[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8109 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                                H. R. 8109

To amend title XVIII of the Social Security Act to codify the Medicare 
                    low-wage index hospital policy.


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                    IN THE HOUSE OF REPRESENTATIVES

                             March 26, 2026

Mr. Kustoff (for himself and Ms. Sewell) 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 codify the Medicare 
                    low-wage index hospital policy.

    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 Struggling Hospitals Act''.

SEC. 2. CODIFICATION OF THE MEDICARE LOW-WAGE INDEX HOSPITAL POLICY.

    Section 1886(d)(3)(E) of the Social Security Act (42 U.S.C. 
1395ww(d)(3)(E)) is amended--
            (1) in clause (i), in the first sentence, by striking ``or 
        (iv)'' and inserting ``, (iv), or (v)''; and
            (2) by adding at the end the following new clause:
                            ``(v) Area wage index adjustment for low-
                        wage hospitals.--
                                    ``(I) In general.--For discharges 
                                occurring on or after October 1, 2019, 
                                the area wage index applicable under 
                                this subparagraph for a fiscal year to 
                                a hospital with an area wage index 
                                (determined without regard to this 
                                clause) below the 25th percentile area 
                                wage index shall be increased by \1/2\ 
                                of the difference between the otherwise 
                                applicable final area wage index for 
                                such fiscal year for such hospital and 
                                the 25th percentile area wage index for 
                                such fiscal year across all hospitals.
                                    ``(II) Budget neutrality.-- 
                                Pursuant to the fourth sentence of 
                                clause (i), this clause shall be 
                                applied in a budget neutral manner. Any 
                                adjustments made for the purposes of 
                                such application of budget neutrality 
                                may not--
                                            ``(aa) decrease the area 
                                        wage index applicable under 
                                        this subparagraph to a hospital 
                                        with an area wage index 
                                        (determined without regard to 
                                        this clause) below the 75th 
                                        percentile area wage index for 
                                        the fiscal year; or
                                            ``(bb) result in an area 
                                        wage index applicable under 
                                        this subparagraph to a hospital 
                                        for such fiscal year that is 
                                        less than 95 percent of the 
                                        area wage index applicable 
                                        under this subparagraph to such 
                                        hospital for the preceding 
                                        fiscal year.''.
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