Sec. 3133. IMPROVEMENT TO MEDICARE DISPROPORTIONATE SHARE HOSPITAL (DSH) PAYMENTS
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## SEC. 3133 IMPROVEMENT TO MEDICARE DISPROPORTIONATE SHARE HOSPITAL
(DSH)PAYMENTS Section 1886 of the Social Security Act (42 U.S.C. 1395ww), as amended by sections 3001, 3008, and 3025, is amended— ####
(1)in subsection (d)(5)(F)(i), by striking “For” and inserting “Subject to subsection (r), for”; and ####
(2)by adding at the end the following new subsection: > > ### “(r) Adjustments to Medicare DSH Payments > > > #### “(1) Empirically justified dsh payments > > For fiscal year 2014 and each subsequent fiscal year, instead of the amount of disproportionate share hospital payment that would otherwise be made under subsection (d)(5)(F) to a subsection
(d)hospital for the fiscal year, the Secretary shall pay to the subsection
(d)hospital 25 percent of such amount (which represents the empirically justified amount for such payment, as determined by the Medicare Payment Advisory Commission in its March 2007 Report to the Congress). > > > #### “(2) Additional payment > > In addition to the payment made to a subsection
(d)hospital under paragraph (1), for fiscal year 2014 and each subsequent fiscal year, the Secretary shall pay to such subsection
(d)hospitals an additional amount equal to the product of the following factors: > > > ##### “(A) Factor one > > A factor equal to the difference between— > > > ###### “(i) > > the aggregate amount of payments that would be made to subsection
(d)hospitals under subsection (d)(5)(F) if this subsection did not apply for such fiscal year (as estimated by the Secretary); and > > > ###### “(ii) > > the aggregate amount of payments that are made to subsection
(d)hospitals under paragraph
(1)for such fiscal year (as so estimated). > > > ##### “(B) Factor two > > > ###### “(i) Fiscal years 2014, 2015, 2016, and 2017 > > For each of fiscal years 2014, 2015, 2016, and 2017, a factor equal to 1 minus the percent change in the percent of individuals under the age of 65 who are uninsured, as determined by comparing the percent of such individuals— > > > ###### “(I) > > who are uninsured in 2013, the last year before coverage expansion under the Patient Protection and Affordable Care Act (as calculated by the Secretary based on the most recent estimates available from the Director of the Congressional Budget Office before a vote in either House on the Health Care and Education Reconciliation Act of 2010 that, if determined in the affirmative, would clear such Act for enrollment); and > > > ###### “(II) > > who are uninsured in the most recent period for which data is available (as so calculated), > > minus 0.1 percentage points for fiscal year 2014 and minus 0.2 percentage points for each of fiscal years 2015, 2016, and 2017. > > > ###### “(ii) 2018 and subsequent years > > For fiscal year 2018 and each subsequent fiscal year, a factor equal to 1 minus the percent change in the percent of individuals who are uninsured, as determined by comparing the percent of individuals— > > > ###### “(I) > > who are uninsured in 2013 (as estimated by the Secretary, based on data from the Census Bureau or other sources the Secretary determines appropriate, and certified by the Chief Actuary of the Centers for Medicare & Medicaid Services); and > > > ###### “(II) > > who are uninsured in the most recent period for which data is available (as so estimated and certified), > > minus 0.2 percentage points for each of fiscal years 2018 and 2019. > > > ##### “(C) Factor three > > A factor equal to the percent, for each subsection
(d)hospital, that represents the quotient of— > > > ###### “(i) > > the amount of uncompensated care for such hospital for a period selected by the Secretary (as estimated by the Secretary, based on appropriate data (including, in the case where the Secretary determines that alternative data is available which is a better proxy for the costs of subsection
(d)hospitals for treating the uninsured, the use of such alternative data)); and > > > ###### “(ii) > > the aggregate amount of uncompensated care for all subsection
(d)hospitals that receive a payment under this subsection for such period (as so estimated, based on such data). > > > #### “(3) Limitations on review > > There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of the following: > > > ##### “(A) > > Any estimate of the Secretary for purposes of determining the factors described in paragraph (2). > > > ##### “(B) > > Any period selected by the Secretary for such purposes.” > .
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Sec. 3133
IMPROVEMENT TO MEDICARE DISPROPORTIONATE SHARE HOSPITAL (DSH) PAYMENTS
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