Sec. 204. Revision of the Medicare-dependent hospital (MDH) program
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Section 1886(d)(5)(G) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(G)) is amended— in clause (i), by striking and before April 1, 2014, ; and in clause (ii)(II), by striking and before April 1, 2014, . Section 1886(b)(3)(D) of the Social Security Act (42 U.S.C. 1395ww(b)(3)(D)) is amended— in the matter preceding clause (i), by striking and before April 1, 2014, ; and in clause (iv), by striking through fiscal year 2013 and the portion of fiscal year 2014 before April 1, 2014 and inserting or a subsequent fiscal year .
Section 1886(o)(7)(D)(ii)(I) of the Social Security Act (42 U.S.C. 1395ww(o)(7)(D)(ii)(I)) is amended by striking (with respect to discharges occurring during fiscal year 2012 and 2013) . Section 1886(q)(2)(B)(i) of the Social Security Act (42 U.S.C. 1395ww(q)(2)(B)(i)) is amended by striking (with respect to discharges occurring during fiscal years 2012 and 2013) . Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 1993 ( 42 U.S.C. 1395ww note) is amended by striking fiscal year 1998, fiscal year 1999, or fiscal year 2000 through the first 2 quarters of fiscal year 2014 and inserting or fiscal year 1998 or a subsequent fiscal year .
The Comptroller General of the United States shall conduct a study on the following: The payor mix of medicare-dependent, small rural hospitals (as defined in section 1886(d)(5)(G)(iv)), how such mix will trend in future years, and whether or not the requirement under subclause
(IV)of such section should be revised. The characteristics of medicare-dependent, small rural hospitals that meet the requirement of such subclause
(IV)through the application of paragraph (a)(iii)(A) or (a)(iii)(B) of section 412.108 of the Code of Federal Regulations, including Medicare inpatient and outpatient utilization, payor mix, and financial status, including Medicare and total margins, and whether or not Medicare payments for such hospitals should be revised. Such other items related to medicare-dependent, small rural hospitals as the Comptroller General determines appropriate. Not later than 12 months after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate. Notwithstanding any other provision of law, for purposes of fiscal year 2014, the Secretary of Health and Human Services may implement the provisions of, and the amendments made by, this section through program instruction or otherwise.
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Sec. 204
Revision of the Medicare-dependent hospital (MDH) program
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