[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1218 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1218

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


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 9, 2009

Mr. Menendez (for himself and Mr. Lautenberg) 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 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 2009''.

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, 2009, 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, 2009, 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);
                            ``(III) that is not a physician-owned 
                        hospital, as defined in section 489.3 of title 
                        42, Code of Federal Regulations (as in effect 
                        as of the date of the enactment of this 
                        subparagraph); and
                            ``(IV) 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.''.
    (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 (M)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(M) For cost reporting periods occurring on or 
                after October 1, 2009, 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 or 2006 
                        (whichever results in a higher target amount), 
                        increased by the applicable percentage increase 
                        under subparagraph (B)(iv) for each of fiscal 
                        years 2003 through 2009 or 2007 through 2009, 
                        respectively; 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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