[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5220 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 5220

 To amend title XVIII of the Social Security Act to preserve essential 
                            rural hospitals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 20, 2000

Mr. Paul (for himself, Mr. Edwards, and Mr. Smith of Texas) 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 preserve essential 
                            rural hospitals.

    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 Rural Hospital 
Preservation Act of 2000''.

SEC. 2. REVISIONS IN THE MEDICARE PROGRAM TO PRESERVE ESSENTIAL RURAL 
              HOSPITALS.

    (a) Essential Rural Hospital Defined.--Section 1861 of the Social 
Security Act (42 U.S.C. 1395x) is amended by adding at the end the 
following new subsection:

                       ``Essential Rural Hospital

    ``(uu) The term `essential rural hospital' means a subsection (d) 
hospital (as defined in section 1886(d)(1)(B)) that is located in a 
rural area (as defined in section 1886(d)(2)(D)) and that has 50 or 
fewer beds.''.
    (b) Floor on Wage Index Applied Under Inpatient Hospital 
Prospective Payment System.--Section 1886(d)(3)(E) of the Social 
Security Act (42 U.S.C. 1395ww(d)(3)(E)) is amended by adding at the 
end the following: ``In no case shall the wage index factor for an 
essential rural hospital (as defined in section 1861(uu)) be less than 
1.0.''.
    (c) Treating as Allowable Costs 100 Percent of Bad Debts 
Attributable to Medicare Copayments and Deductions.--Section 
1861(v)(1)(T) of such Act (42 U.S.C. 1395x(v)(1)(T)) is amended by 
inserting ``(other than essential rural hospitals, as defined in 
subsection (uu))'' after ``In determining such reasonable costs for 
hospitals''.
    (d) Exemption From Hospital Outpatient Prospective Payment 
System.--Section 1833(t)(13) of such Act (42 U.S.C. 1395l(t)(13)) is 
amended by adding at the end the following new subparagraph:
                    ``(B) Exemption of essential rural hospitals.--The 
                system under this subsection shall not apply to covered 
                OPD services furnished in an essential rural hospital 
                (as defined in section 1861(uu)).''.
    (e) DSH Payments.--Section 1886(d)(5)(F) of such Act (42 U.S.C. 
1395ww(d)(5)(F)) is amended--
            (1) in clause (i)--
                    (A) by striking ``or'' at the end of subclause (I);
                    (B) by striking the period at the end of subclause 
                (II); and
                    (C) by adding at the end the following new 
                subclause:
            ``(III) is an essential rural hospital (as defined in 
        section 1861(uu)).'';
            (2) in clause (ii), by striking ``clause (ix)'' and 
        inserting ``clauses (ix) and (x)''; and
            (3) by adding at the end the following new clause:
    ``(x) In no case shall the disproportionate share adjustment 
percentage under this subparagraph for a hospital described in clause 
(i)(III) be less than 20 percent.''.
    (f) Effective Dates.--The amendments made by--
            (1) subsections (b) and (e) apply to discharges occurring 
        on or after October 1, 2000;
            (2) subsection (c) applies to cost reporting periods 
        beginning on or after October 1, 2000; and
            (3) subsection (d) applies to covered OPD services 
        furnished on or after October 1, 2000.
                                 <all>