[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1580 Introduced in House (IH)]







108th CONGRESS
  1st Session
                                H. R. 1580

To amend title XVIII of the Social Security Act to provide for national 
standardized payment amounts for inpatient hospital services furnished 
          under the Medicare Program, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 3, 2003

 Mr. English (for himself, Mr. Tanner, Mr. Sherwood, Mr. McNulty, Mr. 
 Berry, Mr. Murtha, Mr. McHugh, Mr. Farr, Mr. Udall of Colorado, Mrs. 
  Emerson, Mr. Allen, Mr. Reynolds, Mr. Peterson of Pennsylvania, Mr. 
  Kanjorski, Mr. Holden, Mr. Ortiz, Mr. Turner of Texas, Mr. Davis of 
Tennessee, Mr. Platts, Mr. Doyle, Mr. Latham, Mr. Pomeroy, Mr. Boswell, 
 Mr. Cooper, and Mr. Rogers of Alabama) introduced the following bill; 
         which was referred to the Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to provide for national 
standardized payment amounts for inpatient hospital services furnished 
          under the Medicare Program, and for other purposes.

    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 Area Wage Index and 
Standardized Rate Act of 2003''.

SEC. 2. ESTABLISHING A SINGLE STANDARDIZED AMOUNT UNDER MEDICARE 
              INPATIENT HOSPITAL PPS.

    (a) In General.--Section 1886(d)(3)(A) of the Social Security Act 
(42 U.S.C. 1395ww(d)(3)(A)) is amended--
            (1) in clause (iv), by inserting ``and ending on or before 
        September 30, 2003,'' after ``October 1, 1995,''; and
            (2) by redesignating clauses (v) and (vi) as clauses (vii) 
        and (viii), respectively, and inserting after clause (iv) the 
        following new clauses:
            ``(v) For discharges occurring in the fiscal year beginning 
        on October 1, 2003, the average standardized amount for 
        hospitals located in areas other than a large urban area shall 
        be equal to the average standardized amount for hospitals 
        located in a large urban area.
            ``(vi) For discharges occurring in a fiscal year beginning 
        on or after October 1, 2004, the Secretary shall compute an 
        average standardized amount for hospitals located in all areas 
        within the United States equal to the average standardized 
        amount computed under clause (v) or this clause for the 
        previous fiscal year increased by the applicable percentage 
        increase under subsection (b)(3)(B)(i) for the fiscal year 
        involved.''.
    (b) Computing DRG-specific Rates.--
            (1) In general.--Section 1886(d)(3)(D) of such Act (42 
        U.S.C. 1395ww(d)(3)(D)) is amended--
                    (A) in the heading by striking ``in different 
                areas'';
                    (B) in the matter preceding clause (i)--
                            (i) by inserting ``for fiscal years before 
                        fiscal year 1997'' before ``a regional DRG 
                        prospective payment rate for each region,''; 
                        and
                            (ii) by striking ``each of which is'';
                    (C) in clause (i)--
                            (i) by inserting ``for fiscal years before 
                        fiscal year 2004,'' after ``(i)''; and
                            (ii) by striking ``and'' at the end;
                    (D) in clause (ii)--
                            (i) by inserting ``for fiscal years before 
                        fiscal year 2004,'' after ``(ii)''; and
                            (ii) by striking the period at the end and 
                        inserting ``; and''; and
                    (E) by adding at the end the following new clause:
                    ``(iii) for a fiscal year beginning after fiscal 
                year 2003, for hospitals located in all areas, to the 
                product of--
                            ``(I) the applicable average standardized 
                        amount (computed under subparagraph (A)), 
                        reduced under subparagraph (B), and adjusted or 
                        reduced under subparagraph (C) for the fiscal 
                        year; and
                            ``(II) the weighting factor (determined 
                        under paragraph (4)(B)) for that diagnosis-
                        related group.''.
            (2) Technical conforming sunset.--Section 1886(d)(3) of 
        such Act (42 U.S.C. 1395ww(d)(3)) is amended in the matter 
        preceding subparagraph (A) by inserting ``for fiscal years 
        before fiscal year 1997'' before ``a regional DRG prospective 
        payment rate''.

SEC. 3. ADJUSTMENT TO WAGE INDEX.

    Section 1886(d)(3)(E) of the Social Security Act (42 U.S.C. 
1395ww(d)(3)(E)) is amended--
            (1) in the fourth sentence, by inserting ``, except that 
        this sentence shall not apply to the substitution required by 
        the succeeding sentence''; and
            (2) by adding at the end the following: ``For discharges 
        occurring during fiscal years beginning on or after October 1, 
        2003, in the case of a subsection (d) hospital for which the 
        factor established by the Secretary under the first sentence 
        for the fiscal year is less than 1.0, the Secretary shall 
        substitute for the proportion otherwise estimated under such 
        sentence but for this sentence a proportion of 62 percent.''.
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