Save Rural Hospitals Act of 2023
This bill establishes an area wage adjustment floor for Medicare hospital payments in states that are not frontier states. The Centers for Medicare & Medicaid Services must establish a maximum rate to preserve budget neutrality.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3635 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 3635
To amend title XVIII of the Social Security Act to ensure fairness in
Medicare hospital payments by establishing a floor for the area wage
index applied with respect to certain hospitals.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 24, 2023
Mr. Ferguson (for himself, Ms. Sewell, Mrs. Harshbarger, Mr. Mann, Mr.
Allen, Mr. Carter of Georgia, Mr. Thompson of Mississippi, and Mr.
Neguse) 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 ensure fairness in
Medicare hospital payments by establishing a floor for the area wage
index applied with respect to certain hospitals.
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 ``Save Rural Hospitals Act of 2023''.
SEC. 2. ENSURING FAIRNESS IN MEDICARE HOSPITAL PAYMENTS IN A BUDGET
NEUTRAL MANNER.
(a) Hospital Inpatient Services.--Section 1886(d)(3)(E) of the
Social Security Act (42 U.S.C. 1395www(d)(3)(E)) is amended--
(1) in clause (i), by striking ``or (iv)'' and inserting
``(iv), or (v)''; and
(2) by adding at the end the following new clause:
``(v) Floor on area wage index for hospitals in
certain other areas.--
``(I) In general.--For discharges occurring
on or after October 1, 2023, the area wage
index applicable under this subparagraph to any
hospital which is not located in a frontier
State (as defined in clause (iii)(II)) may not
be less than 0.85.
``(II) Ensuring budget neutrality.--In
order to ensure that the aggregate payments
made under this subsection for a fiscal year
(beginning with fiscal year 2024) are not
greater than the aggregate payments that would
have been made under this subsection for such
fiscal year without the application of
subclause (I), as estimated by the Secretary,
the Secretary shall establish pursuant to
rulemaking a maximum area wage index to apply
under this subparagraph to any hospital which
is not located in a frontier State (as defined
in clause (iii)(II)).
``(III) No impact for hospitals with an
area wage index between the floor and the
maximum index.--Subclauses (I) and (II) shall
have no effect on the area wage index
applicable in a fiscal year to a hospital with
an area wage index that is greater than the
floor under subclause (I) but less than the
maximum area wage index established under
subclause (II) for the fiscal year.''.
(b) Hospital Outpatient Department Services.--Section 1833(t) of
the Social Security Act (42 U.S.C. 1395l(t)), is amended--
(1) in paragraph (2)(D), by striking ``paragraph (19), the
Secretary'' and inserting ``paragraphs (19) and (23), the
Secretary''; and
(2) by adding at the end the following new paragraph:
``(23) Floor on area wage adjustment factor for hospital
outpatient department services in areas other than in frontier
states.--
``(A) In general.--With respect to covered OPD
services furnished on or after January 1, 2024, the
area wage adjustment factor applicable under the
payment system established under this subsection to any
hospital outpatient department which is not located in
a frontier State (as defined in section
1886(d)(3)(E)(iii)(II)) may not be less than 0.85.
``(B) Ensuring budget neutrality.--In order to
ensure that the aggregate payments made under this
subsection for a year (beginning with 2024) are not
greater than the aggregate payments that would have
been made under this subsection for such year without
the application of subparagraph (A), as estimated by
the Secretary, the Secretary shall establish pursuant
to rulemaking a maximum area wage adjustment factor to
apply under the payment system established under this
subsection to any hospital outpatient department which
is not located in a frontier State (as defined in
clause (iii)(II)).
``(C) No impact for hospitals with an area wage
adjustment factor between the floor and the maximum
factor.--Subparagraphs (A) and (B) shall have no effect
on the area wage adjustment factor applicable in a year
to a hospital with an area wage adjustment factor that
is greater than the floor under subparagraph (A) but
less than the maximum area wage adjustment factor
established under subparagraph (B) for the year.''.
<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 Subcommittee on Health.
Referred to the Subcommittee on Health.
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