,,ii  #aacth ,,congress  #ast ,session  
,s4 #aeee  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,september #bf1
 #bjac,mr4 ,wicker introduced the       
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to amend titles ,,xviii and 
,,xix of the ,social ,security ,act to  
provide for a delay in the              
implementation schedule of the          
reductions in disproportionate share    
hospital payments1 and for other        
purposes4  #a4 ,short title ,the ,act   
may be cited as the ,,dsh ,reduction    
,relief ,act of #bjac4  #b4 ,delay in   
implementation of revised medicare      
disproportionate share hospital payment 
methodology  7a7 ,two-,year delay       
,section #ahhf7r7 of the ,social        
,security ,act 7#db ,u4,s4,c4           
#acieww7r77 is amended-- 7#a7 in        
paragraph 7#a71 by striking ,for fiscal 
year #bjad and inserting ,for fiscal    
year #bjaf2 and  7#b7 in paragraph      
7#b7-- 7,a7 in the matter preceding     

subparagraph 7,a71 by striking for      
fiscal year #bjad and inserting for     
fiscal year #bjaf2  7,b7 in subparagraph
 7,b77i7-- 7i7 in the heading of clause 
7i71 by striking #bjad1 #bjae1 #bjaf1   
and #bjag and inserting #bjaf1 #bjag1   
#bjah1 and #bjai2  7ii7 in the matter   
preceding subclause 7,i71 by striking   
,for each of fiscal years #bjad1 #bjae1 
#bjaf1 and #bjag and inserting ,for each
 of fiscal years #bjaf1 #bjag1 #bjah1   
and #bjai2 and  7iii7 in the matter     
following subclause 7,,ii7-- 7,i7 by    
striking fiscal year #bjad and inserting
 fiscal year #bjaf2 and  7,,ii7 by      
striking fiscal years #bjae1 #bjaf1 and 
#bjag and inserting fiscal years #bjag1 
#bjah1 and #bjai2 and  7,c7 in          
subparagraph 7,b77ii7-- 7i7 in the      
heading of clause 7ii71 by striking     
#bjah and inserting #bjbj2  7ii7 in the 
matter preceding subclause 7,i71 by     
striking ,for fiscal year #bjah and     
inserting ,for fiscal year #bjbj2 and   
7iii7 in the matter following subclause 

7,,ii71 by striking fiscal years #bjah  
and #bjai and inserting fiscal years    
#bjbj and #bjba4  7b7 ,effective date   
,the amendments made by subsection 7a7  
shall take effect as if included in the 
enactment of section #cacc of the       
,patient ,protection and ,affordable    
,care ,act 7,public ,law #aaa-adh71 as  
amended by section #ajcaf of such ,act1 
and as further amended by section #aajd 
of the ,health ,care and ,education     
,reconciliation ,act of #bjaj 7,public  
,law #aaa-aeb74  #c4 ,modification of   
reduction schedule for ,medicaid ,,dsh  
allotments to ,states  7a7 ,elimination 
of reductions for fiscal years #bjad and
 #bjae ,section #aibc7;f77#g77;,a7 of   
the ,social ,security ,act 7#db         
,u4,s4,c4 #acifr-#d7;f77#g77;,a77 is    
amended-- 7#a7 in clause 7i7 in the     
matter preceding subclause 7,i71 by     
striking fiscal years #bjad and         
inserting fiscal years #bjaf 2 and  7#b7
 in clause 7ii71 by striking subclauses 
7,i7 and 7,,ii7 and redesignating       

subclauses 7,,iii7 through 7,,vii7 as   
subclauses 7,i7 through 7,v71           
respectively4  7b7 ,effective date ,the 
amendments made by subsection 7a7 shall 
take effect as if included in the       
enactment of section #abjc of the       
,health ,care and ,education            
,reconciliation ,act of #bjaj 7,public  
,law #aaa-aeb74  #d4 ,rebasing of       
,medicaid disproportionate share        
hospital allotments ,section            
#aibc7;f77#h7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #acifr-#d7;f77#h77  
is amended-- 7#a7 by redesignating      
subparagraph 7,c7 as subparagraph 7,d72 
7#b7 by inserting after subparagraph    
7,b7 the following new subparagraph3    
7,c7 ,fiscal year #bjbc ,only with      
respect to fiscal year #bjbc1 the ,,dsh 
allotment for a ,state1 in lieu of the  
amount determined under paragraph 7#c7  
for the ,state for that year1 shall be  
equal to the ,,dsh allotment for the    
,state for fiscal year #bjbb1 as        
determined under subparagraph 7,b71     

increased1 subject to subparagraphs 7,b7
 and 7,c7 of paragraph 7#c71 and        
paragraph 7#e71 by the percentage change
 in the consumer price index for all    
urban consumers 7all items2 ,u4,s4 city 
average71 for fiscal year #bjbb4  2 and 
7#c7 in subparagraph 7,d7 7as           
redesignated by paragraph 7#a7 of this  
section71 by striking fiscal year #bjbb 
and inserting 8fiscal year #bjbc4