Section 10308

SEC. 10308. REVISIONS TO NATIONAL PILOT PROGRAM ON PAYMENT BUNDLING.

[a] In General- Section 1866D of the Social Security Act, as added by section 3023, is amended--

[1] in paragraph [a][2][B], in the matter preceding clause [i], by striking '8 conditions' and inserting '10 conditions';

[2] by striking subsection [c][1][B] and inserting the following:

'[B] EXPANSION- The Secretary may, at any point after January 1, 2016, expand the duration and scope of the pilot program, to the extent determined appropriate by the Secretary, if--

'[i] the Secretary determines that such expansion is expected to--

'[I] reduce spending under title XVIII of the Social Security Act without reducing the quality of care; or

'[II] improve the quality of care and reduce spending;

'[ii] the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that such expansion would reduce program spending under such title XVIII; and

'[iii] the Secretary determines that such expansion would not deny or limit the coverage or provision of benefits under this title for individuals.'; and

[3] by striking subsection [g] and inserting the following new subsection:

'[g] Application of Pilot Program to Continuing Care Hospitals-

'[1] IN GENERAL- In conducting the pilot program, the Secretary shall apply the provisions of the program so as to separately pilot test the continuing care hospital model.

'[2] SPECIAL RULES- In pilot testing the continuing care hospital model under paragraph [1], the following rules shall apply:

'[A] Such model shall be tested without the limitation to the conditions selected under subsection [a][2][B].

'[B] Notwithstanding subsection [a][2][D], an episode of care shall be defined as the full period that a patient stays in the continuing care hospital plus the first 30 days following discharge from such hospital.

'[3] CONTINUING CARE HOSPITAL DEFINED- In this subsection, the term 'continuing care hospital' means an entity that has demonstrated the ability to meet patient care and patient safety standards and that provides under common management the medical and rehabilitation services provided in inpatient rehabilitation hospitals and units [as defined in section 1886[d][1][B][ii]], long term care hospitals [as defined in section 1886[d][1][B][iv][I]], and skilled nursing facilities [as defined in section 1819[a]] that are located in a hospital described in section 1886[d].'.

[b] Technical Amendments-

[1] Section 3023 is amended by striking '1886C' and inserting '1866C'.

[2] Title XVIII of the Social Security Act is amended by redesignating section 1866D, as added by section 3024, as section 1866E.