Page:United States Statutes at Large Volume 100 Part 1.djvu/192

 100 STAT. 156

PUBLIC LAW 99-272—APR. 7, 1986

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(ii) during the remaining 5 months of the period the "target percentage" is 45 percent and the "DRG percentage" is 55 percent. (3) CHANGE IN BLENDED RATE.—The amendments made by subsection (c) shall apply to discharges occurring on or after May 1, 1986. (4) EXCEPTION.—

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42 USC 1395WW.

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(A) Notwithstanding any other provision of this subsection, the amendments made by this section shall not apply to payments with respect to the operating costs of inpatient hospital services (as defined in section 1886(a)(4) of the Social Security Act) of a subsection (d) hospital (as defined in section 1886(d)(1)(B) of such Act) located in the State of Oregon. (B) Notwithstanding any other provision of law, for a cost reporting period beginning during fiscal year 1986 of a subsection (d) hospital to which the amendments made by this section do not apply, for purposes of section 1886(d)( 1)(A) of of Social Security Act— (i) during the first 7 months of the period the "target percentage" is 50 percent and the "DRG percentage" is 50 percent, and . (ii) during the remaining 5 months of the period the "target percentage" is 25 percent and the "DRG percentage" is 75 percent. (C) Notwithstanding any other provision of law, for purposes of section 1886(d)(1)(D) of such Act, the applicable combined adjusted DRG prospective payment rate for a subsection (d) hospital to which the amendments made by this section do not apply is, for discharges occurring on or after October 1, 1985, and before May 1, 1986, a combined rate consisting of 25 percent of the national adjusted DRG prospective payment rate and 75 percent of the regional adjusted DRG prospective payment rate for such discharges.

SEC. 9103. APPLICATION OF REVISED HOSPITAL WAGE INDEX.

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(a) APPLICATION OF REVISED INDEX PROSPECTIVELY.—(1) Section 42 USC 1395WW note.

42 USC 1395WW.

42 USC 1395WW note. 26 USC 1 note. 42 USC 1395ww note.

2316(b) of the Deficit Reduction Act of 1984 (98 Stat. 1081) is amended to read as follows: "(b) The Secretary shall adjust the payment amounts for hospitals for discharges occurring on or after May 1, 1986, to reflect the changes the Secretary has promulgated in final regulations (on September 3, 1985) relating to the hospital wage index under section 1886(d)(3)(E) of the Social Security Act. For discharges occurring after September 30, 1986, the Secretary shall provide for such periodic adjustments in the appropriate wage index used under that section as may be necessary, taking into account changes in the wage levels and relative proportions of full-time and part-time workers.". (2) The amendment made by paragraph (1) shall be effective as if it had been included in the Deficit Reduction Act of 1984. (b) STUDY OF METHODOLOGY FOR AREA WAGE ADJUSTMENT FOR CENTRAL CITIES.—(1) The Secretary of Health and Human Services,

in consultation with the Prospective Payment Assessment Commission, shall collect information and shall develop one or more methodologies to permit the adjustment of the wage indices used for

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