I 112th CONGRESS 2d Session H. R. 5943 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.

1.

Short title

This Act may be cited as the Rural Hospital Access Act of 2012.

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.

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.

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.