[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1529 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 1529

  To require the Secretary of Health and Human Services to modify the 
   treatment of certain patient days for purposes of determining the 
amount of disproportionate share adjustment payments to hospitals under 
                         the Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 22, 1999

 Mr. English (for himself, Mr. Coyne, Mr. Weldon of Pennsylvania, Mr. 
 Brady of Pennsylvania, Mr. Peterson of Pennsylvania, Mr. Borski, Mr. 
Gekas, Mr. Doyle, Mr. Goodling, Mr. Fattah, Mr. Greenwood, Mr. Hoeffel, 
 Mr. Pitts, Mr. Holden, Mr. Sherwood, Mr. Kanjorski, Mr. Shuster, Mr. 
    Klink, Mr. Murtha, Mr. Toomey, and Mr. Mascara) introduced the 
 following bill; which was referred to the Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
  To require the Secretary of Health and Human Services to modify the 
   treatment of certain patient days for purposes of determining the 
amount of disproportionate share adjustment payments to hospitals 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. SHORT TITLE.

    This Act may be cited as the ``Indigent Care Reimbursement Act of 
1999''.

SEC. 2. TREATMENT OF CERTAIN PATIENT DAYS IN DETERMINING DSH PAYMENTS 
              UNDER MEDICARE.

    (a) Limit on Disallowances.--The Secretary of Health and Human 
Services (in this section referred to as the ``Secretary'') may not--
            (1) in calculating the disproportionate patient percentage 
        (as defined in section 1886(d)(5)(F)(vi) of the Social Security 
        Act (42 U.S.C. 1395ww(d)(5)(F)(vi))) of a hospital that is 
        located in a subsection (c) State for discharges occurring 
        before October 1, 1998, treat patient days for individuals 
        eligible for general assistance under the laws of such State, 
        for purposes of subclause (II) of such section, as not 
        consisting of patients who (for such days) were eligible for 
        medical assistance under a State plan approved under title XIX 
        of such Act; or
            (2) recoup payments from (or otherwise reduce, disallow, or 
        adjust payments under title XVIII of such Act to) such a 
        hospital for discharges occurring before such date based on the 
        treatment of patient days for general assistance in the manner 
        prohibited by paragraph (1).
    (b) Refunds of Recouped Amounts.--If, before the date of the 
enactment of this section, the Secretary has recouped payments from (or 
otherwise reduced, disallowed, or adjusted payments under title XVIII 
of such Act to) a hospital that is located in a subsection (c) State 
based on the treatment of patient days for general assistance in the 
manner prohibited by subsection (a)(1), the Secretary shall refund to 
the hospital the portion of the amount recouped, reduced, disallowed, 
or adjusted that is attributable to discharges occurring before October 
1, 1998.
    (c) Subsection (c) State Defined.--For purposes of this section, 
the term ``subsection (c) State'' means a State that meets the 
following requirements:
            (1) No subsection (d) hospital (as defined in section 
        1886(d)(1)(B) of such Act (42 U.S.C. 1395ww(d)(1)(B))) located 
        in the State is owned and operated by a unit of State or local 
        government.
            (2) The total amount of payments under section 
        1886(d)(5)(F) of such Act (42 U.S.C. 1395ww(d)(5)(F)) (relating 
        to disproportionate share payments) for hospitals located in 
        the State that were included in a medicare public use file 
        entitled ``PPS XIII Hospital Data Set'' is not less than 
        $150,000,000 nor more than $170,000,000.
            (3) The total number of individuals residing in the State 
        and enrolled in an insurance program established under title 
        XVIII of such Act during calendar year 1996 was more than 
        2,000,000, but less than 2,200,000.
            (4) More than 15.8 percent of the individuals residing in 
        the State during 1995 had attained age 65.
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