I 
114TH CONGRESS 
2D SESSION 
H. R. 5614 
To amend title XVIII of the Social Security Act to provide for a change 
in Medicare classification for certain hospitals. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 1, 2016 
Mr. CROWLEY 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 provide 
for a change in Medicare classification for certain hospitals. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. CHANGE IN MEDICARE CLASSIFICATION FOR 
CERTAIN HOSPITALS. 
(a) IN GENERAL.—Subsection (d)(1)(B) of section 
1886 of the Social Security Act (42 U.S.C. 1395ww) is 
amended— 
(1) in clause (iv)— 
(A) in subclause (I)— 
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(i) by striking ‘‘(iv)(I)’’ and inserting 
‘‘(iv)’’; and 
(ii) by striking ‘‘or’’ at the end; and 
(B) in subclause (II)— 
(i) by striking ‘‘, or’’ at the end and 
inserting a semicolon; and 
(ii) by redesignating such subclause as 
clause (vi) and by moving it to immediately 
follow clause (v); and 
(iii) in clause (v), by striking the 
semicolon at the end and inserting ‘‘, or’’. 
(b) CONFORMING PAYMENT REFERENCES.—The sec-
ond sentence of subsection (d)(1)(B) of such section is 
amended— 
(1) by inserting ‘‘(as in effect as of such date)’’ 
after ‘‘clause (iv)’’; and 
(2) by inserting ‘‘(or, in the case of a hospital 
described in clause (iv)(II), as so in effect, shall be 
classified under clause (vi) on and after the effective 
date of such clause (vi) and for cost-reporting peri-
ods beginning on or after January 1, 2015, shall not 
be subject to subsection (m) as of the date of such 
classification)’’ after ‘‘so classified’’. 
(c) APPLICATION.— 
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(1) IN GENERAL.—For cost-reporting periods 
beginning on or after January 1, 2015, in the case 
of an applicable hospital (as defined in paragraph 
(3)), the following shall apply: 
(A) Payment for inpatient operating costs 
shall be made on the TEFRA basis in the man-
ner provided in section 412.526(c) of title 42, 
Code of Federal Regulations (as in effect on 
January 1, 2015). 
(B) Payment for capital costs shall be 
made in the manner provided by section 
412.526(c)(4) of title 42, Code of Federal Reg-
ulations (as in effect on such date). 
(C) Claims for payment for Medicare bene-
ficiaries who are discharged on of after January 
1, 2015, shall be processed as claims which are 
paid on a TEFRA payment basis as described 
in section 412.526(c) of title 42, Code of Fed-
eral Regulations (as in effect on such date). 
(2) ASSIGNMENT
OF
NEW
PROVIDER
NUM-
BER.—The Secretary of Health and Human Services 
shall assign a new provider number for an applicable 
hospital (as defined in paragraph (3)), effective for 
its first cost-reporting period beginning on or after 
the date of enactment of this Act. 
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(3) APPLICABLE HOSPITAL DEFINED.—In this 
subsection, the term ‘‘applicable hospital’’ means a 
hospital that is classified under clause (iv)(II) of sec-
tion 1886(d)(1)(B) of the Social Security Act (42 
U.S.C. 1395ww(d)(1)(B)) on the day before the date 
of the enactment of this Act and which is classified 
under clause (vi) of such section, as added by sub-
section (a), on or after such date of enactment. 
(d) CONFORMING TECHNICAL AMENDMENT.—Sec-
tion 1899B(a)(2)(A)(iv) of the Social Security Act (42 
U.S.C. 1395lll(a)(2)(A)(iv)) is amended by striking 
‘‘1886(d)(1)(B)(iv)(II)’’ 
and 
inserting 
‘‘1886(d)(1)(B)(vi)’’. 
Æ 
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