I 

109TH CONGRESS 

2D SESSION H. R. 5496 

To amend title XVIII of the Social Security Act to provide special treatment 

of certain cancer hospitals under the Medicare Program. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 25, 2006 

Mr. FERGUSON 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 provide 

special treatment of certain cancer hospitals under the 

Medicare Program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. MEDICARE TREATMENT FOR CERTAIN CANCER 

4 HOSPITALS. 

5 (a) IN GENERAL.—Section 1886(d)(1)(B) of the So6 cial Security Act (42 U.S.C. 1395ww(d)(1)(B)) is amend7 ed— 

8 (1) by striking ‘‘or’’ at the end of clause (iv); 

9 (2) by striking the semicolon at the end of 

10 clause (v) and inserting ‘‘, or’’; and 


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1 (3) by inserting after clause (v) the following 

2 new clause: 

3 ‘‘(vi) a hospital that— 

4 ‘‘(I) is located in a State which ranks (ac5 cording to the National Cancer Institute’s sta6 tistics published in May 2005 for 2001 and 

7 2002) first among all States in the incidence of 

8 prostate cancer, third in the incidence rate for 

9 non-Hodgkins lymphoma, fourth in the inci10 dence rates for thyroid cancer and ovarian can11 cer, and third in the highest death rates from 

12 uterine cancer and breast cancer; 

13 ‘‘(II) is located in a State that, as of De14 cember 31, 2005, had only one center under 

15 section 414 of the Public Health Service Act 

16 that has been designated by the National Can17 cer Institute as a comprehensive center cur18 rently serving all 21 counties in the most dense19 ly populated State in the nation, serving more 

20 than 70,000 patient visits annually; 

21 ‘‘(III) as of December 31, 2005, served as 

22 the teaching and clinical care, research and 

23 training hospital for the Center described in 

24 subclause (II), providing significant financial 

25 and operational support to such Center; 


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1 ‘‘(IV) as of December 31, 2005, served as 

2 a core and essential element in such Center 

3 which conducts more than 130 clinical trial ac4 tivities, national cooperative group studies, in5 vestigator-initiated and peer review studies and 

6 received during 2003 at least $80,000,000 in 

7 research grant awards; 

8 ‘‘(V) as of December 31, 2005, can dem9 onstrate that it has been a unique and an inte10 gral component of such Center since such Cen11 ter’s inception; 

12 ‘‘(VI) as of December 31, 2005, includes 

13 dedicated patient care units organized primarily 

14 for the treatment of and research on cancer 

15 with approximately 125 beds, 75 percent of 

16 which are dedicated to cancer patients, and con17 tains a radiation oncology department as well 

18 as specialized emergency services for oncology 

19 patients; 

20 ‘‘(VII) as of December 31, 2003, is identi21 fied as the focus of the Center’s inpatient ac22 tivities in the Center’s application as an NCI23 designated comprehensive cancer center and 

24 shares the NCI comprehensive cancer designa25 tion with the Center; and 


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1 ‘‘(VIII) as of December 31, 2005, has been 

2 recognized with a certificate of approval by the 

3 American College of Surgeons Commission on 

4 Cancer;’’. 

5 (b) CONFORMING AMENDMENT.—Section 

6 1886(d)(3)(E) of such Act (42 U.S.C. 1395ww(d)(3)(E)) 

7 is amended by striking ‘‘clause (v)’’ and inserting ‘‘clauses 

8 (v) and (vi)’’. 

9 (c) PAYMENT.— 

10 (1) APPLICATION TO COST REPORTING PERI11 ODS.—Any classification by reason of section 

12 1886(d)(1)(B)(vi) of the Social Security Act (42 

13 U.S.C. 1395ww(d)(1)(B)(vi)) (as added by sub14 section (a)) shall apply to all cost reporting periods 

15 beginning on or after January 1, 2005. 

16 (2) BASE TARGET AMOUNT.—Notwithstanding 

17 section 1886(b)(3)(E) of the Social Security Act (42 

18 U.S.C. 1395ww(b)(3)(E), in the case of a hospital 

19 described in section 1886(d)(1)(B)(vi) of the Social 

20 Security Act, as added by subsection (a), such hos21 pital shall be permitted to resubmit the 2005 Medi22 care 2552 cost report incorporating a cancer hos23 pital sub-provider number, and apply the Medicare 

24 ratio-of-cost-to-charge settlement methodology for 

25 outpatient cancer services. In the case of such hosVerDate Aug 31 2005 04:30 Jun 01, 2006 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5496.IH H5496

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1 pital the PPS cancer exemption under section 

2 1886(b)(3)(E)(i) of such Act for the first cost re3 porting period beginning on or after January 1, 

4 2005, shall be the allowable operating costs of inpa5 tient hospital services (referred to in subclause (I) of 

6 such section) for such first cost reporting period. 

7 (3) DEADLINE FOR PAYMENTS.—Any payments 

8 owed to a hospital as a result of this section for pe9 riods occurring before the date of the enactment of 

10 this Act shall be made expeditiously, but in no event 

11 later than 1 year after such date of enactment. 

12 (d) MAINTENANCE OF EXEMPTION.—Once admitted 

13 as a PPS cancer-exempt hospital, a hospital described in 

14 section 1886(d)(1)(B)(vi) of the Social Security Act shall 

15 retain that status as long as the Center referred to in such 

16 section remains a comprehensive cancer center. 

Æ 


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