[Congressional Record Volume 171, Number 113 (Monday, June 30, 2025)]
[Senate]
[Page S4126]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 2788. Mr. GRASSLEY submitted an amendment intended to be proposed
by him to the bill H.R. 1, to provide for reconciliation pursuant to
title II of H. Con. Res. 14; which was ordered to lie on the table; as
follows:
At the appropriate place in title VII, insert the
following:
Subtitle_--Rebasing Calculation of Payments for Sole Community
Hospitals and Medicare-dependent Hospitals
SEC. 7_001. REBASING OF THE CALCULATION OF PAYMENTS FOR SOLE
COMMUNITY HOSPITALS.
(a) Rebasing Permitted.--Section 1886(b)(3) of the Social
Security Act (42 U.S.C. 1395ww(b)(3)) is amended by adding at
the end the following new subparagraph:
``(M)(i) For cost reporting periods beginning on or after
October 1, 2025, in the case of a sole community hospital
there shall be substituted for the amount otherwise
determined under subsection (d)(5)(D)(i) of this section, if
such substitution results in a greater amount of payment
under this section for the hospital, the subparagraph (M)
rebased target amount.
``(ii) For purposes of this subparagraph, the term
`subparagraph (M) rebased target amount' has the meaning
given the term `target amount' in subparagraph (C), except
that--
``(I) there shall be substituted for the base cost
reporting period the 12-month cost reporting period beginning
during fiscal year 2016;
``(II) any reference in subparagraph (C)(i) to the `first
cost reporting period' described in such subparagraph is
deemed a reference to the first cost reporting period
beginning on or after October 1, 2025; and
``(III) the applicable percentage increase shall only be
applied under subparagraph (C)(iv) for discharges occurring
on or after October 1, 2025.''.
(b) Conforming Amendments.--Section 1886(b)(3) of the
Social Security Act (42 U.S.C. 1395ww(b)(3)) is amended--
(1) in subparagraph (C), in the matter preceding clause
(i), by striking ``subparagraphs (I) and (L)'' and inserting
``subparagraphs (I), (L), and (M)''; and
(2) in subparagraph (I)(i), in the matter preceding
subclause (I), by striking ``subparagraph (L)'' and inserting
``subparagraphs (L) and (M)''.
SEC. 7_002. REBASING OF THE CALCULATION OF PAYMENTS FOR
MEDICARE-DEPENDENT HOSPITALS.
Section 1886(b)(3) of the Social Security Act (42 U.S.C.
1395ww(b)(3)), as amended by section 7_001, is amended--
(1) in subparagraph (D), by striking ``subparagraph (K)''
and inserting ``subparagraphs (K) and (N)''; and
(2) by adding at the end the following new subparagraph:
``(N)(i) With respect to discharges occurring on or after
October 1, 2025, in the case of a medicare-dependent, small
rural hospital, for purposes of applying subparagraph (D)--
``(I) there shall be substituted for the base cost
reporting period described in subparagraph (D)(i) the 12-
month cost reporting period beginning during fiscal year
2016; and
``(II) any reference in such subparagraph to the `first
cost reporting period' described in such subparagraph is
deemed a reference to the first cost reporting period
beginning on or after October 1, 2025.
``(ii) This subparagraph shall only apply to a hospital if
the substitution described in clause (i)(I) results in an
increase in the target amount under subparagraph (D) for the
hospital.''.
SEC. 7_003. PROHIBITION OF ADJUSTMENTS TO CLASSIFICATIONS AND
WEIGHTING FACTORS RELATING TO THE CALCULATION
OF PAYMENTS FOR SOLE COMMUNITY HOSPITALS AND
MEDICARE-DEPENDENT HOSPITALS.
Section 1886(d)(4)(C) of the Social Security Act (42 U.S.C.
1395ww(d)(4)(C))--
(1) in clause (i), by striking ``The Secretary'' and
inserting ``Subject to clause (v), the Secretary''; and
(2) by adding at the end the following new clause:
``(v) For discharges using the rebased target amounts
described in subparagraph (M) or (N) of subsection (b)(3),
the Secretary may not adjust such amounts for adjustments
required by clause (iii) prior to October 1, 2015.''.
SEC. 7_004. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL
(MDH) PROGRAM.
(a) Extension of Payment Methodology.--Section
1886(d)(5)(G) of the Social Security Act (42 U.S.C.
1395ww(d)(5)(G)) is amended--
(1) in clause (i), by striking ``, and before October 1,
2025''; and
(2) in clause (ii)(II), by striking ``, and before October
1, 2025''.
(b) Conforming Amendments.--
(1) Extension of target amount.--Section 1886(b)(3)(D) of
the Social Security Act (42 U.S.C. 1395ww(b)(3)(D)) is
amended--
(A) in the matter preceding clause (i), by striking ``, and
before October 1, 2025''; and
(B) in clause (iv), by striking ``through fiscal year
2025'' and inserting ``or a subsequent fiscal year''.
(2) Permitting hospitals to decline reclassification.--
Section 13501(e)(2) of the Omnibus Budget Reconciliation Act
of 1993 (42 U.S.C. 1395ww note) is amended by striking
``fiscal year 2000 through fiscal year 2025'' and inserting
``a subsequent fiscal year''.
SEC. 7_005. EXTENSION OF THE INCREASED PAYMENTS UNDER THE
MEDICARE LOW-VOLUME HOSPITAL PROGRAM.
Section 1886(d)(12) of the Social Security Act (42 U.S.C.
1395(d)(12)) is amended--
(1) in subparagraph (B)--
(A) in the subparagraph heading, by inserting ``for fiscal
years 2005 through 2010'' after ``increase''; and
(B) in the matter preceding clause (i), by striking ``and
for discharges occurring in fiscal year 2026 and subsequent
fiscal years'';
(2) in subparagraph (C)(i)--
(A) in the matter preceding subclause (I), by striking ``
fiscal years 2011 through 2025'' and inserting ``fiscal year
2011 and subsequent fiscal years'';
(B) in subclause (III)--
(i) by striking ``each of fiscal years 2019 through 2025''
and inserting ``fiscal year 2019 and each subsequent fiscal
year''; and
(ii) by striking ``; and'' at the end and inserting a
period; and
(C) by striking subclause (IV); and
(3) in subparagraph (D)--
(A) by amending the subparagraph heading to reach as
follows: ``Applicable percentage increase beginning with
fiscal year 2011.--'';
(B) in the matter preceding clause (i), by striking
``fiscal years 2011 through 2025'' and inserting ``fiscal
year 2011 and subsequent fiscal years''; and
(C) in clause (ii), by striking ``each of fiscal years 2019
through 2025'' and inserting ``fiscal year 2019 and each
subsequent fiscal year''.
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