[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4677 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 4677

       To promote access to health care services in rural areas.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 15, 2000

Mr. Foley (for himself, Mr. Lucas of Oklahoma, Mr. Tanner, Mr. Nussle, 
  Mr. Stenholm, Mr. McIntyre, Mr. Pomeroy, Mr. Berry, and Mr. Dickey) 
 introduced the following bill; which was referred to the Committee on 
  Ways and Means, and in addition to the Committee on Commerce, 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 promote access to health care services in rural areas.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Health Care Access 
and Rural Equality Act of 2000''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
  TITLE I--INCREASE IN MARKET BASKET PERCENTAGE ADJUSTMENT FOR RURAL 
                               HOSPITALS

Sec. 101. Increase in market basket percentage adjustment for rural 
                            hospitals.
     TITLE II--CAPITAL RELIEF FOR RURAL HEALTH CARE INFRASTRUCTURE

Sec. 201. Capital infrastructure revolving loan program.
 TITLE III--REFINEMENT OF THE MEDICARE DEPENDENT, SMALL RURAL HOSPITAL 
                                PROGRAM

Sec. 301. Making the medicare dependent, small rural hospital program 
                            permanent.
Sec. 302. Option to base eligibility on discharges during any of the 3 
                            most recent audited cost reporting periods.
          TITLE IV--EXEMPTION FOR MEDICARE SWING BED HOSPITALS

Sec. 401. Exemption of medicare swing bed hospitals from the 
                            prospective payment system for skilled 
                            nursing facilities.
           TITLE V--TREATMENT OF PHYSICIAN PATHOLOGY SERVICES

Sec. 501. Treatment of certain physician pathology services under 
                            medicare.
 TITLE VI--MEDICAID PAYMENT CORRECTION FOR CERTAIN RURAL HEALTH CLINICS

Sec. 601. Limit on certain medicaid recoupments and disallowances.
 TITLE VII--TECHNICAL CORRECTIONS TO THE BALANCED BUDGET REFINEMENT ACT

Sec. 701. Payments to critical access hospitals for clinical diagnostic 
                            laboratory tests.
Sec. 702. All-inclusive payment option for outpatient critical access 
                            hospital services.
Sec. 703. Extension of option to use rebased target amounts to all sole 
                            community hospitals.
Sec. 704. Grants for upgrading data systems.

  TITLE I--INCREASE IN MARKET BASKET PERCENTAGE ADJUSTMENT FOR RURAL 
                               HOSPITALS

SEC. 101. INCREASE IN MARKET BASKET PERCENTAGE ADJUSTMENT FOR RURAL 
              HOSPITALS.

    Section 1886(b)(3)(B)(i) of the Social Security Act (42 U.S.C. 
1395ww(b)(3)(B)(i)) (as amended by section 406 of the Medicare, 
Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (113 Stat. 
1501A-373), as enacted into law by section 1000(a)(6) of Public Law 
106-113) is amended--
            (1) in subclause (XVI)--
                    (A) by striking ``(other than sole community 
                hospitals)'' and inserting ``(other than any hospital 
                that is located in a rural area and that has less than 
                100 beds, is classified under subsection (d)(5)(C), or 
                is a sole community hospital (as defined in subsection 
                (d)(5)(D)(iii)))''; and
                    (B) by striking ``increase for sole community 
                hospitals'' and inserting ``increase for any hospital 
                that is located in a rural area and that has less than 
                100 beds, is classified under subsection (d)(5)(C), or 
                is a sole community hospital (as defined in subsection 
                (d)(5)(D)(iii))''; and
            (2) in subclause (XVII)--
                    (A) by inserting ``(other than any hospital that is 
                located in a rural area and that has less than 100 
                beds, is classified under subsection (d)(5)(C), or is a 
                sole community hospital (as defined in subsection 
                (d)(5)(D)(iii)))'' after ``for hospitals''; and
                    (B) by inserting ``, and the market basket 
                percentage increase for any hospital that is located in 
                a rural area and that has less than 100 beds, is 
                classified under subsection (d)(5)(C), or is a sole 
                community hospital (as defined in subsection 
                (d)(5)(D)(iii))'' after ``in all areas''.

     TITLE II--CAPITAL RELIEF FOR RURAL HEALTH CARE INFRASTRUCTURE

SEC. 201. CAPITAL INFRASTRUCTURE REVOLVING LOAN PROGRAM.

