To direct the Secretary of Health and Human Services to analyze differences in actual operating costs among rural, large urban, and other urban hospitals, and for other purposes.

Directs the Secretary of Health and Human Services to conduct a study and report to the Congress and the Prospective Payment Assessment Commission on differences in actual operating costs among rural, large urban, and other urban hospitals under title XVIII (Medicare) of the Social Security Act. Requires such Commission to submit an evaluation of the Secretary's findings to the Congress.