[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 830 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 830
To amend title XVIII of the Social Security Act to protect and preserve
access of Medicare beneficiaries to health care in rural areas.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2003
Mr. McInnis (for himself, Mr. Houghton, Mr. Camp, Mr. English, Mr.
Lewis of Kentucky, Mr. Hefley, Mr. Tancredo, Mr. Beauprez, Mrs.
Musgrave, Mr. Clyburn, Mr. Hayes, Mr. Peterson of Minnesota, Mr. Davis
of Illinois, Mr. Green of Wisconsin, Mr. Murtha, Mr. Gordon, Mr. Case,
Mr. McNulty, and Mr. Janklow) introduced the following bill; which was
referred to the Committee on Ways and Means, and in addition to the
Committee on Energy and Commerce, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to protect and preserve
access of Medicare beneficiaries to health care in rural areas.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; AMENDMENTS TO SOCIAL SECURITY ACT; TABLE OF
CONTENTS.
(a) Short Title.--This Act may be cited as the ``Medicare Rural
Health Care Preservation Act of 2003''.
(b) Amendments to Social Security Act.--Except as otherwise
specifically provided, whenever in this Act an amendment is expressed
in terms of an amendment to or repeal of a section or other provision,
the reference shall be considered to be made to that section or other
provision of the Social Security Act.
(c) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; amendments to Social Security Act; table of
contents.
Sec. 2. Five-year continuation of medicare managed care cost contracts.
Sec. 3. Temporary protection for sole community hospitals under
outpatient prospective payment schedule.
Sec. 4. Improvements to the critical access hospital program.
Sec. 5. Extension of temporary increase for home health services
furnished in a rural area.
Sec. 6. Increase in payments for hospice care furnished in frontier
areas.
Sec. 7. Treatment of eligibility for hospice care.
SEC. 2. FIVE-YEAR CONTINUATION OF MEDICARE MANAGED CARE COST CONTRACTS.
Section 1876(h)(5)(C) (42 U.S.C. 1395mm(h)(5)(C)) is amended by
striking ``2004'' and inserting ``2009''.
SEC. 3. TEMPORARY PROTECTION FOR SOLE COMMUNITY HOSPITALS UNDER
OUTPATIENT PROSPECTIVE PAYMENT SCHEDULE.
Section 1833(t)(7)(D) (42 U.S.C. 1395l(t)(7)(D)) is amended by
adding at the end the following new clause:
``(iii) Temporary treatment for sole
community hospitals.--In the case of a hospital
described in section 1886(d)(5)(C)(iii) that
furnishes covered OPD services for which the
PPS amount is less than the pre-BBA amount--
``(I) in the case of such services
furnished during 2004 or 2005, the
amount of payment under this subsection
shall be increased by the amount of
such difference;
``(II) in the case of such services
furnished during 2006 or 2007, the
amount of payment under this subsection
shall be increased by 95 percent of the
amount of such difference; and
``(III) in the case of such
services furnished during 2008 or 2009,
the amount of payment under this
subsection shall be increased by 90
percent of the amount of such
difference.''.
SEC. 4. IMPROVEMENTS TO CRITICAL ACCESS HOSPITAL PROGRAM.
(a) Reinstatement of Periodic Interim Payment (PIP).--Section
1815(e)(2) (42 U.S.C. 1395g(e)(2)) is amended--
(1) by striking ``and'' at the end of subparagraph (C);
(2) by adding ``and'' at the end of subparagraph (D); and
(3) by inserting after subparagraph (D) the following new
subparagraph:
``(E) inpatient critical access hospital services;''.
(b) Condition for Application of Special Physician Payment
Adjustment.--Section 1834(g)(2) (42 U.S.C. 1395m(g)(2)) is amended by
adding after and below subparagraph (B) the following:
``The Secretary may not require, as a condition for applying
subparagraph (B) with respect to a critical access hospital,
that each physician providing professional services in the
hospital must assign billing rights with respect to such
services, except that such subparagraph shall not apply to
those physicians who have not assigned such billing rights.''.
(c) Flexibility in Bed Limitation for Hospitals.--Section 1820 (42
U.S.C. 1395i-4) is amended--
(1) in subsection (c)(2)(B)(iii), by inserting ``subject to
paragraph (3)'' after ``(iii) provides'';
(2) by adding at the end of subsection (c) the following
new paragraph:
``(3) Increase in maximum number of beds for hospitals with
strong seasonal census fluctuations.--
``(A) In general.--Subject to subparagraph (C), in
the case of a hospital that demonstrates that it meets
the standards established under subparagraph (B) and
has not made the election described in subsection
(f)(2)(A), the bed limitations otherwise applicable
under paragraph (2)(B)(iii) and subsection (f) shall be
increased by 5 beds.
