109 HR 5496 IH: To amend title XVIII of the Social Security Act to U.S. House of Representatives 2006-05-25 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I 109th CONGRESS 2d Session H. R. 5496 IN THE HOUSE OF REPRESENTATIVES May 25, 2006 Mr. Ferguson 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 special treatment of certain cancer hospitals under the Medicare Program.

1.

Medicare treatment for certain cancer hospitals

(a)

In general

Section 1886(d)(1)(B) of the Social Security Act (42 U.S.C. 1395ww(d)(1)(B)) is amended— (1)by striking or at the end of clause (iv); (2)by striking the semicolon at the end of clause (v) and inserting , or; and (3)by inserting after clause (v) the following new clause: (vi)a hospital that— (I)is located in a State which ranks (according to the National Cancer Institute’s statistics published in May 2005 for 2001 and 2002) first among all States in the incidence of prostate cancer, third in the incidence rate for non-Hodgkins lymphoma, fourth in the incidence rates for thyroid cancer and ovarian cancer, and third in the highest death rates from uterine cancer and breast cancer; (II)is located in a State that, as of December 31, 2005, had only one center under section 414 of the Public Health Service Act that has been designated by the National Cancer Institute as a comprehensive center currently serving all 21 counties in the most densely populated State in the nation, serving more than 70,000 patient visits annually; (III)as of December 31, 2005, served as the teaching and clinical care, research and training hospital for the Center described in subclause (II), providing significant financial and operational support to such Center; (IV)as of December 31, 2005, served as a core and essential element in such Center which conducts more than 130 clinical trial activities, national cooperative group studies, investigator-initiated and peer review studies and received during 2003 at least $80,000,000 in research grant awards; (V)as of December 31, 2005, can demonstrate that it has been a unique and an integral component of such Center since such Center’s inception; (VI)as of December 31, 2005, includes dedicated patient care units organized primarily for the treatment of and research on cancer with approximately 125 beds, 75 percent of which are dedicated to cancer patients, and contains a radiation oncology department as well as specialized emergency services for oncology patients; (VII)as of December 31, 2003, is identified as the focus of the Center’s inpatient activities in the Center’s application as an NCI-designated comprehensive cancer center and shares the NCI comprehensive cancer designation with the Center; and (VIII)as of December 31, 2005, has been recognized with a certificate of approval by the American College of Surgeons Commission on Cancer; . (b)

Conforming amendment

Section 1886(d)(3)(E) of such Act (42 U.S.C. 1395ww(d)(3)(E)) is amended by striking clause (v) and inserting clauses (v) and (vi). (c)

Payment

(1)

Application to cost reporting periods

Any classification by reason of section 1886(d)(1)(B)(vi) of the Social Security Act (42 U.S.C. 1395ww(d)(1)(B)(vi)) (as added by subsection (a)) shall apply to all cost reporting periods beginning on or after January 1, 2005. (2)

Base target amount

Notwithstanding section 1886(b)(3)(E) of the Social Security Act (42 U.S.C. 1395ww(b)(3)(E), in the case of a hospital described in section 1886(d)(1)(B)(vi) of the Social Security Act, as added by subsection (a), such hospital shall be permitted to resubmit the 2005 Medicare 2552 cost report incorporating a cancer hospital sub-provider number, and apply the Medicare ratio-of-cost-to-charge settlement methodology for outpatient cancer services. In the case of such hospital the PPS cancer exemption under section 1886(b)(3)(E)(i) of such Act for the first cost reporting period beginning on or after January 1, 2005, shall be the allowable operating costs of inpatient hospital services (referred to in subclause (I) of such section) for such first cost reporting period. (3)

Deadline for payments

Any payments owed to a hospital as a result of this section for periods occurring before the date of the enactment of this Act shall be made expeditiously, but in no event later than 1 year after such date of enactment. (d)

Maintenance of exemption

Once admitted as a PPS cancer-exempt hospital, a hospital described in section 1886(d)(1)(B)(vi) of the Social Security Act shall retain that status as long as the Center referred to in such section remains a comprehensive cancer center.