[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9351 Introduced in House (IH)]

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118th CONGRESS
  2d Session
                                H. R. 9351

    To amend title XIX of the Social Security Act to modify certain 
  limitations on disproportionate share hospital payment adjustments 
                      under the Medicaid program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            August 13, 2024

   Mr. LaLota (for himself, Ms. Clarke of New York, Mr. Bucshon, Ms. 
Matsui, Mr. Lawler, and Mr. Mrvan) introduced the following bill; which 
          was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
    To amend title XIX of the Social Security Act to modify certain 
  limitations on disproportionate share hospital payment adjustments 
                      under the Medicaid program.

    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 ``Save our Safety-Net Hospitals Act of 
2024''.

SEC. 2. MODIFYING CERTAIN LIMITATIONS ON DISPROPORTIONATE SHARE 
              HOSPITAL PAYMENT ADJUSTMENTS UNDER THE MEDICAID PROGRAM.

    (a) In General.--Section 1923(g) of the Social Security Act (42 
U.S.C. 1396r-4(g)) is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (A)--
                            (i) in the matter preceding clause (i), by 
                        striking ``(other than a hospital described in 
                        paragraph (2)(B))'';
                            (ii) in clause (i), by inserting ``with 
                        respect to such hospital and year'' after 
                        ``described in subparagraph (B)''; and
                            (iii) in clause (ii)--
                                    (I) in subclause (I), by striking 
                                ``and'' at the end;
                                    (II) in subclause (II), by striking 
                                the period and inserting ``; and''; and
                                    (III) by adding at the end the 
                                following new subclause:
                                    ``(III) payments made under title 
                                XVIII or by an applicable plan (as 
                                defined in section 1862(b)(8)(F)) for 
                                such services.''; and
                    (B) in subparagraph (B)--
                            (i) in the matter preceding clause (i), by 
                        striking ``in this clause are'' and inserting 
                        ``in this subparagraph are, with respect to a 
                        hospital and a year,''; and
                            (ii) by adding at the end the following new 
                        clause:
                            ``(iii) Individuals who are eligible for 
                        medical assistance under the State plan or 
                        under a waiver of such plan and for whom the 
                        State plan or waiver is the secondary payor for 
                        such services after application of benefits 
                        under title XVIII or under an applicable plan 
                        (as defined in section 1862(b)(8)(F)), but only 
                        if the hospital has in the aggregate incurred 
                        costs exceeding payments under such State plan, 
                        waiver, title XVIII, or applicable plan for 
                        such services furnished to such individuals 
                        during such year.'';
            (2) by striking paragraph (2);
            (3) by redesignating paragraph (3) as paragraph (2); and
            (4) in paragraph (2), as so redesignated, by striking 
        ``Notwithstanding paragraph (2) of this subsection (as in 
        effect on October 1, 2021), paragraph (2)'' and inserting 
        ``Paragraph (2)''.
    (b) Effective Date.--
            (1) In general.--The amendments made by this section shall 
        apply to payment adjustments made under section 1923 of the 
        Social Security Act (42 U.S.C. 1396r-4) during fiscal years 
        beginning on or after October 1, 2021.
            (2) No required recoupment based on change in cap 
        amounts.--In the case of a payment adjustment made by a State 
        under section 1923 of the Social Security Act (42 U.S.C. 1396r-
        4) prior to the date of the enactment of this Act that was, 
        without application of the amendments made by this section, 
        consistent with the methodology of such State for making such 
        adjustments, such adjustment shall be deemed to be consistent 
        with such methodology with the application of such amendments.
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