Establishing a new criterion for the nonapplication of site-neutral payments to long-term care hospitals under the Medicare program

Section 1886(m)(6)(A) of the Social Security Act (42 U.S.C. 1395ww(m)(6)(A)) is amended— (1) in clause (ii)(I), by striking or the ventilator criterion under clause (iv) and inserting, the ventilator criterion under clause (iv), or the high acuity criterion described in clause (v); and (2) by adding at the end the following new clause: (v) High acuity criterion The criterion specified in this clause (in this paragraph referred to as the high acuity criterion) for a discharge from a long-term care hospital in a fiscal year is that— (I) the discharge was assigned to a Medicare-Severity-Long-Term-Care-Diagnosis-Related-Group (MS-LTC-DRG) with a relative weight for such fiscal year that was equal to or greater than 0.8; and (II) the discharge occurred on or after October 1, 2026..