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106TH CONGRESS

2D SESSION H. R. 5228

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

relief for essential hospitals in a region, to assist in the long-range

economic recovery of such hospitals, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 20, 2000

Mr. KANJORSKI (for himself and Mr. NEY) 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 immediate relief for essential hospitals in a region,

to assist in the long-range economic recovery of such

hospitals, 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 ‘‘Essential and Critical

5 Hospital Preservation Act of 2000’’.
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1 SEC. 2. SPECIAL PAYMENTS TO ESSENTIAL HOSPITALS AND

2 DEVELOPMENT OF ECONOMIC RECOVERY

3 PLAN.

4 Section 1886(g) of the Social Security Act (42 U.S.C.

5 1395ww(g)) is amended by inserting after paragraph (4)

6 the following new paragraphs:

7 ‘‘(5)(A) Effective October 1, 2000, and there8 after, in the case of a deemed hospital (as described

9 in subparagraph (B)), the Secretary shall increase

10 all payments for all services provided under this title

11 by such deemed hospital (including in-patient, out12 patient, skilled nursing facility, home health agency,

13 hospice, and end-stage renal disease, and other cov14 ered services provided by such deemed hospital) by

15 10 percent for a period of five fiscal years, subject

16 to the conditions under paragraph (6).

17 ‘‘(B) A deemed hospital referred to in subpara18 graph (A) is a hospital that—

19 ‘‘(i) is located in a Metropolitan Statistical

20 Area that, during fiscal years 1999, 2000, and

21 2001, had an area wage index value which, be22 fore the application of section 4410 of the Bal23 anced Budget Act of 1997 (Public Law 105–

24 33) is lower than the wage index applicable to

25 hospitals located in rural areas in the State in

26 which the hospital is located,
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1 ‘‘(ii) is located in a Metropolitan Statistical

2 Area that is contiguous to at least two other

3 Metropolitan Statistical Areas, and

4 ‘‘(iii) is located in a Metropolitan Statis5 tical Area where, for cost reporting periods be6 ginning during fiscal year 1997, all hospitals in

7 that Metropolitan Statistical Area had, on an

8 aggregate basis, a medicare-eligible beneficiary

9 patient discharge percentage exceeding 40 per10 cent.

11 ‘‘(6)(A) Within one year of receiving deemed

12 status and increased payments under this title by

13 reason of paragraph (5), each hospital in the Metro14 politan Statistical Area, either individually or (not15 withstanding any other provision of law) coopera16 tively, shall submit to the Secretary an economic re17 covery plan for long-range (post-deemed status) fi18 nancial viability. The Secretary shall offer assistance

19 in the development of such plan or plans.

20 ‘‘(B) Such plan may include capital payments

21 and operating payments to—

22 ‘‘(i) right-size capacity,

23 ‘‘(ii) coordinate and share high cost serv24 ices,
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1 ‘‘(iii) ensure a viable regional emergency

2 room network and access,

3 ‘‘(iv) convert unused acute care beds to

4 skilled nursing facility, intermediate care facil5 ity, or assisted living facility support facility

6 beds,

7 ‘‘(v) assist in the conversion of unused

8 acute care beds to psychiatric, long-term care,

9 or rehabilitation care hospital beds as are deter10 mined by the hospital to be in short supply, and

11 ‘‘(vi) such other adjustments to the current

12 acute care hospital facility as shall ensure the

13 long-term economic viability of the facility and

14 the continuation of essential health care serv15 ices to the community.

16 ‘‘(C) The Secretary shall review such economic

17 recovery plans, provide assistance in the improve18 ment and modification of such plans, and within one

19 year of receipt of a plan which the Secretary deter20 mines has a reasonable opportunity of ensuring the

21 long-term viability of the facility or facilities, the

22 Secretary shall further increase the payment in23 creases under paragraph (5) by such additional

24 amount as to ensure the successful completion of the
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1 economic recovery plan or plans under this para2 graph.

3 ‘‘(7) Notwithstanding any other provision of

4 law, the additional payments made to deemed hos5 pitals under paragraphs (5) and (6) shall not result

6 in payment reductions to any hospital or provider

7 under this title.’’.

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