HR 5228 IH
SEC. 2. SPECIAL PAYMENTS TO ESSENTIAL HOSPITALS AND
DEVELOPMENT OF ECONOMIC RECOVERY
PLAN.
Section 1886(g) of the Social Security Act (42 U.S.C.
1395ww(g)) is amended by inserting after paragraph (4)
the following new paragraphs:
‘‘(5)(A) Effective October 1, 2000, and there-
after, in the case of a deemed hospital (as described
in subparagraph (B)), the Secretary shall increase
all payments for all services provided under this title
by such deemed hospital (including in-patient, out-
patient, skilled nursing facility, home health agency,
hospice, and end-stage renal disease, and other cov-
ered services provided by such deemed hospital) by
10 percent for a period of five fiscal years, subject
to the conditions under paragraph (6).
‘‘(B) A deemed hospital referred to in subpara-
graph (A) is a hospital that—
‘‘(i) is located in a Metropolitan Statistical
Area that, during fiscal years 1999, 2000, and
2001, had an area wage index value which, be-
fore the application of section 4410 of the Bal-
anced Budget Act of 1997 (Public Law 105–
33) is lower than the wage index applicable to
hospitals located in rural areas in the State in
which the hospital is located,
HR 5228 IH
‘‘(ii) is located in a Metropolitan Statistical
Area that is contiguous to at least two other
Metropolitan Statistical Areas, and
‘‘(iii) is located in a Metropolitan Statis-
tical Area where, for cost reporting periods be-
ginning during fiscal year 1997, all hospitals in
that Metropolitan Statistical Area had, on an
aggregate basis, a medicare-eligible beneficiary
patient discharge percentage exceeding 40 per-
cent.
‘‘(6)(A) Within one year of receiving deemed
status and increased payments under this title by
reason of paragraph (5), each hospital in the Metro-
politan Statistical Area, either individually or (not-
withstanding any other provision of law) coopera-
tively, shall submit to the Secretary an economic re-
covery plan for long-range (post-deemed status) fi-
nancial viability. The Secretary shall offer assistance
in the development of such plan or plans.
‘‘(B) Such plan may include capital payments
and operating payments to—
‘‘(i) right-size capacity,
‘‘(ii) coordinate and share high cost serv-
ices,
HR 5228 IH
‘‘(iii) ensure a viable regional emergency
room network and access,
‘‘(iv) convert unused acute care beds to
skilled nursing facility, intermediate care facil-
ity, or assisted living facility support facility
beds,
‘‘(v) assist in the conversion of unused
acute care beds to psychiatric, long-term care,
or rehabilitation care hospital beds as are deter-
mined by the hospital to be in short supply, and
‘‘(vi) such other adjustments to the current
acute care hospital facility as shall ensure the
long-term economic viability of the facility and
the continuation of essential health care serv-
ices to the community.
‘‘(C) The Secretary shall review such economic
recovery plans, provide assistance in the improve-
ment and modification of such plans, and within one
year of receipt of a plan which the Secretary deter-
mines has a reasonable opportunity of ensuring the
long-term viability of the facility or facilities, the
Secretary shall further increase the payment in-
creases under paragraph (5) by such additional
amount as to ensure the successful completion of the
HR 5228 IH
economic recovery plan or plans under this para-
graph.
‘‘(7) Notwithstanding any other provision of
law, the additional payments made to deemed hos-
pitals under paragraphs (5) and (6) shall not result
in payment reductions to any hospital or provider
under this title.’’.
Æ