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<bill bill-stage="Introduced-in-House" bill-type="olc" dms-id="H134D274BF37B4038BF03B37CA5FC727" public-private="public">
<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>110 HR 7105 IH: Urban Medicare-Dependent Hospitals
</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2008-09-25</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>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.</dc:rights>
</dublinCore>
</metadata>
	<form>
		<distribution-code display="yes">I</distribution-code>
		<congress>110th CONGRESS</congress>
		<session>2d Session</session>
		<legis-num>H. R. 7105</legis-num>
		<current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber>
		<action>
			<action-date date="20080925">September 25, 2008</action-date>
			<action-desc><sponsor name-id="S000097">Mr. Saxton</sponsor> (for
			 himself and <cosponsor name-id="S000522">Mr. Smith of New Jersey</cosponsor>)
			 introduced the following bill; which was referred to the
			 <committee-name committee-id="HWM00">Committee on Ways and
			 Means</committee-name></action-desc>
		</action>
		<legis-type>A BILL</legis-type>
		<official-title>To amend title XVIII of the Social Security Act to
		  preserve access to urban Medicare-dependent hospitals.</official-title>
	</form>
	<legis-body id="H59A40AFB52A447CFAD796D26FBE75BB7" style="OLC">
		<section id="H60FBFD21321E41B6ABED521E1D1E6B08" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the
			 <quote><short-title>Urban Medicare-Dependent Hospitals
			 Preservation Act of 2008</short-title></quote>.</text>
		</section><section id="H5CE7B2472D4647AD9D34BF00D7E00045"><enum>2.</enum><header>Criteria and
			 payment for certain urban Medicare-dependent hospitals</header>
			<subsection id="H0A0A10DD9F8A41ED8963EAF6E72B7827"><enum>(a)</enum><header>In
			 general</header><text>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:</text>
				<quoted-block id="H9271EAF27BB84DF79E2D7D8E67400569" style="OLC">
					<subparagraph id="HE1E5717681534D32A64800066C43F9A8" indent="up2"><enum>(M)</enum><clause commented="no" display-inline="yes-display-inline" id="H284F8692F11348CCB9FCB73E96F71370"><enum>(i)</enum><text>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).</text>
						</clause><clause id="H15AF78A7E22B4CB8BA32929B495CF2CF" indent="up1"><enum>(ii)</enum><text>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).</text>
						</clause><clause id="HEF267099D34640109FE4634C376FAE6C" indent="up1"><enum>(iii)</enum><text>The term <term>urban
				Medicare-dependent hospital</term> means, with respect to any cost reporting
				period to which clause (i) applies, any hospital—</text>
							<subclause id="HA1A6EAA04236472FAB933768D58FDC7"><enum>(I)</enum><text>located in an urban area;</text>
							</subclause><subclause id="HB3B316F181EF42AD93DB7038BF002B29"><enum>(II)</enum><text>that does not receive payment—</text>
								<item commented="no" id="H6C04050264E1429788FC3E774253D31"><enum>(aa)</enum><text>under subparagraph (C) as a rural
				referral center;</text>
								</item><item id="H738F98A2FFD8462E9BDCE586E3EE4F"><enum>(bb)</enum><text>under subparagraph (D) as a sole
				community hospital;</text>
								</item><item id="HC32C68173DA846CEB7F845B8EC461860"><enum>(cc)</enum><text>under subparagraph (B) or under
				subsection (h); or</text>
								</item><item id="H8102CCF3EBD8423190BE281123C9CEAD"><enum>(dd)</enum><text display-inline="yes-display-inline">under subparagraph (F); and</text>
								</item></subclause><subclause id="H58BAB2888D7342FF9E9647D99928C859"><enum>(III)</enum><text>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.</text>
							</subclause></clause><clause commented="no" id="H20C59D52CFE34539B149FD0324B099BA" indent="up1"><enum>(iv)</enum><text display-inline="yes-display-inline">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.</text>
						</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
			</subsection><subsection id="H7ABFFDE3A60C4EDB9EE00C4F3B57B4E"><enum>(b)</enum><header>Target payment
			 amount</header><text>Section 1886(b)(3) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(b)(3)</external-xref>) is
			 amended—</text>
				<paragraph id="H9474514F02EF4193B4307000ACD8E2E7"><enum>(1)</enum><text>in subparagraph
			 (B)(iv), by striking <quote>and (D)</quote> and inserting <quote>, (D), and
			 (L)</quote>; and</text>
				</paragraph><paragraph id="H99F6D0B4004F4E59ACDDFAC60800F4D8"><enum>(2)</enum><text>by adding at the
			 end the following new subparagraph:</text>
					<quoted-block id="H88A0D3DB307449D191971BC1942EA8D9" style="OLC">
						<subparagraph id="H044CFFFC696B466BB028BDBF7C94B000" indent="up2"><enum>(L)</enum><text>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
				<term>target amount</term> means—</text>
							<clause id="HEAC22C4CD38E4D3486F1FB40D69408B5"><enum>(i)</enum><text>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</text>
							</clause><clause id="HDDDB70A24D894A7ABD005827027BA1CD"><enum>(ii)</enum><text>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).</text>
							</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
				</paragraph></subsection></section></legis-body>
</bill>


