[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5943 Introduced in House (IH)]

112th CONGRESS
  2d Session
                                H. R. 5943

   To amend title XVIII of the Social Security Act to provide for an 
  extension of the Medicare-dependent hospital (MDH) program and the 
increased payments under the Medicare low-volume hospital program, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 8, 2012

  Mr. Reed (for himself and Mr. Welch) introduced the following bill; 
         which was referred to the Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
   To amend title XVIII of the Social Security Act to provide for an 
  extension of the Medicare-dependent hospital (MDH) program and the 
increased payments under the Medicare low-volume hospital program, and 
                          for other purposes.

    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 ``Rural Hospital Access Act of 2012''.

SEC. 2. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL (MDH) PROGRAM.

    (a) Extension of Payment Methodology.--Section 1886(d)(5)(G) of the 
Social Security Act (42 U.S.C. 1395ww(d)(5)(G)) is amended--
            (1) in clause (i), by striking ``October 1, 2012'' and 
        inserting ``October 1, 2013''; and
            (2) in clause (ii)(II), by striking ``October 1, 2012'' and 
        inserting ``October 1, 2013''.
    (b) Conforming Amendments.--
            (1) Extension of target amount.--Section 1886(b)(3)(D) of 
        the Social Security Act (42 U.S.C. 1395ww(b)(3)(D)) is 
        amended--
                    (A) in the matter preceding clause (i), by striking 
                ``October 1, 2012'' and inserting ``October 1, 2013''; 
                and
                    (B) in clause (iv), by striking ``through fiscal 
                year 2012'' and inserting ``through fiscal year 2013''.
            (2) Permitting hospitals to decline reclassification.--
        Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 
        1993 (42 U.S.C. 1395ww note) is amended by striking ``through 
        fiscal year 2012'' and inserting ``through fiscal year 2013''.

SEC. 3. EXTENSION OF THE INCREASED PAYMENTS UNDER THE MEDICARE LOW-
              VOLUME HOSPITAL PROGRAM.

    Section 1886(d)(12) of the Social Security Act (42 U.S.C. 
1395ww(d)(12)) is amended--
            (1) in subparagraph (B), in the matter preceding clause 
        (i), by striking ``2013'' and inserting ``2014'';
            (2) in subparagraph (C)(i), by striking ``and 2012'' each 
        place it appears and inserting ``, 2012, and 2013''; and
            (3) in subparagraph (D), by striking ``and 2012'' and 
        inserting ``, 2012, and 2013''.

SEC. 4. GAO STUDY AND REPORT ON MEDICARE-DEPENDENT HOSPITAL AND LOW-
              VOLUME HOSPITAL PROGRAMS.

    (a) Study.--
            (1) In general.--The Comptroller General of the United 
        States shall conduct a study on the following programs under 
        title XVIII of the Social Security Act under which certain 
        small, rural hospitals or small hospitals receive add-on 
        payments for inpatient hospital services furnished to 
        individuals entitled to benefits under part A of title XVIII of 
        the Social Security Act or enrolled under part B of such title:
                    (A) MDH program.--The Medicare-dependent, small 
                rural hospital (MDH) program for a small, rural 
                hospital that meets the criteria of section 
                1886(d)(5)(G)(iv) of the Social Security Act (42 U.S.C. 
                1395ww(d)(5)(G)(iv)), hereinafter in this section 
                referred to as an ``MDH hospital''.
                    (B) Low-volume hospital program.--The low-volume 
                hospital program for a small hospital with fewer than 
                1,600 discharges annually that meets the criteria of 
                section 1886(d)(12)(C)(i) of such Act (42 U.S.C. 
                1395ww(d)(12)(C)(i)), hereinafter in this section 
                referred to as a ``low-volume hospital''.
            (2) Matters studied.--The study under paragraph (1) shall 
        include an examination and analysis of the following:
                    (A) Cost comparison among hospitals.--How operating 
                and capital costs of MDH hospitals and low-volume 
                hospitals, respectively, compare to such costs of other 
                subsection (d) hospitals (as defined in section 
                1886(d)(1)(B) of the Social Security Act (42 U.S.C. 
                1395ww(d)(1)(B))) that participate in the Medicare 
                program under title XVIII of such Act.
                    (B) Impact of add-on payments on hospitals 
                margins.--The impact of add-on payments under 
                paragraphs (5)(G) and (12)(A), respectively, of section 
                1886(d) of such Act (42 U.S.C. 1395ww(d)) on Medicare 
                payment margins, as defined by the Secretary of Health 
                and Human Services, of MDH hospitals and low-volume 
                hospitals, respectively, including whether the absence 
                of such add-on payments would likely result in negative 
                Medicare payment margins for such hospitals.
    (b) Report to Congress.--Not later than two years after the date of 
the enactment of this Act, the Comptroller General shall submit to 
Congress a report on the study conducted under subsection (a). The 
report shall include the study findings and such recommendations, with 
respect to the MDH program and the low-volume hospital program 
described in subsection (a)(1), as the Comptroller General determines 
to be appropriate.
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