[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 1051 Introduced in Senate (IS)]

103d CONGRESS
  1st Session
                                S. 1051

 To amend title XVIII of the Social Security Act to extend the period 
    during which medicare-dependent, small rural hospitals receive 
additional payments under the medicare program for the operating costs 
of inpatient hospital services, to revise the criteria for determining 
  whether hospitals are eligible for such additional payments, and to 
    provide additional payments under the medicare program to other 
               medicare-dependent <plus-minus>hospitals.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                May 27 (legislative day, April 19), 1993

 Mr. Mack (for himself and Mr. Graham) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to extend the period 
    during which medicare-dependent, small rural hospitals receive 
additional payments under the medicare program for the operating costs 
of inpatient hospital services, to revise the criteria for determining 
  whether hospitals are eligible for such additional payments, and to 
    provide additional payments under the medicare program to other 
                     medicare-dependent hospitals.

    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 ``Medicare Dependent Hospital Relief 
Act of 1993''.

SEC. 2. SPECIAL TREATMENT FOR MEDICARE-DEPENDENT, SMALL RURAL 
              HOSPITALS.

    (a) Extension of Special Treatment.--
            (1) Determination of payment amount.--Section 1886(b)(3)(D) 
        of the Social Security Act (42 U.S.C. 1395ww(b)(3)(D)) is 
        amended by striking ``March 31, 1993,'' and inserting ``March 
        31, 1996,''.
            (2) Eligibility for designation.--Section 1886(d)(5)(G)(i) 
        of such Act (42 U.S.C. 1395ww(d)(5)(G)(i)) is amended by 
        striking ``March 31, 1993,'' and inserting ``March 31, 1996,''.
            (3) Effective date.--The amendments made by paragraphs (1) 
        and (2) shall take effect as if included in the enactment of 
        section 6003(f) of the Omnibus Budget Reconciliation Act of 
        1989.
    (b) Revision of Criteria for Designation.--
            (1) In general.--Section 1886(d)(5)(G)(iii)(IV) of the 
        Social Security Act (42 U.S.C. 1395ww(d)(5)(G)(iii)(IV)) is 
        amended by striking ``during the cost reporting period 
        beginning during fiscal year 1987'' and inserting ``during at 
        least 2 of the cost reporting periods beginning on or after 
        October 1, 1986, and ending on or before September 30, 1990,''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply to cost reporting periods beginning on or after 
        April 1, 1993.

SEC. 3. ADDITIONAL PAYMENT FOR OTHER MEDICARE DEPENDENT HOSPITALS.

    (a) In General.--Section 1886(d)(5) of the Social Security Act (42 
U.S.C. 1395ww(d)(5)) is amended--
            (1) by redesignating subparagraphs (H) and (I) as 
        subparagraphs (I) and (J); and
            (2) by inserting after subparagraph (G) the following new 
        subparagraph:
    ``(G)(i) For discharges occurring on or after October 1, 1993, and 
on or before September 30, 1995, the Secretary shall provide, in 
accordance with this subparagraph, for an additional payment amount for 
each subsection (d) hospital--
            ``(I) that is not a medicare-dependent, small rural 
        hospital (as defined in subparagraph (G)(iii)); and
            ``(II) for which not less than 65 percent of its inpatient 
        days or discharges during at least 2 of the cost reporting 
        periods beginning on or after October 1, 1986, and ending on or 
        before September 30, 1990, were attributable to inpatients 
        entitled to benefits under part A.
    ``(ii) The amount of the additional payment made under this 
subparagraph for each discharge shall be equal to 3 percent of the sum 
of--
            ``(I) the amount determined under paragraph (1)(A)(iii); 
        and
            ``(II) the amount paid to the hospital under subparagraph 
        (A) for that discharge.''.
    (b) Applicability to Hospitals in Puerto Rico.--Section 
1886(d)(9)(D) of such Act (42 U.S.C. 1395ww(d)(9)(D)) is amended--
            (1) in clause (iv), by striking ``Subparagraph (H)'' and 
        inserting ``Subparagraph (I)'';
            (2) by redesignating clause (iv) as clause (v); and
            (3) by inserting after clause (iii) the following new 
        clause:
            ``(iv) Subparagraph (G) (relating to additional payments 
        for medicare-dependent hospitals).''.
    (c) Effective Date.--The amendments made by subsections (a) and (b) 
shall apply to discharges occurring on or after October 1, 1993.

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