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Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2005

Location: Washington, DC


The SPEAKER pro tempore. Pursuant to House Resolution 754 and rule XVIII, the Chair declares the House in the Committee of the Whole House on the State of the Union for the consideration of the bill, H.R. 5006.



Mr. LoBIONDO. Mr. Chairman, I offer an amendment.

The Clerk read as follows:

Amendment offered by Mr. LoBiondo:

In title II, amend section 221 (page 65, line 19, through page 68, line 2) to read as follows:

SEC. 221. (a) Notwithstanding section 412.23(b)(2) of title 42 of the Code of Federal Regulations, none of the funds appropriated by this Act may be expended by the Secretary of Health and Human Services to treat a hospital or unit of a hospital that was certified by the Secretary as an inpatient rehabilitation facility on or before June 30, 2004, as a subsection (d) hospital (as defined in section 1886(d)(1)(B) of the Social Security Act (42 U.S.C. 1395ww(d)(1)(B))) until, not later than 60 days after the date on which the report under subsection (b) is issued, the Secretary, taking into account the recommendations in such report-

(1) determines that the classification criteria of hospitals and units of hospitals as inpatient rehabilitation facilities under such section 412.23(b)(2) are not inconsistent with such recommendations; or
(2) promulgates a regulation providing for revised criteria under such section 412.23(b)(2), which regulation shall be effective and final immediately on an interim basis as of the date of publication of the regulation.
(b) The study referred to in subsection (a) is a study by the Comptroller General of the United States directed in the statement of managers accompanying the conference report on the bill H.R. 1 of the 108th Congress regarding clinically appropriate standards for defining inpatient rehabilitation services under such section 412.23(b)(2).
© The aggregate amount appropriated under title II for "Centers for Medicare and Medicaid Services-Program Management" is hereby reduced by $3,500,000.

Mr. LoBIONDO (during the reading). Mr. Chairman, I ask unanimous consent that the amendment be considered as read and printed in the RECORD.

The CHAIRMAN. Is there objection to the request of the gentleman from New Jersey?

There was no objection.

Mr. LoBIONDO. Mr. Chairman, I rise today in strong support of the LoBiondo-Lowey-Wamp amendment. The gentlewoman from New York (Mrs. Lowey) and the gentleman from Tennessee (Mr. Wamp) have joined together in trying to bring this to the attention of our colleagues.

Before I discuss the amendment, however, I would like to thank the gentleman from Florida (Mr. Young) and the gentleman from Ohio (Mr. Regula) for their support on this critical issue. I would also like to thank the gentleman from California (Mr. Thomas) and his staff for their willingness to work with me and my colleagues on this issue, and to help in crafting an amendment which will help rehab patients across the country.

The LoBiondo-Lowey-Wamp amendment would halt the Centers for Medicare and Medicaid Services, CMS, on the implementation of the so-called 75 percent rule until a study is completed on the issue. As many know, rehabilitation hospitals provide essential care to patients recovering from conditions such as a stroke, hip replacement or cardiopulmonary disease. This policy, commonly known as the 75 percent rule, sets limits on which patients would be eligible for care at these facilities.

Under the current rule which went into effect on July 1, fewer Americans will have access to rehab care. This is wrong. Fewer patients needing treatment for conditions such as arthritis and joint replacement will qualify for this care, an important element in the overall recovery process. It is simply wrong not to do something about this. In addition, access to rehab care for patients recovering from cancer, cardiac conditions, transplant and pulmonary conditions is also threatened.

This amendment is by no means the first attempt to deal with the issue. Over the past year, the majority of Members of Congress not once, but twice has called on CMS to withhold implementation of the 75 percent rule until a thorough independent assessment by medical experts is completed. A similar directive was included in both the Medicare Modernization Act passed last November and the fiscal year 2004 omnibus appropriations bill. Yet despite the will of Congress, CMS finalized the 75 percent rule in April and implemented it on July 1 without either commissioning a study in advance or making significant, much-needed updates.

Our amendment seeks to ensure that Congress' intent is carried out and that patients across America continue to have access to the rehab care they need. It will ensure that experts in the field of rehabilitative care study the issue and make recommendations that will produce a rule for rehab hospitals that reflects the advances medicine has made in the area of rehabilitative care.

I would like all of my colleagues to think what it would be like for them if they had to go to one of their constituents who needed rehab care, and they were denied access to the rehab hospital in their district; or worse yet, that rehab hospital had to close. What would my colleagues think if they had a family member, someone in their family, that was denied rehabilitative care, very good care, because of a stupid rule that we were not able to fix? People across America who need these services will not accept that Congress stood back and did nothing when there is something we can do.

I thank all Members in this Chamber who have supported our efforts to change the 75 percent rule, and I urge Members to cast a yes vote for the LoBiondo-Lowey-Wamp amendment.

Mr. REGULA. Mr. Chairman, will the gentleman yield?

Mr. LoBIONDO. I yield to the gentleman from Ohio.

Mr. REGULA. Mr. Chairman, with the understanding that this has been cleared with the Committee on Ways and Means, we are prepared to accept this amendment.

Mr. LoBIONDO. Mr. Chairman, I thank the gentleman from Ohio.


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