[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 885 Introduced in Senate (IS)]
107th CONGRESS
1st Session
S. 885
To amend title XVIII of the Social Security Act to provide for national
standardized payment amounts for inpatient hospital services furnished
under the medicare program.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 15, 2001
Mr. Hutchinson (for himself, Mr. Cleland, and Mr. Miller) introduced
the following bill; which was read twice and referred to the Committee
on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to provide for national
standardized payment amounts for inpatient hospital services furnished
under the medicare program.
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 ``Area Wage and Base Payment
Improvement Act''.
SEC. 2. ESTABLISHING A SINGLE STANDARDIZED AMOUNT UNDER MEDICARE
INPATIENT HOSPITAL PPS.
(a) In General.--Section 1886(d)(3)(A) of the Social Security Act
(42 U.S.C. 1395ww(d)(3)(A)) is amended--
(1) in clause (iv), by inserting ``and ending on or before
September 30, 2001,'' after ``October 1, 1995,''; and
(2) by redesignating clauses (v) and (vi) as clauses (vii)
and (viii), respectively, and inserting after clause (iv) the
following new clauses:
``(v) For discharges occurring in the fiscal year beginning
on October 1, 2001, the average standardized amount for
hospitals located in areas other than a large urban area shall
be equal to the average standardized amount for hospitals
located in a large urban area.
``(vi) For discharges occurring in a fiscal year beginning
on or after October 1, 2002, the Secretary shall compute an
average standardized amount for hospitals located in all areas
within the United States equal to the average standardized
amount computed under clause (v) or this clause for the
previous fiscal year increased by the applicable percentage
increase under subsection (b)(3)(B)(i) for the fiscal year
involved.''.
(b) Conforming Amendments.--
(1) Update factor.--Section 1886(b)(3)(B)(i)(XVII) of the
Social Security Act (42 U.S.C. 1395ww(b)(3)(B)(i)(XVII)) is
amended by striking ``for hospitals in all areas,'' and
inserting ``for hospitals located in a large urban area,''.
(2) Computing drg-specific rates.--
(A) In general.--Section 1886(d)(3)(D) of such Act
(42 U.S.C. 1395ww(d)(3)(D)) is amended--
(i) in the heading by striking ``in
different areas'';
(ii) in the matter preceding clause (i)--
(I) by inserting ``for fiscal years
before fiscal year 1997'' before ``a
regional DRG prospective payment rate
for each region,''; and
(II) by striking ``each of which
is'';
(iii) in clause (i)--
(I) by inserting ``for fiscal years
before fiscal year 2002,'' after
``(i)''; and
(II) by striking ``and'' at the
end;
(iv) in clause (ii)--
(I) by inserting ``for fiscal years
before fiscal year 2002,'' after
``(ii)''; and
(II) by striking the period at the
end and inserting ``; and''; and
(v) by adding at the end the following new
clause:
``(iii) for a fiscal year beginning after fiscal
year 2001, for hospitals located in all areas, to the
product of--
``(I) the applicable average standardized
amount (computed under subparagraph (A)),
reduced under subparagraph (B), and adjusted or
reduced under subparagraph (C) for the fiscal
year; and
``(II) the weighting factor (determined
under paragraph (4)(B)) for that diagnosis-
related group.''.
(B) Technical conforming sunset.--Section
1886(d)(3) of such Act (42 U.S.C. 1395ww(d)(3)) is
amended in the matter preceding subparagraph (A) by
inserting ``for fiscal years before fiscal year 1997''
before ``a regional DRG prospective payment rate''.
SEC. 3. FLOOR ON AREA WAGE ADJUSTMENT FACTORS USED UNDER MEDICARE PPS
FOR INPATIENT AND OUTPATIENT HOSPITAL SERVICES.
(a) Inpatient PPS.--Section 1886(d)(3)(E) of the Social Security
Act (42 U.S.C. 1395ww(d)(3)(E)) is amended--
(1) by inserting ``(i) In general.--'' before ``The
Secretary'', and adjusting the margin two ems to the right;
(2) by striking ``The Secretary'' and inserting ``Subject
to clause (ii), the Secretary''; and
(3) by adding at the end the following new clause:
``(ii) Floor on area wage adjustment factor.--
Notwithstanding clause (i), in determining payments
under this subsection for discharges occurring on or
after October 1, 2001, the Secretary shall substitute a
factor of .925 for any factor that would otherwise
apply under such clause that is less than .925. Nothing
in this clause shall be construed as authorizing--
``(I) the application of the last sentence
of clause (i) to any substitution made pursuant
to this clause, or
``(II) the application of the preceding
sentence of this clause to adjustments for area
wage levels made under other payment systems
established under this title (other than the
payment system under section 1833(t)) to which
the factors established under clause (i)
apply.''.
(b) Outpatient PPS.--Section 1833(t)(2) of the Social Security Act
(42 U.S.C. 1395l(t)(2)) is amended by adding at the end the following:
``For purposes of subparagraph (D) for items and services furnished on
or after October 1, 2001, if the factors established under clause (i)
of section 1886(d)(3)(E) are used to adjust for relative differences in
labor and labor-related costs under the payment system established
under this subsection, the provisions of clause (ii) of such section
(relating to a floor on area wage adjustment factor) shall apply to
such factors, as used in this subsection, in the same manner and to the
same extent (including waiving the applicability of the requirement for
such floor to be applied in a budget neutral manner) as they apply to
factors under section 1886.''.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S4946-4947)
Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S4947)
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