Sec. 50205. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL (MDH) PROGRAM
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## SEC. 50205 EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL
(MDH)PROGRAM ###
(a)In General 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 “October 1, 2017” and inserting “October 1, 2022”; ####
(2)in clause (ii)(II), by striking “October 1, 2017” and inserting “October 1, 2022”; and ####
(3)in clause (iv), by striking subclause
(I)and inserting the following new subclause: > > ###### “(I) > > that is located in— > > > ###### “(aa) > > a rural area; or > > > ###### “(bb) > > a State with no rural area (as defined in paragraph (2)(D)) and satisfies any of the criteria in subclause (I), (II), or
(III)of paragraph (8)(E)(ii),” > ; and ####
(4)by inserting after subclause
(IV)the following new flush sentences:"“Subclause (I)(bb) shall apply for purposes of payment under clause
(ii)only for discharges of a hospital occurring on or after the effective date of a determination of medicare-dependent small rural hospital status made by the Secretary with respect to the hospital after the date of the enactment of this sentence. For purposes of applying subclause
(II)of paragraph (8)(E)(ii) under subclause (I)(bb), such subclause
(II)shall be applied by inserting ‘as of January 1, 2018,’ after ‘such State’ each place it appears.”". ###
(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 “October 1, 2017” and inserting “October 1, 2022”; and #####
(B)in clause (iv), by striking “through fiscal year 2017” and inserting “through fiscal year 2022”. ####
(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 “through fiscal year 2017” and inserting “through fiscal year 2022”. ###
(c)GAO Study and Report ####
(1)Study The Comptroller General of the United States (in this subsection referred to as the “Comptroller General”) shall conduct a study on the medicare-dependent, small rural hospital program under section 1886(d) of the Social Security Act (42 U.S.C. 1395x(d)). Such study shall include an analysis of the following: #####
(A)The payor mix of medicare-dependent, small rural hospitals (as defined in paragraph (5)(G)(iv) of such section 1886(d)), how such mix will trend in future years (based on current trends and projections), and whether or not the requirement under subclause
(IV)of such paragraph should be revised. #####
(B)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 title 42, 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. #####
(C)Such other items related to medicare-dependent, small rural hospitals as the Comptroller General determines appropriate. ####
(2)Report Not later than 2 years after the date of the enactment of this Act, the Comptroller General shall submit to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate.
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