I 
113TH CONGRESS 
1ST SESSION H. R. 3613 
To amend title XVIII of the Social Security Act to provide for a change 
in payment for certain hospitals under Medicare. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 21, 2013 
Mr. RANGEL (for himself and 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 payment for certain hospitals under 
Medicare. 
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 PAYMENT 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 
(2) in clause (v), by striking the semicolon at 
the end and inserting ‘‘, or’’. 
(b) CONFORMING
PAYMENT
REFERENCES.—Sub-
section (b) of such section is amended— 
(1) in paragraph (2)(E)(ii), by adding at the 
end the following new subclause: 
‘‘(III) Hospitals described in 
clause (vi) of such subsection.’’; 
(2) in paragraph (3)(F)(iii), by adding at the 
end the following new subclause: 
‘‘(VI) 
Hospitals 
described 
in 
clause (vi) of such subsection.’’; 
(3) in paragraph (3)(G)(ii), by inserting ‘‘or 
(vi)’’ after ‘‘clause (iv)’’; 
(4) in paragraph (3)(H)(iv), by adding at the 
end the following new subclause: 
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‘‘(IV) 
Hospitals 
described 
in 
clause (vi) of such subsection.’’; 
(5) in paragraph (3)(J), by striking ‘‘subsection 
(d)(1)(B)(iv)’’ and inserting ‘‘clause (iv) or (vi) of 
subsection (d)(1)(B)’’; and 
(6) in paragraph (7)(B), by adding at the end 
the following new clause: 
‘‘(iv) Hospitals described in clause (vi) 
of such subsection.’’. 
(c) ADDITIONAL CONFORMING AMENDMENTS.—The 
second 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, 2014, shall not 
be subject to subsection (m) as of the date of such 
classification)’’ after ‘‘so classified’’. 
(d) APPLICATION.—In the case of a hospital that is 
classified under clause (iv)(II) of section 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 
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which is classified under clause (vi) of such section after 
such date of enactment, payments for inpatient operating 
costs for cost reporting periods beginning on or after Jan-
uary 1, 2014, shall be based upon the target amount per 
discharge established pursuant to section 1886(b) of such 
Act (42 U.S.C. 1395ww(b)) in effect for the cost reporting 
period for such hospital beginning during fiscal year 2001, 
increased for each succeeding cost reporting period (begin-
ning before the date of the enactment of this Act) by the 
applicable 
percentage 
increase 
under 
section 
1886(b)(3)(B)(ii) 
of 
such 
Act 
(42 
U.S.C. 
1395ww(b)(3)(B)(ii)). 
Æ 
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