[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 97 Introduced in Senate (IS)]

103d CONGRESS
  1st Session
                                 S. 97

 To amend title XVIII of the Social Security Act and title III of the 
 Public Health Service Act to protect and improve the availability and 
                 quality of health care in rural areas.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

             January 21 (legislative day, January 5), 1993

Mr. Harkin (for himself and Mr. Conrad) 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 and title III of the 
 Public Health Service Act to protect and improve the availability and 
                 quality of health care in rural areas.

    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 ``Rural Health Care Protection and 
Improvement Act of 1993''.

SEC. 2. EXTENSION OF CERTAIN PAYMENT PROVISIONS FOR MEDICARE-DEPENDENT 
              SMALL RURAL HOSPITALS.

    (a) In General.--Section 1886(d)(5)(G)(i) of the Social Security 
Act (42 U.S.C. 1395ww(d)(5)(G)(i)) is amended by striking ``March 31, 
1993'' and inserting ``March 31, 1996''.
    (b) Payment.--Section 1886(b)(3)(D) of such Act (42 U.S.C. 
1395ww(b)(3)(D)) is amended by striking ``March 31, 1993'' and 
inserting ``March 31, 1996''.
    (c) 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 or 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 1993 or 1994 as if the decision 
        by the Review Board had not occurred.
    (d) Effective Date.--
            (1) The amendments made by subsections (a) and (b) shall be 
        effective as of January 1, 1992.
            (2) The amendments made by subsection (c) shall be 
        effective on the date of the enactment of this Act.

SEC. 3. EXTENSION AND EXPANSION OF RURAL HEALTH TRANSITION GRANT 
              PROGRAM.

    (a) In General.--Section 4005(e)(9) of the Omnibus Budget 
Reconciliation Act of 1987, as amended by section 6003(g)(1)(B) of the 
Omnibus Budget Reconciliation Act of 1989, is amended--
            (1) by striking ``1989 and'' and inserting ``1989,''; and
            (2) by striking ``1992'' and inserting ``1992 and 
        $30,000,000 for each of the fiscal years 1993, 1994, 1995, 
        1996, and 1997''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect on the date of the enactment of this Act.

SEC. 4. ESTABLISHMENT OF RURAL HEALTH OUTREACH GRANT PROGRAM.

    (a) In General.--Subpart I of part D of title III of the Public 
Health Service Act (42 U.S.C. 254b et seq.) is amended by adding at the 
end the following new section:

``SEC. 330A. RURAL HEALTH OUTREACH GRANT PROGRAM.

    ``(a) In General.--The Secretary may make grants to demonstrate the 
effectiveness of outreach to populations in rural areas that do not 
normally seek or do not have adequate access to health or mental health 
services. Grants shall be awarded to enhance linkages, integration, and 
cooperation in order to provide health or mental health services, to 
enhance services, or increase access to or utilization of health or 
mental health services.
    ``(b) Mission of the Outreach Projects.--Projects under subsection 
(a) should be designed to facilitate integration and coordination of 
services in or among rural communities in order to address the needs of 
populations living in rural or frontier communities.
    ``(c) Composition of Program.--
            ``(1) Consortium arrangements.--Participation in the 
        program established in subsection (a) requires the formation of 
        consortium arrangements among 3 or more separate and distinct 
        entities to carry out an outreach project.
            ``(2) Certain requirements.--
                    ``(A) A consortium under paragraph (1) must be 
                composed of 3 or more public or private nonprofit 
                health care or social service providers. Consortium 
                members may include such entities as local health 
                departments, community or migrant health centers, 
                community mental health centers, hospitals or private 
                practices, or other publicly funded health or social 
                services agencies.
                    ``(B) Grantees currently receiving support under 
                this program shall continue to be eligible for support.
    ``(d) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $50,000,000 
for fiscal year 1994, and such sums as may be necessary for each of the 
fiscal years 1995, 1996, 1997 and 1998.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect on the date of the enactment of this Act.

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