[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2381 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                S. 2381

 To amend title XVIII of the Social Security Act to extend and improve 
  protections for sole community hospitals under the Medicare program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           November 16, 2007

  Mr. Salazar (for himself and Mr. Bingaman) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to extend and improve 
  protections for sole community hospitals under the Medicare program.

    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 Sole Community Hospital 
Preservation Act of 2007''.

SEC. 2. MEDICARE SOLE COMMUNITY HOSPITAL IMPROVEMENTS.

    (a) Permanent Hold Harmless for Sole Community Hospitals Under the 
Prospective Payment System for Hospital Outpatient Department Services 
Under the Medicare Program.--Section 1833(t)(7)(D) of the Social 
Security Act (42 U.S.C. 1395l(t)(7)(D)) is amended by adding at the end 
the following new clause:
                            ``(iii) Permanent hold harmless for sole 
                        community hospitals.--In the case of a sole 
                        community hospital (as defined in section 
                        1886(d)(5)(D)(iii)), for covered OPD services 
                        furnished after December 31, 2007, for which 
                        the PPS amount is less than the pre-BBA amount, 
                        the amount of payment under this subsection 
                        shall be increased by the amount of such 
                        difference.''.
    (b) Rebasing for Sole Community Hospitals.--
            (1) Rebasing permitted.--Section 1886(b)(3) of the Social 
        Security Act (42 U.S.C. 1395ww(b)(3)) is amended by adding at 
        the end the following new subparagraph:
    ``(L)(i) For cost reporting periods beginning on or after October 
1, 2007, in the case of a sole community hospital there shall be 
substituted for the amount otherwise determined under subsection 
(d)(5)(D)(i) of this section, if such substitution results in a greater 
amount of payment under this section for the hospital--
            ``(I) with respect to discharges occurring in fiscal year 
        2008, 75 percent of the subsection (d)(5)(D)(i) amount (as 
        described in subparagraph (I)(i)(I)) and 25 percent of the 
        subparagraph (L) rebased target amount (as defined in clause 
        (ii));
            ``(II) with respect to discharges occurring in fiscal year 
        2009, 50 percent of the subsection (d)(5)(D)(i) amount and 50 
        percent of the subparagraph (L) rebased target amount;
            ``(III) with respect to discharges occurring in fiscal year 
        2010, 25 percent of the subsection (d)(5)(D)(i) amount and 75 
        percent of the subparagraph (L) rebased target amount; and
            ``(IV) with respect to discharges occurring after fiscal 
        year 2010, 100 percent of the subparagraph (L) rebased target 
        amount.
    ``(ii) For purposes of this subparagraph, the `subparagraph (L) 
rebased target amount' has the meaning given the term `target amount' 
in subparagraph (C), except that--
            ``(I) there shall be substituted for the base cost 
        reporting period the 12-month cost reporting period beginning 
        during fiscal year 2002;
            ``(II) any reference in subparagraph (C)(i) to the `first 
        cost reporting period' described in such subparagraph is deemed 
        a reference to the first cost reporting period beginning on or 
        after October 1, 2007; and
            ``(III) the applicable percentage increase shall only be 
        applied under subparagraph (C)(iv) for discharges occurring in 
        fiscal years beginning with fiscal year 2008.''.
            (2) Conforming amendments.--Section 1886(b)(3) of the 
        Social Security Act (42 U.S.C. 1395ww(b)(3)) is amended--
                    (A) in subparagraph (C), in the matter preceding 
                clause (i), by striking ``subparagraph (I)'' and 
                inserting ``subparagraphs (I) and (L)''; and
                    (B) in subparagraph (I)(i)--
                            (i) in the matter preceding subclause (I), 
                        by striking ``For'' and inserting ``Subject to 
                        subparagraph (L), for''; and
                            (ii) in subclause (I), by inserting ``and 
                        subparagraph (L)'' after ``referred to in this 
                        clause''.
                                 <all>