To amend title XVIII of the Social Security Act to apply budget neutrality on a State-specific basis in the calculation of the Medicare hospital wage index floor for non-rural areas.

Revises requirements for the non-rural area wage index floor in the formula for the national adjusted diagnosis-related group (DRG) prospective payment rate used in calculating payments under title XVIII (Medicare) of the Social Security Act for each inpatient hospital discharge in a fiscal year involving inpatient hospital services of a subsection (d) hospital.

(Generally, a subsection [d] hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system [IPPS] when providing covered inpatient services to eligible beneficiaries.)

Directs the Secretary of Health and Human Services (HHS), in the case of discharges occurring on or after October 1, 2013, to apply budget neutrality, under the Balanced Budget Act of 1997 and related regulations, on a state-specific rather than national basis in the calculation of the Medicare hospital wage index floor, including a minimum wage index, for each non-rural area, using a specified methodology as if it had been fully implemented for FY2011 using a 100% state-specific adjustment to the area wage index.

Declares that nothing in this Act shall be construed as preventing the Secretary, for discharges occurring on or after October 1, 2014, from modifying related regulations in carrying out budget neutrality requirements.

Amends the Patient Protection and Affordable Care Act to end the application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor as of October 1, 2013.

[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2053 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 2053

    To amend title XVIII of the Social Security Act to apply budget 
neutrality on a State-specific basis in the calculation of the Medicare 
             hospital wage index floor for non-rural areas.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 20, 2013

Mr. Brady of Texas (for himself, Mr. Reed, Mr. Tiberi, Mr. Roskam, Mr. 
 Buchanan, Mr. Schock, Mr. Kelly of Pennsylvania, Mr. Renacci, and Mr. 
Griffith of Virginia) 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 apply budget 
neutrality on a State-specific basis in the calculation of the Medicare 
             hospital wage index floor for non-rural areas.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. APPLYING BUDGET NEUTRALITY ON A STATE-SPECIFIC BASIS IN THE 
              CALCULATION OF THE MEDICARE HOSPITAL WAGE INDEX FLOOR FOR 
              NON-RURAL AREAS.

    (a) In General.--Section 1886(d)(3)(E) of the Social Security Act 
(42 U.S.C. 1395ww(d)(3)(E)) is amended by adding at the end the 
following new clause:
                            ``(iv) Application of budget neutrality 
                        relating to floor on wage area index in non-
                        rural areas.--
                                    ``(I) Application on a state-
                                specific basis beginning in fiscal year 
                                2014.--Subject to subclause (II), in 
                                the case of discharges occurring on or 
                                after October 1, 2013, for purposes of 
                                applying section 4410(b) of the 
                                Balanced Budget Act of 1997, the 
                                Secretary shall administer such section 
                                4410(b) and paragraph (e) of section 
                                412.64 of title 42, Code of Federal 
                                Regulations, as if paragraph (e)(4)(ii) 
                                of such section 412.64 had never 
                                applied and by using the methodology 
                                promulgated in the Federal Register on 
                                August 19, 2008 (73 Fed. Reg. 48570) 
                                (applied as if such methodology had 
                                been fully implemented for fiscal year 
                                2011 using a 100 percent State-specific 
                                adjustment to the area wage index).
                                    ``(II) Construction.--Nothing in 
                                subclause (I) shall be construed as 
                                preventing the Secretary, for 
                                discharges occurring on or after 
                                October 1, 2014, from modifying the 
                                regulations under such section 412.64 
                                in carrying out the budget neutrality 
                                requirements of such section 
                                4410(b).''.
    (b) Conforming Amendment Terminating Application of Budget 
Neutrality on a Nationwide Basis.--Section 3141 of the Patient 
Protection and Affordable Care Act (42 U.S.C. 1395ww note) is amended 
by inserting ``and before October 1, 2013,'' after ``2010,''.
                                 <all>