[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7105 Introduced in House (IH)]







110th CONGRESS
  2d Session
                                H. R. 7105

 To amend title XVIII of the Social Security Act to preserve access to 
                  urban Medicare-dependent hospitals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 25, 2008

  Mr. Saxton (for himself and Mr. Smith of New Jersey) 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 preserve access to 
                  urban Medicare-dependent hospitals.

    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 ``Urban Medicare-Dependent Hospitals 
Preservation Act of 2008''.

SEC. 2. CRITERIA AND PAYMENT FOR CERTAIN URBAN MEDICARE-DEPENDENT 
              HOSPITALS.

    (a) In General.--Section 1886(d)(5) of the Social Security Act (42 
U.S.C. 1395ww(d)(5)) is amended by adding at the end the following new 
subparagraph:
    ``(M)(i) For cost reporting periods beginning on or after October 
1, 2008, in the case of a subsection (d) hospital which is an urban 
Medicare-dependent hospital, payment under paragraph (1)(A) shall be 
equal to the sum of the amount determined under clause (ii) and the 
amount determined under paragraph (1)(A)(iii).
    ``(ii) The amount determined under this clause is, for discharges 
occurring during the cost reporting period that begins on or after 
October 1, 2008, and any subsequent cost reporting period, 75 percent 
of the amount by which the hospital's target amount for the cost 
reporting period (as defined in subsection (b)(3)(L)) exceeds the 
amount determined under paragraph (1)(A)(iii).
    ``(iii) The term `urban Medicare-dependent hospital' means, with 
respect to any cost reporting period to which clause (i) applies, any 
hospital--
            ``(I) located in an urban area;
            ``(II) that does not receive payment--
                    ``(aa) under subparagraph (C) as a rural referral 
                center;
                    ``(bb) under subparagraph (D) as a sole community 
                hospital;
                    ``(cc) under subparagraph (B) or under subsection 
                (h); or
                    ``(dd) under subparagraph (F); and
            ``(III) for which not less than 60 percent of its inpatient 
        days or discharges during the cost reporting period beginning 
        in fiscal year 2006, or two of the three most recently audited 
        cost reporting periods for which the Secretary has a settled 
        cost report, were attributable to inpatients entitled to 
        benefits under part A.
    ``(iv) The Secretary shall for each fiscal year make an appropriate 
adjustment in the national standardized amount under paragraph (3) to 
ensure that any payments made under this subparagraph are made in a 
manner that assures that the aggregate payments under this subsection 
are not greater or less than those that would have been made without 
such additional payments.''.
    (b) Target Payment Amount.--Section 1886(b)(3) of such Act (42 
U.S.C. 1395ww(b)(3)) is amended--
            (1) in subparagraph (B)(iv), by striking ``and (D)'' and 
        inserting ``, (D), and (L)''; and
            (2) by adding at the end the following new subparagraph:
    ``(L) For cost reporting periods occurring on or after October 1, 
2008, in the case of a hospital that is an urban Medicare-dependent 
hospital (as defined in subsection (d)(5)(M)), the term `target amount' 
means--
            ``(i) with respect to the first 12-month cost reporting 
        period in which this subparagraph is applied to the hospital, 
        the allowable operating costs of inpatient hospital services 
        (as defined in subsection (a)(4)) recognized under this title 
        for the hospital for the 12-month cost reporting period 
        beginning during fiscal year 2002, increased by the applicable 
        percentage increase under subparagraph (B)(iv) for each of 
        fiscal years 2003 through 2008; and
            ``(ii) with respect to discharges occurring after the first 
        12-month cost reporting period in which this subparagraph is 
        applied to the hospital, the target amount for the preceding 
        year increased by the applicable percentage increase under 
        subparagraph (B)(iv).''.
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