To amend title XVIII of the Social Security Act to provide for a change in payment for certain hospitals under Medicare.

Amends title XVIII (Medicare) of the Social Security Act (SSA), with respect to payment to hospitals for inpatient hospital services, to revise the payment formula for certain "subsection (d) hospitals" under Medicare.

(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.)

Specifies as the kind of subsection (d) hospital to which this payment formula applies any hospital that: (1) first received a payment in 1986 which has an average inpatient length of stay of more than 20 days, and (2) has 80% or more of its annual Medicare inpatient discharges with a principal diagnosis that reflects a finding of neoplastic disease in the 12-month cost reporting period ending in FY1997.

Requires payments for inpatient operating costs, in the case of such hospitals, for cost reporting periods beginning on or after January 1, 2014, to be based upon the established target amount per discharge, increased for each succeeding cost reporting period by the market basket percentage increase.

[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3613 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 3613

To amend title XVIII of the Social Security Act to provide for a change 
            in payment for certain hospitals under Medicare.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 21, 2013

Mr. Rangel (for himself and Mr. Crowley) 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 provide for a change 
            in payment for certain hospitals under Medicare.

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

SECTION 1. CHANGE IN MEDICARE PAYMENT FOR CERTAIN HOSPITALS.

    (a) In General.--Subsection (d)(1)(B) of section 1886 of the Social 
Security Act (42 U.S.C. 1395ww) is amended--
            (1) in clause (iv)---
                    (A) in subclause (I)--
                            (i) by striking ``(iv)(I)'' and inserting 
                        ``(iv)''; and
                            (ii) by striking ``or''at the end; and
                    (B) in subclause (II)--
                            (i) by striking ``, or'' at the end and 
                        inserting a semicolon; and
                            (ii) by redesignating such subclause as 
                        clause (vi) and by moving it to immediately 
                        follow clause (v); and
            (2) in clause (v), by striking the semicolon at the end and 
        inserting ``, or''.
    (b) Conforming Payment References.--Subsection (b) of such section 
is amended--
            (1) in paragraph (2)(E)(ii), by adding at the end the 
        following new subclause:
                                    ``(III) Hospitals described in 
                                clause (vi) of such subsection.'';
            (2) in paragraph (3)(F)(iii), by adding at the end the 
        following new subclause:
                                    ``(VI) Hospitals described in 
                                clause (vi) of such subsection.'';
            (3) in paragraph (3)(G)(ii), by inserting ``or (vi)'' after 
        ``clause (iv)'';
            (4) in paragraph (3)(H)(iv), by adding at the end the 
        following new subclause:
                                    ``(IV) Hospitals described in 
                                clause (vi) of such subsection.'';
            (5) in paragraph (3)(J), by striking ``subsection 
        (d)(1)(B)(iv)'' and inserting ``clause (iv) or (vi) of 
        subsection (d)(1)(B)''; and
            (6) in paragraph (7)(B), by adding at the end the following 
        new clause:
                            ``(iv) Hospitals described in clause (vi) 
                        of such subsection.''.
    (c) Additional Conforming Amendments.--The second sentence of 
subsection (d)(1)(B) of such section is amended--
            (1) by inserting ``(as in effect as of such date)'' after 
        ``clause (iv)''; and
            (2) by inserting ``(or, in the case of a hospital described 
        in clause (iv)(II), as so in effect, shall be classified under 
        clause (vi) on and after the effective date of such clause (vi) 
        and for cost reporting periods beginning on or after January 1, 
        2014, shall not be subject to subsection (m) as of the date of 
        such classification)'' after ``so classified''.
    (d) Application.--In the case of a hospital that is classified 
under clause (iv)(II) of section 1886(d)(1)(B) of the Social Security 
Act (42 U.S.C. 1395ww(d)(1)(B)) on the day before the date of the 
enactment of this Act and which is classified under clause (vi) of such 
section after such date of enactment, payments for inpatient operating 
costs for cost reporting periods beginning on or after January 1, 2014, 
shall be based upon the target amount per discharge established 
pursuant to section 1886(b) of such Act (42 U.S.C. 1395ww(b)) in effect 
for the cost reporting period for such hospital beginning during fiscal 
year 2001, increased for each succeeding cost reporting period 
(beginning before the date of the enactment of this Act) by the 
applicable percentage increase under section 1886(b)(3)(B)(ii) of such 
Act (42 U.S.C. 1395ww(b)(3)(B)(ii)).
                                 <all>