In the Senate of the United States,

September 30 (legislative day, September 29), 2003.

Resolved, That the bill from the House of Representatives (H.R. 3146) entitled ‘‘An Act to extend the Temporary

Assistance for Needy Families block grant program, and certain tax and trade programs, and for other purposes’’, do

pass with the following

AMENDMENT:

1 Page 10, after line 16, insert:

2 SEC. 402. EXTENSION OF PROVISION EQUALIZING URBAN

3 AND RURAL STANDARDIZED MEDICARE INPA4 TIENT HOSPITAL PAYMENTS.

5 (a) IN GENERAL.—Paragraphs (1) and (2) of section

6 402(b) of the Miscellaneous Appropriations Act, 2003 (Pub7 lic Law 108–7; 117 Stat. 548) are each amended by striking

8 ‘‘September 30, 2003’’ and inserting ‘‘March 31, 2004’’.

9 (b) EFFECTIVE DATE.—

10 (1) IN GENERAL.—Subject to paragraph (2), the

11 amendments made by subsection (a) shall take effect
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1 as if included in the enactment of the Miscellaneous

2 Appropriations Act, 2003.

3 (2) AUTHORITY TO DELAY IMPLEMENTATION.—

4 (A) IN GENERAL.—If the Secretary of

5 Health and Human Services (in this subsection

6 referred to as the ‘‘Secretary’’) determines that it

7 is not administratively feasible to implement the

8 amendments made by subsection (a), notwith9 standing such amendments and in order to com10 ply with Congressional intent, the Secretary may

11 delay the implementation of such amendments

12 until such time as the Secretary determines to be

13 appropriate, but in no case later than November

14 1, 2003.

15 (B) TEMPORARY ADJUSTMENT FOR REMAIN16 DER OF FISCAL YEAR 2004 TO EFFECT FULL RATE

17 CHANGE.—If the Secretary delays implementa18 tion of the amendments made by subsection (a)

19 under subparagraph (A), the Secretary shall

20 make such adjustment to the amount of pay21 ments affected by such delay, for the portion of

22 fiscal year 2004 after the date of the delayed im23 plementation, in such manner as the Secretary

24 estimates will ensure that the total payments for

25 inpatient hospital services so affected with re-
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1 spect to such fiscal year is the same as would

2 have been made if this paragraph had not been

3 enacted.

4 (C) NO EFFECT ON PAYMENTS FOR SUBSE5 QUENT PAYMENT PERIODS.—The application of

6 subparagraphs (A) and (B) shall not affect pay7 ment rates and shall not be taken into account

8 in calculating payment amounts for services fur9 nished for periods after September 30, 2004.

10 (D) ADMINISTRATION OF PROVISIONS.—

11 (i) NO RULEMAKING OR NOTICE RE12 QUIRED.—The Secretary may carry out the

13 authority under this paragraph by program

14 memorandum or otherwise and is not re15 quired to prescribe regulations or to provide

16 notice in the Federal Register in order to

17 carry out such authority.

18 (ii) LIMITATION ON REVIEW.—There

19 shall be no administrative or judicial re20 view under section 1869 or 1878 of the So21 cial Security Act (42 U.S.C. 1395ff and

22 1395oo), or otherwise of any delay or deter23 mination made by the Secretary under this

24 paragraph or the application of the pay-
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1 ment rates determined under this para2 graph.

Attest:

Secretary.
108TH CONGRESS

1ST SESSION H. R. 3146

AMENDMENT