Sec. 30608. Adjustments to uncompensated care pools and disproportionate share hospital payments
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Section 1903 of the Social Security Act ( 42 U.S.C. 1396b ) is amended by adding at the end the following new subsection: With respect to a State with a State plan (or waiver of such plan) that does not provide, with respect to a fiscal year (beginning with fiscal year 2023), to all individuals described in section 1902(a)(10)(A)(i)(VIII) benchmark coverage described in section 1937(b)(1) or benchmark equivalent coverage described in section 1937(b)(2), in the case of any experimental, pilot, or demonstration project undertaken under section 1115, with respect to such State and fiscal year, that provides for Federal financial participation with respect to expenditures for payments to providers for otherwise uncompensated care that is furnished to low-income individuals, uninsured individuals, or underinsured individuals, notwithstanding any waiver authority available under such section, such project shall exclude from Federal financial participation any expenditures for care that is furnished with respect to such fiscal year to individuals described in section 1902(a)(10)(A)(i)(VIII). .
Section 1923(f) of the Social Security Act (42 U.S.C.1396r–4(f)) is amended— in paragraph (3)(A), by striking paragraphs (6), (7), and
(8)and inserting paragraphs (6), (7), (8), and
(10); in paragraph (6)(A)(vi), by inserting (except paragraph (10)) before , any other provision of law ; in paragraph (7)(A)(i), by inserting without regard to paragraph (10), before the Secretary ; and by adding at the end the following new paragraph: For fiscal year 2023 and each subsequent fiscal year— in the case of a State with a State plan (or waiver of such plan) that, with respect to such fiscal year, does not provide to all individuals described in section 1902(a)(10)(A)(i)(VIII) benchmark coverage described in section 1937(b)(1) or benchmark equivalent coverage described in section 1937(b)(2), the Secretary shall reduce the DSH allotment to the State for such fiscal year in the amount equal to 12.5 percent of the DSH allotment that would (after the application of paragraph (6), and without the application of paragraphs (7), (8), or this paragraph) be determined under this subsection for the State for such fiscal year; in the case of a State with a State plan (or waiver of such plan) that, with respect to such fiscal year, initially provides to all individuals described in section 1902(a)(10)(A)(i)(VIII) benchmark coverage described in 1937(b)(1) or benchmark equivalent coverage described in section 1937(b)(2), but during such fiscal year stops providing to any such individual such benchmark or benchmark equivalent coverage, the Secretary shall reduce the DSH allotment to the State for such fiscal year in the amount equal to the product of— 12.5 percent of the DSH allotment that would (after the application of paragraph (6), and without the application of paragraphs (7), (8), or this paragraph) be determined under this subsection for the State for such fiscal year; and expressed as a percentage, the number of days of such fiscal year during which such State plan (or waiver of such plan), with respect to such fiscal year, did not provide to such individuals such benchmark or benchmark equivalent coverage; or in the case of a State with a State plan (or waiver of such plan) that, with respect to such fiscal year, either— initially does not provide to all individuals described in section 1902(a)(10)(A)(i)(VIII) benchmark coverage described in 1937(b)(1) or benchmark equivalent coverage described in section 1937(b)(2), but during the fiscal year establishes a State plan (or waiver of such plan) that provides, for the remainder of the fiscal year, all such individuals such benchmark or benchmark equivalent coverage; or did not provide to all such individuals such benchmark or benchmark equivalent coverage during the fiscal year preceding such fiscal year described in the matter preceding subclause (I), but on the first day of such fiscal year establishes a State plan (or waiver of such plan) that provides, for the entirety of such fiscal year, all such individuals such benchmark or benchmark equivalent coverage; the DSH allotment for such State for such fiscal year is equal to the DSH allotment under this subsection (without application of this paragraph) for the State for the entirety of such fiscal year. The DSH allotment for a State for fiscal years after which a State provides under a State plan (or waiver of such plan) to all individuals described in section 1902(a)(10)(A)(i)(VIII) benchmark coverage described in section 1937(b)(1) or benchmark equivalent coverage described in section 1937(b)(2) and, for which the State continues to provide under the State plan (or waiver of such plan) such benchmark or benchmark equivalent coverage to such individuals, without the providing of such benchmark or benchmark equivalent coverage being stopped during a fiscal year (as described in the matter preceding subclause
(I)of subparagraph (A)(ii)), shall be calculated under paragraph
(3)without regard to this paragraph. . Section 1923(f)(7)(A)(i)(II) of the Social Security Act (42 U.S.C.1396r–4(f)(7)(A)(i)(II)) is amended by adding at period at the end.
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U.S. Code
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- 42 USC 1396r–4(f)
- 42 USC 1396r–4(f)(7)(A)(i)(II)
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Sec. 30608
Adjustments to uncompensated care pools and disproportionate share hospital payments
Cite42 USC 1396r–4(f)
Cite42 USC 1396r–4(f)(7)(A)(i)(II)
Cites 3Cited by 0 across 0 sources