,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #cfac  ,,in ,,the ,,house ,,of  
,,representatives  ,november #ba1       
#bjac,mr4 ,rangel 7for himself and ,mr4 
,crowley7 introduced the following bill2
 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 ,medicare4  
#a4 ,change in ,medicare payment for    
certain hospitals  7a7 ,in general      
,subsection 7d77#a77;,b7 of section     
#ahhf of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acieww7 is amended-- 7#a7 in
 clause 7iv7--- 7,a7 in subclause 7,i7--
 7i7 by striking 7iv77,i7 and inserting 
7iv72 and  7ii7 by striking orat the    
end2 and  7,b7 in subclause 7,,ii7-- 7i7
 by striking 1 or at the end and        
inserting a semicolon2 and  7ii7 by     
redesignating such subclause as clause  
7vi7 and by moving it to immediately    
follow clause 7v72 and  7#b7 in clause  
7v71 by striking the semicolon at the   

end and inserting 1 or4  7b7 ,conforming
 payment references ,subsection 7b7 of  
such section is amended-- 7#a7 in       
paragraph 7#b77;,e77ii71 by adding at   
the end the following new subclause3    
7,,iii7 ,hospitals described in clause  
7vi7 of such subsection4  2  7#b7 in    
paragraph 7#c77;,f77iii71 by adding at  
the end the following new subclause3    
7,,vi7 ,hospitals described in clause   
7vi7 of such subsection4  2  7#c7 in    
paragraph 7#c77;,g77ii71 by inserting or
 7vi7 after clause 7iv72  7#d7 in       
paragraph 7#c77;,h77iv71 by adding at   
the end the following new subclause3    
7,,iv7 ,hospitals described in clause   
7vi7 of such subsection4  2  7#e7 in    
paragraph 7#c77;,j71 by striking        
subsection 7d77#a77;,b77iv7 and         
inserting clause 7iv7 or 7vi7 of        
subsection 7d77#a77;,b72 and  7#f7 in   
paragraph 7#g77;,b71 by adding at the   
end the following new clause3  7iv7     
,hospitals described in clause 7vi7 of  
such subsection4  4  7c7 ,additional    

conforming amendments ,the second       
sentence of subsection 7d77#a77;,b7 of  
such section is amended-- 7#a7 by       
inserting 7as in effect as of such date7
 after clause 7iv72 and  7#b7 by        
inserting 7or1 in the case of a hospital
 described in clause 7iv77,,ii71 as so  
in effect1 shall be classified under    
clause 7vi7 on and after the effective  
date of such clause 7vi7 and for cost   
reporting periods beginning on or after 
,january #a1 #bjad1 shall not be subject
 to subsection 7m7 as of the date of    
such classification7 after so           
classified4  7d7 ,application ,in the   
case of a hospital that is classified   
under clause 7iv77,,ii7 of section      
#ahhf7;d77#a77;,b7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acieww7d77#a77;,b77 on the day before  
the date of the enactment of this ,act  
and which is classified under clause    
7vi7 of such section after such date of 
enactment1 payments for inpatient       
operating costs for cost reporting      

periods beginning on or after ,january  
#a1 #bjad1 shall be based upon the      
target amount per discharge established 
pursuant to section #ahhf7;b7 of such   
,act 7#db ,u4,s4,c4 #acieww7b77 in      
effect for the cost reporting period for
 such hospital beginning during fiscal  
year #bjja1 increased for each          
succeeding cost reporting period        
7beginning before the date of the       
enactment of this ,act7 by the          
applicable percentage increase under    
section #ahhf7;b77#c77;,b77ii7 of such  
,act 7#db ,u4,s4,c4                     
#acieww7b77#c77;,b77ii774