I 

110TH CONGRESS 

1ST SESSION H. R. 1177 

To amend title XVIII of the Social Security Act to extend and improve 

protections for sole community hospitals under the Medicare Program. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 16, 2007 

Mr. TANNER (for himself and Mr. GRAVES) introduced the following bill; 

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

and improve protections for sole community 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 ‘‘Sole Community Hos5 pital Preservation Act of 2007’’. 


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1 SEC. 2. PERMANENT HOLD HARMLESS FOR SOLE COMMU2 NITY HOSPITALS UNDER THE PROSPECTIVE 

3 PAYMENT SYSTEM FOR HOSPITAL OUT4 PATIENT DEPARTMENT SERVICES UNDER 

5 THE MEDICARE PROGRAM. 

6 Section 1833(t)(7)(D) of the Social Security Act (42 

7 U.S.C. 1395l(t)(7)(D)) is amended by adding at the end 

8 the following new clause: 

9 ‘‘(iii) PERMANENT HOLD HARMLESS

10 FOR SOLE COMMUNITY HOSPITALS.—In the 

11 case of a sole community hospital (as de12 fined in section 1886(d)(5)(D)(iii)), for 

13 covered OPD services furnished after De14 cember 31, 2007, for which the PPS 

15 amount is less than the pre-BBA amount, 

16 the amount of payment under this sub17 section shall be increased by the amount of 

18 such difference.’’. 

19 SEC. 3. REBASING FOR SOLE COMMUNITY HOSPITALS. 

20 (a) REBASING PERMITTED.—Section 1886(b)(3) of 

21 the Social Security Act (42 U.S.C. 1395ww(b)(3)) is 

22 amended by adding at the end the following new subpara23 graph: 

24 ‘‘(L)(i) For cost reporting periods beginning on or 

25 after October 1, 2007, in the case of a sole community 

26 hospital there shall be substituted for the amount otherVerDate Aug 31 2005 23:32 Feb 22, 2007 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1177.IH H1177

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1 wise determined under subsection (d)(5)(D)(i) of this sec2 tion, if such substitution results in a greater amount of 

3 payment under this section for the hospital— 

4 ‘‘(I) with respect to discharges occurring in fis5 cal year 2008, 75 percent of the subsection 

6 (d)(5)(D)(i) amount (as described in subparagraph 

7 (I)(i)(I)) and 25 percent of the subparagraph (L) 

8 rebased target amount (as defined in clause (ii)); 

9 ‘‘(II) with respect to discharges occurring in fis10 cal year 2009, 50 percent of the subsection 

11 (d)(5)(D)(i) amount and 50 percent of the subpara12 graph (L) rebased target amount; 

13 ‘‘(III) with respect to discharges occurring in 

14 fiscal year 2010, 25 percent of the subsection 

15 (d)(5)(D)(i) amount and 75 percent of the subpara16 graph (L) rebased target amount; and 

17 ‘‘(IV) with respect to discharges occurring after 

18 fiscal year 2010, 100 percent of the subparagraph 

19 (L) rebased target amount. 

20 ‘‘(ii) For purposes of this subparagraph, the ‘sub21 paragraph (L) rebased target amount’ has the meaning 

22 given the term ‘target amount’ in subparagraph (C), ex23 cept that— 

24 ‘‘(I) there shall be substituted for the base cost 

25 reporting period the 12-month cost reporting period 


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1 beginning during fiscal year 2000 or 2001, which2 ever results in the greater amount of payment under 

3 this section for the hospital; 

4 ‘‘(II) any reference in subparagraph (C)(i) to 

5 the ‘first cost reporting period’ described in such 

6 subparagraph is deemed a reference to the first cost 

7 reporting period beginning on or after October 1, 

8 2007; and 

9 ‘‘(III) the applicable percentage increase shall 

10 only be applied under subparagraph (C)(iv) for dis11 charges occurring in fiscal years beginning with fis12 cal year 2008.’’. 

13 (b) CONFORMING AMENDMENTS.—Such section is 

14 further amended— 

15 (1) in subparagraph (C), in the matter pre16 ceding clause (i), by striking ‘‘subparagraph (I)’’ 

17 and inserting ‘‘subparagraphs (I) and (L)’’; and 

18 (2) in subparagraph (I)(i)— 

19 (A) in the matter preceding subclause (I), 

20 by striking ‘‘For’’ and inserting ‘‘Subject to 

21 subparagraph (L), for’’; and 

22 (B) in subclause (I), by inserting ‘‘and 

23 subparagraph (L)’’ after ‘‘referred to in this 

24 clause’’. 

Æ 


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