[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1263 Introduced in Senate (IS)]







106th CONGRESS
  1st Session
                                S. 1263

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


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 22, 1999

 Mr. Jeffords (for himself, Mr. Hatch, and Mr. Gorton) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
  To amend the Balanced Budget Act of 1997 to limit the reductions in 
  medicare payments under the 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 MEDICARE PAYMENTS UNDER PPS FOR HOSPITAL 
              OUTPATIENT DEPARTMENT SERVICES.

    (a) In General.--Section 4523 of the Balanced Budget Act of 1997 
(Public Law 105-33; 111 Stat. 445) 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 the Social Security 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 
                the Social Security Act.
            ``(3) Application to certain hospitals.--In the case of 
        hospitals described in section 1833(t)(8) of the Social 
        Security 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.
                                 <all>