Title: Rural Community Hospital Demonstration Extension Act of 2020
Policy area: Health

Summary:
Rural Community Hospital Demonstration Extension Act of 2020
This bill extends for five years the Rural Community Hospital Demonstration Program, through which Medicare pays certain rural hospitals on the basis of reasonable incurred costs rather than under the standard prospective payment system.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3615 Introduced in Senate (IS)]

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116th CONGRESS
  2d Session
                                S. 3615

To amend the Medicare Prescription Drug, Improvement, and Modernization 
   Act of 2003 to extend the rural community hospital demonstration 
                                program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 6, 2020

 Ms. Murkowski (for herself, Mr. Bennet, and Mr. Sullivan) introduced 
the following bill; which was read twice and referred to the Committee 
                               on Finance

_______________________________________________________________________

                                 A BILL


 
To amend the Medicare Prescription Drug, Improvement, and Modernization 
   Act of 2003 to extend the rural community hospital demonstration 
                                program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Community Hospital 
Demonstration Extension Act of 2020''.

SEC. 2. FIVE-YEAR EXTENSION OF THE RURAL COMMUNITY HOSPITAL 
              DEMONSTRATION PROGRAM.

    (a) Extension.--
            (1) In general.--Subsection (a)(5) of section 410A of the 
        Medicare Prescription Drug, Improvement, and Modernization Act 
        of 2003 (Public Law 108-173; 42 U.S.C. 1395ww note), is amended 
        by striking ``10-year extension period'' and inserting ``15-
        year extension period''.
            (2) Conforming amendments for extension.--
                    (A) Extension of demonstration period.--Subsection 
                (g) of such section 410A is amended--
                            (i) in the subsection heading, by striking 
                        ``Ten-Year'' and inserting ``Fifteen-Year'';
                            (ii) in paragraph (1)--
                                    (I) by striking ``additional 10-
                                year'' and inserting ``additional 15-
                                year''; and
                                    (II) by striking ``10-year 
                                extension period'' and inserting ``15-
                                year extension period'';
                            (iii) in paragraph (2), by striking ``10-
                        year extension period'' and inserting ``15-year 
                        extension period'';
                            (iv) in paragraph (3), by striking ``10-
                        year extension period'' and inserting ``15-year 
                        extension period'';
                            (v) in paragraph (4), by striking ``10-year 
                        extension period'' each place it appears and 
                        inserting ``15-year extension period'';
                            (vi) in paragraph (5), by striking ``10-
                        year extension period'' and inserting ``15-year 
                        extension period''; and
                            (vii) in subparagraph (A) of paragraph (6), 
                        by striking ``10-year extension period'' and 
                        inserting ``15-year extension period''.
                    (B) Rule for hospitals that are not original 
                participants in the demonstration.--Paragraph (5) of 
                subsection (g) of such section 410A is amended--
                            (i) by striking ``program.--During'' and 
                        inserting ``program.--
                    ``(A) CURES act extension.--During''; and
                            (ii) by adding at the end the following new 
                        subparagraph:
                    ``(B) Additional extension.--During the third 5 
                years of the 15-year extension period, the Secretary 
                shall apply the provisions of paragraph (4) to rural 
                community hospitals that are not described in paragraph 
                (4) but are participating in the demonstration program 
                under this section as of December 30, 2019, in a 
                similar manner as such provisions apply to rural 
                community hospitals described in paragraph (4).''.
                    (C) Solicitation of applications.--Subparagraph (A) 
                of subsection (g)(6) of such section 410A is amended--
                            (i) by striking ``general.--The Secretary'' 
                        and inserting ``In general.--
                            ``(i) CURES act solicitation.--The 
                        Secretary''; and
                            (ii) by adding at the end the following new 
                        clause:
                            ``(ii) Additional solicitation.--The 
                        Secretary shall, notwithstanding subsection 
                        (a)(2) or paragraph (2) of this subsection, not 
                        later than 120 days after the date of the 
                        enactment of this clause, issue a solicitation 
                        for applications to select up to the maximum 
                        number of additional rural community hospitals 
                        located in any State to participate in the 
                        demonstration program under this section for 
                        the third 5 years of the 15-year extension 
                        period without exceeding the limitation under 
                        paragraph (3) of this subsection.''.
    (b) Clarification of Application of Case Mix Adjustment.--
Subsection (b) of such section 410A is amended by adding at the end the 
following new paragraph:
            ``(3) Case mix adjustment.--The Secretary shall provide for 
        an appropriate adjustment under this paragraph to take into 
        account variations in case mix of rural community hospitals, 
        using the most recent case-mix data available.''.
    (c) Change in Timing for Report.--Subsection (e) of such section 
410A is amended by striking ``Not later than August 1, 2018'' and 
inserting ``Not later than August 1, 2023''.
    (d) Clarifying Technical Amendments.--Such section 410A, as amended 
by subsections (a), (b), and (c), is further amended--
            (1) in subsection (a)(1), by inserting ``of Health and 
        Human Services'' after ``Secretary'';
            (2) in subsection (f)(1)(A)(iv) by inserting ``of the 
        Social Security Act (42 U.S.C. 1395i-4)'' after ``section 
        1820''; and
            (3) in subsection (g)--
                    (A) in the heading of paragraph (4), by striking 
                ``Hospitals in demonstration program on date of 
                enactment'' and inserting ``Hospitals Participating in 
                the Demonstration Program During the Initial 5-Year 
                Period''; and
                    (B) in clause (i) of paragraph (6)(A), as amended 
                by subsection (a)(2)(C)(i), by striking ``not later 
                than 120 days after the date of the enactment of this 
                paragraph'' and inserting ``not later than April 12, 
                2017''.
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