,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #agdi  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #aj1 #bjba,mr4   
,kell] 7= himself1 ,mr4 ,kelly (        
,p5nsylvania1 ,mr4 ,?ompson (           
,p5nsylvania1 ,mr4 ,griffi?1 ,mr4       
,lucas1 & ,mr4 ,/eube7 introduc$ !      
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,ways & ,means  ,a ,,bill 
,to am5d title ,,xviii ( ! ,social      
,security ,act to direct ! ,secret>y (  
,heal? & ,human ,s]vices to conduct a   
/udy on pot5tial disp>ities 9 incurr$   
co/s = rural & urban hospitals "u !     
inpati5t prospective paym5t sy/em & to  
au?orize appropriate paym5t adju/m5ts4  
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,review+ ,urban & ,rural ,adju/m5ts to
 ,level ,hospital ,exp5ses & ,lopsid$   
,paym5ts ,act ( #bjba or ! ,,rural      
,,help ,act ( #bjba4  #b4 ,/udy on      
incurr$ co/s disp>ities "u ,,ipps2      
au?orization ( paym5t adju/m5ts ,section
 #ahhf7;d77#e7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acieww7d77#e77 is  

am5d$ by add+ at ! end ! foll[+ new     
subp>agraph3  7,n7 7i7 ,n lat] ?an #b   
ye>s aft] ! date ( ! enactm5t ( ?is     
subp>agraph1 ! ,secret>y %all conduct a 
/udy to det]m9e if1 "u ! me?odology =   
det]m9+ paym5ts "u p>agraph 7#a77;,a71 &
 us+ bo? national & hospital-specific   
co/-to-*>ge ratios1 co/s incurr$ by     
hospitals locat$ 9 rural areas by       
diagnosis-relat$ gr\p exce$ ^? co/s     
incurr$ by hospitals locat$ 9 urban     
areas4  7ii7 ,ins(> z ! ,secret>y       
det]m9es ?r\gh ! /udy conduct$ "u clause
 7i7 t co/s incurr$ by hospitals locat$ 
9 rural areas exce$ ^? co/s incurr$ by  
hospitals locat$ 9 urban areas1 !       
,secret>y %all provide = an appropriate 
adju/m5t to paym5ts "u p>agraph         
7#a77;,a7 to reflect ^? high] co/s =    
dis*>ges occurr+ on or aft] ,octob] #a (
 a ye> specifi$ by ! ,secret>y 7b 9 no  
case lat] ?an #b ye>s aft] ! date ( !   
enactm5t ( ?is subp>agraph74  4