```

[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4995 Introduced in House (IH)]

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.

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

SECTION 1. PARITY IN DISPROPORTIONATE SHARE ADJUSTMENTS.

    (a) Increase in DSH Percentage for Rural Hospitals.--
            (1) In general.--Section 1886(d)(5)(F)(iv) of the Social 
        Security Act (42 U.S.C. 1395ww(d)(5)(F)(iv)) is amended--
                    (A) in subclause (II) by inserting before the 
                semicolon the following: ``or, if greater, the percent 
                determined in accordance with the applicable formula 
                described in clause (vii)'';
                    (B) in subclause (III) by inserting before the 
                semicolon the following: ``or, if greater, the percent 
                determined in accordance with the applicable formula 
                described in clause (vii)'';
                    (C) in subclause (IV) by striking ``is equal to'' 
                and all that follows and inserting ``is equal to the 
                greatest of 10 percent, the percent determined in 
                accordance with the applicable formula described in 
                clause (vii), or the percent determined in accordance 
                with applicable formula described in clause (viii);'';
                    (D) in subclause (V) by striking ``is equal to'' 
                and all that follows and inserting ``is equal to the 
                greater of the percent determined in accordance with 
                the applicable formula described in clause (vii) or the 
                percent determined in accordance with applicable 
                formula described in clause (viii); or''; and
                    (E) in subclause (VI) by inserting before the 
                semicolon the following: ``or, if greater, the percent 
                determined in accordance with the applicable formula 
                described in clause (vii)''.
            (2) Effective date.--The amendments made by paragraph (1) 
        apply with respect to discharges occurring on or after October 
        1, 2000.
    (b) Reduction in Disproportionate Patient Percentage for Rural 
Hospitals.--
            (1) In general.--Section 1886(d)(5)(F)(v) of such Act (42 
        U.S.C. 1395ww(d)(5)(F)(v)) is amended to read as follows:
    ``(v) For discharges occurring on or after October 1, 2005, in this 
subparagraph, a hospital `serves a significantly disproportionate 
number of low income patients' for a cost reporting period if the 
hospital has a disproportionate patient percentage (as defined in 
clause (vi)) for that period which equals, or exceeds 15 percent.''.
            (2) Transitional phase-in of increase.--During the five-
        fiscal year period beginning with fiscal year 2001, the 
        Secretary of Health and Human Services shall phase in, in equal 
        increments over such period, the reduction in disproportionate 
        patient percentage provided for under the amendment made by 
        paragraph (1).
                                 <all>
```