Sponsors (7)
The bill improves specialized care and training for catastrophic spinal cord and brain injury patients by creating designated LTCH treatment and payment stability, but it raises Medicare costs and may reduce local access or financially strain smaller hospitals.
Medicare beneficiaries with severe spinal cord injuries or acquired brain injuries can receive more specialized, continuous care through designated catastrophic specialty long-term care hospitals (LTCHs).
Designated catastrophic specialty LTCHs receive predictable payment treatment for up to three years, helping hospitals sustain specialized services and plan investments.
Hospitals and clinicians benefit from a required focus on neurorehabilitation research and training, which supports clinical advances and workforce development in spinal cord and brain injury care.
Taxpayers and Medicare may face higher spending because exempting designated LTCHs from standard Medicare payment rules can increase program costs.
Medicare beneficiaries in states without designated catastrophic specialty LTCHs may face reduced access if they must travel out-of-state to receive care.
Smaller or local LTCHs that do not meet high-volume, out-of-state draw, or research criteria could lose referrals and face financial strain.
Based on analysis of 2 sections of legislative text.
Creates a Medicare exception allowing the Secretary to designate "catastrophic specialty hospitals" and pay them outside the standard LTCH payment rules.
Official title: To amend title XVIII of the Social Security Act to establish new payment rules for certain catastrophic specialty hospitals under the Medicare program.
Introduced September 30, 2025 by Barry D. Loudermilk · Last progress September 30, 2025
Creates a new Medicare exception that lets the Secretary designate certain long-term care hospitals as "catastrophic specialty hospitals" and pay them outside the standard LTCH payment rules. Designated hospitals must meet multi-year volume, service-continuum, case-count, geographic draw (at least 30% out-of-state admissions), and neurorehabilitation research/training criteria, and designations last initially for the current cost reporting period plus three years with a re‑designation process and a 60‑day cure opportunity.