[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 1342 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                S. 1342

 To amend title XVIII of the Social Security Act to increase access to 
quality health care in frontier communities by allowing health clinics 
   and health centers greater medicare flexibility and reimbursement.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 29, 1997

  Mr. Murkowski (for himself and Mr. Thomas) 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 increase access to 
quality health care in frontier communities by allowing health clinics 
   and health centers greater medicare flexibility and reimbursement.

    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 Frontier Health Clinic and 
Center Act of 1997''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Frontier communities face unparalleled geographic, 
        climatic, and economic barriers to quality health care.
            (2) Health clinics and health centers located in frontier 
        areas do not have the resources or the demand to provide full 
        service inpatient and outpatient health care.
            (3) Many requirements under the medicare program under 
        title XVIII of the Social Security Act (42 U.S.C. 1395 et 
        seq.), designed for large suburban and urban facilities, do not 
        account for the unique conditions of smaller facilities in 
        remote communities.
            (4) Increasing the ability of health clinics and health 
        centers to provide health services enables patients to remain 
        closer to home while receiving those services, improves the 
        quality of care provided to individuals, reduces costs, and 
        spurs economic development by keeping health care dollars in 
        the local economy.

SEC. 3. CERTAIN HEALTH CLINICS AND HEALTH CENTERS PERMITTED TO 
              PARTICIPATE IN THE MEDICARE RURAL HOSPITAL FLEXIBILITY 
              PROGRAM.

    (a) In General.--Section 1820(c)(2) of the Social Security Act (42 
U.S.C. 1395i-4(c)(2)) (as amended by section 4201(a) of the Balanced 
Budget Act of 1997 (Public Law 105-33; 111 Stat. 370)) is amended--
            (1) in subparagraph (A), by striking ``subparagraph (B)'' 
        and inserting ``subparagraphs (B) and (C)'';
            (2) in subparagraph (B)(i) by striking ``public hospital'' 
        and inserting ``public hospital (or a health clinic or health 
        center if designated under subparagraph (C))''; and
            (3) by adding at the end the following:
                    ``(C) Health clinics and centers.--A State may 
                designate a health clinic or a health center (as 
                defined by the State) as a critical access hospital if 
                the health clinic or center--
                            ``(i) is licensed by the State as a health 
                        clinic or a health center;
                            ``(ii) is located in--
                                    ``(I) a county (or equivalent area) 
                                within the State that has an average 
                                population of not more than 6 
                                individuals per square mile; and
                                    ``(II) a health professional 
                                shortage area (as defined in section 
                                332(a)(1)(A) of the Public Health 
                                Service Act); and
                            ``(iii) meets the criteria for designation 
                        as a critical access hospital under 
                        subparagraph (B), except that clause (i)(II) of 
                        such subparagraph shall be applied by 
                        substituting `50-mile' for `35-mile'.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect as if included in the enactment of the Balanced Budget Act 
of 1997 (Public Law 105-33; 111 Stat. 251).
                                 <all>