Amends title XVIII (Medicare) of the Social Security Act, with respect to inpatient hospital service payments to certain hospitals (subsection (d) hospitals) on the basis of prospective rates, to exclude certain cancer hospitals from the meaning of subsection (d) hospital.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5496 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 5496
To amend title XVIII of the Social Security Act to provide special
treatment of certain cancer hospitals under the Medicare Program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 25, 2006
Mr. Ferguson 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 provide special
treatment of certain cancer hospitals 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. MEDICARE TREATMENT FOR CERTAIN CANCER HOSPITALS.
(a) In General.--Section 1886(d)(1)(B) of the Social Security Act
(42 U.S.C. 1395ww(d)(1)(B)) is amended--
(1) by striking ``or'' at the end of clause (iv);
(2) by striking the semicolon at the end of clause (v) and
inserting ``, or''; and
(3) by inserting after clause (v) the following new clause:
``(vi) a hospital that--
``(I) is located in a State which ranks (according
to the National Cancer Institute's statistics published
in May 2005 for 2001 and 2002) first among all States
in the incidence of prostate cancer, third in the
incidence rate for non-Hodgkins lymphoma, fourth in the
incidence rates for thyroid cancer and ovarian cancer,
and third in the highest death rates from uterine
cancer and breast cancer;
``(II) is located in a State that, as of December
31, 2005, had only one center under section 414 of the
Public Health Service Act that has been designated by
the National Cancer Institute as a comprehensive center
currently serving all 21 counties in the most densely
populated State in the nation, serving more than 70,000
patient visits annually;
``(III) as of December 31, 2005, served as the
teaching and clinical care, research and training
hospital for the Center described in subclause (II),
providing significant financial and operational support
to such Center;
``(IV) as of December 31, 2005, served as a core
and essential element in such Center which conducts
more than 130 clinical trial activities, national
cooperative group studies, investigator-initiated and
peer review studies and received during 2003 at least
$80,000,000 in research grant awards;
``(V) as of December 31, 2005, can demonstrate that
it has been a unique and an integral component of such
Center since such Center's inception;
``(VI) as of December 31, 2005, includes dedicated
patient care units organized primarily for the
treatment of and research on cancer with approximately
125 beds, 75 percent of which are dedicated to cancer
patients, and contains a radiation oncology department
as well as specialized emergency services for oncology
patients;
``(VII) as of December 31, 2003, is identified as
the focus of the Center's inpatient activities in the
Center's application as an NCI-designated comprehensive
cancer center and shares the NCI comprehensive cancer
designation with the Center; and
``(VIII) as of December 31, 2005, has been
recognized with a certificate of approval by the
American College of Surgeons Commission on Cancer;''.
(b) Conforming Amendment.--Section 1886(d)(3)(E) of such Act (42
U.S.C. 1395ww(d)(3)(E)) is amended by striking ``clause (v)'' and
inserting ``clauses (v) and (vi)''.
(c) Payment.--
(1) Application to cost reporting periods.--Any
classification by reason of section 1886(d)(1)(B)(vi) of the
Social Security Act (42 U.S.C. 1395ww(d)(1)(B)(vi)) (as added
by subsection (a)) shall apply to all cost reporting periods
beginning on or after January 1, 2005.
(2) Base target amount.--Notwithstanding section
1886(b)(3)(E) of the Social Security Act (42 U.S.C.
1395ww(b)(3)(E), in the case of a hospital described in section
1886(d)(1)(B)(vi) of the Social Security Act, as added by
subsection (a), such hospital shall be permitted to resubmit
the 2005 Medicare 2552 cost report incorporating a cancer
hospital sub-provider number, and apply the Medicare ratio-of-
cost-to-charge settlement methodology for outpatient cancer
services. In the case of such hospital the PPS cancer exemption
under section 1886(b)(3)(E)(i) of such Act for the first cost
reporting period beginning on or after January 1, 2005, shall
be the allowable operating costs of inpatient hospital services
(referred to in subclause (I) of such section) for such first
cost reporting period.
(3) Deadline for payments.--Any payments owed to a hospital
as a result of this section for periods occurring before the
date of the enactment of this Act shall be made expeditiously,
but in no event later than 1 year after such date of enactment.
(d) Maintenance of Exemption.--Once admitted as a PPS cancer-exempt
hospital, a hospital described in section 1886(d)(1)(B)(vi) of the
Social Security Act shall retain that status as long as the Center
referred to in such section remains a comprehensive cancer center.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Ways and Means.
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