I 
109TH CONGRESS 
2D SESSION 
H. R. 5976 
To provide for a hardship waiver for recoupment of certain Medicare 
payments. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 28, 2006 
Mr. BAKER introduced the following bill; which was referred to the Committee 
on Ways and Means 
A BILL 
To provide for a hardship waiver for recoupment of certain 
Medicare payments. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. HARDSHIP WAIVER FOR RECOUPMENT OF 
MEDICARE PAYMENTS. 
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, in the case of a facility described in subsection 
(b), the Secretary of Health and Human Services— 
(1) shall waive any recoupment or recovery of 
alleged medicare overpayments described in sub-
section (c) in order to permit the facility’s continued 
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provision of critical services to its medicare and un-
derserved populations; and 
(2) shall not impose any sanction (including 
any civil monetary penalty or exclusion from partici-
pation in any Federal health care program) against 
the facility in connection with any cost report filing 
made by the facility relating to such alleged medi-
care overpayments. 
(b) FACILITY DESCRIBED.—A facility described in 
this subsection is a critical access hospital (as defined in 
section 1861(mm)(1) of the Social Security Act, 42 U.S.C. 
1395x(mm)(1)) that meets the following requirements 
(and includes any skilled nursing facility that is contained 
within the same facility as such critical access hospital): 
(1) SOLE
ACUTE
CARE
HOSPITAL
FACILITY 
SERVING RURAL, UNDERSERVED AREA.— 
(A) The facility is located in a rural area 
(as defined for purposes of such section) that is 
designated under section 330(b)(3)(A) of the 
Public 
Health 
Service 
Act 
(42 
U.S.C. 
254b(b)(3)(A)) as an area with a shortage of 
personal health services. 
(B) There is no other acute general hos-
pital or critical access hospital that provides in-
patient or outpatient hospital services in the 
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county (or equivalent area) in which the facility 
is located. 
(2) PUBLIC FACILITY.—The facility is operated 
by a political subdivision of a State. 
(3) IMPROVED FISCAL MANAGEMENT.—The fa-
cility has made changes in its management so that 
tax payments described in subsection (c) are being 
made in a proper and timely manner. 
(4) HURRICANE
KATRINA
DISASTER
AREA.— 
The county (or equivalent area) in which the facility 
is located is an area that— 
(A) has been declared in accordance with 
section 401 of the Robert T. Stafford Disaster 
Relief and Emergency Assistance Act (42 
U.S.C. 5170) as a result of Hurricane Katrina; 
and 
(B) the President has determined, as of 
September 14, 2005, warrants individual or 
public assistance from the Federal Government 
under such Act. 
(c) MEDICARE OVERPAYMENTS DESCRIBED.— 
(1) IN GENERAL.—The medicare overpayments 
described in this subsection for a facility are pay-
ments made to the facility under title XVIII of the 
Social Security Act before the date of the enactment 
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of this Act that were attributable to alleged payment 
of compromised payroll taxes (as defined in para-
graph (2)). 
(2) COMPROMISED PAYROLL TAXES.—For pur-
poses of paragraph (1), the term ‘‘compromised pay-
roll taxes’’ means, with respect to a facility, amounts 
incurred before the date of the enactment of this 
Act— 
(A) that were originally owed by the facil-
ity for its share of the Federal Insurance Con-
tributions Act (FICA) and other payroll taxes; 
(B) that were not paid; and 
(C) for which the facility is no longer liable 
under a tax compromise permitted under sec-
tion 7122 of the Internal Revenue Code of 
1986. 
Æ 
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