I 
109TH CONGRESS 
2D SESSION 
H. R. 5496 
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 25, 2006 
Mr. FERGUSON 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. MEDICARE TREATMENT FOR CERTAIN CANCER 
HOSPITALS. 
(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 2005 for 2001 and 
2002) first among all States in the incidence of 
prostate cancer, third in the incidence rate for 
non-Hodgkins lymphoma, fourth in the inci-
dence rates for thyroid cancer and ovarian can-
cer, and third in the highest death rates from 
uterine cancer and breast cancer; 
‘‘(II) is located in a State that, as of De-
cember 31, 2005, 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, serving more 
than 70,000 patient visits annually; 
‘‘(III) as of December 31, 2005, served as 
the teaching and clinical care, research and 
training hospital for the Center described in 
subclause (II), providing significant financial 
and operational support to such Center; 
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‘‘(IV) as of December 31, 2005, 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 
received during 2003 at least $80,000,000 in 
research grant awards; 
‘‘(V) as of December 31, 2005, 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, 2005, 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, 2003, is identi-
fied as the focus of the Center’s inpatient ac-
tivities in the Center’s application as an NCI- 
designated comprehensive cancer center and 
shares the NCI comprehensive cancer designa-
tion with the Center; and 
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‘‘(VIII) as of December 31, 2005, has been 
recognized with a certificate of approval by the 
American College of Surgeons Commission on 
Cancer;’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
1886(d)(3)(E) of such Act (42 U.S.C. 1395ww(d)(3)(E)) 
is amended by striking ‘‘clause (v)’’ and inserting ‘‘clauses 
(v) and (vi)’’. 
(c) PAYMENT.— 
(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 added by sub-
section (a)) shall apply to all cost reporting periods 
beginning on or after January 1, 2005. 
(2) BASE TARGET AMOUNT.—Notwithstanding 
section 1886(b)(3)(E) of the Social Security Act (42 
U.S.C. 1395ww(b)(3)(E), in the case of a hospital 
described in section 1886(d)(1)(B)(vi) of the Social 
Security Act, as added by subsection (a), such hos-
pital shall be permitted to resubmit the 2005 Medi-
care 2552 cost report incorporating a cancer hos-
pital sub-provider number, and apply the Medicare 
ratio-of-cost-to-charge settlement methodology for 
outpatient cancer services. In the case of such hos-
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pital the PPS cancer exemption under section 
1886(b)(3)(E)(i) of such Act for the first cost re-
porting period beginning on or after January 1, 
2005, shall be the allowable operating costs of inpa-
tient hospital services (referred to in subclause (I) of 
such section) 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. 
(d) MAINTENANCE OF EXEMPTION.—Once admitted 
as a PPS cancer-exempt hospital, a hospital described in 
section 1886(d)(1)(B)(vi) of the Social Security Act shall 
retain that status as long as the Center referred to in such 
section remains a comprehensive cancer center. 
Æ 
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