I

106TH CONGRESS

2D SESSION H. R. 4997

To amend title XVIII of the Social Security Act to revise and improve

the Medicare-dependent, small rural hospital program.

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 revise

and improve the Medicare-dependent, small rural hospital

program.

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-Dependent,

5 Small Rural Hospital Equity Act of 2000’’.
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1 SEC. 2. APPLICATION OF THE MEDICARE PATIENT POPU2 LATION PERCENTAGE MEASUREMENT OF

3 MEDICARE-DEPENDENT, SMALL RURAL HOS4 PITALS TO THE THREE MOST RECENT COST

5 REPORTING PERIODS.

6 (a) IN GENERAL.—Section 1886(d)(5)(G)(iv)(IV) of

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

8 1395ww(d)(5)(G)(iv)(IV)) is amended by inserting after

9 ‘‘during the cost reporting period beginning in fiscal year

10 1987’’ ‘‘ or, at the election of the hospital (in a form and

11 manner determined by the Secretary), during any of the

12 three most recent 12-month cost reporting periods for

13 which the Secretary has the settled cost reports’’.

14 (b) EFFECTIVE DATE.—The amendment made by

15 subsection (a) applies with respect to discharges occurring

16 on or after October 1, 2000.

17 SEC. 3. REBASING FOR CERTAIN MEDICARE-DEPENDENT,

18 SMALL RURAL HOSPITALS.

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

20 U.S.C. 1395ww(b)(3)) is amended—

21 (1) in subparagraph (D), by inserting ‘‘subject

22 to subparagraph (J),’’ before ‘‘the term ‘target

23 amount’ means’’; and

24 (2) by adding at the end the following new sub25 paragraph:
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1 ‘‘(J)(i) For cost reporting periods beginning on or

2 after October 1, 2000, in the case of a medicare-depend3 ent, small rural hospital that elects (in a form and manner

4 determined by the Secretary) this subparagraph to apply

5 to the hospital, there shall be substituted for the target

6 amount applicable to the hospital under subparagraph

7 (D)—

8 ‘‘(I) with respect to discharges occurring in fis9 cal year 2001, 75 percent of the target amount oth10 erwise applicable to the hospital under subparagraph

11 (D) (referred to in this clause as the ‘subparagraph

12 (D) target amount’) and 25 percent of the rebased

13 target amount (as defined in clause (ii));

14 ‘‘(II) with respect to discharges occurring in fis15 cal year 2002, 50 percent of the subparagraph (D)

16 target amount and 50 percent of the rebased target

17 amount;

18 ‘‘(III) with respect to discharges occurring in

19 fiscal year 2003, 25 percent of the subparagraph

20 (D) target amount and 75 percent of the rebased

21 target amount; and

22 ‘‘(IV) with respect to discharges occurring after

23 fiscal year 2003, 100 percent of the rebased target

24 amount.
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1 ‘‘(ii) For purposes of this subparagraph, the term

2 ‘rebased target amount’ has the meaning given the term

3 ‘target amount’ in subparagraph (D) except that—

4 ‘‘(I) there shall be substituted for the base cost

5 reporting period under subparagraph (D) any of the

6 three most recent 12-month cost reporting periods

7 for which the Secretary has the settled cost reports,

8 whichever results in the greatest increase in the tar9 get amount for the hospital;

10 ‘‘(II) any reference in subparagraph (D)(i) to

11 the ‘first cost reporting period’ described in such

12 subparagraph is deemed a reference to the first cost

13 reporting period beginning on or after October 1,

14 2000; and

15 ‘‘(III) applicable increase percentage shall only

16 be applied under subparagraph (D)(iv) for dis17 charges occurring in fiscal years beginning with fis18 cal year 2002.’’.

19 SEC. 4. MAKING THE MEDICARE DEPENDENT, SMALL

20 RURAL HOSPITAL PROGRAM PERMANENT.

21 (a) PAYMENT METHODOLOGY.—Section

22 1886(d)(5)(G) of the Social Security Act (42 U.S.C.

23 1395ww(d)(5)(G)) is amended—

24 (1) in clause (i), by striking ‘‘and before Octo25 ber 1, 2006,’’; and
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1 (2) in clause (ii)(II), by striking ‘‘and before

2 October 1, 2006,’’.

3 (b) CONFORMING AMENDMENTS.—

4 (1) TARGET AMOUNT.—Section 1886(b)(3)(D)

5 of the Social Security Act (42 U.S.C.

6 1395ww(b)(3)(D)) is amended—

7 (A) in the matter preceding clause (i), by

8 striking ‘‘and before October 1, 2006,’’; and

9 (B) in clause (iv), by striking ‘‘through fis10 cal year 2005,’’ and inserting ‘‘or any subse11 quent fiscal year,’’.

12 (2) PERMITTING HOSPITALS TO DECLINE RE13 CLASSIFICATION.—Section 13501(e)(2) of the Omni14 bus Budget Reconciliation Act of 1993 (42 U.S.C.

15 1395ww note) is amended by striking ‘‘or fiscal year

16 2000 through fiscal year 2005’’ and inserting ‘‘fiscal

17 year 2000, or any subsequent fiscal year,’’.

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