[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 3187 Introduced in Senate (IS)]







106th CONGRESS
  2d Session
                                S. 3187

    To require the Secretary of Health and Human Services to apply 
aggregate upper payment limits to non-State publicly owned or operated 
                 facilities under the medicaid program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

            October 11 (legislative day, September 22), 2000

 Mr. Roth introduced the following bill; which was read the first time

_______________________________________________________________________

                                 A BILL


 
    To require the Secretary of Health and Human Services to apply 
aggregate upper payment limits to non-State publicly owned or operated 
                 facilities under the medicaid 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 ``Medicaid Protection Act''.

SEC. 2. APPLICATION OF AGGREGATE UPPER PAYMENT LIMITS TO NON-STATE 
              PUBLICLY OWNED OR OPERATED FACILITIES.

    (a) Issuance of Final Regulation.--Not later than 30 days after the 
date of enactment of this Act, the Secretary of Health and Human 
Services (in this section referred to as the ``Secretary''), 
notwithstanding any requirement of the Administrative Procedures Act 
under chapter 5 of title 5, United States Code, or any other provision 
of law, shall issue a final regulation that provides as follows (in 
addition to any other limitations established under part 447 of title 
42, Code of Federal Regulations):
            (1) Application of upper payment limits.--Except as 
        provided in paragraph (3), aggregate payments to each group of 
        non-State publicly owned or operated facilities described in 
        paragraph (2) under the medicaid program under title XIX of the 
        Social Security Act (42 U.S.C. 1396 et seq.) (in this section 
        referred to as the ``medicaid program'') may not exceed the 
        amount that can reasonably be estimated would have been paid 
        under medicare reasonable cost payment principles under title 
        XVIII of such Act (42 U.S.C. 1395 et seq.).
            (2) Groups described.--For purposes of this subsection, 
        each of the following is a group of facilities:
                    (A) Hospitals with respect to their provision of 
                inpatient hospital services (as such terms are used for 
                purposes of the medicaid program).
                    (B) Hospitals with respect to their provision of 
                outpatient hospital services (as so used).
                    (C) Nursing facilities (as so used).
                    (D) Intermediate care facilities for the mentally 
                retarded (as so used).
            (3) Disproportionate share.--The upper payment limitation 
        established under paragraph (1) does not apply to payment 
        adjustments made under a State plan to hospitals found to serve 
        a disproportionate number of low-income patients with special 
        needs as provided in section 1923 of the Social Security Act 
        (42 U.S.C.1396r-4).
            (4) Immediate application.--Except as provided in paragraph 
        (5), the regulation is effective upon publication, applies to 
        services furnished on or after that date, and requires States 
        to immediately apply payment rates under the medicaid program 
        to each group of non-State publicly owned or operated 
        facilities described in paragraph (2) in compliance with the 
        regulation.
            (5) Transition period for prior approved amendments.--In 
        the case of any State plan amendment under the medicaid program 
        that, as of the date of enactment of this section, has been 
        approved on a basis other than a deemed approval basis as a 
        result of an expired deadline for approval by the Secretary, 
        and that provides for payments that are in excess of the 
        payment limitation established under the regulation, the 
        regulation provides that a State shall be considered to be in 
        compliance with the regulation so long as the State makes 
        specific payment reductions on a timeline specified in the 
        regulation so that, for any period (or portion of a period) 
        that occurs on or after October 1, 2002, payments made by the 
        State under the medicaid program comply with the regulation.
    (b) Disapproval of Plan Amendments.--Upon the publication of the 
final regulation under subsection (a), the Secretary shall disapprove 
any pending proposed State plan amendment under the medicaid program 
insofar as such amendment would permit payments under the medicaid 
program in excess of payments permitted under the final regulation 
required under subsection (a).
                                 <all>