II

105TH CONGRESS

1ST SESSION S. 1342

To amend title XVIII of the Social Security Act to increase access to quality

health care in frontier communities by allowing health clinics and health

centers greater medicare flexibility and reimbursement.

IN THE SENATE OF THE UNITED STATES

OCTOBER 29, 1997

Mr. MURKOWSKI (for himself and Mr. THOMAS) 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

access to quality health care in frontier communities

by allowing health clinics and health centers greater medicare flexibility and reimbursement.

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 Frontier

5 Health Clinic and Center Act of 1997’’.

6 SEC. 2. FINDINGS.

7 Congress finds the following:
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1 (1) Frontier communities face unparalleled geo2 graphic, climatic, and economic barriers to quality

3 health care.

4 (2) Health clinics and health centers located in

5 frontier areas do not have the resources or the de6 mand to provide full service inpatient and outpatient

7 health care.

8 (3) Many requirements under the medicare pro9 gram under title XVIII of the Social Security Act

10 (42 U.S.C. 1395 et seq.), designed for large subur11 ban and urban facilities, do not account for the

12 unique conditions of smaller facilities in remote com13 munities.

14 (4) Increasing the ability of health clinics and

15 health centers to provide health services enables pa16 tients to remain closer to home while receiving those

17 services, improves the quality of care provided to in18 dividuals, reduces costs, and spurs economic develop19 ment by keeping health care dollars in the local

20 economy.
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1 SEC. 3. CERTAIN HEALTH CLINICS AND HEALTH CENTERS

2 PERMITTED TO PARTICIPATE IN THE MEDI3 CARE RURAL HOSPITAL FLEXIBILITY PRO4 GRAM.

5 (a) IN GENERAL.—Section 1820(c)(2) of the Social

6 Security Act (42 U.S.C. 1395i–4(c)(2)) (as amended by

7 section 4201(a) of the Balanced Budget Act of 1997 (Pub8 lic Law 105–33; 111 Stat. 370)) is amended—

9 (1) in subparagraph (A), by striking ‘‘subpara10 graph (B)’’ and inserting ‘‘subparagraphs (B) and

11 (C)’’;

12 (2) in subparagraph (B)(i) by striking ‘‘public

13 hospital’’ and inserting ‘‘public hospital (or a health

14 clinic or health center if designated under subpara15 graph (C))’’; and

16 (3) by adding at the end the following:

17 ‘‘(C) HEALTH CLINICS AND CENTERS.—A

18 State may designate a health clinic or a health

19 center (as defined by the State) as a critical ac20 cess hospital if the health clinic or center—

21 ‘‘(i) is licensed by the State as a

22 health clinic or a health center;

23 ‘‘(ii) is located in—

24 ‘‘(I) a county (or equivalent area)

25 within the State that has an average
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1 population of not more than 6 individ2 uals per square mile; and

3 ‘‘(II) a health professional short4 age area (as defined in section

5 332(a)(1)(A) of the Public Health

6 Service Act); and

7 ‘‘(iii) meets the criteria for designa8 tion as a critical access hospital under sub9 paragraph (B), except that clause (i)(II) of

10 such subparagraph shall be applied by sub11 stituting ‘50-mile’ for ‘35-mile’.’’.

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

13 subsection (a) shall take effect as if included in the enact14 ment of the Balanced Budget Act of 1997 (Public Law

15 105–33; 111 Stat. 251).

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