119-s335

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 335 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 335

 To amend title XVIII of the Social Security Act to rebase the 
 calculation of payments for sole community hospitals and Medicare-
 dependent hospitals, and for other purposes.

_______________________________________________________________________

 IN THE SENATE OF THE UNITED STATES

 January 30, 2025

 Mr. Grassley (for himself, Mr. Welch, Mrs. Capito, Mr. Kaine, Mr. 
 Wicker, Mrs. Shaheen, Mr. Moran, Ms. Smith, Mrs. Hyde-Smith, Mr. 
 Fetterman, Mr. Boozman, and Mr. Kelly) introduced the following bill; 
 which was read twice and referred to the Committee on Finance

_______________________________________________________________________

 A BILL

 To amend title XVIII of the Social Security Act to rebase the 
 calculation of payments for sole community hospitals and Medicare-
 dependent hospitals, and for other purposes.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Rural Hospital Support Act''.

SEC. 2. REBASING OF THE CALCULATION OF PAYMENTS FOR SOLE COMMUNITY 
 HOSPITALS.

    (a) Rebasing Permitted.--

Section 1886

    (b)

    (3) of the Social Security 
Act (42 U.S.C. 1395ww

    (b)

    (3) ) is amended by adding at the end the 
following new subparagraph:
 ``
            (M) 
            (i) For cost reporting periods beginning on or 
 after October 1, 2025, in the case of a sole community 
 hospital there shall be substituted for the amount 
 otherwise determined under subsection
            (d) (5)
            (D) 
            (i) of 
 this section, if such substitution results in a greater 
 amount of payment under this section for the hospital, 
 the subparagraph
            (M) rebased target amount.
 ``
            (ii) For purposes of this subparagraph, the term 
 `subparagraph
            (M) rebased target amount' has the 
 meaning given the term `target amount' in subparagraph
            (C) , except that--
 ``
            (I) there shall be substituted for the 
 base cost reporting period the 12-month cost 
 reporting period beginning during fiscal year 
 2016;
 ``
            (II) any reference in subparagraph
            (C) 
            (i) to the `first cost reporting period' described 
 in such subparagraph is deemed a reference to 
 the first cost reporting period beginning on or 
 after October 1, 2025; and
 ``
            (III) the applicable percentage increase 
 shall only be applied under subparagraph
            (C) 
            (iv) for discharges occurring on or after 
 October 1, 2025.''.

    (b) Conforming Amendments.--

Section 1886

    (b)

    (3) of the Social 
Security Act (42 U.S.C. 1395ww

    (b)

    (3) ) is amended--

    (1) in subparagraph
            (C) , in the matter preceding clause
            (i) , by striking ``subparagraphs
            (I) and
            (L) '' and inserting 
 ``subparagraphs
            (I) ,
            (L) , and
            (M) ''; and

    (2) in subparagraph
            (I) 
            (i) , in the matter preceding 
 subclause
            (I) , by striking ``subparagraph
            (L) '' and inserting 
 ``subparagraphs
            (L) and
            (M) ''.

SEC. 3. REBASING OF THE CALCULATION OF PAYMENTS FOR MEDICARE-DEPENDENT 
 HOSPITALS.

 

Section 1886

    (b)

    (3) of the Social Security Act (42 U.S.C. 
1395ww

    (b)

    (3) ), as amended by 

section 2, is amended--

    (1) in subparagraph
            (D) , by striking ``subparagraph
        (K) '' 
 and inserting ``subparagraphs
        (K) and
        (N) ''; and

    (2) by adding at the end the following new subparagraph:
 ``
        (N)
            (i) With respect to discharges occurring on or 
 after October 1, 2025, in the case of a medicare-
 dependent, small rural hospital, for purposes of 
 applying subparagraph
            (D) --
 ``
            (I) there shall be substituted for the 
 base cost reporting period described in 
 subparagraph
            (D) 
            (i) the 12-month cost reporting 
 period beginning during fiscal year 2016; and
 ``
            (II) any reference in such subparagraph 
 to the `first cost reporting period' described 
 in such subparagraph is deemed a reference to 
 the first cost reporting period beginning on or 
 after October 1, 2025.
 ``
            (ii) This subparagraph shall only apply to a 
 hospital if the substitution described in clause
            (i) 
            (I) results in an increase in the target amount under 
 subparagraph
            (D) for the hospital.''.

