I

107TH CONGRESS

1ST SESSION H. R. 1656

To amend title XVIII of the Social Security Act to increase payments under

the Medicare Program to Puerto Rico hospitals.

IN THE HOUSE OF REPRESENTATIVES

MAY 1, 2001

Mr. GREENWOOD (for himself, Mr. MCCRERY, Mr. TOWNS, Mr. FOLEY, Mr.

MCDERMOTT, Mr. ACEVEDO-VILA ́, Mr. RANGEL, and Mr. SERRANO) 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 increase

payments under the Medicare Program to Puerto Rico

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 ‘‘Medicare Puerto Rico

5 Hospital Payment Parity Act of 2001’’.

6 SEC. 2. MODIFICATION OF PAYMENT RATE FOR PUERTO

7 RICO HOSPITALS.

8 Section 1886(d)(9)(A) of the Social Security Act (42

9 U.S.C. 1395ww(d)(9)(A)) is amended—
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1 (1) in clause (i), by striking ‘‘October 1, 1997,

2 50 percent (’’ and inserting ‘‘October 1, 2001, 25

3 percent (for discharges between October 1, 1997,

4 and September 30, 2001, 50 percent,’’; and

5 (2) in clause (ii), in the matter preceding sub6 clause (I), by striking ‘‘after October 1, 1997, 50

7 percent (’’ and inserting ‘‘after October 1, 2001, 75

8 percent (for discharges between October 1, 1997,

9 and September 30, 2001, 50 percent,’’.

10 SEC. 3. CALCULATION OF MEDICARE DSH PAYMENTS FOR

11 PPS HOSPITALS IN PUERTO RICO.

12 (a) IN GENERAL.—Section 1886(d)(9) of the Social

13 Security Act (42 U.S.C. 1395ww(d)(9)) is amended—

14 (1) by striking subparagraph (D)(iii) and in15 serting the following:

16 ‘‘(iii) Subparagraph (F) (relating to dispropor17 tionate share payments), except that for this

18 purpose—

19 ‘‘(I) the sum described in clause (ii) of this

20 subparagraph shall be substituted for the sum

21 referred to in paragraph (5)(F)(ii)(I); and

22 ‘‘(II) the number of a subsection (d) Puer23 to Rico hospital’s SSI proxy patient days (as

24 defined in subparagraph (E)) shall be sub-
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1 stituted for the numerator referred to in para2 graph (5)(F)(vi)(I).’’; and

3 (2) by adding at the end the following new sub4 paragraph:

5 ‘‘(E)(i) For purposes of subparagraph (D)(iii)(II),

6 the term ‘subsection (d) Puerto Rico hospital’s SSI proxy

7 patient days’ means the product obtained by multiplying—

8 ‘‘(I) the SSI proxy percentage (as defined in

9 clause (ii)); by

10 ‘‘(II) the total number of the hospital’s patient

11 days for such period.

12 ‘‘(ii) For purposes of clause (i)(I), the term ‘SSI

13 proxy percentage’ means, with respect to all subsection (d)

14 Puerto Rico hospitals for cost reporting periods beginning

15 in a fiscal year, the unweighted average of the fractions

16 (expressed as percentages) determined under paragraph

17 (5)(F)(vi)(I) for all subsection (d) hospitals in the income18 equivalent proxy State (as defined in clause (iii)) for the

19 most recent cost reporting period for which adequate data

20 are available (other than hospitals for which such fraction

21 or percentage is zero).

22 ‘‘(iii) For purposes of clause (ii), the term ‘income23 equivalent proxy State’ means, for cost reporting periods

24 beginning in a fiscal year, the State (other than a State

25 for which title XVI, as in effect without regard to the
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1 amendment made by section 301 of the Social Security

2 Amendments of 1972, continues to apply) the per capita

3 income of which most closely approximates the per capita

4 income of Puerto Rico (as determined by the Secretary

5 based on the most recent period for which adequate data

6 are available).’’.

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

8 subsection (a) shall apply to discharges occurring on or

9 after October 1, 2001.

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