    (a) In General.--Part A of title XVI of the Public Health Service 
Act (42 U.S.C. 300q et seq.) is amended by adding at the end the 
following new section:

            ``capital infrastructure revolving loan program

    ``Sec. 1603. (a) Authority To Make and Guarantee Loans.--
            ``(1) Authority to make loans.--The Secretary may make 
        loans from the fund established under section 1602(d) to any 
        rural entity for projects for capital improvements, including--
                    ``(A) the acquisition of land necessary for the 
                capital improvements;
                    ``(B) the construction, renovation, or 
                modernization of any building;
                    ``(C) the acquisition or repair of fixed or major 
                movable equipment; and
                    ``(D) such other project expenses as the Secretary 
                determines appropriate.
            ``(2) Authority to guarantee loans.--
                    ``(A) In general.--The Secretary may guarantee the 
                payment of principal and interest for loans to rural 
                entities for projects for capital improvements 
                described in paragraph (1) to non-Federal lenders.
                    ``(B) Interest subsidies.--In the case of a 
                guarantee of any loan to a rural entity under 
                subparagraph (A), the Secretary may pay to the holder 
                of such loan and for and on behalf of the project for 
which the loan was made, amounts sufficient to reduce by not more than 
3 percent of the net effective interest rate otherwise payable on such 
loan.
    ``(b) Amount of Loan.--The principal amount of a loan directly made 
or guaranteed under subsection (a) for a project for capital 
improvement may not exceed $5,000,000.
    ``(c) Funding Limitations.--
            ``(1) Government credit subsidy exposure.--The total of the 
        Government credit subsidy exposure under the Credit Reform Act 
        of 1990 scoring protocol with respect to the loans outstanding 
        at any time with respect to which guarantees have been issued, 
        or which have been directly made, under subsection (a) may not 
        exceed $50,000,000 per year.
            ``(2) Total amounts.--Subject to paragraph (1), the total 
        of the principal amount of all loans directly made or 
        guaranteed under subsection (a) may not exceed $250,000,000 per 
        year.
    ``(d) Additional Assistance.--
            ``(1) Nonrepayable grants.--Subject to paragraph (2), the 
        Secretary may make a grant to a rural entity, in an amount not 
        to exceed $50,000, for purposes of capital assessment and 
        business planning.
            ``(2) Limitation.--The cumulative total of grants awarded 
        under this subsection may not exceed $2,500,000 per year.
    ``(e) Termination of Authority.--The Secretary may not directly 
make or guarantee any loan under subsection (a) or make a grant under 
subsection (d) after September 30, 2005.''.
    (b) Rural Entity Defined.--Section 1624 of the Public Health 
Service Act (42 U.S.C. 300s-3) is amended by adding at the end the 
following new paragraph:
            ``(15)(A) The term `rural entity' includes--
                    ``(i) a rural health clinic, as defined in section 
                1861(aa)(2) of the Social Security Act;
                    ``(ii) any medical facility with at least 1, but 
                less than 50 beds that is located in--
                            ``(I) a county that is not part of a 
                        metropolitan statistical area; or
                            ``(II) a rural census tract of a 
                        metropolitan statistical area (as determined 
                        under the most recent modification of the 
                        Goldsmith Modification, originally published in 
                        the Federal Register on February 27, 1992 (57 
                        Fed. Reg. 6725));
                    ``(iii) a hospital that is classified as a rural, 
                regional, or national referral center under section 
                1886(d)(5)(C) of the Social Security Act; and
                    ``(iv) a hospital that is a sole community hospital 
                (as defined in section 1886(d)(5)(D)(iii) of the Social 
                Security Act).
            ``(B) For purposes of subparagraph (A), the fact that a 
        clinic, facility, or hospital has been geographically 
        reclassified under the medicare program under title XVIII of 
        the Social Security Act shall not preclude a hospital from 
        being considered a rural entity under clause (i) or (ii) of 
        subparagraph (A).''.
    (c) Conforming Amendments.--Section 1602 of the Public Health 
Service Act (42 U.S.C. 300q-2) is amended--
            (1) in subsection (b)(2)(D), by inserting ``or 
        1603(a)(2)(B)'' after ``1601(a)(2)(B)''; and
            (2) in subsection (d)--
                    (A) in paragraph (1)(C), by striking ``section 
                1601(a)(2)(B)'' and inserting ``sections 1601(a)(2)(B) 
                and 1603(a)(2)(B)''; and
                    (B) in paragraph (2)(A), by inserting ``or 
                1603(a)(2)(B)'' after ``1601(a)(2)(B)''.

