SEC. 3. EXTENSION OF THE INCREASED PAYMENTS UNDER 
THE 
MEDICARE 
LOW-VOLUME 
HOSPITAL 
PROGRAM. 
Section 1886(d)(12) of the Social Security Act (42 
U.S.C. 1395ww(d)(12)) is amended— 
(1) in subparagraph (B), in the matter pre-
ceding clause (i), by striking ‘‘2013’’ and inserting 
‘‘2014’’; 
(2) in subparagraph (C)(i), by striking ‘‘and 
2012’’ each place it appears and inserting ‘‘, 2012, 
and 2013’’; and 
(3) in subparagraph (D), by striking ‘‘and 
2012’’ and inserting ‘‘, 2012, and 2013’’. 
SEC. 4. GAO STUDY AND REPORT ON MEDICARE-DEPEND-
ENT HOSPITAL AND LOW-VOLUME HOSPITAL 
PROGRAMS. 
(a) STUDY.— 
(1) IN GENERAL.—The Comptroller General of 
the United States shall conduct a study on the fol-
lowing programs under title XVIII of the Social Se-
curity Act under which certain small, rural hospitals 
or small hospitals receive add-on payments for inpa-
tient hospital services furnished to individuals enti-
tled to benefits under part A of title XVIII of the 
Social Security Act or enrolled under part B of such 
title: 
VerDate Mar 15 2010 
20:52 Jun 13, 2012
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5943.IH
H5943
mstockstill on DSK4VPTVN1PROD with BILLS
(A) MDH PROGRAM.—The Medicare-de-
pendent, small rural hospital (MDH) program 
for a small, rural hospital that meets the cri-
teria of section 1886(d)(5)(G)(iv) of the Social 
Security Act (42 U.S.C. 1395ww(d)(5)(G)(iv)), 
hereinafter in this section referred to as an 
‘‘MDH hospital’’. 
(B) LOW-VOLUME HOSPITAL PROGRAM.— 
The low-volume hospital program for a small 
hospital with fewer than 1,600 discharges annu-
ally 
that 
meets 
the 
criteria 
of 
section 
1886(d)(12)(C)(i) of such Act (42 U.S.C. 
1395ww(d)(12)(C)(i)), hereinafter in this sec-
tion referred to as a ‘‘low-volume hospital’’. 
(2) MATTERS
STUDIED.—The study under 
paragraph (1) shall include an examination and 
analysis of the following: 
(A) 
COST
COMPARISON
AMONG
HOS-
PITALS.—How operating and capital costs of 
MDH hospitals and low-volume hospitals, re-
spectively, compare to such costs of other sub-
section (d) hospitals (as defined in section 
1886(d)(1)(B) of the Social Security Act (42 
U.S.C. 1395ww(d)(1)(B))) that participate in 
VerDate Mar 15 2010 
20:52 Jun 13, 2012
Jkt 019200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5943.IH
H5943
mstockstill on DSK4VPTVN1PROD with BILLS
the Medicare program under title XVIII of such 
Act. 
(B) IMPACT
OF
ADD-ON
PAYMENTS
ON 
HOSPITALS
MARGINS.—The impact of add-on 
payments 
under 
paragraphs 
(5)(G) 
and 
(12)(A), respectively, of section 1886(d) of such 
Act (42 U.S.C. 1395ww(d)) on Medicare pay-
ment margins, as defined by the Secretary of 
Health and Human Services, of MDH hospitals 
and low-volume hospitals, respectively, including 
whether the absence of such add-on payments 
would likely result in negative Medicare pay-
ment margins for such hospitals. 
(b) REPORT
TO CONGRESS.—Not later than two 
years after the date of the enactment of this Act, the 
Comptroller General shall submit to Congress a report on 
the study conducted under subsection (a). The report shall 
include the study findings and such recommendations, 
with respect to the MDH program and the low-volume 
hospital program described in subsection (a)(1), as the 
Comptroller General determines to be appropriate. 
Æ 
VerDate Mar 15 2010 
20:52 Jun 13, 2012
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6301
E:\BILLS\H5943.IH
H5943
mstockstill on DSK4VPTVN1PROD with BILLS