,,ii  #aafth ,,congress  #b;d ,session  
,s4 #ejgg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #bj1 
#bjbj,mr4 ,cornyn introduced the        
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to amend title ,,xix of the 
,social ,security ,act to adjust the    
limitations on ,medicaid                
disproportionate share hospital         
payments4  #a4 ,short title ,this ,act  
may be cited as the ,children's         
,hospital ,protection ,act4  #b4        
,medicaid shortfall and third-party     
payments  7a7 ,in general ,subsection   
7g7 of section #aibc of the ,social     
,security ,act 7#db ,u4,s4,c4 #acifr-#d7
 is amended to read as follows3  7g7    
,limit on amount of payment to hospital 
7#a7 ,in general  7,a7 ,amount of       
adjustment subject to uncompensated     
costs ,a payment adjustment during a    
fiscal year shall not be considered to  
be consistent with subsection 7c7 with  
respect to a hospital 7other than a     

hospital described in paragraph         
7#b77;,b77 if the payment adjustment    
exceeds an amount equal to-- 7i7 the    
costs incurred during the year of       
furnishing hospital services by the     
hospital to individuals described in    
subparagraph 7,b7 minus--  7ii7 the sum 
of-- 7,i7 payments under this title     
7other than under this section7 for such
 services2 and  7,,ii7 payments by      
uninsured patients for such services4   
7,b7 ,individuals described ,for        
purposes of subparagraph 7,a71 the      
individuals described in this clause are
 the following3 7i7 ,individuals who are
 eligible for medical assistance under  
the ,state plan or under a waiver of    
such plan and for whom the ,state plan  
or waiver is the primary payor for such 
services4  7ii7 ,subject to subparagraph
 7,c71 individuals who have no health   
insurance 7or other source of third     
party coverage7 for services provided   
during the year1 as determined by the   
,secretary4  7,c7 ,exclusion of certain 

payments ,for purposes of subparagraph  
7,b77ii71 payments made to a hospital   
for services provided to indigent       
patients made by a ,state or a unit of  
local government within a ,state shall  
not be considered to be a source of     
third party coverage4  7#b7 ,application
 of limits for certain hospitals  7,a7  
,in general ,a payment adjustment during
 a fiscal year shall not be considered  
to be consistent with subsection 7c7    
with respect to a hospital described in 
subparagraph 7,b7 if the payment        
adjustment exceeds the higher of-- 7i7  
the amount determined for the hospital  
and fiscal year under paragraph         
7#a77;,a72 and  7ii7 the amount         
determined for the hospital under       
paragraph 7#a77;,a7 as in effect on     
,january #a1 #bjbj4  7,b7 ,hospitals    
described ,a hospital is described in   
this subparagraph for a fiscal year if1 
for the most recent cost reporting      
period ending before such fiscal year1  
the hospital is in at least the #ihth   

percentile of all hospitals with respect
 to the number of hospital days for such
 period that were made up of patients   
who 7for such days7 were entitled to    
benefits under part ,a of title ,,xviii 
and were entitled to supplemental       
security income benefits under title    
,,xvi 7excluding any ,state             
supplementary benefits paid with respect
 to such patients74  4  7b7 ,effective  
date ,the amendment made by this section
 shall take effect on ,october #a1      
#bjba1 and shall apply to payment       
adjustments made under section #aibc of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #acifr-#d7 during fiscal years
 beginning on or after such date4