II 113th CONGRESS 1st Session S. 1555 IN THE SENATE OF THE UNITED STATES September 26, 2013 Mr. Wicker introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments, and for other purposes.

1. Short title The Act may be cited as the DSH Reduction Relief Act of 2013 . 2. Delay in implementation of revised medicare disproportionate share hospital payment methodology (a) Two-Year delay Section 1886(r) of the Social Security Act (42 U.S.C. 1395ww(r)) is amended— (1) in paragraph (1), by striking For fiscal year 2014 and inserting For fiscal year 2016 ; and (2) in paragraph (2)— (A) in the matter preceding subparagraph (A), by striking for fiscal year 2014 and inserting for fiscal year 2016 ; (B) in subparagraph (B)(i)— (i) in the heading of clause (i), by striking 2014, 2015, 2016, and 2017 and inserting 2016, 2017, 2018, and 2019 ; (ii) in the matter preceding subclause (I), by striking For each of fiscal years 2014, 2015, 2016, and 2017 and inserting For each of fiscal years 2016, 2017, 2018, and 2019 ; and (iii) in the matter following subclause (II)— (I) by striking fiscal year 2014 and inserting fiscal year 2016 ; and (II) by striking fiscal years 2015, 2016, and 2017 and inserting fiscal years 2017, 2018, and 2019 ; and (C) in subparagraph (B)(ii)— (i) in the heading of clause (ii), by striking 2018 and inserting 2020 ; (ii) in the matter preceding subclause (I), by striking For fiscal year 2018 and inserting For fiscal year 2020 ; and (iii) in the matter following subclause (II), by striking fiscal years 2018 and 2019 and inserting fiscal years 2020 and 2021 . (b) Effective date The amendments made by subsection (a) shall take effect as if included in the enactment of section 3133 of the Patient Protection and Affordable Care Act ( Public Law 111–148 ), as amended by section 10316 of such Act, and as further amended by section 1104 of the Health Care and Education Reconciliation Act of 2010 ( Public Law 111–152 ). 3. Modification of reduction schedule for Medicaid DSH allotments to States (a) Elimination of reductions for fiscal years 2014 and 2015 Section 1923(f)(7)(A) of the Social Security Act ( 42 U.S.C. 1396r–4(f)(7)(A) ) is amended— (1) in clause (i) in the matter preceding subclause (I), by striking fiscal years 2014 and inserting fiscal years 2016 ; and (2) in clause (ii), by striking subclauses (I) and (II) and redesignating subclauses (III) through (VII) as subclauses (I) through (V), respectively. (b) Effective date The amendments made by subsection (a) shall take effect as if included in the enactment of section 1203 of the Health Care and Education Reconciliation Act of 2010 ( Public Law 111–152 ). 4. Rebasing of Medicaid disproportionate share hospital allotments Section 1923(f)(8) of the Social Security Act ( 42 U.S.C. 1396r–4(f)(8) ) is amended— (1) by redesignating subparagraph (C) as subparagraph (D); (2) by inserting after subparagraph (B) the following new subparagraph: (C) Fiscal year 2023 Only with respect to fiscal year 2023, the DSH allotment for a State, in lieu of the amount determined under paragraph (3) for the State for that year, shall be equal to the DSH allotment for the State for fiscal year 2022, as determined under subparagraph (B), increased, subject to subparagraphs (B) and (C) of paragraph (3), and paragraph (5), by the percentage change in the consumer price index for all urban consumers (all items; U.S. city average), for fiscal year 2022. ; and (3) in subparagraph (D) (as redesignated by paragraph (1) of this section), by striking fiscal year 2022 and inserting “fiscal year 2023.