<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="billres.xsl"?>
<!DOCTYPE bill PUBLIC "-//US Congress//DTDs/bill.dtd//EN" "bill.dtd">
<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-KEL26275-Y8C-GX-M6L"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>119 S4233 IS: Save Struggling Hospitals Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2026-03-26</dc:date>
<dc:format>text/xml</dc:format>
<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>
</dublinCore>
</metadata>
<form>
<distribution-code display="yes">II</distribution-code><congress>119th CONGRESS</congress><session>2d Session</session><legis-num>S. 4233</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20260326">March 26, 2026</action-date><action-desc><sponsor name-id="S327">Mr. Warner</sponsor> (for himself, <cosponsor name-id="S396">Mrs. Blackburn</cosponsor>, <cosponsor name-id="S395">Mrs. Hyde-Smith</cosponsor>, and <cosponsor name-id="S412">Mr. Tuberville</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSFI00">Committee on Finance</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To amend title XVIII of the Social Security Act to codify the Medicare low-wage index hospital policy.</official-title></form><legis-body><section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Save Struggling Hospitals Act</short-title></quote>.</text></section><section id="H56354ACAEC5A4166B1B86A569541DFAA"><enum>2.</enum><header>Codification of the Medicare low-wage index hospital policy</header><text display-inline="no-display-inline">Section 1886(d)(3)(E) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(d)(3)(E)</external-xref>) is amended—</text><paragraph commented="no" display-inline="no-display-inline" id="H3D83D422A78F4E2A9F82A143FA27EF74"><enum>(1)</enum><text>in clause (i), in the first sentence, by striking <quote>or (iv)</quote> and inserting <quote>, (iv), or (v)</quote>; and</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H05F96F53E02448A0B757DD28816F7151"><enum>(2)</enum><text display-inline="yes-display-inline">by adding at the end the following new clause:</text><quoted-block id="H2A3186A83AC145CE847BAA5F16913CF5" display-inline="no-display-inline" style="OLC"><clause id="H08D75E25098049E4BEDCF336FFFF9B0D"><enum>(v)</enum><header>Area wage index adjustment for low-wage hospitals</header><subclause id="HC84D07B3E4DC4ADAA266253204A3A536"><enum>(I)</enum><header>In general</header><text display-inline="yes-display-inline">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 ½ 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.</text></subclause><subclause id="H9DA543DC5A154FEF97C0F890FF80AFA6"><enum>(II)</enum><header>Budget neutrality</header><text> 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—</text><item id="H5D4F5E2B15844C588E3D2544658A780C"><enum>(aa)</enum><text>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</text></item><item id="HA3A582FD32CB498CA170497E2FC1E47E" commented="no" display-inline="no-display-inline"><enum>(bb)</enum><text display-inline="yes-display-inline">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.</text></item></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section></legis-body></bill>

