I 

115TH CONGRESS 

2D SESSION H. R. 5498 

To amend title XVIII of the Social Security Act to extend the floor on 

the area wage index under the inpatient prospective payment system 

to certain sole community hospitals and to amend the Public Health 

Service Act to provide eligibility for certain sole community hospitals 

to discounted drug prices under the 340B drug pricing program. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 12, 2018 

Mr. PETERSON (for himself and Mr. TIPTON) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committee on Ways and Means, 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 extend 

the floor on the area wage index under the inpatient 

prospective payment system to certain sole community 

hospitals and to amend the Public Health Service Act 

to provide eligibility for certain sole community hospitals 

to discounted drug prices under the 340B drug pricing 

program. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Rural Hospital Fron3 tier Fairness Act’’. 

4 SEC. 2. EXTENDING FLOOR ON AREA WAGE INDEX TO CER5 TAIN SOLE COMMUNITY HOSPITALS. 

6 Section 1886(d)(3)(E)(iii) of the Social Security Act 

7 (42 U.S.C. 1395ww(d)(3)(E)(iii)) is amended— 

8 (1) in subclause (I), by inserting before the pe9 riod at the end the following: ‘‘and, for discharges 

10 occurring on or after October 1, 2018, the area 

11 wage index applicable under this subparagraph to 

12 any sole community hospital that is located not more 

13 than 75 miles from the closest frontier State and 

14 that makes an election under subclause (V) may not 

15 be less than 1.00’’; and 

16 (2) by adding at the end the following new sub17 clause: 

18 ‘‘(V) SOLE COMMUNITY HOS19 PITAL ELECTION.—The Secretary 

20 shall provide for a process under 

21 which a sole community hospital de22 scribed in subclause (I) may elect, at 

23 such time and in such manner as 

24 specified by the Secretary, to apply 

25 subclause (I) to such sole community 

26 hospital.’’. 


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1 SEC. 3. ELIGIBILITY OF CERTAIN SOLE COMMUNITY HOS2 PITALS FOR DISCOUNTED DRUG PRICES 

3 UNDER THE 340B DRUG PRICING PROGRAM. 

4 (a) IN GENERAL.—Section 340B(a)(4) of the Public 

5 Health Service Act (42 U.S.C. 256b(a)(4)) is amended by 

6 adding at the end the following new subparagraph: 

7 ‘‘(P) An entity that is a sole community 

8 hospital (as defined in section 

9 1886(d)(5)(C)(iii) of the Social Security Act), 

10 that was classified as such a hospital before Oc11 tober 1, 2015, and that is located not more 

12 than 75 miles from the closest frontier State 

13 (as defined in section 1886(d)(3)(E)(iii)(II) of 

14 such Act).’’. 

15 (b) EFFECTIVE DATE.— 

16 (1) IN GENERAL.—The amendment made by 

17 subsection (a) shall apply to drugs purchased on or 

18 after the first day of the first month that begins 

19 more than 60 days after the date of the enactment 

20 of this Act. 

21 (2) CONFORMING 340B AGREEMENTS.—The 

22 Secretary of Health and Human Services shall pro23 vide for such timely modification of agreements en24 tered into under section 340B of the Public Health 

25 Service Act (42 U.S.C. 256b) as is necessary to pro26 vide for the application of the amendment made by 


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1 subsection (a) on a timely basis consistent with 

2 paragraph (1). 

Æ 


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