I 

113TH CONGRESS 

1ST SESSION H. R. 1390 

To amend title XVIII of the Social Security Act to preserve access to urban 

Medicare-dependent hospitals. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 21, 2013 

Mr. SMITH of New Jersey (for himself, Mr. DEUTCH, Mr. LOBIONDO, Mr. 

RUNYAN, Mr. LARSON of Connecticut, Ms. FRANKEL of Florida, and Mr. 

COURTNEY) 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 preserve 

access to urban Medicare-dependent 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 ‘‘Urban Medicare-De5 pendent Hospitals Preservation Act of 2013’’. 


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1 SEC. 2. CRITERIA AND PAYMENT FOR CERTAIN URBAN 

2 MEDICARE-DEPENDENT HOSPITALS. 

3 (a) IN GENERAL.—Section 1886(d)(5) of the Social 

4 Security Act (42 U.S.C. 1395ww(d)(5)) is amended by 

5 adding at the end the following new subparagraph: 

6 ‘‘(M)(i) For cost reporting periods begin7 ning on or after October 1, 2013, and before 

8 October 1, 2016, in the case of a subsection (d) 

9 hospital which is an urban Medicare-dependent 

10 hospital, payment under paragraph (1)(A) shall 

11 be equal to the sum of the amount determined 

12 under clause (ii) and the amount determined 

13 under paragraph (1)(A)(iii). 

14 ‘‘(ii) The amount determined under this 

15 clause is, for discharges occurring during a cost 

16 reporting period that begins on or after October 

17 1, 2013, and before October 1, 2016, 50 per18 cent of the amount by which the hospital’s tar19 get amount for the cost reporting period (as de20 fined in subsection (b)(3)(L)) exceeds the 

21 amount determined under paragraph (1)(A)(iii). 

22 ‘‘(iii) For purposes of this subparagraph, 

23 the term ‘urban Medicare-dependent hospital’ 

24 means, with respect to any cost reporting pe25 riod to which clause (i) applies, any hospital— 


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1 ‘‘(I) located in an urban area or re2 classified to an urban area for wage index 

3 purposes; 

4 ‘‘(II) that does not receive payment— 

5 ‘‘(aa) under subparagraph (C) as 

6 a rural referral center; 

7 ‘‘(bb) under subparagraph (D) as 

8 a sole community hospital; 

9 ‘‘(cc) under subparagraph (B) or 

10 under subsection (h); or 

11 ‘‘(dd) under subparagraph (F); 

12 ‘‘(III) that is not a physician-owned 

13 hospital, as defined in section 489.3 of title 

14 42, Code of Federal Regulations (as in ef15 fect as of the date of the enactment of this 

16 subparagraph); and 

17 ‘‘(IV) for which not less than 60 per18 cent of its inpatient days or discharges 

19 during the cost reporting period beginning 

20 in fiscal year 2006, or two of the three 

21 most recently audited cost reporting peri22 ods for which the Secretary has a settled 

23 cost report, were attributable to inpatients 

24 entitled to benefits under part A and not 


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1 enrolled in a Medicare Advantage plan 

2 under part C.’’. 

3 (b) TARGET PAYMENT AMOUNT.—Section 

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

5 1395ww(b)(3)) is amended— 

6 (1) in subparagraph (B)(iv), by striking ‘‘and 

7 (D)’’ and inserting ‘‘, (D), and (M)’’; and 

8 (2) by adding at the end the following new sub9 paragraph: 

10 ‘‘(M) For cost reporting periods occurring 

11 on or after October 1, 2013, and before October 

12 1, 2016, in the case of a hospital that is an 

13 urban Medicare-dependent hospital (as defined 

14 in subsection (d)(5)(M)), the term ‘target 

15 amount’ means— 

16 ‘‘(i) with respect to the first 12-month 

17 cost reporting period in which this sub18 paragraph is applied to the hospital, the 

19 allowable operating costs of inpatient hos20 pital services (as defined in subsection 

21 (a)(4)) recognized under this title for the 

22 hospital for the 12-month cost reporting 

23 period beginning during fiscal year 2002 or 

24 2006 (whichever results in a higher target 

25 amount), increased by the applicable perVerDate Mar 15 2010 02:33 Mar 30, 2013 Jkt 029200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390

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1 centage increase under subparagraph 

2 (B)(iv) for each of fiscal years 2003 

3 through 2013 or 2007 through 2013, re4 spectively; and 

5 ‘‘(ii) with respect to discharges occur6 ring after the first 12-month cost reporting 

7 period in which this subparagraph is ap8 plied to the hospital, the target amount for 

9 the preceding year increased by the appli10 cable percentage increase under subpara11 graph (B)(iv).’’. 

Æ 


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