``(B) Standards.--The Secretary shall specify
standards for determining whether a critical access
hospital has sufficiently strong seasonal variations in
patient admissions to justify the increase in bed
limitation provided under subparagraph (A).''; and
(3) in subsection (f)--
(A) by inserting ``(1)'' after ``(f)''; and
(B) by adding at the end the following new
paragraph:
``(2)(A) A hospital may elect to treat the reference in paragraph
(1) to `15 beds' as a reference to `25 beds', but only if no more than
10 beds in the hospital are at any time used for non-acute care
services. A hospital that makes such an election is not eligible for
the increase provided under subsection (c)(3)(A).
``(B) The limitations in numbers of beds under the first sentence
of paragraph (1) are subject to adjustment under subsection (c)(3).''.
(d) 5-Year Extension of the Authorization for Appropriations for
Grant Program.--Section 1820(j) (42 U.S.C. 1395i-4(j)) is amended by
striking ``through 2002'' and inserting ``through 2007''.
(e) Prohibition of Retroactive Recoupment.--The Secretary shall not
recoup (or otherwise seek to recover) overpayments made for outpatient
critical access hospital services under part B of title XVIII of the
Social Security Act, for services furnished in cost reporting periods
that began before October 1, 2002, insofar as such overpayments are
attributable to payment being based on 80 percent of reasonable costs
(instead of 100 percent of reasonable costs minus 20 percent of
charges).
(f) Effective Dates.--
(1) Reinstatement of pip.--The amendments made by
subsection (a) shall apply to payments made on or after January
1, 2004.
(2) Physician payment adjustment condition.--The amendment
made by subsection (b) shall be effective as if included in the
enactment of section 403(d) of the Medicare, Medicaid, and
SCHIP Balanced Budget Refinement Act of 1999 (113 Stat. 1501A-
371).
SEC. 5. EXTENSION OF TEMPORARY INCREASE FOR HOME HEALTH SERVICES
FURNISHED IN A RURAL AREA.
(a) In General.--Section 508(a) of the Medicare, Medicaid, and
SCHIP Benefits Improvement and Protection Act of 2000 (114 Stat. 2763A-
533), as enacted into law by section 1(a)(6) of Public Law 106-554, is
amended--
(1) by striking ``24-Month Increase Beginning April 1,
2001'' and inserting ``In General''; and
(2) by striking ``April 1, 2003'' and inserting ``January
1, 2006''.
(b) Conforming Amendment.--Section 547(c)(2) of such Act (114 Stat.
2763A-553) is amended by striking ``the period beginning on April 1,
2001, and ending on September 30, 2002,'' and inserting ``a period
under such section''.
SEC. 6. INCREASE IN PAYMENTS FOR HOSPICE CARE FURNISHED IN FRONTIER
AREAS.
(a) 10 Percent Increase in Payment for Hospice Care Furnished in a
Frontier Area.--Section 1814(i)(1) (42 U.S.C. 1395f(i)(1)) is amended
by adding at the end the following new subparagraph:
``(D) With respect to hospice care furnished in a frontier area on
or after January 1, 2004, and before January 1, 2009, the payment rates
otherwise established for such care shall be increased by 10 percent.
For purposes of this subparagraph, the term `frontier area' means a
county in which the population density is less than 7 persons per
square mile.''.
(b) Report on Costs.--Not later than January 1, 2008, the
Comptroller General of the United States shall submit to Congress a
report on the costs of furnishing hospice care in frontier areas. Such
report shall include recommendations regarding the appropriateness of
extending, and modifying, the payment increase provided under the
amendment made by subsection (a).
SEC. 7. TREATMENT OF ELIGIBILITY FOR HOSPICE CARE.
(a) Deemed Eligibility Based on Death in Fact.--
(1) In general.--Section 1814(i) of the Social Security Act
is amended by adding at the end the following new paragraph:
``(4) For purposes of section 1814(a)(7)(A), the Secretary and a
fiscal intermediary shall not take any action to deny payment for
hospice care for an individual on the basis that the individual is not
terminally ill if the individual dies within 6 months of the date the
individual is initially admitted into the hospice program for the
receipt of hospice care.''.
(2) Effective date.--The amendment made by paragraph (1)
shall take effect on January 1, 2004.
(b) CMS Report.--
(1) In general.--The Administrator of the Centers for
Medicare & Medicaid Services shall evaluate the standards used
by fiscal intermediaries in denying physician certifications
under section 1814(a)(7) of the Social Security Act (42 U.S.C.
1395f(a)(7)) that an individual is terminally ill (and thereby
making such individuals ineligible to elect the hospice care
alternative) and the impact of such decisions on length of
stay. Such evaluation shall review the impact of the amendments
made by section 322(a) of the Medicare, Medicaid, and SCHIP
Benefits Improvement and Protection Act of 2000 (114 Stat.
2763A-501), as enacted into law by section 1(a)(6) of Public
Law 106-554 and the results of the study conducted under
section 322(b) of such Act of 2000.
(2) Report.--Not later than 6 months after the date of the
enactment of this Act, the Administrator shall submit to
Congress a report on the evaluation under paragraph (1).
<all>
Introduced in House
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman.
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