I

106TH CONGRESS

1ST SESSION H. R. 1529

To require the Secretary of Health and Human Services to modify the

treatment of certain patient days for purposes of determining the amount

of disproportionate share adjustment payments to hospitals under the

Medicare Program.

IN THE HOUSE OF REPRESENTATIVES

APRIL 22, 1999

Mr. ENGLISH (for himself, Mr. COYNE, Mr. WELDON of Pennsylvania, Mr.

BRADY of Pennsylvania, Mr. PETERSON of Pennsylvania, Mr. BORSKI,

Mr. GEKAS, Mr. DOYLE, Mr. GOODLING, Mr. FATTAH, Mr. GREENWOOD,

Mr. HOEFFEL, Mr. PITTS, Mr. HOLDEN, Mr. SHERWOOD, Mr. KANJORSKI, Mr. SHUSTER, Mr. KLINK, Mr. MURTHA, Mr. TOOMEY, and Mr.

MASCARA) introduced the following bill; which was referred to the Committee on Ways and Means

A BILL

To require the Secretary of Health and Human Services

to modify the treatment of certain patient days for purposes of determining the amount of disproportionate

share adjustment payments to 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. SHORT TITLE.

4 This Act may be cited as the ‘‘Indigent Care Reim5 bursement Act of 1999’’.
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1 SEC. 2. TREATMENT OF CERTAIN PATIENT DAYS IN DETER2 MINING DSH PAYMENTS UNDER MEDICARE.

3 (a) LIMIT ON DISALLOWANCES.—The Secretary of

4 Health and Human Services (in this section referred to

5 as the ‘‘Secretary’’) may not—

6 (1) in calculating the disproportionate patient

7 percentage (as defined in section 1886(d)(5)(F)(vi)

8 of the Social Security Act (42 U.S.C.

9 1395ww(d)(5)(F)(vi))) of a hospital that is located

10 in a subsection (c) State for discharges occurring be11 fore October 1, 1998, treat patient days for individ12 uals eligible for general assistance under the laws of

13 such State, for purposes of subclause (II) of such

14 section, as not consisting of patients who (for such

15 days) were eligible for medical assistance under a

16 State plan approved under title XIX of such Act; or

17 (2) recoup payments from (or otherwise reduce,

18 disallow, or adjust payments under title XVIII of

19 such Act to) such a hospital for discharges occurring

20 before such date based on the treatment of patient

21 days for general assistance in the manner prohibited

22 by paragraph (1).

23 (b) REFUNDS OF RECOUPED AMOUNTS.—If, before

24 the date of the enactment of this section, the Secretary

25 has recouped payments from (or otherwise reduced, dis26 allowed, or adjusted payments under title XVIII of such
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1 Act to) a hospital that is located in a subsection (c) State

2 based on the treatment of patient days for general assist3 ance in the manner prohibited by subsection (a)(1), the

4 Secretary shall refund to the hospital the portion of the

5 amount recouped, reduced, disallowed, or adjusted that is

6 attributable to discharges occurring before October 1,

7 1998.

8 (c) SUBSECTION (c) STATE DEFINED.—For purposes

9 of this section, the term ‘‘subsection (c) State’’ means a

10 State that meets the following requirements:

11 (1) No subsection (d) hospital (as defined in

12 section 1886(d)(1)(B) of such Act (42 U.S.C.

13 1395ww(d)(1)(B))) located in the State is owned

14 and operated by a unit of State or local government.

15 (2) The total amount of payments under section

16 1886(d)(5)(F) of such Act (42 U.S.C.

17 1395ww(d)(5)(F)) (relating to disproportionate

18 share payments) for hospitals located in the State

19 that were included in a medicare public use file enti20 tled ‘‘PPS XIII Hospital Data Set’’ is not less than

21 $150,000,000 nor more than $170,000,000.

22 (3) The total number of individuals residing in

23 the State and enrolled in an insurance program es24 tablished under title XVIII of such Act during cal-
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1 endar year 1996 was more than 2,000,000, but less

2 than 2,200,000.

3 (4) More than 15.8 percent of the individuals

4 residing in the State during 1995 had attained age

5 65.

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