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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6430 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 6430
To amend title XVIII of the Social Security Act to extend Medicare-
dependent hospital and Medicare low-volume hospital payments, and to
direct the Comptroller General of the United States to carry out a
report on Medicare rural hospital classifications.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 15, 2023
Mrs. Miller of West Virginia (for herself 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 extend Medicare-
dependent hospital and Medicare low-volume hospital payments, and to
direct the Comptroller General of the United States to carry out a
report on Medicare rural hospital classifications.
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 ``Assistance for Rural Community
Hospitals Act'' or the ``ARCH Act''.
SEC. 2. EXTENDING MEDICARE-DEPENDENT HOSPITAL AND MEDICARE LOW-VOLUME
HOSPITAL PAYMENTS.
(a) MDH Extension.--
(1) Extension of payment methodology.--Section
1886(d)(5)(G) of the Social Security Act (42 U.S.C.
1395ww(d)(5)(G)) is amended--
(A) in clause (i), by striking ``October 1, 2024''
and inserting ``October 1, 2029''; and
(B) in clause (ii)(II), by striking ``October 1,
2024'' and inserting ``October 1, 2029''.
(2) Conforming amendments.--
(A) Extension of target amount.--Section
1886(b)(3)(D) of the Social Security Act (42 U.S.C.
1395ww(b)(3)(D)) is amended--
(i) in the matter preceding clause (i), by
striking ``October 1, 2024'' and inserting
``October 1, 2029'' ; and
(ii) in clause (iv), by striking ``fiscal
year 2024'' and inserting ``fiscal year
2029,''.
(B) 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 2024'' and
inserting ``fiscal year 2029,''.
(b) LVH Extension.--Section 1886(d)(12) of the Social Security Act
(42 U.S.C. 1395ww(d)(12)) is amended--
(1) in subparagraph (C)(i)--
(A) in the matter preceding subclause (I), by
striking ``through 2024'' and inserting ``through
2029'';
(B) in subclause (III), by striking ``through
2024'' and inserting ``through 2029''; and
(C) in subclause (IV), by striking ``2025'' and
inserting ``2030''; and
(2) in subparagraph (D)--
(A) in the matter preceding clause (i), by striking
``through 2024'' and inserting ``through 2029''; and
(B) in clause (ii), by striking ``through 2024''
and inserting ``through 2029''.
SEC. 3. GAO REPORT ON MEDICARE RURAL HOSPITAL CLASSIFICATIONS.
Not later than 180 days after the date of the enactment of this
Act, the Comptroller General of the United States shall submit to
Congress a report on Medicare rural hospital classifications that
includes the following information:
(1) The total number of hospitals that, with respect to any
of the 5 fiscal years preceding such date of enactment, had any
of the following classifications:
(A) Classification as a critical access hospital
(as defined in section 1861(mm)(1) of the Social
Security Act (42 U.S.C. 1395x(mm)(1))).
(B) Classification as a rural emergency hospital
(as defined in section 1861(kkk)(2) of such Act (42
U.S.C. 1395x(kkk)(2))).
(C) Classification as a rural referral center (as
described in section 1886(d)(5)(C) of such Act (42
U.S.C. 1395ww(d)(5)(C)).
(D) Classification as a sole community hospital (as
defined in section 1886(d)(5)(D)(iii) of such Act (42
U.S.C. 1395ww(d)(5)(D)(iii))).
(E) Classification as a medicare-dependent, small
rural hospital (as defined in section 1886(d)(5)(G)(iv)
of such Act (42 U.S.C. 1395ww(d)(5)(G)(iv))).
(F) Classification as a low-volume hospital (as
defined in section 1886(d)(12)(C)(i) of such Act (42
U.S.C. 1395ww(d)(12)(C)(i))).
(2) An analysis of the extent to which there is overlap
between the criteria for any two or more of the classifications
described in paragraph (1).
(3) Recommendations for--
(A) simplification with respect to such
classifications and any such overlap; and
(B) changes with respect to the criteria for such
classifications that would promote financial
sustainability for rural hospitals and improve access
to health care for individuals in rural areas.
(4) The projected effects of allowing sole community
hospitals (as described in paragraph (1)(D)) and medicare-
dependent, small rural hospitals (as described in paragraph
(1)(E)) to use a cost reporting period beginning during fiscal
year 2019 for the purpose of calculating adjusted payments
under section 1886(d)(5) of the Social Security Act (42 U.S.C.
1395ww(d)(5)).
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Ways and Means.
Referred to the Subcommittee on Health.
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