PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Subcommittee on Health.
Congressional Research Service
Version 00 · Introduced in House · Nov 29, 2011
Amends title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services (HHS), in making payment under the prospective payment system (PPS) to certain long-term care (LTC) hospitals for discharges in rate years beginning on and after October 1, 2011, to make payment adjustments for cases identified as: (1) meeting or exceeding the fixed high episode efficient case threshold, and (2) meeting or below the episode outlier case threshold.
Directs the Secretary to adopt rules which identify the predicted probability of those Medicare beneficiaries admitted as inpatients to LTC hospitals from a subsection (d) hospital for whom the payment for services received during an episode of hospital care is predicted to be less than if they had remained in the subsection (d) hospital (episode efficient cases).
(Generally, a subsection [d] hospital is an acute care hospital particularly one that receives payments under Medicare's inpatient PPS when providing covered inpatient services to eligible beneficiaries.)
Showing the opening paragraphs of the official summary.
Directs the Secretary to: (1) establish separate thresholds for high episode efficient cases (Medicare beneficiary discharges with the highest 10% probability of being episode efficient cases) and episode outlier cases (Medicare beneficiary discharges with the lowest 10% probability of being episode efficient cases) for LTC hospitals located in a rural area, and (2) establish separate high episode efficient case and episode outlier case thresholds for LTC hospitals located in urban areas for beneficiaries discharged from a subsection (d) hospital which accounts for more than 25% of the Medicare beneficiaries discharged from subsection (d) hospitals in a Metropolitan Statistical Area.
Establishes a two-year moratorium, beginning December 29, 2012, on the establishment of new LTC hospitals and LTC satellite facilities and on the increase in beds in existing LTC hospitals or satellite facilities.
People & committees
Rep. Murphy, Christopher [D-CT-5] · D–CT
Legislative record
A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.
Referred to the Subcommittee on Health.
Referred to the House Committee on Ways and Means.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We currently store references to these documents.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Feb 7, 2024. Consult Congress.gov for the current record.
AI Conversation Starters
Choose a perspective, copy a prompt, and paste it into your preferred AI. Each prompt includes the bill version and available official source links, and asks for counterarguments as well as supporting evidence.
Analyze H.R.3516 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.
Examine H.R.3516 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.
Examine H.R.3516 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.
Examine H.R.3516 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.