 TITLE III--REFINEMENT OF THE MEDICARE DEPENDENT, SMALL RURAL HOSPITAL 
                                PROGRAM

SEC. 301. MAKING THE MEDICARE DEPENDENT, SMALL RURAL HOSPITAL PROGRAM 
              PERMANENT.

    (a) Payment Methodology.--Section 1886(d)(5)(G) of the Social 
Security Act (42 U.S.C. 1395ww(d)(5)(G)) (as amended by section 404(a) 
of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 
1999 (113 Stat. 1501A-372), as enacted into law by section 1000(a)(6) 
of Public Law 106-113) is amended--
            (1) in clause (i), by striking ``and before October 1, 
        2006,''; and
            (2) in clause (ii)(II), by striking ``and before October 1, 
        2006,''.
    (b) Conforming Amendments.--
            (1) Target amount.--Section 1886(b)(3)(D) of the Social 
        Security Act (42 U.S.C. 1395ww(b)(3)(D)) (as amended by section 
        404(b)(1) of the Medicare, Medicaid, and SCHIP Balanced Budget 
        Refinement Act of 1999 (113 Stat. 1501A-372), as enacted into 
        law by section 1000(a)(6) of Public Law 106-113) is amended--
                    (A) in the matter preceding clause (i), by striking 
                ``and before October 1, 2006,''; and
                    (B) in clause (iv), by striking ``through fiscal 
                year 2005,'' and inserting ``or any subsequent fiscal 
                year,''.
            (2) Permitting hospitals to decline reclassification.--
        Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 
        1993 (42 U.S.C. 1395ww note) (as amended by section 404(b)(2) 
        of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement 
        Act of 1999 (113 Stat. 1501A-372), as enacted into law by 
        section 1000(a)(6) of Public Law 106-113) is amended by 
        striking ``or fiscal year 2000 through fiscal year 2005'' and 
        inserting ``fiscal year 2000, or any subsequent fiscal year,''.

SEC. 302. OPTION TO BASE ELIGIBILITY ON DISCHARGES DURING ANY OF THE 3 
              MOST RECENT AUDITED COST REPORTING PERIODS.

    (a) Option To Base Eligibility on Discharges During Any of the 3 
Most Recent Audited Cost Reporting Periods.--Section 
1886(d)(5)(G)(iv)(IV) of the Social Security Act (42 U.S.C. 
1395ww(d)(5)(G)(iv)(IV)) is amended by inserting ``, or any of the 3 
most recent audited cost reporting periods,'' after ``1987''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to cost reporting periods beginning on or after the 
date of enactment of this Act.

          TITLE IV--EXEMPTION FOR MEDICARE SWING BED HOSPITALS

SEC. 401. EXEMPTION OF MEDICARE SWING BED HOSPITALS FROM THE 
              PROSPECTIVE PAYMENT SYSTEM FOR SKILLED NURSING 
              FACILITIES.

    (a) Exemption for Medicare Swing Bed Hospitals.--
            (1) In general.--Section 1888(e)(7) of the Social Security 
        Act (42 U.S.C. 1395yy(e)(7)(A)) is amended--
                    (A) in the heading, by striking ``Transition'' and 
                inserting ``Exemption'';
                    (B) by striking subparagraph (A) and inserting the 
                following new subparagraph:
                    ``(A) In general.--The prospective payment system 
                under this subsection shall not apply to items and 
                services provided by a facility described in 
                subparagraph (B).''; and
                    (C) in subparagraph (B), by striking ``, for which 
                payment'' and all that follows before the period.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall take effect as if included in the enactment of section 
        4432 of the Balanced Budget Act of 1997 (Public Law 105-133; 
        111 Stat. 414).
    (b) Repeal of BBRA Amendments.--
            (1) In general.--Section 408 of the Medicare, Medicaid, and 
        SCHIP Balanced Budget Refinement Act of 1999 (113 Stat. 1501A-
        375), as enacted into law by section 1000(a)(6) of Public Law 
        106-113, and the amendments made by such section are repealed.
            (2) Effective date.--The Secretary shall apply and 
        administer the Social Security Act as if section 408 of the 
        Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 
        1999 (113 Stat. 1501A-375), as enacted into law by section 
        1000(a)(6) of Public Law 106-113, and the amendments made by 
        such section had never been enacted into law.

