,,ii  #aaith ,,congress  #b;d ,session  
,s4 #dbcc  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #bf1    
#bjbf,mr4 ,warner 7for himself1 ,mrs4   
,blackburn1 ,mrs4 ,hyde-,smith1 and ,mr4
 ,tuberville7 introduced the following  
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to amend title ,,xviii of the ,social
 ,security ,act to codify the ,medicare 
low-wage index hospital policy4  #a4    
,short title ,this ,act may be cited as 
the ,save ,struggling ,hospitals ,act4  
#b4 ,codification of the ,medicare      
low-wage index hospital policy ,section 
#ahhf7;d77#c77;,e7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acieww7d77#c77;,e77 is amended-- 7#a7  
in clause 7i71 in the first sentence1 by
 striking or 7iv7 and inserting 1 7iv71 
or 7v72 and  7#b7 by adding at the end  
the following new clause3  7v7 ,area    
wage index adjustment for low-wage      
hospitals  7,i7 ,in general ,for        
discharges occurring on or after        

,october #a1 #bjai1 the area wage index 
applicable under this subparagraph for a
 fiscal year to a hospital with an area 
wage index 7determined without regard to
 this clause7 below the #beth percentile
 area wage index shall be increased by  
of the difference between the otherwise 
applicable final area wage index for    
such fiscal year for such hospital and  
the #beth percentile area wage index for
 such fiscal year across all hospitals4 
7,,ii7 ,budget neutrality ,pursuant to  
the fourth sentence of clause 7i71 this 
clause shall be applied in a budget     
neutral manner4 ,any adjustments made   
for the purposes of such application of 
budget neutrality may not-- 7aa7        
decrease the area wage index applicable 
under this subparagraph to a hospital   
with an area wage index 7determined     
without regard to this clause7 below the
 #geth percentile area wage index for   
the fiscal year2 or  7bb7 result in an  
area wage index applicable under this   
subparagraph to a hospital for such     

fiscal year that is less than #ie       
percent of the area wage index          
applicable under this subparagraph to   
such hospital for the preceding fiscal  
year4  4