I 

115TH CONGRESS 

1ST SESSION H. R. 1130 

To amend title XVIII of the Social Security Act to ensure fairness in Medicare 

hospital payments by establishing a floor for the area wage index applied 

with respect to certain hospitals. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 16, 2017 

Mrs. BLACK (for herself, Ms. SEWELL of Alabama, Mrs. BLACKBURN, Mr. 

ROE of Tennessee, Mr. BYRNE, Mr. COHEN, Mrs. ROBY, Mr. ROGERS of 

Alabama, Mr. BROOKS of Alabama, Mr. DUNCAN of Tennessee, Mr. COOPER, Mr. DESJARLAIS, Mr. FLEISCHMANN, Mr. KUSTOFF of Tennessee, 

and Mr. ADERHOLT) introduced the following bill; which was referred to 

the Committee on Ways and Means, and in addition to the Committee 

on Energy and 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 ensure 

fairness in Medicare hospital payments by establishing 

a floor for the area wage index applied with respect 

to certain 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 ‘‘Fair Medicare Hospital 

5 Payments Act of 2017’’. 


sradovich on DSK3GMQ082PROD with BILLS
2 

•HR 1130 IH

1 SEC. 2. ENSURING FAIRNESS IN MEDICARE HOSPITAL PAY2 MENTS IN A BUDGET NEUTRAL MANNER. 

3 (a) HOSPITAL INPATIENT SERVICES.—Section 

4 1886(d)(3)(E) of the Social Security Act (42 U.S.C. 

5 1395www(d)(3)(E)) is amended— 

6 (1) in clause (i), by striking ‘‘clause (ii) or (iii)’’ 

7 and inserting ‘‘clause (ii), (iii), or (iv)’’; and 

8 (2) by adding at the end the following new 

9 clause: 

10 ‘‘(iv) FLOOR ON AREA WAGE INDEX FOR HOS11 PITALS IN CERTAIN OTHER AREAS.— 

12 ‘‘(I) IN GENERAL.—For discharges occur13 ring on or after October 1, 2017, the area wage 

14 index applicable under this subparagraph to 

15 any hospital which is not located in a frontier 

16 State (as defined in clause (iii)(II)) may not be 

17 less than 0.874. 

18 ‘‘(II) ENSURING BUDGET NEUTRALITY.— 

19 In order to ensure that the aggregate payments 

20 made under this subsection for a fiscal year 

21 (beginning with fiscal year 2018) are not great22 er than the aggregate payments that would 

23 have been made under this subsection for such 

24 fiscal year without the application of subclause 

25 (I), as estimated by the Secretary, the Sec26 retary shall establish pursuant to rulemaking a 


sradovich on DSK3GMQ082PROD with BILLS
3 

•HR 1130 IH

1 maximum area wage index to apply under this 

2 subparagraph to any hospital which is not lo3 cated in a frontier State (as defined in clause 

4 (iii)(II)). 

5 ‘‘(III) NO IMPACT FOR HOSPITALS WITH

6 AN AREA WAGE INDEX BETWEEN THE FLOOR

7 AND THE MAXIMUM INDEX.—Subclauses (I) 

8 and (II) shall have no effect on the area wage 

9 index applicable in a fiscal year to a hospital 

10 with an area wage index that is greater than 

11 the floor under subclause (I) but less than the 

12 maximum area wage index established under 

13 subclause (II) for the fiscal year.’’. 

14 (b) HOSPITAL OUTPATIENT DEPARTMENT SERV15 ICES.—Section 1833(t) of the Social Security Act (42 

16 U.S.C. 1395l(t)), is amended— 

17 (1) in paragraph (2)(D), by striking ‘‘para18 graph (19), the Secretary’’ and inserting ‘‘para19 graphs (19) and (22), the Secretary’’; and 

20 (2) by adding at the end the following new 

21 paragraph: 

22 ‘‘(22) FLOOR ON AREA WAGE ADJUSTMENT

23 FACTOR FOR HOSPITAL OUTPATIENT DEPARTMENT

24 SERVICES IN AREAS OTHER THAN IN FRONTIER

25 STATES.— 


sradovich on DSK3GMQ082PROD with BILLS
4 

•HR 1130 IH

1 ‘‘(A) IN GENERAL.—With respect to cov2 ered OPD services furnished on or after Janu3 ary 1, 2018, the area wage adjustment factor 

4 applicable under the payment system estab5 lished under this subsection to any hospital out6 patient department which is not located in a 

7 frontier State (as defined in section 

8 1886(d)(3)(E)(iii)(II)) may not be less than 

9 0.874. 

10 ‘‘(B) ENSURING BUDGET NEUTRALITY.— 

11 In order to ensure that the aggregate payments 

12 made under this subsection for a year (begin13 ning with 2018) are not greater than the aggre14 gate payments that would have been made 

15 under this subsection for such year without the 

16 application of subparagraph (A), as estimated 

17 by the Secretary, the Secretary shall establish 

18 pursuant to rulemaking a maximum area wage 

19 adjustment factor to apply under the payment 

20 system established under this subsection to any 

21 hospital outpatient department which is not lo22 cated in a frontier State (as defined in clause 

23 (iii)(II)). 

24 ‘‘(C) NO IMPACT FOR HOSPITALS WITH AN

25 AREA WAGE ADJUSTMENT FACTOR BETWEEN


sradovich on DSK3GMQ082PROD with BILLS
5 

•HR 1130 IH

1 THE FLOOR AND THE MAXIMUM FACTOR.—Sub2 paragraphs (A) and (B) shall have no effect on 

3 the area wage adjustment factor applicable in a 

4 year to a hospital with an area wage adjust5 ment factor that is greater than the floor under 

6 subparagraph (A) but less than the maximum 

7 area wage adjustment factor established under 

8 subparagraph (B) for the year.’’. 

Æ 


sradovich on DSK3GMQ082PROD with BILLS