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) in-
troduced 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.
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 ‘‘Medicare Puerto Rico
Hospital Payment Parity Act of 2001’’.
SEC. 2. MODIFICATION OF PAYMENT RATE FOR PUERTO
RICO HOSPITALS.
Section 1886(d)(9)(A) of the Social Security Act (42
U.S.C. 1395ww(d)(9)(A)) is amended—
(1) in clause (i), by striking ‘‘October 1, 1997,
50 percent (’’ and inserting ‘‘October 1, 2001, 25
percent (for discharges between October 1, 1997,
and September 30, 2001, 50 percent,’’; and
(2) in clause (ii), in the matter preceding sub-
clause (I), by striking ‘‘after October 1, 1997, 50
percent (’’ and inserting ‘‘after October 1, 2001, 75
percent (for discharges between October 1, 1997,
and September 30, 2001, 50 percent,’’.
SEC. 3. CALCULATION OF MEDICARE DSH PAYMENTS FOR
PPS HOSPITALS IN PUERTO RICO.
(a) IN GENERAL.—Section 1886(d)(9) of the Social
Security Act (42 U.S.C. 1395ww(d)(9)) is amended—
(1) by striking subparagraph (D)(iii) and in-
serting the following:
‘‘(iii) Subparagraph (F) (relating to dispropor-
tionate share payments), except that for this
purpose—
‘‘(I) the sum described in clause (ii) of this
subparagraph shall be substituted for the sum
referred to in paragraph (5)(F)(ii)(I); and
‘‘(II) the number of a subsection (d) Puer-
to Rico hospital’s SSI proxy patient days (as
defined in subparagraph (E)) shall be sub-
stituted for the numerator referred to in para-
graph (5)(F)(vi)(I).’’; and
(2) by adding at the end the following new sub-
paragraph:
‘‘(E)(i) For purposes of subparagraph (D)(iii)(II),
the term ‘subsection (d) Puerto Rico hospital’s SSI proxy
patient days’ means the product obtained by multiplying—
‘‘(I) the SSI proxy percentage (as defined in
clause (ii)); by
‘‘(II) the total number of the hospital’s patient
days for such period.
‘‘(ii) For purposes of clause (i)(I), the term ‘SSI
proxy percentage’ means, with respect to all subsection (d)
Puerto Rico hospitals for cost reporting periods beginning
in a fiscal year, the unweighted average of the fractions
(expressed as percentages) determined under paragraph
(5)(F)(vi)(I) for all subsection (d) hospitals in the income-
equivalent proxy State (as defined in clause (iii)) for the
most recent cost reporting period for which adequate data
are available (other than hospitals for which such fraction
or percentage is zero).
‘‘(iii) For purposes of clause (ii), the term ‘income-
equivalent proxy State’ means, for cost reporting periods
beginning in a fiscal year, the State (other than a State
for which title XVI, as in effect without regard to the
amendment made by section 301 of the Social Security
Amendments of 1972, continues to apply) the per capita
income of which most closely approximates the per capita
income of Puerto Rico (as determined by the Secretary
based on the most recent period for which adequate data
are available).’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) shall apply to discharges occurring on or
after October 1, 2001.
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