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<dc:title>118 HR 9351 IH: Save our Safety-Net Hospitals Act of 2024</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2024-08-13</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">118th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">H. R. 9351</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20240813">August 13, 2024</action-date><action-desc><sponsor name-id="L000598">Mr. LaLota</sponsor> (for himself, <cosponsor name-id="C001067">Ms. Clarke of New York</cosponsor>, <cosponsor name-id="B001275">Mr. Bucshon</cosponsor>, <cosponsor name-id="M001163">Ms. Matsui</cosponsor>, <cosponsor name-id="L000599">Mr. Lawler</cosponsor>, and <cosponsor name-id="M001214">Mr. Mrvan</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend title XIX of the Social Security Act to modify certain limitations on disproportionate share hospital payment adjustments under the Medicaid program.</official-title></form><legis-body id="H403DCBCDAE074745B88902DC621B63C4" style="OLC"><section id="HF26BB90CB991402A80A7BB74291D770F" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Save our Safety-Net Hospitals Act of 2024</short-title></quote>.</text></section><section id="HA014B5109A664AC9BCCF74A44FAE7166"><enum>2.</enum><header>Modifying certain limitations on disproportionate share hospital payment adjustments under the Medicaid program</header><subsection id="H9BE9F86287714A6A9B46EBD5C46BF5DA"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1923(g) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-4">42 U.S.C. 1396r–4(g)</external-xref>) is amended—</text><paragraph id="HE344DCBBA9A141C6AE88C01E9425F664"><enum>(1)</enum><text>in paragraph (1)—</text><subparagraph id="H8DFB3E3841AB45B89CF2C916A600F5E6"><enum>(A)</enum><text>in subparagraph (A)—</text><clause id="H75AFBEA26D4849EE8551DB30656645DF"><enum>(i)</enum><text>in the matter preceding clause (i), by striking <quote>(other than a hospital described in paragraph (2)(B))</quote>;</text></clause><clause id="H514B9ABCE7844C7A891D7AE69830A9F4"><enum>(ii)</enum><text>in clause (i), by inserting <quote>with respect to such hospital and year</quote> after <quote>described in subparagraph (B)</quote>; and </text></clause><clause id="H9A90BEECC2A84E5AB28AB1345E84A761"><enum>(iii)</enum><text>in clause (ii)—</text><subclause id="H7BDD887EE9ED42E4AA45C48EF2996421"><enum>(I)</enum><text>in subclause (I), by striking <quote>and</quote> at the end;</text></subclause><subclause id="HB13CD37A2FBF458FB768F150CF8D21B2"><enum>(II)</enum><text>in subclause (II), by striking the period and inserting <quote>; and</quote>; and</text></subclause><subclause id="HAE3A97773C1643D28194782168336DA2"><enum>(III)</enum><text>by adding at the end the following new subclause:</text><quoted-block style="OLC" id="HDEA7D2364EE1419A9C8815378D1078EA" display-inline="no-display-inline"><subclause id="H3435F04D82A74AE68921CD7356CA73CB"><enum>(III)</enum><text display-inline="yes-display-inline">payments made under title XVIII or by an applicable plan (as defined in section 1862(b)(8)(F)) for such services.</text></subclause><after-quoted-block>; and</after-quoted-block></quoted-block></subclause></clause></subparagraph><subparagraph id="HE92EBC9A7F784921B947AC0943F1FF2D"><enum>(B)</enum><text>in subparagraph (B)—</text><clause id="H7CE4643206C449A7B99A0F6F00B18F11"><enum>(i)</enum><text>in the matter preceding clause (i), by striking <quote>in this clause are</quote> and inserting <quote>in this subparagraph are, with respect to a hospital and a year,</quote>; and</text></clause><clause id="H748D2A5771E440CAA0EC720B1A8E0AFE"><enum>(ii)</enum><text>by adding at the end the following new clause:</text><quoted-block style="OLC" id="H1142E3581FEB4472BCD8D7099C4D674D" display-inline="no-display-inline"><clause id="H56B65951C2994CB095AC172E91D76B8C"><enum>(iii)</enum><text display-inline="yes-display-inline">Individuals who are eligible for medical assistance under the State plan or under a waiver of such plan and for whom the State plan or waiver is the secondary payor for such services after application of benefits under title XVIII or under an applicable plan (as defined in section 1862(b)(8)(F)), but only if the hospital has in the aggregate incurred costs exceeding payments under such State plan, waiver, title XVIII, or applicable plan for such services furnished to such individuals during such year.</text></clause><after-quoted-block>;</after-quoted-block></quoted-block></clause></subparagraph></paragraph><paragraph id="H964E3651769942FE910116954E3C926D"><enum>(2)</enum><text>by striking paragraph (2);</text></paragraph><paragraph id="H2DD60A0B71A648A6809CB671A8D371DE"><enum>(3)</enum><text>by redesignating paragraph (3) as paragraph (2); and</text></paragraph><paragraph id="H866D52370DF04E34B9759913A1C084CF"><enum>(4)</enum><text>in paragraph (2), as so redesignated, by striking <quote>Notwithstanding paragraph (2) of this subsection (as in effect on October 1, 2021), paragraph (2)</quote> and inserting <quote>Paragraph (2)</quote>.</text></paragraph></subsection><subsection id="HA6A962E668994C5C9F1A9B8F7FA8BB77"><enum>(b)</enum><header>Effective date</header><paragraph id="HDF3E8BECAD4A4C498CAD0A7AFB4B31D1"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The amendments made by this section shall apply to payment adjustments made under section 1923 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-4">42 U.S.C. 1396r–4</external-xref>) during fiscal years beginning on or after October 1, 2021.</text></paragraph><paragraph id="HF335771DD280406E98098F473D11A595"><enum>(2)</enum><header>No required recoupment based on change in cap amounts</header><text>In the case of a payment adjustment made by a State under section 1923 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r-4">42 U.S.C. 1396r–4</external-xref>) prior to the date of the enactment of this Act that was, without application of the amendments made by this section, consistent with the methodology of such State for making such adjustments, such adjustment shall be deemed to be consistent with such methodology with the application of such amendments. </text></paragraph></subsection></section></legis-body></bill> 

