[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2284 Introduced in Senate (IS)]







108th CONGRESS
  2d Session
                                S. 2284

 To expand the medicare rural community hospital demonstration program 
                    to include outpatient services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 6, 2004

 Mr. Nelson of Nebraska (for himself and Mr. Brownback) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
 To expand the medicare rural community hospital demonstration program 
                    to include outpatient 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 ``Medicare Rural Community Hospital 
Demonstration Project Expansion Act of 2004''.

SEC. 2. EXPANSION OF THE MEDICARE COMMUNITY HOSPITAL DEMONSTRATION 
              PROGRAM.

    (a) Expansion.--
            (1) In general.--Section 410A(a)(1) of the Medicare 
        Prescription Drug, Improvement, and Modernization Act of 2003 
        (Public Law 108-173) is amended by inserting ``covered 
        outpatient hospital services (as defined in subsection 
        (f)(3))'' after ``subsection (f)(2))''.
            (2) Payment.--Section 410A(b) of the Medicare Prescription 
        Drug, Improvement, and Modernization Act of 2003 (Public Law 
        108-173) is amended--
                    (A) in paragraph (1), in the heading, by striking 
                ``In general'' and inserting ``Covered inpatient 
                hospital services''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(3) Covered outpatient hospital services.--The amount of 
        payment under the demonstration program for covered outpatient 
        hospital services furnished in a rural community hospital is, 
        at the election of the hospital in the application referred to 
        in subsection (a)(3)--
                    ``(A) the reasonable costs of providing such 
                services, without regard to the amount of the customary 
                or other charge and any limitation under section 
                1861(v)(1)(U) of the Social Security Act (42 U.S.C. 
                1395x(v)(1)(U)); or
                    ``(B) the amount of payment that would otherwise be 
                provided for such services under the prospective 
                payment system for hospital outpatient department 
                services under section 1833(t) of such Act (42 U.S.C. 
                1395l(t)).
            ``(4) Beneficiary cost-sharing for covered outpatient 
        hospital services.--The amount of beneficiary cost-sharing for 
        covered outpatient hospital services furnished in a rural 
        community hospital under the demonstration program shall be the 
        amount determined under section 1833(t) of the Social Security 
        Act (42 U.S.C. 1395l(t)), without regard to any payment under 
        paragraph (3)(A) of this subsection.''.
            (3) Funding.--Section 410A(c)(1) of the Medicare 
        Prescription Drug, Improvement, and Modernization Act of 2003 
        (Public Law 108-173) is amended by inserting ``and the Federal 
        Supplementary Insurance Trust Fund established under section 
        1841 of such Act (42 U.S.C. 1395t), in such proportion as the 
        Secretary determines to be appropriate,'' after ``(42 U.S.C. 
        1395i)''.
            (4) Definition.--Section 410A(f) of the Medicare 
        Prescription Drug, Improvement, and Modernization Act of 2003 
        (Public Law 108-173) is amended by adding at the end the 
        following new paragraph:
            ``(3) Covered outpatient hospital services.--The term 
        ``covered outpatient hospital services'' has the meaning given 
        the term ``covered OPD services'' in section 1833(t)(1)(B) of 
        the Social Security Act (42 U.S.C. 1395l(t)(1)(B)).''.
    (b) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of section 410A of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (Public 
Law 108-173).
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