[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4997 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 4997

 To amend title XVIII of the Social Security Act to revise and improve 
         the Medicare-dependent, small rural hospital program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 27, 2000

Mr. Peterson of Pennsylvania (for himself and Mrs. Emerson) 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 amend title XVIII of the Social Security Act to revise and improve 
         the Medicare-dependent, small rural hospital 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-Dependent, Small Rural 
Hospital Equity Act of 2000''.

SEC. 2. APPLICATION OF THE MEDICARE PATIENT POPULATION PERCENTAGE 
              MEASUREMENT OF MEDICARE-DEPENDENT, SMALL RURAL HOSPITALS 
              TO THE THREE MOST RECENT COST REPORTING PERIODS.

    (a) In General.--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 after ``during the cost reporting period beginning in fiscal 
year 1987'' `` or, at the election of the hospital (in a form and 
manner determined by the Secretary), during any of the three most 
recent 12-month cost reporting periods for which the Secretary has the 
settled cost reports''.
    (b) Effective Date.--The amendment made by subsection (a) applies 
with respect to discharges occurring on or after October 1, 2000.

SEC. 3. REBASING FOR CERTAIN MEDICARE-DEPENDENT, SMALL RURAL HOSPITALS.

    Section 1886(b)(3) of the Social Security Act (42 U.S.C. 
1395ww(b)(3)) is amended--
            (1) in subparagraph (D), by inserting ``subject to 
        subparagraph (J),'' before ``the term `target amount' means''; 
        and
            (2) by adding at the end the following new subparagraph:
    ``(J)(i) For cost reporting periods beginning on or after October 
1, 2000, in the case of a medicare-dependent, small rural hospital that 
elects (in a form and manner determined by the Secretary) this 
subparagraph to apply to the hospital, there shall be substituted for 
the target amount applicable to the hospital under subparagraph (D)--
            ``(I) with respect to discharges occurring in fiscal year 
        2001, 75 percent of the target amount otherwise applicable to 
        the hospital under subparagraph (D) (referred to in this clause 
        as the `subparagraph (D) target amount') and 25 percent of the 
        rebased target amount (as defined in clause (ii));
            ``(II) with respect to discharges occurring in fiscal year 
        2002, 50 percent of the subparagraph (D) target amount and 50 
        percent of the rebased target amount;
            ``(III) with respect to discharges occurring in fiscal year 
        2003, 25 percent of the subparagraph (D) target amount and 75 
        percent of the rebased target amount; and
            ``(IV) with respect to discharges occurring after fiscal 
        year 2003, 100 percent of the rebased target amount.
    ``(ii) For purposes of this subparagraph, the term `rebased target 
amount' has the meaning given the term `target amount' in subparagraph 
(D) except that--
            ``(I) there shall be substituted for the base cost 
        reporting period under subparagraph (D) any of the three most 
        recent 12-month cost reporting periods for which the Secretary 
        has the settled cost reports, whichever results in the greatest 
        increase in the target amount for the hospital;
            ``(II) any reference in subparagraph (D)(i) to the `first 
        cost reporting period' described in such subparagraph is deemed 
        a reference to the first cost reporting period beginning on or 
        after October 1, 2000; and
            ``(III) applicable increase percentage shall only be 
        applied under subparagraph (D)(iv) for discharges occurring in 
        fiscal years beginning with fiscal year 2002.''.

SEC. 4. 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)) 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)) 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) is amended by striking ``or fiscal 
        year 2000 through fiscal year 2005'' and inserting ``fiscal 
        year 2000, or any subsequent fiscal year,''.
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