SEC. 4. PROHIBITION OF ADJUSTMENTS TO CLASSIFICATIONS AND WEIGHTING 
 FACTORS RELATING TO THE CALCULATION OF PAYMENTS FOR SOLE 
 COMMUNITY HOSPITALS AND MEDICARE-DEPENDENT HOSPITALS.

 

Section 1886
            (d) (4)
            (C) of the Social Security Act (42 U.S.C. 
1395ww
            (d) (4)
            (C) )--

    (1) in clause
            (i) , by striking ``The Secretary'' and 
 inserting ``Subject to clause
            (v) , the Secretary''; and

    (2) by adding at the end the following new clause:
 ``
            (v) For discharges using the rebased target amounts described in 
subparagraph
            (M) or
        (N) of subsection

    (b)

    (3) , the Secretary may not 
adjust such amounts for adjustments required by clause
            (iii) prior to 
October 1, 2015.''.

SEC. 5. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL

    (MDH) PROGRAM.

    (a) Extension of Payment Methodology.--

Section 1886
            (d) (5)
        (G) of the 
Social Security Act (42 U.S.C. 1395ww
            (d) (5)
        (G) ) is amended--

    (1) in clause
            (i) , by striking ``, and before April 1, 
 2025''; and

    (2) in clause
            (ii) 
            (II) , by striking ``, and before April 1, 
 2025''.

    (b) Conforming Amendments.--

    (1) Extension of target amount.--

Section 1886

    (b)

    (3)
            (D) of 
 the Social Security Act (42 U.S.C. 1395ww

    (b)

    (3)
            (D) ) is 
 amended--
        (A) in the matter preceding clause
            (i) , by striking 
 ``, and before April 1, 2025''; and
        (B) in clause
            (iv) , by striking ``through fiscal 
 year 2024 and the portion of fiscal year 2025 beginning 
 on October 1, 2024, and ending on March 31, 2025'' and 
 inserting ``or a subsequent fiscal year''.

    (2) Permitting hospitals to decline reclassification.--
 

Section 13501

    (e)

    (2) of the Omnibus Budget Reconciliation Act of 
 1993 (42 U.S.C. 1395ww note) is amended by striking ``fiscal 
 year 2000 through fiscal year 2024, or the portion of fiscal 
 year 2025 beginning on October 1, 2024, and ending on March 31, 
 2025'' and inserting ``a subsequent fiscal year''.

SEC. 6. EXTENSION OF THE INCREASED PAYMENTS UNDER THE MEDICARE LOW-
 VOLUME HOSPITAL PROGRAM.

 

Section 1886
            (d) (12) of the Social Security Act (42 U.S.C. 
1395
            (d) (12) ) is amended--

    (1) in subparagraph
        (B) --
        (A) in the subparagraph heading, by inserting ``for 
 fiscal years 2005 through 2010'' after ``increase''; 
 and
        (B) in the matter preceding clause
            (i) , by striking 
 ``and for discharges occurring during the portion of 
 fiscal year 2025 beginning on April 1, 2025, and ending 
 on September 30, 2025, and in fiscal year 2026 and 
 subsequent fiscal years'';

    (2) in subparagraph
            (C) 
            (i) --
        (A) in the matter preceding subclause
            (I) , by 
 striking ``fiscal years 2011 through 2024 and the 
 portion of fiscal year 2025 beginning on October 1, 
 2024, and ending on March 31, 2025'' and inserting 
 ``fiscal year 2011 and subsequent fiscal years'';
        (B) in subclause
            (III) --
            (i) by striking ``each of fiscal years 2019 
 through 2024 and the portion of fiscal year 
 2025 beginning on October 1, 2024, and ending 
 on March 31, 2025'' and inserting ``fiscal year 
 2019 and each subsequent fiscal year''; and
            (ii) by striking ``; and'' at the end and 
 inserting a period; and
            (C) by striking subclause
            (IV) ; and

    (3) in subparagraph
            (D) --
        (A) by amending the subparagraph heading to reach 
 as follows: ``Applicable percentage increase beginning 
 with fiscal year 2011.--'';
        (B) in the matter preceding clause
            (i) , by striking 
 ``fiscal years 2011 through 2024 or during the portion 
 of fiscal year 2025 beginning on October 1, 2024, and 
 ending on March 31, 2025'' and inserting ``fiscal year 
 2011 and subsequent fiscal years''; and
            (C) in clause
            (ii) , by striking ``each of fiscal 
 years 2019 through 2024 and the portion of fiscal year 
 2025 beginning on October 1, 2024, and ending on March 
 31, 2025'' and inserting ``fiscal year 2019 and each 
 subsequent fiscal year''.
 <all>