,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #ajacd  ,,9 ,,! ,,h\se ,,(         
,,repres5tatives  ,augu/ #bj1 #bjbf,ms4 
,s*olt5 introduc$ ! foll[+ bill2 :i* 0  
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce  ,a ,,bill  ,to e/abli% an     
eligibility exception = ! drug disc\nt  
program due to cuts to ! ,m$icaid       
program4  #a4 ,%ort title ,?is ,act may 
be cit$ z ! ,local ,heal? ,c>e          
,protection ,act ( #bjbf4  #b4          
,eligibility exception = ! drug disc\nt 
program due to cuts to ! ,m$icaid       
program  7a7 ,9 g5]al ,not)/&+ any o!r  
provision ( law1 9 ! case ( a hospital  
describ$ 9 subsection 7b7 t1 ) respect  
to co/ report+ p]iods t beg9 dur+ fiscal
 ye> #bjbf or a subsequ5t fiscal ye>1 b 
d n end aft] ,septemb] #cj1 #bjcj1 does 
n meet ! applicable requirem5t = !      
disproportionate %>e adju/m5t p]c5tage  
describ$ 9 subsection 7c71 b o!rwise    
meets ! requirem5ts = be+ a cov]$ entity
 "u subp>agraph 7,l71 7,m71 or 7,o7 (   
subsection 7a77#d7 ( section #cdj;,b ( !

 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #bef;b7 & is 9 compliance )   
all o!r requirem5ts ( ! program "u su*  
section1 %all be deem$ a cov]$ entity = 
purposes ( su* section = ! p]iod--  7#a7
 beg9n+ on ! date ( ! enactm5t ( ?is    
,act 7or1 if lat]1 ) ! fir/ ( su* co/   
report+ p]iods = :i* ! hospital does n s
 meet su* applicable requirem5t = !     
disproportionate %>e adju/m5t p]c5tage1 
b o!rwise meets all o!r su* requirem5ts 
= be+ su* a cov]$ entity & ( su*        
program72 &  7#b7 end+ ) ! la/ ( su* co/
 report+ p]iods 7end+ n lat] ?an        
,septemb] #cj1 #bjcj7 = :i* ! hospital  
does n s meet su* applicable requirem5t 
= ! disproportionate %>e adju/m5t       
p]c5tage1 b o!rwise meets all o!r su*   
requirem5ts = be+ su* a cov]$ entity & (
 su* program4  7b7 ,hospitals ,a        
hospital describ$ 9 ?is subsection is an
 entity t1 on ,july #c1 #bjbe1 0 a cov]$
 entity describ$ 9 subp>agraph 7,l71    
7,m71 or 7,o7 ( subsection 7a77#d7 (    
section #cdj;,b ( ! ,public ,heal?      

,s]vice ,act p>ticipat+ 9 ! drug disc\nt
 program "u su* section4  7c7           
,applicable requirem5t =                
disproportionate %>e adju/m5t p]c5tage  
,! applicable requirem5t = !            
disproportionate %>e adju/m5t p]c5tage  
describ$ 9 ?is subsection is--  7#a7 9 !
 case ( a hospital describ$ 9 subsection
 7a7 t o!rwise meets ! requirem5ts "u   
subp>agraph 7,l7 or 7,m7 ( section      
#cdj;,b7a77#d7 ( ! ,public ,heal?       
,s]vice ,act1 ! requirem5t "u           
subp>agraph 7,l77ii7 ( su* section2 &   
7#b7 9 ! case ( a hospital describ$ 9   
subsection 7a7 t o!rwise meets !        
requirem5ts "u subp>agraph 7,o7 ( su*   
section #cdj;,b7a77#d71 ! requirem5t )  
respect to ! disproportionate %>e       
adju/m5t p]c5tage describ$ 9 su*        
subp>agraph 7,o74  7d7 ,report ,n lat]  
?an #a ye> aft] ! date ( ! enactm5t (   
?is ,act1 ! ,comptroll] ,g5]al ( !      
,unit$ ,/ates %all conduct a /udy &     
submit to ,congress a report on !       
crit]ia us$ to det]m9e :e!r an entity is

 a cov]$ entity & ! crit]ia us$ by      
,/ates to det]m9e :e!r a hospital s]ves 
a disproportionate numb] ( l[ income    
pati5ts ) special ne$s = purposes (     
section #aibc ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acifr-#d74 ,su* report 
%all also-- 7#a7 evaluate ! impact (    
decl9+ paym5ts "u section               
#ahhf7;d77#e77;,f7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acifww7d77#e77;,f77 9 rural areas1     
includ+ :e!r su* decl9+ paym5ts         
correlate ) ! loss ( critical s]vices   
su* z ob/etrics & gynecology1 oncology1 
or o!r ess5tial specialties2  7#b7      
review curr5t proposals to revise !     
=mula = det]m9+ paym5t adju/m5ts "u su* 
section1 includ+ ^? put =w>d by !       
,m$ic>e ,paym5t ,advisory ,commission1 !
 ,am]ican ,hospital ,association1       
,am]ica's ,ess5tial ,hospitals1 & !     
,*ildr5's ,heal? ,association2  7#c7    
assess ! /r5g?s & weaknesses ( ea*      
proposal describ$ 9 p>agraph 7#b7 to    
in=m future policy decisions2  7#d7     

analyze ! curr5t me?odology = det]m9+   
su* paym5t adju/m5ts1 includ+ any *anges
 9 su* me?odology to acc\nt = rec5t     
litigation2 &  7#e7 id5tify common      
factors & und]ly+ causes t lead to a    
decl9e 9 su* paym5t adju/m5ts =         
hospitals1 includ+-- 7,a7 :e!r          
disability det]m9ations made by !       
,social ,security ,adm9i/ration         
accurately reflect eligibility1         
p>ticul>ly 9 light ( case backlogs2 &   
7,b7 :e!r limit$ po/-acute c>e capacity 
9 rural or und]s]v$ areas is impact+ su*
 paym5t adju/m5ts4  7e7 ,def9ition ,9   
?is section1 ! t]m cov]$ entity has !   
mean+ giv5 su* t]m 9 section            
#cdj;,b7a77#d7 ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4             
#bef;b7a77#d774