           TITLE V--TREATMENT OF PHYSICIAN PATHOLOGY SERVICES

SEC. 501. TREATMENT OF CERTAIN PHYSICIAN PATHOLOGY SERVICES UNDER 
              MEDICARE.

    (a) In General.--Notwithstanding any other provision of law, when 
an independent laboratory, under a grandfathered arrangement with a 
hospital, furnishes the technical component of a physician pathology 
service with respect to a fee-for-service medicare beneficiary who is 
an inpatient of the hospital, such component shall be treated as a 
service for which payment shall be made to the laboratory under section 
1848 of the Social Security Act (42 U.S.C. 1395w-4) and not as an 
inpatient hospital service for which payment is made to the hospital 
under section 1886(d) of such Act (42 U.S.C. 1395ww(d)).
    (b) Definitions.--For purposes of this section--
            (1) the term ``grandfathered arrangement'' means an 
        arrangement between an independent laboratory and a hospital--
                    (A) that was in effect as of July 22, 1999, even if 
                such arrangement is subsequently renewed; and
                    (B) under which the laboratory furnishes the 
                technical component of physician pathology services 
                with respect to hospital inpatients and submits a claim 
                for payment for such component to a medicare carrier 
                (and not to the hospital);
            (2) the term ``fee-for-service medicare beneficiary'' means 
        an individual who--
                    (A) is entitled to benefits under part A of title 
                XVIII of the Social Security Act (42 U.S.C. 1395c et 
                seq.); and
                    (B) is not enrolled in a Medicare+Choice plan under 
                part C of such Act (42 U.S.C. 1395w-21 et seq.), a plan 
                offered by an eligible organization under section 1876 
                of such Act (42 U.S.C. 1395mm), or a medicare managed 
                care demonstration project; and
            (3) the term ``medicare carrier'' means an organization 
        with a contract under section 1842 of such Act (42 U.S.C. 
        1395u).
    (c) Effective Date.--This section shall apply to services furnished 
on or after July 22, 1999.

 TITLE VI--MEDICAID PAYMENT CORRECTION FOR CERTAIN RURAL HEALTH CLINICS

SEC. 601. LIMIT ON CERTAIN MEDICAID RECOUPMENTS AND DISALLOWANCES.

    (a) In General.--Notwithstanding any other provision of law--
            (1) a State plan approved under title XIX of the Social 
        Security Act may not recoup or deny payments under such plan 
        that--
                    (A) are for rural health clinic services (as 
                defined in section 1905(l)(1) of such title) furnished 
                on or after January 1, 1998, and before October 1, 
                2000; and
                    (B) are alleged overpayments due to a determination 
                that the amendment made by section 4205(a)(1)(A) of the 
                Balanced Budget Act of 1997 (relating to per visit 
                limits for provider-based clinics under medicare) 
                applies to rural health clinic services furnished under 
                such title XIX; and
            (2) the Secretary of Health and Human Services (in this 
        section referred to as the ``Secretary'') may not withhold, 
        suspend, disallow, or deny Federal financial participation 
        under section 1903 of the Social Security Act (42 U.S.C. 1396b) 
with respect to alleged overpayments described in paragraph (1).
    (b) Payment of Amounts Recouped, Denied, or Disallowed.--If, before 
the date of the enactment of this section--
            (1) a State plan has recouped or denied payments described 
        in subsection (a)(1), or
            (2) the Secretary has withheld, suspended, disallowed, or 
        denied Federal financial participation under title XIX of the 
        Social Security Act with respect to such payments,
the State plan or the Secretary, as the case may be, shall pay the 
amounts recouped, denied, withheld, suspended, or disallowed, to the 
rural health clinic or the State, as the case may be.

 TITLE VII--TECHNICAL CORRECTIONS TO THE BALANCED BUDGET REFINEMENT ACT

SEC. 701. PAYMENTS TO CRITICAL ACCESS HOSPITALS FOR CLINICAL DIAGNOSTIC 
              LABORATORY TESTS.

