II 110th CONGRESS 1st Session S. 2381 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.

1.

Short title

This Act may be cited as the Medicare Sole Community Hospital Preservation Act of 2007.

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.