,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #cbhh  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #bi1 #bjae ,mr4 
,m>*ant 7= himself & ,mr4 ,b\/any7      
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means  ,a     
,,bill  ,to am5d title ,,xviii ( !      
,social ,security ,act to *ange ! me?od 
( det]m9+ disproportionate %>e hospital 
7,,d%7 paym5ts "u ! ,m$ic>e program1 & =
 o!r purposes4  #a4 ,%ort title ,?is    
,act may be cit$ z ! ,/r5g!n+ ,,d% &    
,m$ic>e ,?r\gh ,subsidy ,recapture &    
,paym5t ,re=m ,act ( #bjae4  #b4 ,*ange 
9 det]m9ation ( ,m$ic>e ,,d% paym5ts    
,p>agraph 7#a7 ( section #ahhf7r7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7r77 is am5d$--  7#a7 by /rik+ s 
mu* ( su* p>agraph z prec$es fiscal ye> 
#bjad & ins]t+ ! foll[+3  7#a7 ,,d%     
paym5ts  7,a7 ,9 g5]al ,subject to      
subp>agraph 7,b71 =  2  7#b7 by /rik+   
7:i* repres5ts & all t foll[s ?r\gh     
,report to ! ,congress72 &  7#c7 by add+
 at ! end ! foll[+ new subp>agraph3     

7,b7 ,aggregate limitation beg9n+ )     
fiscal ye> #bjag ,z "p ( ! rulemak+ to  
c>ry out subsection 7d7 = fiscal ye>    
#bjag & ea* subsequ5t fiscal ye>1 !     
,secret>y %all e/imate ! aggregate am\nt
 ( paym5ts to be made = su* fiscal ye>  
"u subp>agraph 7,a7 7det]m9$ )\t reg>d  
to ?is subp>agraph7 &1 if ! am\nt s     
e/imat$ exce$s #c1cjj1jjj1jjj1 !n ea*   
am\nt paid "u subp>agraph 7,a7 = t      
fiscal ye> %all be multipli$ by ! ratio 
( #c1cjj1jjj1jjj to ! am\nt s e/imat$4  
4  #c4 ,additional ,,d% paym5t = c]ta9  
qualify+ hospitals ,section #ahhf7r7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#acieww7r77 is am5d$-- 7#a7 by          
r$esignat+ p>agraph 7#c7 z p>agraph     
7#d72 &  7#b7 by ins]t+ aft] p>agraph   
7#b7 ! foll[+ new p>agraph3  7#c7       
,additional paym5t = c]ta9 qualify+     
hospitals  7,a7 ,9 g5]al ,= fiscal ye>  
#bjag & ea* subsequ5t fiscal ye>1 9     
addition to ! paym5ts made to a qualify+
 hospital "u p>agraphs 7#a7 & 7#b71 !   
,secret>y %all pay to ea* qualify+      

hospital an am\nt equal to              
#a1jjj1jjj1jjj multipli$ by ! factor t  
w\ld be calculat$ "u p>agraph 7#b77;,c7 
= su* qualify+ hospital if ea* ref]5ce 9
 su* p>agraph to a subsection 7d7       
hospital 7 treat$ z a ref]5ce to a      
qualify+ hospital4  7,b7 ,qualify+      
hospital def9$ ,9 ?is p>agraph1 qualify+
 hospital means a subsection 7d7        
hospital t is locat$ 9 ,alabama1        
,florida1 ,georgia1 ,idaho1 ,kansas1    
,l\isiana1 ,ma9e1 ,mississippi1         
,miss\ri1 ,nebraska1 ,nor? ,c>ol9a1     
,oklahoma1 ,s\? ,c>ol9a1 ,s\? ,dakota1  
,t5nessee1 ,texas1 ,utah1 ,virg9ia1     
,wiscons91 or ,wyom+4  4  #d4 ,recapture
 ( ov]paym5ts result+ f c]ta9 f$]ally   
subsidiz$ heal? insurance  7a7 ,9 g5]al 
,p>agraph 7#b7 ( section #cf;,b7f7 ( !  
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by /rik+ subp>agraph 7,b74  7b7 ,con=m+ 
am5dm5t ,s mu* ( p>agraph 7#b7 ( section
 #cf;,b7f7 ( su* ,code1 z am5d$ by      
subsection 7a71 z prec$es advance       
paym5ts is am5d$ to read z foll[s3  7#b7

 ,excess advance paym5ts ,if !  4  7c7  
,effective date ,! am5dm5ts made by ?is 
section %all apply to taxable ye>s end+ 
aft] ,decemb] #ca1 #bjae4