    (a) Payment on Cost Basis Without Beneficiary Cost-Sharing.--
            (1) In general.--Section 1833(a)(6) of the Social Security 
        Act (42 U.S.C. 1395l(a)(6)) is amended by inserting 
        ``(including clinical diagnostic laboratory services furnished 
        by a critical access hospital)'' after ``outpatient critical 
        access hospital services''.
            (2) No beneficiary cost-sharing.--
                    (A) In general.--Section 1834(g) of the Social 
                Security Act (42 U.S.C. 1395m(g)) is amended by 
                inserting ``(except that in the case of clinical 
                diagnostic laboratory services furnished by a critical 
                access hospital the amount of payment shall be equal to 
                100 percent of the reasonable costs of the critical 
                access hospital in providing such services)'' before 
                the period at the end.
                    (B) BBRA amendment.--Section 1834(g) of the Social 
                Security Act (42 U.S.C. 1395m(g)) (as amended by 
                section 403(d) of the Medicare, Medicaid, and SCHIP 
                Balanced Budget Refinement Act of 1999 (113 Stat. 
                1501A-371), as enacted into law by section 1000(a)(6) 
                of Public Law 106-113) is amended--
                            (i) in paragraph (1), by inserting 
                        ``(except that in the case of clinical 
                        diagnostic laboratory services furnished by a 
                        critical access hospital the amount of payment 
                        shall be equal to 100 percent of the reasonable 
                        costs of the critical access hospital in 
                        providing such services)'' after ``such 
                        services,''; and
                            (ii) in paragraph (2)(A), by inserting 
                        ``(except that in the case of clinical 
                        diagnostic laboratory services furnished by a 
                        critical access hospital the amount of payment 
                        shall be equal to 100 percent of the reasonable 
                        costs of the critical access hospital in 
                        providing such services)'' before the period at 
                        the end.
    (b) Conforming Amendments.--Paragraphs (1)(D)(i) and (2)(D)(i) of 
section 1833(a) of the Social Security Act (42 U.S.C. 
1395l(a)(1)(D)(i); 1395l(a)(2)(D)(i)) (as amended by section 403(e) of 
the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 
1999 (113 Stat. 1501A-371), as enacted into law by section 1000(a)(6) 
of Public Law 106-113) are each amended by striking ``or which are 
furnished on an outpatient basis by a critical access hospital''.
    (c) Technical Amendment.--Section 403(d)(2) of the Medicare, 
Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (113 Stat. 
1501A-371), as enacted into law by section 1000(a)(6) of Public Law 
106-113, is amended by striking ``subsection (a)'' and inserting 
``paragraph (1)''.
    (d) Effective Dates.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendments made by this section shall apply to services 
        furnished on or after November 29, 1999.
            (2) BBRA and technical amendments.--The amendments made by 
        subsections (a)(2)(B) and (c) shall take effect as if included 
        in the enactment of section 403(d) of the Medicare, Medicaid, 
        and SCHIP Balanced Budget Refinement Act of 1999 (113 Stat. 
        1501A-371), as enacted into law by section 1000(a)(6) of Public 
        Law 106-113.

SEC. 702. ALL-INCLUSIVE PAYMENT OPTION FOR OUTPATIENT CRITICAL ACCESS 
              HOSPITAL SERVICES.

    (a) All-Inclusive Payment Option for Outpatient Critical Access 
Hospital Services.--Section 1834(g) (42 U.S.C. 1395m(g)) (as amended by 
section 601 of this Act and section 403(d) of the Medicare, Medicaid, 
and SCHIP Balanced Budget Refinement Act of 1999 (113 Stat. 1501A-371), 
as enacted into law by section 1000(a)(6) of Public Law 106-113) is 
amended--
            (1) by striking paragraph (1) and inserting the following 
        new paragraph:
            ``(1) Election of cah.--At the election of a critical 
        access hospital, the amount of payment for outpatient critical 
        access hospital services under this part shall be determined 
        under paragraph (2) or (3), such amount determined under either 
        paragraph without regard to the amount of the customary or 
        other charge.''; and
            (2) by striking paragraph (3) and inserting the following 
        new paragraph:
            ``(3) All-inclusive rate.--If a critical access hospital 
        elects this paragraph to apply, with respect to both facility 
        services and professional services, there shall be paid amounts 
        equal to the reasonable costs of the critical access hospital 
        in providing such services (except that in the case of clinical 
        diagnostic laboratory services furnished by a critical access 
        hospital the amount of payment shall be equal to 100 percent of 
        the reasonable costs of the critical access hospital in 
        providing such services), less the amount that such hospital 
        may charge as described in section 1866(a)(2)(A).''.
    (b) Effective Date.--The amendments made by subparagraph (a) shall 
take effect as if included in the enactment of section 403(d) of the 
Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 
(113 Stat. 1501A-371), as enacted into law by section 1000(a)(6) of 
Public Law 106-113.

