I
106TH CONGRESS
1ST SESSION
H. R. 2241
To amend the Balanced Budget Act of 1997 to limit the reductions in
Federal payments under the Medicare prospective payment system for
hospital outpatient department services.
IN THE HOUSE OF REPRESENTATIVES
JUNE 16, 1999
Mr. FOLEY (for himself, Mrs. JOHNSON of Connecticut, Mr. HAYWORTH, Mr.
ENGLISH, Mr. DAVIS of Florida, Mr. PETERSON of Minnesota, and Mr.
LARSON) introduced the following bill; which was referred to the Com-
mittee on Commerce, and in addition to the Committee on Ways and
Means, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned
A BILL
To amend the Balanced Budget Act of 1997 to limit the
reductions in Federal payments under the Medicare pro-
spective payment system for hospital outpatient depart-
ment services.
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 ‘‘Hospital Outpatient
Preservation Act of 1999’’.
SEC. 2. LIMITING REDUCTIONS IN FEDERAL PAYMENTS
UNDER PPS FOR HOSPITAL OUTPATIENT DE-
PARTMENT SERVICES.
(a) IN GENERAL.—Section 4523 of the Balanced
Budget Act of 1997 is amended by adding at the end the
following:
‘‘(e) TEMPORARY LIMIT ON REDUCTIONS IN FED-
ERAL PAYMENTS.—
‘‘(1) IN
GENERAL.—Notwithstanding section
1833(t) of the Social Security Act (42 U.S.C.
1395l(t)), as added by subsection (a), the amount
that is paid from the Federal Supplementary Med-
ical Insurance Trust Fund for covered OPD services
furnished by a hospital during a calendar year (or
portion thereof) specified in paragraph (2)(A) may
not be less than the applicable percentage of the
case mix adjusted average amount that would have
been payable to such hospital for such services (in-
cluding cost sharing) if the prospective payment sys-
tem established under such section did not apply.
Such average amount may be determined on a pro-
spective basis using the Secretary’s best estimate of
the reasonable costs incurred in furnishing covered
OPD services or on a retrospective basis using cost
reports submitted by a hospital.
‘‘(2) DEFINITIONS.—For purposes of paragraph
(1)—
‘‘(A) subject to paragraph (3), the term
‘applicable percentage’ means—
‘‘(i) with respect to covered OPD
services furnished during the first full cal-
endar year (and any portion of the imme-
diately preceding calendar year) for which
the prospective payment system established
under section 1833(t) of such Act is in ef-
fect, 95 percent;
‘‘(ii) with respect to the second full
calendar year for which such system is in
effect, 90 percent; and
‘‘(iii) with respect to the third full cal-
endar year for which such system is in ef-
fect, 85 percent; and
‘‘(B) the term ‘covered OPD services’ has
the meaning given to such term in section
1833(t)(1)(B) of such Act.
‘‘(3) APPLICATION TO CERTAIN HOSPITALS.—In
the case of hospitals described in section 1833(t)(8)
of such Act, the ‘applicable percentage’ for a cal-
endar year (or portion thereof) shall be the same ap-
plicable percentage that applies to covered OPD
services furnished by hospitals that are not described
in such section during such calendar year (or portion
thereof).
‘‘(4) RULE
OF
CONSTRUCTION.—Nothing in
this subsection shall be construed as affecting the
amount of cost sharing paid by individuals enrolled
under part B of title XVIII of the Social Security
Act for covered OPD services.’’.
(b) 
CONFORMING
AMENDMENT.—Section
1833(t)(1)(A) of the Social Security Act (42 U.S.C.
1395l(t)(1)(A)) is amended by inserting ‘‘except as pro-
vided in section 4523(e) of the Balanced Budget Act of
1997,’’ after ‘‘1999,’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall become effective as if included in the en-
actment of the Balanced Budget Act of 1997.
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