I 

108TH CONGRESS 

1ST SESSION H. R. 1580

To amend title XVIII of the Social Security Act to provide for national 

standardized payment amounts for inpatient hospital services furnished 

under the Medicare Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 3, 2003

Mr. ENGLISH (for himself, Mr. TANNER, Mr. SHERWOOD, Mr. MCNULTY, Mr. 

BERRY, Mr. MURTHA, Mr. MCHUGH, Mr. FARR, Mr. UDALL of Colorado, 

Mrs. EMERSON, Mr. ALLEN, Mr. REYNOLDS, Mr. PETERSON of Pennsylvania, Mr. KANJORSKI, Mr. HOLDEN, Mr. ORTIZ, Mr. TURNER of Texas, 

Mr. DAVIS of Tennessee, Mr. PLATTS, Mr. DOYLE, Mr. LATHAM, Mr. 

POMEROY, Mr. BOSWELL, Mr. COOPER, and Mr. ROGERS of Alabama) 

introduced the following bill; which was referred to the Committee on 

Ways and Means 

A BILL

To amend title XVIII of the Social Security Act to provide 

for national standardized payment amounts for inpatient 

hospital services furnished under the Medicare Program, 

and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Area Wage 

5 Index and Standardized Rate Act of 2003’’. 
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1 SEC. 2. ESTABLISHING A SINGLE STANDARDIZED AMOUNT 

2 UNDER MEDICARE INPATIENT HOSPITAL 

3 PPS. 

4 (a) IN GENERAL.—Section 1886(d)(3)(A) of the So5 cial Security Act (42 U.S.C. 1395ww(d)(3)(A)) is amend6 ed—

7 (1) in clause (iv), by inserting ‘‘and ending on 

8 or before September 30, 2003,’’ after ‘‘October 1, 

9 1995,’’; and 

10 (2) by redesignating clauses (v) and (vi) as 

11 clauses (vii) and (viii), respectively, and inserting 

12 after clause (iv) the following new clauses: 

13 ‘‘(v) For discharges occurring in the fiscal year 

14 beginning on October 1, 2003, the average standard15 ized amount for hospitals located in areas other than 

16 a large urban area shall be equal to the average 

17 standardized amount for hospitals located in a large 

18 urban area. 

19 ‘‘(vi) For discharges occurring in a fiscal year 

20 beginning on or after October 1, 2004, the Secretary 

21 shall compute an average standardized amount for 

22 hospitals located in all areas within the United 

23 States equal to the average standardized amount 

24 computed under clause (v) or this clause for the pre25 vious fiscal year increased by the applicable percent-
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1 age increase under subsection (b)(3)(B)(i) for the 

2 fiscal year involved.’’. 

3 (b) COMPUTING DRG-SPECIFIC RATES.—

4 (1) IN GENERAL.—Section 1886(d)(3)(D) of 

5 such Act (42 U.S.C. 1395ww(d)(3)(D)) is amend6 ed—

7 (A) in the heading by striking ‘‘IN DIF8 FERENT AREAS’’; 

9 (B) in the matter preceding clause (i)—

10 (i) by inserting ‘‘for fiscal years before 

11 fiscal year 1997’’ before ‘‘a regional DRG 

12 prospective payment rate for each region,’’; 

13 and 

14 (ii) by striking ‘‘each of which is’’; 

15 (C) in clause (i)—

16 (i) by inserting ‘‘for fiscal years before 

17 fiscal year 2004,’’ after ‘‘(i)’’; and 

18 (ii) by striking ‘‘and’’ at the end; 

19 (D) in clause (ii)—

20 (i) by inserting ‘‘for fiscal years before 

21 fiscal year 2004,’’ after ‘‘(ii)’’; and 

22 (ii) by striking the period at the end 

23 and inserting ‘‘; and’’; and 

24 (E) by adding at the end the following new 

25 clause: 
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1 ‘‘(iii) for a fiscal year beginning after fiscal 

2 year 2003, for hospitals located in all areas, to 

3 the product of—

4 ‘‘(I) the applicable average standard5 ized amount (computed under subpara6 graph (A)), reduced under subparagraph 

7 (B), and adjusted or reduced under sub8 paragraph (C) for the fiscal year; and 

9 ‘‘(II) the weighting factor (determined 

10 under paragraph (4)(B)) for that diag11 nosis-related group.’’. 

12 (2) TECHNICAL CONFORMING SUNSET.—Section 

13 1886(d)(3) of such Act (42 U.S.C. 1395ww(d)(3)) is 

14 amended in the matter preceding subparagraph (A) 

15 by inserting ‘‘for fiscal years before fiscal year 

16 1997’’ before ‘‘a regional DRG prospective payment 

17 rate’’. 

18 SEC. 3. ADJUSTMENT TO WAGE INDEX. 

19 Section 1886(d)(3)(E) of the Social Security Act (42 

20 U.S.C. 1395ww(d)(3)(E)) is amended—

21 (1) in the fourth sentence, by inserting ‘‘, ex22 cept that this sentence shall not apply to the substi23 tution required by the succeeding sentence’’; and 

24 (2) by adding at the end the following: ‘‘For 

25 discharges occurring during fiscal years beginning 
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1 on or after October 1, 2003, in the case of a sub2 section (d) hospital for which the factor established 

3 by the Secretary under the first sentence for the fis4 cal year is less than 1.0, the Secretary shall sub5 stitute for the proportion otherwise estimated under 

6 such sentence but for this sentence a proportion of 

7 62 percent.’’.

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