Medicare Hospital Capital Reimbursement Reform Act of 1989

Medicare Hospital Capital Reimbursement Reform Act of 1989 - Amends title XVIII (Medicare) of the Social Security Act to extend current reductions in Medicare payments for the capital-related costs of inpatient hospital services through FY 1992. Increases such reductions for low-occupancy hospitals. Exempts hospitals which treat a disproportionate share of indigent patients from such reductions.

 
HR 1812 IH
101st CONGRESS
1st Session
 H. R. 1812
To amend title XVIII of the Social Security Act to extend for 2 additional
years automatic reductions in payments to hospitals for capital-related
costs of inpatient hospital services, to provide further reductions in such
payments for low-occupancy hospitals, and to exempt hospitals treating a
heavily disproportionate share of indigent patients from such reductions in
such payments.
IN THE HOUSE OF REPRESENTATIVES
April 12, 1989
Mr. DONNELLY 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 extend for 2 additional
years automatic reductions in payments to hospitals for capital-related
costs of inpatient hospital services, to provide further reductions in such
payments for low-occupancy hospitals, and to exempt hospitals treating a
heavily disproportionate share of indigent patients from such reductions in
such payments.
  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 `Medicare Hospital Capital Reimbursement
  Reform Act of 1989'.
SEC. 2. REDUCTIONS IN PAYMENTS FOR CAPITAL-RELATED COSTS.
  (a) EXTENSION OF CURRENT REDUCTIONS- Section 1886(g)(3)(A)(iv) of the
  Social Security Act (42 U.S.C. 1395ww(g)(3)(A)(iv)) is amended by striking
  `(as the case may) be occurring during fiscal year 1989' and inserting
  `(as the case may be) occurring during fiscal years 1989 through 1992'.
  (b) INCREASE IN REDUCTION FOR LOW-OCCUPANCY HOSPITALS- (1) Section
  1886(g)(3)(A) of such Act (42 U.S.C. 1395ww(g)(3)(A)) is amended--
  (1) by striking `(3)(A) Except' and inserting `(3)(A)(i) Except';
  (2) by redesignating clauses (i), (ii), (iii), and (iv) as subclauses (I),
  (II), (III), and (IV); and
  (3) by adding at the end the following new clauses:
  `(ii) In the case of a hospital described in clause (i) for which the
  average actual occupancy percentage during a cost reporting period is less
  than the hospital's target minimum occupancy percentage, the Secretary
  shall reduce the amount of payment otherwise made under this title with
  respect to the capital-related costs of inpatient hospital services of the
  hospital by the product of the percentage applicable under such clause and
  a percentage equal to 100 multiplied by the ratio determined by dividing--
  `(I) the hospital's average actual occupancy percentage during the cost
  reporting period; by
  `(II) the hospital's target minimum occupancy percentage.
  `(iii) In this subparagraph, a hospital's `target minimum occupancy
  percentage' is--
  `(I) 75 percent, if the hospital is located in an urban area and has 100
  or more beds;
  `(II) 65 percent, if the hospital is located in an urban area and has less
  than 100 inpatient beds; and
  `(III) 60 percent, if the hospital is located in a rural area.
  `(iv) In this subparagraph, a hospital's `actual occupancy percentage'
  is the percentage of licensed beds which are occupied, except that,
  for purposes of determining that percentage, beds which are used solely
  for providing administratively necessary days shall not be included in
  calculating the number of a hospital's licensed beds.'.
  (2) The amendments made by this subsection shall apply with respect
  to payments for capital-related costs of inpatient hospital services
  attributable to portions of cost reporting periods or discharges occurring
  on or after October 1, 1989.
  (c) EXEMPTION FROM REDUCTIONS FOR HOSPITALS WITH HIGH DISPROPORTIONATE SHARE
  ADJUSTMENT PERCENTAGE- (1) Section 1886(g)(3)(B) of the Social Security Act
  (42 U.S.C. 1395ww(g)(3)(B)) is amended by striking the period at the end
  and inserting the following: `, or to payments attributable to portions of
  cost reporting periods or discharges (as the case may be) for a hospital
  for which the disproportionate share adjustment percentage (established
  under subsection (d)(5)(F)) for the cost reporting period is greater than
  10 percent.'.
  (2) The amendment made by paragraph (1) shall apply with respect to payments
  for capital-related costs of inpatient hospital services attributable to
  cost reporting periods or discharges occurring on or after October 1, 1989.