[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4428 Introduced in House (IH)]

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114th CONGRESS
  2d Session
                                H. R. 4428

 To amend title XVIII of the Social Security Act to ensure fairness in 
 Medicare hospital payments by establishing a floor for the area wage 
            index applied with respect to certain hospitals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 2, 2016

 Mrs. Black (for herself, Ms. Sewell of Alabama, Mr. Roe of Tennessee, 
 Mr. Duncan of Tennessee, Mr. Fleischmann, Mr. DesJarlais, Mr. Cooper, 
   Mrs. Blackburn, Mr. Fincher, Mr. Cohen, Mr. Byrne, Mrs. Roby, Mr. 
Rogers of Alabama, Mr. Aderholt, Mr. Brooks of Alabama, Mr. David Scott 
 of Georgia, Mr. Griffith, Mr. Westerman, Mr. Crawford, Mr. Hill, Mr. 
Womack, Mr. Bishop of Georgia, Mr. Palmer, Mr. Vela, Mr. Whitfield, Mr. 
Harper, Mr. Boustany, Mr. Richmond, Mr. Allen, Mr. Guthrie, Mr. Carter 
of Georgia, and Mr. Hinojosa) introduced the following bill; which was 
  referred to the Committee on Ways and Means, and in addition to the 
   Committee on Energy and Commerce, 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 ensure fairness in 
 Medicare hospital payments by establishing a floor for the area wage 
            index applied with respect to certain 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 ``The Fair Medicare Hospital Payments 
Act of 2016''.

SEC. 2. ENSURING FAIRNESS IN MEDICARE HOSPITAL PAYMENTS.

    (a) Hospital Inpatient Services.--Section 1886(d)(3)(E) of the 
Social Security Act (42 U.S.C. 1395www(d)(3)(E)) is amended--
            (1) in clause (i), by striking ``clause (ii) or (iii)'' and 
        inserting ``clause (ii), (iii), or (iv)''; and
            (2) by adding at the end the following new clause:
                            ``(iv) Area wage index floor.--
                                    ``(I) In general.--Subject to 
                                subclause (II), for discharges 
                                occurring on or after October 1, 2016, 
                                the area wage index applicable under 
                                this subparagraph to any hospital which 
                                is not located in a frontier State (as 
                                defined in clause (iii)(II)) may not be 
                                less than 0.874.
                                    ``(II) Ensuring budget 
                                neutrality.--In order to ensure that 
                                the aggregate payments made under this 
                                subsection for a fiscal year (beginning 
                                with fiscal year 2017) are not greater 
                                than the aggregate payments that would 
                                have been made under this subsection 
                                for such fiscal year without the 
                                application of subclause (I), the 
                                Secretary shall establish pursuant to 
                                rulemaking a maximum area wage index to 
                                apply under this subparagraph to any 
                                hospital which is not located in a 
                                frontier State (as defined in clause 
                                (iii)(II)).''.
    (b) Hospital Outpatient Department Services.--Section 1833(t) of 
the Social Security Act (42 U.S.C. 1395l(t)), is amended--
            (1) in paragraph (2)(D), by striking ``paragraph (19), the 
        Secretary'' and inserting ``paragraphs (19) and (22), the 
        Secretary''; and
            (2) by adding at the end the following new paragraph:
            ``(22) Floor on area wage adjustment factor for hospital 
        outpatient department services.--
                    ``(A) In general.--Subject to subparagraph (B), 
                with respect to covered OPD services furnished on or 
                after January 1, 2017, the area wage adjustment factor 
                applicable under the payment system established under 
                this subsection to any hospital outpatient department 
                which is not located in a frontier State (as defined in 
                section 1886(d)(3)(E)(iii)(II)) may not be less than 
                0.874.
                    ``(B) Ensuring budget neutrality.--In order to 
                ensure that the aggregate payments made under this 
                subsection for a year (beginning with 2017) are not 
                greater than the aggregate payments that would have 
                been made under this subsection for such year without 
                the application of subparagraph (A), the Secretary 
                shall establish pursuant to rulemaking a maximum area 
                wage adjustment factor to apply under the payment 
                system established under this subsection to any 
                hospital outpatient department which is not located in 
                a frontier State (as defined in clause (iii)(II)).''.
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