Catastrophic Specialty Hospital Act of 2025

This bill would change how Medicare pays certain long-term care hospitals that mainly treat people with severe spinal cord or brain injuries. If a hospital earns a special “catastrophic specialty hospital” label, it would get paid outside the usual long‑term care payment system. This aims to better match payments with the high, complex care these patients need .

To get the label, a hospital must meet strict rules for the past three years: most patients (at least 80%) must be treated for spinal cord or acquired brain injuries; the hospital must offer a full range of care (inpatient, outpatient, and long‑term wellness); it must handle large volumes every year (at least 175 spinal cord injury discharges and 175 brain injury discharges); draw many patients from out of state (at least 30%); and show ongoing work in neurorehab research and training, such as dedicated research staff, published studies, or residency programs. The status lasts for up to three years at a time and can be renewed if the hospital still meets the rules. If the hospital falls short, it has 60 days to submit more proof before losing the label. The new payment option starts for cost reporting periods that begin on or after the date the law takes effect .

• Who is affected: Long‑term care hospitals that specialize in severe spinal cord and brain injury care; their patients; Medicare payments to these hospitals .
• What changes: Qualified hospitals are paid outside the standard long‑term care payment system; they must meet high volume, breadth of services, out‑of‑state patient mix, and research/training standards to qualify and stay qualified .
• When: Applies to hospital cost reporting periods that begin on or after the law’s enactment; designation lasts up to three years at a time, with checks for renewal .