[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2199 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 2199

    To amend title XVIII of the Social Security Act to promote the 
   efficient use of capital by hospitals under the Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 14, 1999

  Mr. Stark introduced the following bill; which was referred to the 
                      Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
    To amend title XVIII of the Social Security Act to promote the 
   efficient use of capital by 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 ``Medicare Hospital Capital Efficiency 
Promotion Act of 1999''.

SEC. 2. REDUCTIONS IN MEDICARE CAPITAL PAYMENTS IN CASE OF EXCESS BED 
              SUPPLY.

    (a) In General.--Notwithstanding any other provision of law, the 
Secretary of Health and Human Services may, for cost reporting periods 
and discharges occurring on or after October 1, 2004, reduce medicare 
capital payments for a hospital located in a hospital catchment area 
if--
            (1) the hospital bed ratio for the area for that type of 
        hospital is higher than the national average hospital bed ratio 
        for that type of hospital; and
            (2) the average hospital occupancy rate for the hospital is 
        below the average hospital occupancy rate for that type of 
        hospital.
    (b) Limitation on Amount of Reduction.--The reduction in payment 
under subsection (a) may not exceed 25 percent of the amount of the 
medicare capital payments.
    (c) Exceptions.--The Secretary shall not make a reduction under 
subsection (a) insofar as the Secretary determines that such reduction 
would be inappropriate as--
            (1) it would adversely effect an ongoing plan for the 
        hospital to reduce the number of inpatient hospital beds, 
        whether directly or through closure or merger with another 
        hospital;
            (2) additional capacity is required to meet the needs of an 
        underserved population, such as a rural area; or
            (3) the hospital has been certified as a critical access 
        hospital under section 1820(e) of the Social Security Act (42 
        U.S.C. 1395i-4(e)).
    (d) Definitions.--For purposes of this section:
            (1) PPS hospital; pps-exempt hospital.--The term ``PPS 
        hospital'' has the meaning given the term ``subsection (d) 
        hospital'' in section 1886(d)(1)(B) of the Social Security Act 
        (42 U.S.C. 1395ww(d)(1)(B)), and the term ``PPS-exempt 
        hospital'' means a hospital other than a PPS hospital.
            (2) Type of hospital.--The term ``type of hospital'' means 
        PPS hospitals and each type of hospital described in a clause 
        of section 1886(d)(1)(B) of the Social Security Act (42 U.S.C. 
        1395ww(d)(1)(B)).
            (3) Hospital catchment area.--The term ``hospital catchment 
        area'' means a standard metropolitan statistical area or such 
        area as the Secretary determines appropriate.
            (4) Hospital bed ratio.--
                    (A) In general.--The term ``hospital bed ratio'' 
                means, for an area and a type of hospital and as 
                determined by the Secretary, the ratio of--
                            (i) the number of licensed inpatient 
                        hospital beds for that type of hospital in the 
                        area, to
                            (ii) the population of the area.
                    (B) Case mix adjustment authority.--In determining 
                a hospital bed ratio, the Secretary may provide for 
                such adjustment as may be appropriate to take into 
                account differences in the case mix of the population 
                served by the hospital.
            (5) Hospital occupancy rate.--The term ``hospital occupancy 
        rate'' means, for a hospital and period and as determined by 
        the Secretary, the average number of inpatient beds in the 
        hospital which are occupied on any day in that period, divided 
        by the average total number of licensed inpatient beds in the 
        hospital on any day in that period.
            (6) Medicare capital payments.--The term ``medicare capital 
        payments'' means payments to a hospital under section 1886 of 
        the Social Security Act (42 U.S.C. 1395ww) for capital-related 
        costs, and includes payments under section 1886(g) of such Act, 
        but does not include payments for a return on equity capital.
            (7) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
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