SEC. 703. EXTENSION OF OPTION TO USE REBASED TARGET AMOUNTS TO ALL SOLE 
              COMMUNITY HOSPITALS.

    (a) In General.--Section 1886(b)(3)(I)(i) of the Social Security 
Act (42 U.S.C. 1395ww(b)(3)(I)(i)) (as added by section 405 of the 
Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 
(113 Stat. 1501A-372), as enacted into law by section 1000(a)(6) of 
Public Law 106-113) is amended--
            (1) in the matter preceding subclause (I)--
                    (A) by striking ``for its cost reporting period 
                beginning during 1999 is paid on the basis of the 
                target amount applicable to the hospital under 
                subparagraph (C) and that''; and
                    (B) by striking ``such target amount'' and 
                inserting ``the amount otherwise determined under 
                subsection (d)(5)(D)(i)'';
            (2) in subclause (I), by striking ``target amount otherwise 
        applicable'' and all that follows through ``target amount')'' 
        and inserting ``the amount otherwise applicable to the hospital 
        under subsection (d)(5)(D)(i) (referred to in this clause as 
        the `subsection (d)(5)(D)(i) amount')''; and
            (3) in each of subclauses (II) and (III), by striking 
        ``subparagraph (C) target amount'' and inserting ``subsection 
        (d)(5)(D)(i) amount''.
    (b) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of the Medicare, Medicaid, and 
SCHIP Balanced Budget Refinement Act of 1999, as enacted into law by 
section 1000(a)(6) of Public Law 106-113.

SEC. 704. GRANTS FOR UPGRADING DATA SYSTEMS.

    (a) In General.--Part B of title XVI of the Public Health Service 
Act (42 U.S.C. 300r et seq.) is amended by adding at the end the 
following new section:

                  ``grants for upgrading data systems

    ``Sec. 1611. (a) Grants to Hospitals.--The Secretary may make 
grants to hospitals that have submitted applications in accordance with 
subsection (c) to assist eligible small rural hospitals in meeting the 
costs of establishing data systems required to meet requirements 
established under the medicare program pursuant to amendments made by 
the Balanced Budget Act of 1997 and the Health Insurance Portability 
and Accountability Act of 1996.
    ``(b) Eligible Small Rural Hospital Defined.--For purposes of this 
section, the term `eligible small rural hospital' means a non-Federal, 
short-term general acute care hospital that--
            ``(1) is located in a rural area, as defined for purposes 
        of section 1886(d) of the Social Security Act; and
            ``(2) has less than 50 beds.
    ``(c) Application.--A hospital seeking a grant under this section 
shall submit an application to the Secretary on or before such date and 
in such form and manner as the Secretary specifies.
    ``(d) Amount of Grant.--A grant to a hospital under this section 
may not exceed $50,000.
    ``(e) Use of Funds.--A hospital receiving a grant under this 
section may use the funds for the purchase of computer software and 
hardware, the education and training of hospital staff on computer 
information systems, the expenses related to the administrative 
simplification requirements under part C of title XI of the Social 
Security Act, and to offset costs related to the implementation of 
prospective payment systems under title XVIII of such Act.
    ``(f) Reports.--
            ``(1) Information.--A hospital receiving a grant under this 
        section shall furnish the Secretary with such information as 
        the Secretary may require to evaluate the project for which the 
        grant is made and to ensure that the grant is expended for the 
        purposes for which it is made.
            ``(2) Timing of submission.--
                    ``(A) Interim reports.--The Secretary shall report 
                to the Committee on Commerce of the House of 
                Representatives and the Committee on Health, Education, 
                Labor, and Pensions of the Senate at least annually on 
                the grant program established under this section, 
                including in such report information on the number of 
                grants made, the nature of the projects involved, the 
                geographic distribution of grant recipients, and such 
                other matters as the Secretary deems appropriate.
                    ``(B) Final report.--The Secretary shall submit a 
                final report to such committees not later than 180 days 
                after the completion of all of the projects for which a 
                grant is made under this section.
    ``(g) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary for grants under this 
section.''.
    (b) Conforming Amendment.--Section 1820(g)(3) of the Social 
Security Act (42 U.S.C. 1395i-4(g)(3)) (as added by section 409 of the 
Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 
(113 Stat. 1501A-375), as enacted into law by section 1000(a)(6) of 
Public Law 106-113) is repealed.
                                 <all>