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HR 1580 IH

To amend title XVIII of the Social Security Act to provide for national standardized payment amounts for inpatient hospital services furnished under the Medicare Program, and for other purposes.

April 3, 2003

Mr. ENGLISH (for himself, Mr. TANNER, Mr. SHERWOOD, Mr. MCNULTY, Mr. BERRY, Mr. MURTHA, Mr. MCHUGH, Mr. FARR, Mr. UDALL of Colorado, Mrs. EMERSON, Mr. ALLEN, Mr. REYNOLDS, Mr. PETERSON of Pennsylvania, Mr. KANJORSKI, Mr. HOLDEN, Mr. ORTIZ, Mr. TURNER of Texas, Mr. DAVIS of Tennessee, Mr. PLATTS, Mr. DOYLE, Mr. LATHAM, Mr. POMEROY, Mr. BOSWELL, Mr. COOPER, and Mr. ROGERS of Alabama) introduced the following bill; which was referred to the Committee on Ways and Means

To amend title XVIII of the Social Security Act to provide for national standardized payment amounts for inpatient hospital services furnished under the Medicare Program, 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 `Medicare Area Wage Index and Standardized Rate Act of 2003'.

SEC. 2. ESTABLISHING A SINGLE STANDARDIZED AMOUNT UNDER MEDICARE INPATIENT HOSPITAL PPS.

(a) IN GENERAL- Section 1886(d)(3)(A) of the Social Security Act (42 U.S.C. 1395ww(d)(3)(A)) is amended--

(1) in clause (iv), by inserting `and ending on or before September 30, 2003,' after `October 1, 1995,'; and

(2) by redesignating clauses (v) and (vi) as clauses (vii) and (viii), respectively, and inserting after clause (iv) the following new clauses:

`(v) For discharges occurring in the fiscal year beginning on October 1, 2003, the average standardized amount for hospitals located in areas other than a large urban area shall be equal to the average standardized amount for hospitals located in a large urban area.

`(vi) For discharges occurring in a fiscal year beginning on or after October 1, 2004, the Secretary shall compute an average standardized amount for hospitals located in all areas within the United States equal to the average standardized amount computed under clause (v) or this clause for the previous fiscal year increased by the applicable percentage increase under subsection (b)(3)(B)(i) for the fiscal year involved.'.

(b) COMPUTING DRG-SPECIFIC RATES-

(1) IN GENERAL- Section 1886(d)(3)(D) of such Act (42 U.S.C. 1395ww(d)(3)(D)) is amended--

(A) in the heading by striking `IN DIFFERENT AREAS';

(B) in the matter preceding clause (i)--

(i) by inserting `for fiscal years before fiscal year 1997' before `a regional DRG prospective payment rate for each region,'; and

(ii) by striking `each of which is';

(C) in clause (i)--

(i) by inserting `for fiscal years before fiscal year 2004,' after `(i)'; and

(ii) by striking `and' at the end;

(D) in clause (ii)--

(i) by inserting `for fiscal years before fiscal year 2004,' after `(ii)'; and

(ii) by striking the period at the end and inserting `; and'; and

(E) by adding at the end the following new clause:

`(iii) for a fiscal year beginning after fiscal year 2003, for hospitals located in all areas, to the product of--

`(I) the applicable average standardized amount (computed under subparagraph (A)), reduced under subparagraph (B), and adjusted or reduced under subparagraph (C) for the fiscal year; and

`(II) the weighting factor (determined under paragraph (4)(B)) for that diagnosis-related group.'.

(2) TECHNICAL CONFORMING SUNSET- Section 1886(d)(3) of such Act (42 U.S.C. 1395ww(d)(3)) is amended in the matter preceding subparagraph (A) by inserting `for fiscal years before fiscal year 1997' before `a regional DRG prospective payment rate'.

SEC. 3. ADJUSTMENT TO WAGE INDEX.

Section 1886(d)(3)(E) of the Social Security Act (42 U.S.C. 1395ww(d)(3)(E)) is amended--

(1) in the fourth sentence, by inserting `, except that this sentence shall not apply to the substitution required by the succeeding sentence'; and

(2) by adding at the end the following: `For discharges occurring during fiscal years beginning on or after October 1, 2003, in the case of a subsection (d) hospital for which the factor established by the Secretary under the first sentence for the fiscal year is less than 1.0, the Secretary shall substitute for the proportion otherwise estimated under such sentence but for this sentence a proportion of 62 percent.'.

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