,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #ejgg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #bj1 #bjbj,mr4
 ,cornyn introduc$ ! foll[+ bill2 :i* 0 
read twice & ref]r$ to ! ,committee on  
,f9ance  ,a ,,bill  ,to am5d title ,,xix
 ( ! ,social ,security ,act to adju/ !  
limitations on ,m$icaid disproportionate
 %>e hospital paym5ts4  #a4 ,%ort title 
,?is ,act may be cit$ z ! ,*ildr5's     
,hospital ,protection ,act4  #b4        
,m$icaid %ortfall & ?ird-p>ty paym5ts   
7a7 ,9 g5]al ,subsection 7g7 ( section  
#aibc ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acifr-#d7 is am5d$ to read z 
foll[s3  7g7 ,limit on am\nt ( paym5t to
 hospital  7#a7 ,9 g5]al  7,a7 ,am\nt ( 
adju/m5t subject to uncomp5sat$ co/s ,a 
paym5t adju/m5t dur+ a fiscal ye> %all n
 be consid]$ to be consi/5t ) subsection
 7c7 ) respect to a hospital 7o!r ?an a 
hospital describ$ 9 p>agraph 7#b77;,b77 
if ! paym5t adju/m5t exce$s an am\nt    
equal to-- 7i7 ! co/s incurr$ dur+ ! ye>
 ( furni%+ hospital s]vices by !        

hospital to individuals describ$ 9      
subp>agraph 7,b7 m9us--  7ii7 ! sum (-- 
7,i7 paym5ts "u ?is title 7o!r ?an "u   
?is section7 = su* s]vices2 &  7,,ii7   
paym5ts by un9sur$ pati5ts = su*        
s]vices4  7,b7 ,individuals describ$ ,= 
purposes ( subp>agraph 7,a71 !          
individuals describ$ 9 ?is clause are ! 
foll[+3 7i7 ,individuals :o are eligible
 = m$ical assi/ance "u ! ,/ate plan or  
"u a waiv] ( su* plan & = :om ! ,/ate   
plan or waiv] is ! prim>y payor = su*   
s]vices4  7ii7 ,subject to subp>agraph  
7,c71 individuals :o h no heal?         
insurance 7or o!r s\rce ( ?ird p>ty     
cov]age7 = s]vices provid$ dur+ ! ye>1 z
 det]m9$ by ! ,secret>y4  7,c7          
,exclusion ( c]ta9 paym5ts ,= purposes (
 subp>agraph 7,b77ii71 paym5ts made to a
 hospital = s]vices provid$ to indig5t  
pati5ts made by a ,/ate or a unit (     
local gov]nm5t )9 a ,/ate %all n be     
consid]$ to be a s\rce ( ?ird p>ty      
cov]age4  7#b7 ,application ( limits =  
c]ta9 hospitals  7,a7 ,9 g5]al ,a paym5t

 adju/m5t dur+ a fiscal ye> %all n be   
consid]$ to be consi/5t ) subsection 7c7
 ) respect to a hospital describ$ 9     
subp>agraph 7,b7 if ! paym5t adju/m5t   
exce$s ! high] (-- 7i7 ! am\nt det]m9$ =
 ! hospital & fiscal ye> "u p>agraph    
7#a77;,a72 &  7ii7 ! am\nt det]m9$ = !  
hospital "u p>agraph 7#a77;,a7 z 9      
effect on ,janu>y #a1 #bjbj4  7,b7      
,hospitals describ$ ,a hospital is      
describ$ 9 ?is subp>agraph = a fiscal   
ye> if1 = ! mo/ rec5t co/ report+ p]iod 
end+ be=e su* fiscal ye>1 ! hospital is 
9 at lea/ ! #ih? p]c5tile ( all         
hospitals ) respect to ! numb] (        
hospital days = su* p]iod t 7 made up ( 
pati5ts :o 7= su* days7 7 entitl$ to    
b5efits "u "p ,a ( title ,,xviii & 7    
entitl$ to supplem5tal security income  
b5efits "u title ,,xvi 7exclud+ any     
,/ate supplem5t>y b5efits paid ) respect
 to su* pati5ts74  4  7b7 ,effective    
date ,! am5dm5t made by ?is section %all
 take effect on ,octob] #a1 #bjba1 &    
%all apply to paym5t adju/m5ts made "u  

section #aibc ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acifr-#d7 dur+ fiscal  
ye>s beg9n+ on or aft] su* date4