,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #acij  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #ba1 #bjac ,mr4  
,smi? ( ,new ,j]sey 7= himself1 ,mr4    
,deut*1 ,mr4 ,lo,biondo1 ,mr4 ,runyan1  
,mr4 ,l>son ( ,connecticut1 ,ms4        
,frankel ( ,florida1 & ,mr4 ,c\rtney7   
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means  ,a     
,,bill  ,to am5d title ,,xviii ( !      
,social ,security ,act to pres]ve access
 to urban ,m$ic>e-dep5d5t hospitals4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,urban ,m$ic>e-,dep5d5t ,hospitals    
,pres]vation ,act ( #bjac4  #b4 ,crit]ia
 & paym5t = c]ta9 urban ,m$ic>e-dep5d5t 
hospitals  7a7 ,9 g5]al ,section        
#ahhf7;d77#e7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acieww7d77#e77 is am5d$
 by add+ at ! end ! foll[+ new          
subp>agraph3  7,m7 7i7 ,= co/ report+   
p]iods beg9n+ on or aft] ,octob] #a1    
#bjac1 & be=e ,octob] #a1 #bjaf1 9 !    
case ( a subsection 7d7 hospital :i* is 
an urban ,m$ic>e-dep5d5t hospital1      

paym5t "u p>agraph 7#a77;,a7 %all be    
equal to ! sum ( ! am\nt det]m9$ "u     
clause 7ii7 & ! am\nt det]m9$ "u        
p>agraph 7#a77;,a77iii74  7ii7 ,! am\nt 
det]m9$ "u ?is clause is1 = dis*>ges    
occurr+ dur+ a co/ report+ p]iod t beg9s
 on or aft] ,octob] #a1 #bjac1 & be=e   
,octob] #a1 #bjaf1 #ej p]c5t ( ! am\nt  
by :i* ! hospital's t>get am\nt = ! co/ 
report+ p]iod 7z def9$ 9 subsection     
7b77#c77,l77 exce$s ! am\nt det]m9$ "u  
p>agraph 7#a77;,a77iii74  7iii7 ,=      
purposes ( ?is subp>agraph1 ! t]m urban 
,m$ic>e-dep5d5t hospital means1 )       
respect to any co/ report+ p]iod to :i* 
clause 7i7 applies1 any hospital--  7,i7
 locat$ 9 an urban area or reclassifi$  
to an urban area = wage index purposes2 
7,,ii7 t does n receive paym5t--  7aa7  
"u subp>agraph 7,c7 z a rural ref]ral   
c5t]2  7bb7 "u subp>agraph 7,d7 z a sole
 community hospital2  7cc7 "u           
subp>agraph 7,b7 or "u subsection 7h72  
or  7dd7 "u subp>agraph 7,f72  7,,iii7 t
 is n a physician-own$ hospital1 z def9$

 9 section #dhi4c ( title #db1 ,code (  
,f$]al ,regulations 7z 9 effect z ( !   
date ( ! enactm5t ( ?is subp>agraph72 & 
7,,iv7 = :i* n less ?an #fj p]c5t ( its 
inpati5t days or dis*>ges dur+ ! co/    
report+ p]iod beg9n+ 9 fiscal ye> #bjjf1
 or two ( ! ?ree mo/ rec5tly audit$ co/ 
report+ p]iods = :i* ! ,secret>y has a  
settl$ co/ report1 7 attributable to    
inpati5ts entitl$ to b5efits "u "p ,a & 
n enroll$ 9 a ,m$ic>e ,advantage plan "u
 "p ,c4  4  7b7 ,t>get paym5t am\nt     
,section #ahhf7;b77#c7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acieww7b77#c77 is am5d$--  7#a7 9      
subp>agraph 7,b77iv71 by /rik+ & 7,d7 & 
ins]t+ 1 7,d71 & 7,m72 &  7#b7 by add+  
at ! end ! foll[+ new subp>agraph3  7,m7
 ,= co/ report+ p]iods occurr+ on or    
aft] ,octob] #a1 #bjac1 & be=e ,octob]  
#a1 #bjaf1 9 ! case ( a hospital t is an
 urban ,m$ic>e-dep5d5t hospital 7z def9$
 9 subsection 7d77#e77,m771 ! t]m t>get 
am\nt means--  7i7 ) respect to ! fir/  
#ab-mon? co/ report+ p]iod 9 :i* ?is    

subp>agraph is appli$ to ! hospital1 !  
all[able op]at+ co/s ( inpati5t hospital
 s]vices 7z def9$ 9 subsection 7a77#d77 
recogniz$ "u ?is title = ! hospital = ! 
#ab-mon? co/ report+ p]iod beg9n+ dur+  
fiscal ye> #bjjb or #bjjf 7:i*ev]       
results 9 a high] t>get am\nt71 increas$
 by ! applicable p]c5tage increase "u   
subp>agraph 7,b77iv7 = ea* ( fiscal ye>s
 #bjjc ?r\gh #bjac or #bjjg ?r\gh #bjac1
 respectively2 &  7ii7 ) respect to     
dis*>ges occurr+ aft] ! fir/ #ab-mon?   
co/ report+ p]iod 9 :i* ?is subp>agraph 
is appli$ to ! hospital1 ! t>get am\nt =
 ! prec$+ ye> increas$ by ! applicable  
p]c5tage increase "u subp>agraph        
7,b77iv74  4