[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1764 Introduced in House (IH)]

103d CONGRESS
  1st Session
                                H. R. 1764

To amend title XVIII of the Social Security Act to extend until October 
   1, 1994, the period during which medicare-dependent, small rural 
hospitals may be paid under alternative reimbursement methodologies for 
 the operating costs of inpatient hospital services under the medicare 
                                program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 21, 1993

 Mr. Gunderson (for himself, Mr. Roberts, Mr. Slattery, Mr. Lancaster, 
and Mr. Bereuter) 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 extend until October 
   1, 1994, the period during which medicare-dependent, small rural 
hospitals may be paid under alternative reimbursement methodologies for 
 the operating costs of inpatient hospital services under the medicare 
                                program.

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

SECTION. 1. MEDICARE-DEPENDENT, SMALL RURAL HOSPITALS.

    (a) In General.--Section 1886(d)(5)(G) (42 U.S.C. 1395ww(d)(5)(G)) 
is amended--
            (1) by amending clause (i) to read as follows:
    ``(i) In the case of a subsection (d) hospital which is a medicare-
dependent, small rural hospital, payment under paragraph (1)(A) for 
discharges occurring before October 1, 1994, shall be equal to the sum 
of the amount determined under clause (ii) and the amount determined 
under paragraph (1)(A)(iii).'';
            (2) by redesignating clauses (ii) and (iii) as clauses 
        (iii) and (iv); and
            (3) by inserting after clause (i) the following new clause:
    ``(ii) The amount determined under this clause is--
            ``(I) for discharges occurring during the first 3 12-month 
        cost reporting periods that begin on or after April 1, 1990, 
        the amount by which the hospital's target amount for the cost 
        reporting period (as defined in subsection (b)(3)(D)) exceeds 
        the amount determined under paragraph (1)(A)(iii); and
            ``(II) for discharges occurring during any subsequent cost 
        reporting period (or portion thereof), 50 percent of the amount 
        by which the hospital's target amount for the cost reporting 
        period (as defined in subsection (b)(3)(D)) exceeds the amount 
        determined under paragraph (1)(A)(iii).''.
    (b) Permitting Hospitals To Decline Reclassification.--If any 
hospital fails to qualify as a medicare-dependent, small rural hospital 
under section 1886(d)(5)(G)(i) of the Social Security Act as a result 
of a decision by the Medicare Geographic Classification Review Board 
under section 1886(d)(10) of such Act to reclassify the hospital as 
being located in an urban area for fiscal year 1994, the Secretary of 
Health and Human Services shall--
            (1) notify such hospital of such failure to qualify,
            (2) provide an opportunity for such hospital to decline 
        such reclassification, and
            (3) if the hospital declines such reclassification, 
        administer the Social Security Act (other than section 
        1886(d)(8)(D)) for fiscal year 1994 as if the decision by the 
        Review Board had not occurred.

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