[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2241 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 2241

  To amend the Balanced Budget Act of 1997 to limit the reductions in 
  Federal payments under the Medicare prospective payment system for 
                hospital outpatient department services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 16, 1999

Mr. Foley (for himself, Mrs. Johnson of Connecticut, Mr. Hayworth, Mr. 
   English, Mr. Davis of Florida, Mr. Peterson of Minnesota, and Mr. 
   Larson) introduced the following bill; which was referred to the 
  Committee on Commerce, and in addition to the Committee on Ways and 
 Means, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To amend the Balanced Budget Act of 1997 to limit the reductions in 
  Federal payments under the Medicare prospective payment system for 
                hospital outpatient department services.

    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 ``Hospital Outpatient Preservation Act 
of 1999''.

SEC. 2. LIMITING REDUCTIONS IN FEDERAL PAYMENTS UNDER PPS FOR HOSPITAL 
              OUTPATIENT DEPARTMENT SERVICES.

    (a) In General.--Section 4523 of the Balanced Budget Act of 1997 is 
amended by adding at the end the following:
    ``(e) Temporary Limit on Reductions in Federal payments.--
            ``(1) In general.--Notwithstanding section 1833(t) of the 
        Social Security Act (42 U.S.C. 1395l(t)), as added by 
        subsection (a), the amount that is paid from the Federal 
        Supplementary Medical Insurance Trust Fund for covered OPD 
        services furnished by a hospital during a calendar year (or 
        portion thereof) specified in paragraph (2)(A) may not be less 
        than the applicable percentage of the case mix adjusted average 
        amount that would have been payable to such hospital for such 
        services (including cost sharing) if the prospective payment 
        system established under such section did not apply. Such 
        average amount may be determined on a prospective basis using 
        the Secretary's best estimate of the reasonable costs incurred 
        in furnishing covered OPD services or on a retrospective basis 
        using cost reports submitted by a hospital.
            ``(2) Definitions.--For purposes of paragraph (1)--
                    ``(A) subject to paragraph (3), the term 
                `applicable percentage' means--
                            ``(i) with respect to covered OPD services 
                        furnished during the first full calendar year 
                        (and any portion of the immediately preceding 
                        calendar year) for which the prospective 
                        payment system established under section 
                        1833(t) of such Act is in effect, 95 percent;
                            ``(ii) with respect to the second full 
                        calendar year for which such system is in 
                        effect, 90 percent; and
                            ``(iii) with respect to the third full 
                        calendar year for which such system is in 
                        effect, 85 percent; and
                    ``(B) the term `covered OPD services' has the 
                meaning given to such term in section 1833(t)(1)(B) of 
                such Act.
            ``(3) Application to certain hospitals.--In the case of 
        hospitals described in section 1833(t)(8) of such Act, the 
        `applicable percentage' for a calendar year (or portion 
        thereof) shall be the same applicable percentage that applies 
        to covered OPD services furnished by hospitals that are not 
        described in such section during such calendar year (or portion 
        thereof).
            ``(4) Rule of construction.--Nothing in this subsection 
        shall be construed as affecting the amount of cost sharing paid 
        by individuals enrolled under part B of title XVIII of the 
        Social Security Act for covered OPD services.''.
    (b) Conforming Amendment.--Section 1833(t)(1)(A) of the Social 
Security Act (42 U.S.C. 1395l(t)(1)(A)) is amended by inserting 
``except as provided in section 4523(e) of the Balanced Budget Act of 
1997,'' after ``1999,''.
    (c) Effective Date.--The amendments made by this section shall 
become effective as if included in the enactment of the Balanced Budget 
Act of 1997.
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