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<dc:title>111 HR 4066 IH: Save Rural Hospitals Act of 2021</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2021-06-22</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">117th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 4066</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20210622">June 22, 2021</action-date><action-desc><sponsor name-id="S001185">Ms. Sewell</sponsor> (for herself and <cosponsor name-id="F000465">Mr. Ferguson</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HWM00">Committee on Ways and Means</committee-name>, and in addition to the Committee on <committee-name committee-id="HIF00">Energy and Commerce</committee-name>, 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</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.</official-title></form><legis-body id="H6798E93E3F27462A8913D0815970AD1C" style="OLC"><section section-type="section-one" id="H1C681A0047C642D689C07E3C1B14C7AB"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Save Rural Hospitals Act of 2021</short-title></quote>.</text></section><section id="H5B42C453B5A14B24B7DA017968D5C400"><enum>2.</enum><header>Ensuring fairness in medicare hospital payments</header><subsection id="H51FF00AD91444CFE8A7AAFB326A50237"><enum>(a)</enum><header>Hospital inpatient services</header><paragraph id="H44DB79381D304892A2DCB6CC52CE64CC"><enum>(1)</enum><header>In general</header><text>Section 1886(d)(3)(E) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395www">42 U.S.C. 1395www(d)(3)(E)</external-xref>) is amended— </text><subparagraph id="H6DA30499A6084CAE82A900A250BB7486"><enum>(A)</enum><text>in clause (i), in the first sentence, by striking <quote>or (iii)</quote> and inserting <quote>, (iii), or (iv)</quote>; and </text></subparagraph><subparagraph id="H54C8A70E86304E37BA986CA71EDA3858"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following new clause: </text><quoted-block style="OLC" display-inline="no-display-inline" id="HC786577DA7E04CC6B2E3C59FB58BEA58"><clause id="H95C80382740741DF9AE8D630C9C947E6"><enum>(iv)</enum><header>Area wage index floor</header><subclause id="HD58217F368514419808B834506CB4573"><enum>(I)</enum><header>In general</header><text>For discharges occurring on or after October 1, 2021, 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 0.85.</text></subclause><subclause id="HB4EF66DF46AC4AACA4E5E480CFDA6AD7"><enum>(II)</enum><header>Waiving budget neutrality</header><text>Pursuant to the fifth sentence of clause (i), this clause shall not be applied in a budget neutral manner.</text></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="H76EF1FB302944E1A926481CC6BBF40A6"><enum>(2)</enum><header>Waiving budget neutrality</header><subparagraph id="HF500F5AADEFC4D10AE9A001A947D5F33"><enum>(A)</enum><header>Technical amendatory correction</header><text>Section 10324(a)(2) of <external-xref legal-doc="public-law" parsable-cite="pl/111/148">Public Law 111–148</external-xref> is amended by striking <quote>third sentence</quote> and inserting <quote>fifth sentence</quote>.</text></subparagraph><subparagraph id="H288F1DA37BAE41C0B26D1DDE5AC8A707"><enum>(B)</enum><header>Waiver</header><text>Section 1886(d)(3)(E)(i) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(d)(3)(E)(i)</external-xref>) is amended, in the fifth sentence—</text><clause id="HD7A7F7FE0C4B440ABBD1984950080566"><enum>(i)</enum><text>by striking <quote>and the amendments</quote> and inserting <quote>, the amendments</quote>; and</text></clause><clause commented="no" display-inline="no-display-inline" id="H7C012F66B7E84F508000E0FC33D3548E"><enum>(ii)</enum><text>by inserting <quote>, and the amendments made by section 2(a)(1) of the <short-title>Save Rural Hospitals Act of 2021</short-title></quote> after <quote>Care Act</quote>.</text></clause></subparagraph></paragraph></subsection><subsection id="H5C459EB87DA149169C1A5C89C843B7D5"><enum>(b)</enum><header>Hospital outpatient department services</header><text>Section 1833(t) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(t)</external-xref>), is amended— </text><paragraph id="HC570B3B232454097903C89D153F1BEA4"><enum>(1)</enum><text>in paragraph (2)(D), by striking <quote>(19), the Secretary</quote>and inserting <quote>(19) and paragraph (23), the Secretary</quote>; and</text></paragraph><paragraph id="H76DF29CEE0F44A97AED74AAA9D7E4673"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="HBE587938417C412490535E28174C8665"><paragraph id="H95981791150646058F88837130F93697"><enum>(23)</enum><header>Floor on area wage adjustment factor for hospital outpatient department services</header><text>With respect to covered OPD services furnished on or after January 1, 2022, 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 0.85. The preceding sentence shall not be implemented in a budget neutral manner.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section></legis-body></bill> 

