I

106TH CONGRESS

2D SESSION H. R. 4995

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

the amount of disproportionate share payment adjustments under the

Medicare Program between urban and rural hospitals.

IN THE HOUSE OF REPRESENTATIVES

JULY 27, 2000

Mr. PETERSON of Pennsylvania (for himself and Mrs. EMERSON) introduced

the following bill; which was referred to the Committee on Ways and

Means, and in addition to the Committee on Commerce, for a period to

be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee

concerned

A BILL

To amend title XVIII of the Social Security Act to provide

for equity in the amount of disproportionate share payment adjustments under the Medicare Program between

urban and rural hospitals.

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

3 SECTION 1. PARITY IN DISPROPORTIONATE SHARE AD4 JUSTMENTS.

5 (a) INCREASE IN DSH PERCENTAGE FOR RURAL

6 HOSPITALS.—
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1 (1) IN GENERAL.—Section 1886(d)(5)(F)(iv) of

2 the Social Security Act (42 U.S.C.

3 1395ww(d)(5)(F)(iv)) is amended—

4 (A) in subclause (II) by inserting before

5 the semicolon the following: ‘‘or, if greater, the

6 percent determined in accordance with the ap7 plicable formula described in clause (vii)’’;

8 (B) in subclause (III) by inserting before

9 the semicolon the following: ‘‘or, if greater, the

10 percent determined in accordance with the ap11 plicable formula described in clause (vii)’’;

12 (C) in subclause (IV) by striking ‘‘is equal

13 to’’ and all that follows and inserting ‘‘is equal

14 to the greatest of 10 percent, the percent deter15 mined in accordance with the applicable for16 mula described in clause (vii), or the percent

17 determined in accordance with applicable for18 mula described in clause (viii);’’;

19 (D) in subclause (V) by striking ‘‘is equal

20 to’’ and all that follows and inserting ‘‘is equal

21 to the greater of the percent determined in ac22 cordance with the applicable formula described

23 in clause (vii) or the percent determined in ac24 cordance with applicable formula described in

25 clause (viii); or’’; and
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1 (E) in subclause (VI) by inserting before

2 the semicolon the following: ‘‘or, if greater, the

3 percent determined in accordance with the ap4 plicable formula described in clause (vii)’’.

5 (2) EFFECTIVE DATE.—The amendments made

6 by paragraph (1) apply with respect to discharges

7 occurring on or after October 1, 2000.

8 (b) REDUCTION IN DISPROPORTIONATE PATIENT

9 PERCENTAGE FOR RURAL HOSPITALS.—

10 (1) IN GENERAL.—Section 1886(d)(5)(F)(v) of

11 such Act (42 U.S.C. 1395ww(d)(5)(F)(v)) is amend12 ed to read as follows:

13 ‘‘(v) For discharges occurring on or after October 1,

14 2005, in this subparagraph, a hospital ‘serves a signifi15 cantly disproportionate number of low income patients’ for

16 a cost reporting period if the hospital has a dispropor17 tionate patient percentage (as defined in clause (vi)) for

18 that period which equals, or exceeds 15 percent.’’.

19 (2) TRANSITIONAL PHASE-IN OF INCREASE.—

20 During the five-fiscal year period beginning with fis21 cal year 2001, the Secretary of Health and Human

22 Services shall phase in, in equal increments over

23 such period, the reduction in disproportionate pa-
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1 tient percentage provided for under the amendment

2 made by paragraph (1).

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