[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 243 Introduced in Senate (IS)]

103d CONGRESS
  1st Session
                                 S. 243

To amend title XVIII of the Social Security Act to extend the provision 
 relating to medicare-dependent, small rural hospitals, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

             January 27 (legislative day, January 5), 1993

Mr. Pryor (for himself, Mr. Rockefeller, and Mr. Boren) 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 provision 
 relating to medicare-dependent, small rural hospitals, and for other 
                               purposes.

    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) of the Social Security Act 
(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--
            ``(I) for any cost reporting period beginning on or after 
        April 1, 1990, and before April 1, 1993, the amount determined 
        under clause (ii); and
            ``(II) for any cost reporting period beginning on or after 
        April 1, 1993, the amount determined under clause (ii) by 
        substituting `50 percent' for `100 percent'.'';
            (2) by redesignating clauses (ii) and (iii) as clauses 
        (iii) and (iv), respectively; and
            (3) by inserting after clause (i) the following new clause:
    ``(ii) The amount determined under this clause is the sum of--
            ``(I) the amount determined under paragraph (1)(A)(iii), 
        and
            ``(II) 100 percent of the excess (if any) of--
                    ``(aa) the hospital's target amount for the cost 
                reporting period, as defined in subsection (b)(3)(D), 
                over
                    ``(bb) 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 1993, 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) of such Act) for fiscal year 1993 as if the 
        decision by the Review Board had not occurred.
    (c) Effective Date.--The amendment made by subsection (a) shall 
take effect on the date of the enactment of this Act.

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