Rural Hospital Support Act
This bill modifies and extends certain payment adjustments for rural hospitals under Medicare's inpatient prospective payment system.
Specifically, the bill indexes payment adjustments for sole community hospitals and Medicare-dependent hospitals to FY2016 operating costs, if it results in higher payments for such hospitals. The bill also makes payment adjustments for Medicare-dependent hospitals and low-volume hospitals permanent (the adjustments currently expire at the end of FY2022).
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1887 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 1887
To amend title XVIII of the Social Security Act to rebase the
calculation of payments for sole community hospitals and Medicare-
dependent hospitals, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 12, 2021
Mr. Reed (for himself and Ms. Sewell) 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 rebase the
calculation of payments for sole community hospitals and Medicare-
dependent hospitals, and for other purposes.
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 ``Rural Hospital Support Act''.
SEC. 2. REBASING OF THE CALCULATION OF PAYMENTS FOR SOLE COMMUNITY
HOSPITALS.
(a) Rebasing Permitted.--Section 1886(b)(3) of the Social Security
Act (42 U.S.C. 1395ww(b)(3)) is amended by adding at the end the
following new subparagraph:
``(M)(i) For cost reporting periods beginning on or
after October 1, 2021, in the case of a sole community
hospital there shall be substituted for the amount
otherwise determined under subsection (d)(5)(D)(i) of
this section, if such substitution results in a greater
amount of payment under this section for the hospital,
the subparagraph (M) rebased target amount.
``(ii) For purposes of this subparagraph, the term
`subparagraph (M) rebased target amount' has the
meaning given the term `target amount' in subparagraph
(C), except that--
``(I) there shall be substituted for the
base cost reporting period the 12-month cost
reporting period beginning during fiscal year
2016;
``(II) any reference in subparagraph (C)(i)
to the `first cost reporting period' described
in such subparagraph is deemed a reference to
the first cost reporting period beginning on or
after October 1, 2021; and
``(III) the applicable percentage increase
shall only be applied under subparagraph
(C)(iv) for discharges occurring on or after
October 1, 2021.''.
(b) Conforming Amendments.--Section 1886(b)(3) of the Social
Security Act (42 U.S.C. 1395ww(b)(3)) is amended--
(1) in subparagraph (C), in the matter preceding clause
(i), by striking ``subparagraphs (I) and (L)'' and inserting
``subparagraphs (I), (L), and (M)''; and
(2) in subparagraph (I)(i), in the matter preceding
subclause (I), by striking ``subparagraph (L)'' and inserting
``subparagraphs (L) and (M)''.
SEC. 3. REBASING OF THE CALCULATION OF PAYMENTS FOR MEDICARE-DEPENDENT
HOSPITALS.
Section 1886(b)(3) of the Social Security Act (42 U.S.C.
1395ww(b)(3)), as amended by subsection (a), is further amended--
(1) in subparagraph (D), by striking ``subparagraph (K)''
and inserting ``subparagraphs (K) and (N)''; and
(2) by adding at the end the following new subparagraph:
``(N)(i) With respect to discharges occurring on or
after October 1, 2021, in the case of a medicare-
dependent, small rural hospital, for purposes of
applying subparagraph (D)--
``(I) there shall be substituted for the
base cost reporting period described in
subparagraph (D)(i) the 12-month cost reporting
period beginning during fiscal year 2016; and
``(II) any reference in such subparagraph
to the `first cost reporting period' described
in such subparagraph is deemed a reference to
the first cost reporting period beginning on or
after October 1, 2021.
``(ii) This subparagraph shall only apply to a
hospital if the substitution described in clause (i)(I)
results in an increase in the target amount under
subparagraph (D) for the hospital.''.
SEC. 4. PROHIBITION OF ADJUSTMENTS TO CLASSIFICATIONS AND WEIGHTING
FACTORS RELATING TO THE CALCULATION OF PAYMENTS FOR SOLE
COMMUNITY HOSPITALS AND MEDICARE-DEPENDENT HOSPITALS.
Section 1886(d)(4)(C) of the Social Security Act (42 U.S.C.
1395ww(d)(4)(C)--
(1) in clause (i), by striking ``The Secretary'' and
inserting ``Subject to clause (v), the Secretary''; and
(2) by adding at the end the following new clause:
``(v) For discharges using the rebased
target amounts described in subparagraph (M) or
(N) of subsection (b)(3), the Secretary may not
adjust such amounts for adjustments required by
clause (iii) prior to October 1, 2015.''.
SEC. 5. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL (MDH) PROGRAM.
(a) Extension of Payment Methodology.--Section 1886(d)(5)(G) of the
Social Security Act (42 U.S.C. 1395ww(d)(5)(G)) is amended--
(1) in clause (i), by striking ``, and before October 1,
2022''; and
(2) in clause (ii)(II), by striking ``, and before October
1, 2022''.
(b) Conforming Amendments.--
(1) Extension of target amount.--Section 1886(b)(3)(D) of
the Social Security Act (42 U.S.C. 1395ww(b)(3)(D)) is
amended--
(A) in the matter preceding clause (i), by striking
``, and before October 1, 2022''; and
(B) in clause (iv), by striking ``through fiscal
year 2022'' and inserting ``or a subsequent fiscal
year''.
(2) Permitting hospitals to decline reclassification.--
Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of
1993 (42 U.S.C. 1395ww note) is amended by striking ``fiscal
year 2000 through fiscal year 2022'' and inserting ``a
subsequent fiscal year''.
SEC. 6. EXTENSION OF THE INCREASED PAYMENTS UNDER THE MEDICARE LOW-
VOLUME HOSPITAL PROGRAM.
Section 1886(d)(12) of the Social Security Act (42 U.S.C.
1395__(d)(12)) is amended--
(1) in subparagraph (B)--
(A) in the header, by inserting ``for fiscal years
2005 through 2010'' after ``increase''; and
(B) in the matter preceding clause (i), by striking
``and for discharges occurring in fiscal year 2023 and
subsequent fiscal years'';
(2) in subparagraph (C)(i)--
(A) in the matter preceding subclause (I), by
striking ``through 2022'' and inserting ``and each
subsequent fiscal year'';
(B) in subclause (II), by adding at the end
``and'';
(C) in subclause (III)--
(i) by striking ``fiscal years 2019 through
2022'' and inserting ``fiscal year 2019 and
each subsequent fiscal year'';
(ii) by striking ``; and'' and inserting a
period; and
(D) by striking subclause (IV); and
(3) in subparagraph (D)--
(A) by revising the header to reach as follows:
``Applicable percentage increase beginning with fiscal
year 2011.--'';
(B) in the matter preceding clause (i), by striking
``fiscal years 2011 through 2022'' and inserting
``fiscal year 2019 and each subsequent fiscal year'';
and
(C) in clause (ii), by striking ``each of fiscal
years 2019 through 2022'' and inserting ``fiscal year
2019 and each subsequent fiscal year''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Ways and Means.
Referred to the Subcommittee on Health.
Llama 3.2 · runs locally in your browser
Ask anything about this bill. The AI reads the full text to answer.
Enter to send · Shift+Enter for new line