II 111th CONGRESS 1st Session S. 1279 IN THE SENATE OF THE UNITED STATES June 17, 2009 Mr. Nelson of Nebraska (for himself, Mr. Hatch, Mr. Begich, Mr. Thune, Mr. Tester, Mr. Johanns, Mr. Dorgan, and Ms. Murkowski) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program.

1.

Short title

This Act may be cited as the Rural Community Hospital Demonstration Extension Act of 2009.

2.

Extension of rural community hospital demonstration program

(a)

5-year extension

Section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2272) is amended by adding at the end the following new subsection: (g)

5-Year Extension of Demonstration Program

(1)

In general

Subject to the succeeding provisions of this subsection, the Secretary shall conduct the demonstration program under this section for an additional 5-year period (in this section referred to as the 5-year extension period) that begins on the date immediately following the last day of the initial 5-year period under subsection (a)(5). (2)

Expansion of demonstration states

Notwithstanding subsection (a)(2), during the 5-year extension period, the program shall be conducted in rural areas in any State. (3)

Increase in maximum number of hospitals participating in the demonstration program

Notwithstanding subsection (a)(4), during the 5-year extension period, not more than 30 rural community hospitals may participate in the demonstration program under this section. (4)

Hospitals in demonstration program on date of enactment

In the case of a rural community hospital that is participating in the demonstration program under this section as of the last day of the initial 5-year period, the Secretary— (A)shall provide for the continued participation of such rural community hospital in the demonstration program during the 5-year extension period unless the rural community hospital makes an election, in such form and manner as the Secretary may specify, to discontinue such participation; and (B)in calculating the amount of payment under subsection (b) to the rural community hospital for covered inpatient hospital services furnished by the hospital during such 5-year extension period, shall substitute, under paragraph (1)(A) of such subsection— (i)the reasonable costs of providing such services for discharges occurring in the first cost reporting period beginning on or after the first day of the 5-year extension period, for (ii)the reasonable costs of providing such services for discharges occurring in the first cost reporting period beginning on or after the implementation of the demonstration program. . (b)

Conforming amendments

(1)

Duration

Subsection (a)(5) of section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2272) is amended by inserting (in this section referred to as the initial 5-year period) and, as provided in subsection (g), for the 5-year extension period after 5-year period. (2)

Additional Report

Subsection (e) of section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2272) is amended to read as follows: (e)

Reports

(1)

Report on initial 5-year period

Not later than 6 months after the last day of the initial 5-year period, the Secretary shall submit to Congress a report on the conduct of the demonstration program under this section during such period, together with recommendations for such legislation and administrative action as the Secretary determines to be appropriate. (2)

Final report

Not later than 6 months after the last day of the 5-year extension period, the Secretary shall submit to Congress a report on the demonstration program under this section, together with recommendations for such legislation and administrative action as the Secretary determines to be appropriate. . (c)

Technical amendments

(1)Subsection (b) of section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2272) is amended— (A)in paragraph (1)(B)(ii), by striking 2) and inserting 2)); and (B)in paragraph (2), by inserting cost before reporting period the first place such term appears in each of subparagraphs (A) and (B). (2)Subsection (f)(1) of section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2272) is amended— (A)in subparagraph (A)(ii), by striking paragraph (2) and inserting subparagraph (B); and (B)in subparagraph (B), by striking paragraph (1)(B) and inserting subparagraph (A)(ii).