I 
110TH CONGRESS 
1ST SESSION H. R. 2386 
To amend title XVIII of the Social Security Act to provide special treatment 
of certain cancer hospitals under the Medicare Program. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 17, 2007 
Mr. PALLONE 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 
special treatment of certain cancer hospitals under the 
Medicare Program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SPECIAL TREATMENT OF CANCER HOSPITALS 
UNDER THE MEDICARE PROGRAM. 
(a) IN GENERAL.—Section 1886(d)(1)(B) of the So-
cial Security Act (42 U.S.C. 1395ww(d)(1)(B)) is amend-
ed— 
(1) by striking ‘‘or’’ at the end of clause (iv); 
(2) by striking the semicolon at the end of 
clause (v) and inserting ‘‘, or’’; and 
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(3) by inserting after clause (v) the following 
new clause: 
‘‘(vi) a hospital that— 
‘‘(I) is located in a State which ranks (ac-
cording to the National Cancer Institute’s sta-
tistics published in May of 2005) among the 
top ten States in the incidence of non-Hodgkins 
lymphoma, ovarian cancer, thyroid cancer, and 
cervical cancer and among the top ten States 
with the highest death rate for breast cancer 
and uterine cancer; 
‘‘(II) is located in a State that as of De-
cember 31, 2006, had only one center under 
section 414 of the Public Health Service Act 
that has been designated by the National Can-
cer Institute as a comprehensive center cur-
rently serving all 21 counties in the most dense-
ly populated State in the nation (U.S. Census 
estimate for 2005: 8,717,925 persons; 1,134.5 
persons per square mile), serving more than 
70,000 patient visits annually; 
‘‘(III) as of December 31, 2006, served as 
the teaching and clinical care, research and 
training hospital for the Center described in 
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subclause (II), providing significant financial 
and operational support to such Center; 
‘‘(IV) as of December 31, 2006, served as 
a core and essential element in such Center 
which conducts more than 130 clinical trial ac-
tivities, national cooperative group studies, in-
vestigator-initiated and peer review studies and 
has received as of 2005 at least $93,000,000 in 
research grant awards; 
‘‘(V) as of December 31, 2006, can dem-
onstrate that it has been a unique and an inte-
gral component of such Center since such Cen-
ter’s inception; 
‘‘(VI) as of December 31, 2006, includes 
dedicated patient care units organized primarily 
for the treatment of and research on cancer 
with approximately 125 beds, 75 percent of 
which are dedicated to cancer patients, and con-
tains a radiation oncology department as well 
as specialized emergency services for oncology 
patients; 
‘‘(VII) as of December 31, 2004, is identi-
fied as the focus of the Center’s inpatient ac-
tivities in the Center’s application as a NCI- 
designated comprehensive cancer center and 
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shares the NCI comprehensive cancer designa-
tion with the Center; and 
‘‘(VIII) as of December 31, 2006, has been 
recognized with a certificate of approval with 
commendation by the American College of Sur-
geons Commission on Cancer;’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
1886(b)(3)(E) of such Act (42 U.S.C. 1395ww(b)(3)(E)) 
is amended by striking ‘‘clause (v)’’ and inserting ‘‘clauses 
(v) and (vi)’’. 
(c) EFFECTIVE DATE; PAYMENTS.— 
(1) APPLICATION
TO
COST
REPORTING
PERI-
ODS.—Any classification by reason of section 
1886(d)(1)(B)(vi) of the Social Security Act (42 
U.S.C. 1395ww(d)(1)(B)(vi)), as inserted by sub-
section (a), shall apply to cost reporting periods be-
ginning on or after January 1, 2006. 
(2) BASE TARGET AMOUNT.—Notwithstanding 
subsection (b)(3)(E) of section 1886 of the Social 
Security Act (42 U.S.C. 1395ww), in the case of a 
hospital described in subsection (d)(1)(B)(vi) of such 
section, as inserted by subsection (a)— 
(A) the hospital shall be permitted to re-
submit the 2006 Medicare 2552 cost report in-
corporating a cancer hospital sub-provider num-
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ber and to apply the Medicare ratio-of-cost-to- 
charge settlement methodology for outpatient 
cancer services; and 
(B) the hospital’s target amount under 
subsection (b)(3)(E)(i) of such section for the 
first cost reporting period beginning on or after 
January 1, 2006, shall be the allowable oper-
ating costs of inpatient hospital services (re-
ferred to in subclause (I) of such subsection) 
for such first cost reporting period. 
(3) DEADLINE FOR PAYMENTS.—Any payments 
owed to a hospital as a result of this section for pe-
riods occurring before the date of the enactment of 
this Act shall be made expeditiously, but in no event 
later than 1 year after such date of enactment. 
Æ 
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