I
106TH CONGRESS
2D SESSION
H. R. 4622
To amend title 18 of the Social Security Act to provide for immediate
relief for essential hospitals in a region, to assist in the long-range
economic recovery of such hospitals, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JUNE 9, 2000
Mr. KANJORSKI introduced the following bill; which was referred to the
Committee on Ways and Means
A BILL
To amend title 18 of the Social Security Act to provide
for immediate relief for essential hospitals in a region,
to assist in the long-range economic recovery of such
hospitals, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Essential Hospital
Preservation Act of 2000’’.
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SEC. 2. SPECIAL PAYMENTS TO ESSENTIAL HOSPITALS AND
DEVELOPMENT OF ECONOMIC RECOVERY
PLAN.
(a) IN GENERAL.—Section 1886(g) of the Social Se-
curity Act is amended by inserting after subsection (4)
the following new subsection:
‘‘(5)(A) Effective October 1, 2000, and there-
after, in the case of a deemed hospital, 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 covered services provided by such deemed
hospital) by 10 per centum for a period of five fiscal
years, subject to the conditions under subsection 6
of this subparagraph.
‘‘(B) A deemed hospital shall be a hospital in
a hospital referral region—
‘‘(i) as defined by the The Center for the
Evaluative Clinical Sciences, Dartmouth Med-
ical School (popularly known as ‘The Dart-
mouth Atlas of Health Care’), and as may be
updated by The Center,
‘‘(ii) except that the Secretary may by reg-
ulation provide for criteria to adjust the hos-
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pitals to be included or excluded from such a
hospital referral region, and
‘‘(iii) 75 per centum of the hospitals in
such referral region shall, for the last completed
cost report period, have had negative Medicare
operating margins and negative total operating
margins, and
‘‘(iv) the Medicare-eligible beneficiary pa-
tient discharge percentage of the hospitals in
the referral region shall exceed 40 per centum.
The hospitals in the referral region shall be deemed
to be essential hospitals necessary for the delivery of
health care to all Medicare and other residents of
the region.
‘‘(6)(A) Within one year of receiving deemed
status and higher Medicare payments under sub-
section 5 of this subparagraph, each hospital in the
referral region, either individually or (notwith-
standing any other provision of law) cooperatively,
shall submit an economic recovery plan to the De-
partment of Health and Human Services for long-
range (post-deemed status) financial viability. The
Secretary shall offer assistance in the development
of such plan or plans.
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‘‘(B) Such plan may include capital payments
and operating payments to—
‘‘(i) right-size capacity,
‘‘(ii) coordinate and share high cost serv-
ices,
‘‘(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 facilities,
‘‘(v) assist in the conversion of unused
acute care beds to psychiatric, long-term care,
or rehabilitation care hospital services as are
determined 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
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Secretary shall further increase the Medicare pay-
ment increases described in subsection 5 of this sub-
paragraph by such additional amount as to ensure
the successful completion of the economic recovery
plan or plans under this subsection.
‘‘(7) Notwithstanding any other provision of
law, the additional payments made to deemed hos-
pitals under subsections 5 and 6 of this subpara-
graph shall not result in payment reductions to any
non-deemed hospital or provider under this Title.’’.
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