I 
113TH CONGRESS 
1ST SESSION H. R. 1920 
To amend titles XVIII and XIX of the Social Security Act to provide for 
a delay in the implementation schedule of the reductions in dispropor-
tionate share hospital payments, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 9, 2013 
Mr. LEWIS introduced the following bill; which was referred to the Committee 
on Ways and Means, and in addition to the Committee on Energy and 
Commerce, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
to provide for a delay in the implementation schedule 
of the reductions in disproportionate share hospital pay-
ments, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
The Act may be cited as the ‘‘DSH Reduction Relief 
Act of 2013’’. 
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SEC. 2. DELAY IN IMPLEMENTATION OF REVISED MEDI-
CARE DISPROPORTIONATE SHARE HOSPITAL 
PAYMENT METHODOLOGY. 
(a) TWO-YEAR DELAY.—Section 1886(r) of the So-
cial Security Act (42 U.S.C. 1395ww(r)) is amended— 
(1) in paragraph (1), by striking ‘‘For fiscal 
year 2014’’ and inserting ‘‘For fiscal year 2016’’; 
and 
(2) in paragraph (2)— 
(A) in the matter preceding subparagraph 
(A), by striking ‘‘for fiscal year 2014’’ and in-
serting ‘‘for fiscal year 2016’’; 
(B) in subparagraph (B)(i)— 
(i) in the heading of clause (i), by 
striking ‘‘2014, 2015, 2016, AND 2017’’ and 
inserting ‘‘2016, 2017, 2018, AND 2019’’; 
(ii) in the matter preceding subclause 
(I), by striking ‘‘For each of fiscal years 
2014, 2015, 2016, and 2017’’ and insert-
ing ‘‘For each of fiscal years 2016, 2017, 
2018, and 2019’’; and 
(iii) in the matter following subclause 
(II)— 
(I) by striking ‘‘fiscal year 2014’’ 
and inserting ‘‘fiscal year 2016’’; and 
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(II) by striking ‘‘fiscal years 
2015, 2016, and 2017’’ and inserting 
‘‘fiscal years 2017, 2018, and 2019’’; 
and 
(C) in subparagraph (B)(ii)— 
(i) in the heading of clause (ii), by 
striking ‘‘2018’’ and inserting ‘‘2020’’; 
(ii) in the matter preceding subclause 
(I), by striking ‘‘For fiscal year 2018’’ and 
inserting ‘‘For fiscal year 2020’’; and 
(iii) in the matter following subclause 
(II), by striking ‘‘fiscal years 2018 and 
2019’’ and inserting ‘‘fiscal years 2020 
and 2021’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect as if included in the enact-
ment of section 3133 of the Patient Protection and Af-
fordable Care Act (Public Law 111–148), as amended by 
section 10316 of such Act, and as further amended by 
section 1104 of the Health Care and Education Reconcili-
ation Act of 2010 (Public Law 111–152). 
SEC. 3. MODIFICATION OF REDUCTION SCHEDULE FOR 
MEDICAID DSH ALLOTMENTS TO STATES. 
(a) ELIMINATION
OF
REDUCTIONS
FOR
FISCAL 
YEARS 2014 AND 2015.—Section 1923(f)(7)(A) of the So-
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cial Security Act (42 U.S.C. 1396r–4(f)(7)(A)) is amend-
ed— 
(1) in clause (i) in the matter preceding sub-
clause (I), by striking ‘‘fiscal years 2014’’ and in-
serting ‘‘fiscal years 2016’’ ; and 
(2) in clause (ii), by striking subclauses (I) and 
(II) and redesignating subclauses (III) through 
(VII) as subclauses (I) through (V), respectively. 
(b) 
CONFORMING
AMENDMENTS.—Section 
1923(f)(6)(A)(v) of the Social Security Act (42 U.S.C. 
1396r–4(f)(6)(A)(v)) is amended— 
(1) in the heading of clause (v), by striking 
‘‘FOR FISCAL YEAR 2013’’ and inserting ‘‘FOR FISCAL 
YEARS 2013 THROUGH 2015’’; and 
(2) in subclause (II)— 
(A) by amending the heading of such sub-
clause to read as follows: ‘‘FISCAL YEARS 2013 
THROUGH 2015’’; 
(B) by inserting ‘‘2014, or 2015’’ after 
‘‘for fiscal year 2013,’’; and 
(C) by striking ‘‘for such fiscal year’’ and 
inserting ‘‘for each such fiscal year’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall take effect as if included in the enact-
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ment of section 1203 of the Health Care and Education 
Reconciliation Act of 2010 (Public Law 111–152). 
Æ 
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