Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015

To amend title XVIII of the Social Security Act to change the method of determining disproportionate share hospital (DSH) payments under the Medicare program, and for other purposes. 1. Short title This Act may be cited as the Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015 2. Change in determination of Medicare DSH payments Paragraph (1) of section 1886(r) of the Social Security Act ( 42 U.S.C. 1395ww(r) (1) by striking so much of such paragraph as precedes fiscal year 2014 (1) DSH payments (A) In general Subject to subparagraph (B), for ; (2) by striking (which represents Report to the Congress) (3) by adding at the end the following new subparagraph: (B) Aggregate limitation beginning with fiscal year 2017 As part of the rulemaking to carry out subsection (d) for fiscal year 2017 and each subsequent fiscal year, the Secretary shall estimate the aggregate amount of payments to be made for such fiscal year under subparagraph (A) (determined without regard to this subparagraph) and, if the amount so estimated exceeds $3,300,000,000, then each amount paid under subparagraph (A) for that fiscal year shall be multiplied by the ratio of $3,300,000,000 to the amount so estimated. . 3. Additional DSH payment for certain qualifying hospitals Section 1886(r) of the Social Security Act ( 42 U.S.C. 1395ww(r) (1) by redesignating paragraph (3) as paragraph (4); and (2) by inserting after paragraph (2) the following new paragraph: (3) Additional payment for certain qualifying hospitals (A) In general For fiscal year 2017 and each subsequent fiscal year, in addition to the payments made to a qualifying hospital under paragraphs (1) and (2), the Secretary shall pay to each qualifying hospital an amount equal to $1,000,000,000 multiplied by the factor that would be calculated under paragraph (2)(C) for such qualifying hospital if each reference in such paragraph to a subsection (d) hospital were treated as a reference to a qualifying hospital. (B) Qualifying hospital defined In this paragraph, qualifying hospital . 4. Recapture of overpayments resulting from certain federally subsidized health insurance (a) In general Paragraph (2) of section 36B(f) (b) Conforming amendment So much of paragraph (2) of section 36B(f) of such Code, as amended by subsection (a), as precedes advance payments (2) Excess advance payments If the . (c) Effective date The amendments made by this section shall apply to taxable years ending after December 31, 2015.

Summary: Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to alter the method of determining disproportionate share hospital (DSH) payments under the Medicare program. (DSH payments compensate hospitals for the higher operating costs they incur in treating a large share of low-income patients.) The Centers for Medicare & Medicaid Services (CMS) must estimate the aggregate amount of payments to be made for each fiscal year; if the estimated amount exceeds $3.3 billion, then each DSH payment shall be made according to its ratio to that limit. CMS must make supplementary DSH payments to certain hospitals located in Alabama, Florida, Georgia, Idaho, Kansa, Louisiana, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, or Wyoming. The bill also amends the Internal Revenue Code to modify provisions related to overpayments made to taxpayers for tax credits under the Patient Protection and Affordable Care Act (PPACA). Under current law, if the advance payments to a taxpayer for premium tax credits under PPACA exceed the allowable credit, the tax imposed shall be increased by the amount of such excess, subject to certain income-based limitations. The bill eliminates these income-based limitations.