Page:United States Statutes at Large Volume 101 Part 2.djvu/843

 PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-49

"(ii) The term 'extended care patient' means an individual being furnished extended care services at a hospital pursuant to an agreement with the Secretary under this section. "(3) In the case of an agreement for a cost reporting period under this section with a hospital that has more than 49 beds, payment may not be made in the period for patient-days of extended care services that exceed 15 percent of the product of the number of days in the period and the average number of licensed beds in the hospital in the period.". (3) REPORT.—The Secretary of Health and Human Services shall report to Congress, not later than February 1, 1989, concerning— (A) the proportion of admissions to hospitals for extended care services under section 1883 of the Social Security Act which are denied or approved by a peer review organization under section 1154(a)(l) of such Act, and (B) on recommendations for methods of encouraging hospitals that— (i) have a low occupancy rate, ,;_ (ii) are eligible to enter (but have not entered) into an agreement under section 1883 of such Act, and (iii) are located in areas with a need for additional providers of extended care services, to enter into such agreements. (4) EFFECTIVE DATE.—The amendments made by paragraphs (1) and (2) shall apply to agreements under section 1883 of the Social Security Act entered into after March 31, 1988.

42 USC 1395tt note.

42 USC 1395tt note.

(c) PAYMENTS TO SOLE COMMUNITY HOSPITALS.—

(1) Section 1886(d)(5)(C)(ii) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(C)(ii)) is amended— (A) by striking "1988" in the second sentence and insert-^* ' ing "1990", and (B) by inserting after the second sentence the following: >>• "A subsection (d) hospital that meets the criteria for classification as a sole community hospital and otherwise te -^ qualifies for the adjustment authorized by the preceding sentence may qualify for such an adjustment without regard to the formula by which payments are determined for the hospital under paragraph (I)(A).". (2)(A) The amendments made by paragraph (1) shall apply to 42 USC 1395WW cost reporting periods beginning on or after October 1, 1987 note. (B) The Secretary of Health and Human Services shall take appropriate steps to ensure that the total amount paid in a fiscal year under title XVIII of the Social Security Act by reason of the amendment made by paragraph (I)(B) does not exceed $5,000,000 in the case of fiscal year 1988 and $10,000,000 for fiscal year 1989. (d) MEDICARE CLASSIFICATION OF RURAL REFERRAL CENTERS.— (1) EXTENSION OF CLASSIFICATION.—

-mil.

(A) IN GENERAL.—The first sentence of section 1886(d)(5)(C)(i)(I) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(C)(i)(I)) is amended by striking "500" and inserting "275". (B) EFFECTIVE DATE.—The amendment made by subpara- 42 USC 1395WW graph (A) shall apply to discharges occurring on or after note. April 1, 1988. (2) STUDY.—

42 USC 1395WW note.

