I 111th CONGRESS 1st Session H. R. 1051 IN THE HOUSE OF REPRESENTATIVES February 12, 2009 Mr. Tanner introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 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 Sole Community Hospital Preservation Act of 2009.

2.

Extension of the medicare hold harmless provision under the prospective payment system for hospital outpatient department services for sole community hospitals

Section 1833(t)(7)(D)(i) of the Social Security Act (42 U.S.C. 1395l(t)(7)(D)(i)) is amended by adding at the end the following new subclause: (IV)In the case of a sole community hospital (as defined in section 1886(d)(5)(D)(iii)), for covered OPD services furnished on or after January 1, 2010, 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. .

3.

Adjustment under the prospective payment system for hospital outpatient department services for sole community hospitals

Section 1833(t)(13) of the Social Security Act (42 U.S.C. 1395l(t)(13)) is amended— (1)in the heading, by striking Authorization of adjustment and inserting Adjustment; and (2)by adding at the end the following new subparagraph: (C)

Adjustment for sole community hospitals

(i)

Adjustment

(I)

In general

Subject to clause (ii), in the case of covered OPD services furnished on or after January 1, 2010, by a sole community hospital (as defined in section 1886(d)(5)(D)(iii)), the amount of payment that would otherwise be made for such services under this subsection (before the application of outliers and coinsurance) shall be increased by an amount equal to 7.1 percent of such amount. (II)

Revision with notice and comment

In the case of covered OPD services furnished on or after January 1, 2012, the Secretary may revise the percent described in subclause (I) based on a study described in subparagraph (A) comparing the costs incurred by sole community hospitals to costs incurred by hospitals located in urban areas. Such a revised adjustment shall not be effective earlier than 1 year after the date of promulgation of a regulation providing for such revised adjustment. (ii)

Not applicable to pass-through devices, drugs, and biologicals

The increase under clause (i) shall not apply to the payment for a device, drug, or biological described in clause (i), (ii), (iii), or (iv) of paragraph (6)(A). (iii)

Exemption from budget neutrality

The provisions of this subparagraph shall not be effected in a manner that results in or requires a reduction or other adjustment in other payment amounts under this subsection. .