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 addi-
tion to the Committee on Energy and Commerce, for a period to be sub-
sequently 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Sole Community Hos-
pital Preservation Act of 2007’’. 
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SEC. 2. PERMANENT HOLD HARMLESS FOR SOLE COMMU-
NITY HOSPITALS UNDER THE PROSPECTIVE 
PAYMENT 
SYSTEM 
FOR 
HOSPITAL 
OUT-
PATIENT 
DEPARTMENT 
SERVICES 
UNDER 
THE MEDICARE PROGRAM. 
Section 1833(t)(7)(D) of the Social Security Act (42 
U.S.C. 1395l(t)(7)(D)) is amended by adding at the end 
the following new clause: 
‘‘(iii) PERMANENT
HOLD
HARMLESS 
FOR SOLE COMMUNITY HOSPITALS.—In the 
case of a sole community hospital (as de-
fined in section 1886(d)(5)(D)(iii)), for 
covered OPD services furnished after De-
cember 31, 2007, for which the PPS 
amount is less than the pre-BBA amount, 
the amount of payment under this sub-
section shall be increased by the amount of 
such difference.’’. 
SEC. 3. REBASING FOR SOLE COMMUNITY HOSPITALS. 
(a) REBASING PERMITTED.—Section 1886(b)(3) of 
the Social Security Act (42 U.S.C. 1395ww(b)(3)) is 
amended by adding at the end the following new subpara-
graph: 
‘‘(L)(i) For cost reporting periods beginning on or 
after October 1, 2007, in the case of a sole community 
hospital there shall be substituted for the amount other-
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wise determined under subsection (d)(5)(D)(i) of this sec-
tion, if such substitution results in a greater amount of 
payment under this section for the hospital— 
‘‘(I) with respect to discharges occurring in fis-
cal year 2008, 75 percent of the subsection 
(d)(5)(D)(i) amount (as described in subparagraph 
(I)(i)(I)) and 25 percent of the subparagraph (L) 
rebased target amount (as defined in clause (ii)); 
‘‘(II) with respect to discharges occurring in fis-
cal year 2009, 50 percent of the subsection 
(d)(5)(D)(i) amount and 50 percent of the subpara-
graph (L) rebased target amount; 
‘‘(III) with respect to discharges occurring in 
fiscal year 2010, 25 percent of the subsection 
(d)(5)(D)(i) amount and 75 percent of the subpara-
graph (L) rebased target amount; and 
‘‘(IV) with respect to discharges occurring after 
fiscal year 2010, 100 percent of the subparagraph 
(L) rebased target amount. 
‘‘(ii) For purposes of this subparagraph, the ‘sub-
paragraph (L) rebased target amount’ has the meaning 
given the term ‘target amount’ in subparagraph (C), ex-
cept that— 
‘‘(I) there shall be substituted for the base cost 
reporting period the 12-month cost reporting period 
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beginning during fiscal year 2000 or 2001, which-
ever results in the greater amount of payment under 
this section for the hospital; 
‘‘(II) any reference in subparagraph (C)(i) to 
the ‘first cost reporting period’ described in such 
subparagraph is deemed a reference to the first cost 
reporting period beginning on or after October 1, 
2007; and 
‘‘(III) the applicable percentage increase shall 
only be applied under subparagraph (C)(iv) for dis-
charges occurring in fiscal years beginning with fis-
cal year 2008.’’. 
(b) CONFORMING AMENDMENTS.—Such section is 
further amended— 
(1) in subparagraph (C), in the matter pre-
ceding clause (i), by striking ‘‘subparagraph (I)’’ 
and inserting ‘‘subparagraphs (I) and (L)’’; and 
(2) in subparagraph (I)(i)— 
(A) in the matter preceding subclause (I), 
by striking ‘‘For’’ and inserting ‘‘Subject to 
subparagraph (L), for’’; and 
(B) in subclause (I), by inserting ‘‘and 
subparagraph (L)’’ after ‘‘referred to in this 
clause’’. 
Æ 
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