlling for patient characteristics (such as 
                medical severity and motor and cognitive function) and 
                discharge destination;
                    (D) the effect of any medicare regulations on 
                access to inpatient rehabilitation care by medicare 
                beneficiaries and the clinical effectiveness of care 
                available to such beneficiaries in other health care 
                settings; and
                    (E) any other topic or issue that the Secretary or 
                Congress requests the Advisory Council to provide 
                advice and recommendations on; and
            (2) appropriate Federal agencies (as defined in subsection 
        (a)) on how to best utilize available research funds and 
        authorities focused on medical rehabilitation research, 
        including post-acute care site of service and outcomes 
        research.
    (e) Periodic Reports.--The Advisory Council shall provide the 
Secretary with periodic reports that summarize--
            (1) the Council's activities; and
            (2) any recommendations for legislation or administrative 
        action the Council considers to be appropriate.
    (f) Termination.--The Advisory Council shall terminate on September 
30, 2010.
    (g) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out the purposes of 
this section.
    (h) Effective Date.--This section shall take effect on the date of 
enactment of this Act.
Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005 - Prohibits the Secretary of Health and Human Services, during the period between July 1, 2005, and the date two years after the enactment of this Act, from: (1) requiring a compliance rate, pursuant to the criterion (commonly known as the "75 percent rule") used to determine whether a hospital or hospital unit is an inpatient rehabilitation facility, that is greater than the 50 percent compliance threshold that became effective on July 1, 2004; (2) changing the designation of any inpatient rehabilitation facility in compliance with the 50 percent threshold; or (3) conducting medical necessity review of inpatient rehabilitation facilities using any guidelines other than the national criteria established in the Medicare Benefits Policy Manual.

Directs the Secretary to establish procedures for: (1) making any necessary retroactive adjustment to restore the status of a facility as an inpatient rehabilitation facility as a result of this Act; (2) making any necessary payments to inpatient rehabilitation facilities based on such adjustment for discharges occurring on or after July 1, 2005, and before enactment of this Act; and (3) developing and implementing an appeals process that provides for expedited review of any adjustment to the status of a facility as an inpatient rehabilitation facility made during such period

Directs the Secretary to establish the National Advisory Council on Medical Rehabilitation to provide advice and recommendations to: (1) Congress and the Secretary concerning the coverage of rehabilitation services under title XVIII (Medicare) of the Social Security Act; and (2) appropriate federal agencies on how best to utilize available research funds and authorities focused on medical rehabilitation research.
{"src": "billsum_test", "title": "To extend the 50 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility and to establish the National Advisory Council on Medical Rehabilitation."}