[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4622 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 4622

 To amend title 18 of the Social Security Act to provide for immediate 
relief for essential hospitals in a region, to assist in the long-range 
      economic recovery of such hospitals, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 9, 2000

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

_______________________________________________________________________

                                 A BILL


 
 To amend title 18 of the Social Security Act to provide for immediate 
relief for essential hospitals in a region, to assist in the long-range 
      economic recovery of such hospitals, and for other purposes.

    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 ``Essential Hospital Preservation Act 
of 2000''.

SEC. 2. SPECIAL PAYMENTS TO ESSENTIAL HOSPITALS AND DEVELOPMENT OF 
              ECONOMIC RECOVERY PLAN.

    (a) In General.--Section 1886(g) of the Social Security Act is 
amended by inserting after subsection (4) the following new subsection:
            ``(5)(A) Effective October 1, 2000, and thereafter, in the 
        case of a deemed hospital, the Secretary shall increase all 
        payments for all services provided under this Title by such 
        deemed hospital (including in-patient, out-patient, skilled 
        nursing facility, home health agency, hospice, and end-stage 
        renal disease, and other covered services provided by such 
        deemed hospital) by 10 per centum for a period of five fiscal 
        years, subject to the conditions under subsection 6 of this 
        subparagraph.
            ``(B) A deemed hospital shall be a hospital in a hospital 
        referral region--
                    ``(i) as defined by the The Center for the 
                Evaluative Clinical Sciences, Dartmouth Medical School 
                (popularly known as `The Dartmouth Atlas of Health 
                Care'), and as may be updated by The Center,
                    ``(ii) except that the Secretary may by regulation 
                provide for criteria to adjust the hospitals to be 
                included or excluded from such a hospital referral 
                region, and
                    ``(iii) 75 per centum of the hospitals in such 
                referral region shall, for the last completed cost 
                report period, have had negative Medicare operating 
                margins and negative total operating margins, and
                    ``(iv) the Medicare-eligible beneficiary patient 
                discharge percentage of the hospitals in the referral 
                region shall exceed 40 per centum.
        The hospitals in the referral region shall be deemed to be 
        essential hospitals necessary for the delivery of health care 
        to all Medicare and other residents of the region.
            ``(6)(A) Within one year of receiving deemed status and 
        higher Medicare payments under subsection 5 of this 
        subparagraph, each hospital in the referral region, either 
        individually or (notwithstanding any other provision of law) 
        cooperatively, shall submit an economic recovery plan to the 
        Department of Health and Human Services for long-range (post-
        deemed status) financial viability. The Secretary shall offer 
        assistance in the development of such plan or plans.
            ``(B) Such plan may include capital payments and operating 
        payments to--
                    ``(i) right-size capacity,
                    ``(ii) coordinate and share high cost services,
                    ``(iii) ensure a viable regional emergency room 
                network and access,
                    ``(iv) convert unused acute care beds to skilled 
                nursing facility, intermediate care facility, or 
                assisted living facility support facilities,
                    ``(v) assist in the conversion of unused acute care 
                beds to psychiatric, long-term care, or rehabilitation 
                care hospital services as are determined to be in short 
                supply, and
                    ``(vi) such other adjustments to the current acute 
                care hospital facility as shall ensure the long-term 
                economic viability of the facility and the continuation 
                of essential health care services to the community.
            ``(C) The Secretary shall review such economic recovery 
        plans, provide assistance in the improvement and modification 
        of such plans, and within one year of receipt of a plan which 
        the Secretary determines has a reasonable opportunity of 
        ensuring the long term viability of the facility or facilities, 
        the Secretary shall further increase the Medicare payment 
        increases described in subsection 5 of this subparagraph by 
        such additional amount as to ensure the successful completion 
        of the economic recovery plan or plans under this subsection.
            ``(7) Notwithstanding any other provision of law, the 
        additional payments made to deemed hospitals under subsections 
        5 and 6 of this subparagraph shall not result in payment 
        reductions to any non-deemed hospital or provider under this 
        Title.''.
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