,,ii  #aaith ,,congress  #ast ,session  
,s4 #eec  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,february #ab1      
#bjbe,mr4 ,sullivan 7for himself1 ,mr4  
,schatz1 and ,ms4 ,murkowski7 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
 establish a floor on payments to sole  
community hospitals located in ,alaska  
and ,hawaii under the hospital          
outpatient prospective payment system4  
#a4 ,short title ,this ,act may be cited
 as the ,save our ,lone ,emergency      
,services ,act or the ,,soles ,act4  #b4
 ,treatment of sole community hospitals 
located in ,alaska and ,hawaii under    
hospital outpatient prospective payment 
system ,section #ahcc7t7 of the ,social 
,security ,act 7#db ,u4,s4,c4 #aciel7t77
 is amended by adding at the end the    
following new paragraph3  7#bc7         
,treatment of sole community hospitals  
located in ,alaska and ,hawaii  7,a7 ,in

 general ,if the ,secretary determines  
that the amount of payment under this   
subsection for covered ,,opd services   
furnished by a sole community hospital  
7as defined in section                  
#ahhf7;d77#e77;,d77iii77 that is located
 in ,alaska or ,hawaii is less than #id 
percent of the reasonable costs 7as     
defined in section #ahfa7v77 of the     
hospital providing such services1 the   
amount of payment under this subsection 
shall be increased by the amount of such
 difference4  7,b7 ,no effect on        
copayments ,nothing in this paragraph   
shall be construed to affect the        
copayment amount under paragraph 7#h74  
7,c7 ,application without regard to     
budget neutrality ,the additional       
payments made under this paragraph-- 7i7
 shall not be considered an adjustment  
under paragraph 7#b77;,e72 and  7ii7    
shall not be implemented in a budget    
neutral manner4  7,d7 ,rulemaking ,not  
later than #f months after the date of  
enactment of this paragraph1 the        

,secretary shall promulgate regulations 
to carry out this paragraph1 which shall
 be effective with respect to covered   
,,opd services furnished on or after the
 first ,january #a after such date4  4