H. R. 7105
IN THE HOUSE OF REPRESENTATIVES
September 25, 2008
Mr. Saxton (for himself and Mr. Smith of New Jersey) introduced the following bill; which was referred to the Committee on Ways and Means
To amend title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals.
This Act may be cited as the
Urban Medicare-Dependent Hospitals
Preservation Act of 2008.
Criteria and payment for certain urban Medicare-dependent hospitals
Section 1886(d)(5) of the Social Security Act (42 U.S.C. 1395ww(d)(5)) is amended by adding at the end the following new subparagraph:
For cost reporting periods beginning on or after October 1, 2008, in the case of a subsection (d) hospital which is an urban Medicare-dependent hospital, payment under paragraph (1)(A) shall be equal to the sum of the amount determined under clause (ii) and the amount determined under paragraph (1)(A)(iii).
The amount determined under this clause is, for discharges occurring during the cost reporting period that begins on or after October 1, 2008, and any subsequent cost reporting period, 75 percent of the amount by which the hospital’s target amount for the cost reporting period (as defined in subsection (b)(3)(L)) exceeds the amount determined under paragraph (1)(A)(iii).
The term urban Medicare-dependent hospital means, with respect to any cost reporting period to which clause (i) applies, any hospital—
located in an urban area;
that does not receive payment—
under subparagraph (C) as a rural referral center;
under subparagraph (D) as a sole community hospital;
under subparagraph (B) or under subsection (h); or
under subparagraph (F); and
for which not less than 60 percent of its inpatient days or discharges during the cost reporting period beginning in fiscal year 2006, or two of the three most recently audited cost reporting periods for which the Secretary has a settled cost report, were attributable to inpatients entitled to benefits under part A.
The Secretary shall for each fiscal year make an appropriate adjustment in the national standardized amount under paragraph (3) to ensure that any payments made under this subparagraph are made in a manner that assures that the aggregate payments under this subsection are not greater or less than those that would have been made without such additional payments.
Target payment amount
Section 1886(b)(3) of such Act (42 U.S.C. 1395ww(b)(3)) is amended—
(B)(iv), by striking
and (D) and inserting
, (D), and
by adding at the end the following new subparagraph:
For cost reporting periods occurring on or after October 1, 2008, in the case of a hospital that is an urban Medicare-dependent hospital (as defined in subsection (d)(5)(M)), the term target amount means—
with respect to the first 12-month cost reporting period in which this subparagraph is applied to the hospital, the allowable operating costs of inpatient hospital services (as defined in subsection (a)(4)) recognized under this title for the hospital for the 12-month cost reporting period beginning during fiscal year 2002, increased by the applicable percentage increase under subparagraph (B)(iv) for each of fiscal years 2003 through 2008; and
with respect to discharges occurring after the first 12-month cost reporting period in which this subparagraph is applied to the hospital, the target amount for the preceding year increased by the applicable percentage increase under subparagraph (B)(iv).