Page:United States Statutes at Large Volume 102 Part 1.djvu/831

 PUBLIC LAW 100-360—JULY 1, 1988

102 STAT. 793

age (defined in section 1886(d)(5)(F)(vi)) shall be computed by substituting for the fraction described in subclause (1) of such section the fraction described in subclause dl) of that section. If a State elects in a State plan amendment under subsection (a) to provide the payment ac^ustment described in paragraph (2), the State must include in the amendment a detailed description of the specific methodol(^ to be used in determining the specified additional payment amount (or increased percentage payment) to be made to each hospital qualifying for such a payment adjustment and must publish at least annually the name of each hospital qucdifying for such a payment ac^ustment and the amount of such payment adjustment made for each such hospital."; and (vii) in subsection (e)— (1) by inserting "(1)" after "SPECIAL RULE.—", (n) by inserting "based on a pooling arrangement involving a majority of the hospitals participating under the plan after "payment adjustments, and (m) by adding at the end the following new paragraph: "(2) In the case of a State that used a health insuring organization before January 1, 1986, to administer a portion of its plan on a Statewide basis, during the 3-year period beginning on July 1, 1988— "(A) the requirements of subsections (b) and (c) shall not apply if the aggr^ate amount of the payment adjustments under the plan for disproportionate share hospitals (as defined under the State plan) is not less than the aggregate amount of payment adjustments otherwise required to be made if such subsections applied, and (B) subsection (d)(2)(B) shall apply to hospitals located in urban areas, as well as in rural areas.. (B) Section 4112 of OBRA is further amended— (i) by striking "(a) IIAPLEMENTATION OF REQUIREMENT.—" and inserting the following: "(a) IN GENERAL.—Title XIX of the Social Security Act is amended— "(1) by redesignating section 1923 as section 1924, and "(2) by inserting after section 1922 the following new section:

State and local governments.

State and local governments.

Urban areas. Rural areas. 42 USC 1396a note.

42 USC 1396s.

ADJUSTMENT IN PAYMENT FOR INPATIENT HOSPITAL SERVICES FURNISHED BY DISPROPORTIONATE SHARE HOSPITAI^ 'SEC. 1923. (a) IMPLEMENTATION OF REQUIREMENT.—";

(ii) in subsection (a)(D, by striking "A State's plan under title XIX of the Social Security Act and inserting "A State plan under this title"; (iii) in subsection (a)(D, by striking "of such Act"; (iv) in subsection (a), by striking "of Health and Himian Services" each place it appears; (v) in the matter following paragraph (2)(B) of subsection (a), by striking "of the Social Security Act"; (vi) in subsections (b) and (c), by striking "under title XIX of the Social Security Act" each place it appecu-s and inserting "under this title;

42 USC 1396r-4.

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