I 

114TH CONGRESS 

1ST SESSION H. R. 3288 

To amend title XVIII of the Social Security Act to change the method 

of determining disproportionate share hospital (DSH) payments under 

the Medicare program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 29, 2015 

Mr. MARCHANT (for himself and Mr. BOUSTANY) introduced the following bill; 

which was referred to the Committee on Ways and Means 

A BILL 

To amend title XVIII of the Social Security Act to change 

the method of determining disproportionate share hospital (DSH) payments under the Medicare program, 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 ‘‘Strengthening DSH 

5 and Medicare Through Subsidy Recapture and Payment 

6 Reform Act of 2015’’. 


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1 SEC. 2. CHANGE IN DETERMINATION OF MEDICARE DSH 

2 PAYMENTS. 

3 Paragraph (1) of section 1886(r) of the Social Secu4 rity Act (42 U.S.C. 1395ww(r)) is amended— 

5 (1) by striking so much of such paragraph as 

6 precedes ‘‘fiscal year 2014’’ and inserting the fol7 lowing: 

8 ‘‘(1) DSH PAYMENTS.— 

9 ‘‘(A) IN GENERAL.—Subject to subpara10 graph (B), for’’; 

11 (2) by striking ‘‘(which represents’’ and all that 

12 follows through ‘‘Report to the Congress)’’; and 

13 (3) by adding at the end the following new sub14 paragraph: 

15 ‘‘(B) AGGREGATE LIMITATION BEGINNING

16 WITH FISCAL YEAR 2017.—As part of the rule17 making to carry out subsection (d) for fiscal 

18 year 2017 and each subsequent fiscal year, the 

19 Secretary shall estimate the aggregate amount 

20 of payments to be made for such fiscal year 

21 under subparagraph (A) (determined without 

22 regard to this subparagraph) and, if the 

23 amount so estimated exceeds $3,300,000,000, 

24 then each amount paid under subparagraph (A) 

25 for that fiscal year shall be multiplied by the 


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1 ratio of $3,300,000,000 to the amount so esti2 mated.’’. 

3 SEC. 3. ADDITIONAL DSH PAYMENT FOR CERTAIN QUALI4 FYING HOSPITALS. 

5 Section 1886(r) of the Social Security Act (42 U.S.C. 

6 1395ww(r)) is amended— 

7 (1) by redesignating paragraph (3) as para8 graph (4); and 

9 (2) by inserting after paragraph (2) the fol10 lowing new paragraph: 

11 ‘‘(3) ADDITIONAL PAYMENT FOR CERTAIN

12 QUALIFYING HOSPITALS.— 

13 ‘‘(A) IN GENERAL.—For fiscal year 2017 

14 and each subsequent fiscal year, in addition to 

15 the payments made to a qualifying hospital 

16 under paragraphs (1) and (2), the Secretary 

17 shall pay to each qualifying hospital an amount 

18 equal to $1,000,000,000 multiplied by the fac19 tor that would be calculated under paragraph 

20 (2)(C) for such qualifying hospital if each ref21 erence in such paragraph to a subsection (d) 

22 hospital were treated as a reference to a quali23 fying hospital. 

24 ‘‘(B) QUALIFYING HOSPITAL DEFINED.— 

25 In this paragraph, ‘qualifying hospital’ means a 


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1 subsection (d) hospital that is located in Ala2 bama, Florida, Georgia, Idaho, Kansas, Lou3 isiana, Maine, Mississippi, Missouri, Nebraska, 

4 North Carolina, Oklahoma, South Carolina, 

5 South Dakota, Tennessee, Texas, Utah, Vir6 ginia, Wisconsin, or Wyoming.’’. 

7 SEC. 4. RECAPTURE OF OVERPAYMENTS RESULTING FROM 

8 CERTAIN FEDERALLY SUBSIDIZED HEALTH 

9 INSURANCE. 

10 (a) IN GENERAL.—Paragraph (2) of section 36B(f) 

11 of the Internal Revenue Code of 1986 is amended by strik12 ing subparagraph (B). 

13 (b) CONFORMING AMENDMENT.—So much of para14 graph (2) of section 36B(f) of such Code, as amended by 

15 subsection (a), as precedes ‘‘advance payments’’ is amend16 ed to read as follows: 

17 ‘‘(2) EXCESS ADVANCE PAYMENTS.—If the’’. 

18 (c) EFFECTIVE DATE.—The amendments made by 

19 this section shall apply to taxable years ending after De20 cember 31, 2015. 

Æ 


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