II

106TH CONGRESS

2D SESSION S. 3037

To amend title XVIII of the Social Security Act to increase payments under

the medicare program to Puerto Rico hospitals.

IN THE SENATE OF THE UNITED STATES

SEPTEMBER 12, 2000

Mr. SANTORUM introduced the following bill; which was read twice and

referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to increase

payments under the medicare program to Puerto Rico

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. SHORT TITLE.

4 This Act may be cited as the ‘‘Medicare Puerto Rico

5 Hospital Payment Parity Act of 2000’’.

6 SEC. 2. INCREASE IN BASE PAYMENT AMOUNTS TO PUERTO

7 RICO HOSPITALS.

8 Section 1886(d)(9)(A) (42 U.S.C. 1395ww(d)(9)(A))

9 is amended—
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•S 3037 IS

1 (1) in clause (i), by striking ‘‘October 1, 1997,

2 50 percent (’’ and inserting ‘‘October 1, 2001, 0

3 percent (for discharges between October 1, 2000,

4 and September 30, 2001, 25 percent, for discharges

5 between October 1, 1997, and September 30, 2000,

6 50 percent,’’; and

7 (2) in clause (ii), in the matter preceding sub8 clause (I), by striking ‘‘October 1, 1997, 50 percent

9 (’’ and inserting ‘‘October 1, 2001, 100 percent (for

10 discharges between October 1, 2000, and September

11 30, 2001, 75 percent, for discharges between Octo12 ber 1, 1997, and September 30, 2000, 50 percent,’’.

13 SEC. 3. CALCULATION OF MEDICARE DSH PAYMENTS FOR

14 PPS HOSPITALS IN PUERTO RICO.

15 (a) IN GENERAL.—Section 1886(d)(9) of the Social

16 Security Act (42 U.S.C. 1395ww(d)(9)) is amended—

17 (1) by striking subparagraph (D)(iii) and in18 serting the following:

19 ‘‘(iii) Subparagraph (F) (relating to dispropor20 tionate share payments), except that for this

21 purpose—

22 ‘‘(I) the sum described in clause (ii) of this

23 subparagraph shall be substituted for the sum

24 referred to in paragraph (5)(F)(ii)(I); and
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1 ‘‘(II) the number of a subsection (d) Puer2 to Rico hospital’s SSI proxy patient days (as

3 defined in subparagraph (E)) shall be sub4 stituted for the numerator referred to in para5 graph (5)(F)(vi)(I).’’; and

6 (2) by adding at the end the following new sub7 paragraph:

8 ‘‘(E)(i) For purposes of subparagraph (D)(iii)(II),

9 the term ‘subsection (d) Puerto Rico hospital’s SSI proxy

10 patient days’ means the product obtained by multiplying—

11 ‘‘(I) the SSI proxy percentage (as defined in

12 clause (ii)); by

13 ‘‘(II) the total number of the hospital’s patient

14 days for such period.

15 ‘‘(ii) For purposes of clause (i)(I), the term ‘SSI

16 proxy percentage’ means, with respect to all subsection (d)

17 Puerto Rico hospitals for cost reporting periods beginning

18 in a fiscal year, the unweighted average of the fractions

19 (expressed as percentages) determined under paragraph

20 (5)(F)(vi)(I) for all subsection (d) hospitals in the income21 equivalent proxy State (as defined in clause (iii)) for the

22 most recent cost reporting period for which adequate data

23 are available (other than hospitals for which such fraction

24 or percentage is zero).
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1 ‘‘(iii) For purposes of clause (ii), the term ‘income2 equivalent proxy State’ means, for cost reporting periods

3 beginning in a fiscal year, the State (other than a State

4 for which title XVI as in effect without regard to the

5 amendment made by section 301 of the Social Security

6 Amendments of 1972 continues to apply) the per capita

7 income of which most closely approximates the per capita

8 income of Puerto Rico (as determined by the Secretary

9 based on the most recent period for which adequate data

10 are available).’’.

11 (b) EFFECTIVE DATE.—The amendments made by

12 subsection (a) shall apply to discharges occurring on or

13 after October 1, 2000.

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