Page:United States Statutes at Large Volume 104 Part 2.djvu/442

 104 STAT. 1388-34 PUBLIC LAW 101-508 —NOV. 5, 1990 "(IX) for fiscal year 1994, the market basket percentage increase for hospitals located in a large urban or other urban area, and the market basket percentage increase plus 1.5 percentage points for hospitals located in a rural area, "(X) for fiscal year 1995, the market basket percentage increase for hospitals located in a large urban or other urban area, and such percentage increase for hospitals located in a rural area as will provide for the average standardized amount determined under subsection (d)(3)(A) for hospitals located in a rural area being equal to such average standardized amount for hospitals located in an urban area (other than a large urban area), and". (2) CONFORMING AMENDMENTS.— (A) Section 1886(b)(3)(B) (42 U.S.C. 1395ww(b)(3)) is amended— (i) in clause (ii), by striking "(A) and (E)," and inserting " (A),(C),(D),and(E),"; (ii) in subparagraphs (C)(ii) and (D)(ii), by striking "(B)(i)" each place it appears and inserting "(B)(ii)". (B) Section 1886(d) (42 U.S.C. 1395ww(d)) is amended— (i) in paragraph (l)(A)(iii), by striking "rural, large urban, or other urban area" and inserting "large urban or other area"; (ii) in paragraph (3)(A)— (I) in clause (ii), by striking "the Secretary" and inserting "and ending on or before September 30, 1994, the Secretary", (II) by redesignating clause (iii) as clause (v), and (III) by inserting after clause (ii) the following new clauses: "(iii) For discharges occurring in the fiscal year beginning on October 1, 1994, the average standardized amount for hospitals located in a rural area shall be equal to the average standardized amount for hospitals located in an other urban area. "(iv) For discharges occurring in a fiscal year beginning on or after October 1, 1995, the Secretary shall compute an average standardized amount for hospitals located in a large urban area and for hospitals located in other areas within the United States and within each region equal to the respective average standardized amount computed for the previous fiscal year under this subparagraph increased by the applicable percentage increase under subsection (b)(3)(B)(i) with respect to hospitals located in the respective areas for the fiscal year involved."; (iii) in paragraph (3)(B), by striking "for hospitals located in an urban area" and all that follows and inserting the following: "by a factor equal to the proportion of payments under this subsection (as estimated by the Secretary) based on DRG prospective pa3anent amounte which are additional payments described in paragraph (5)(A) (relating to outlier payments)."; (iv) in paragraph (3)(D)(i)— (I) in the matter preceding subclause (I), by striking "an urban area (or," and all that follows through "area)," and inserting "a large urban area", and (II) in subclause (I), by striking "an urban area" and inserting "a large urban area"; (v) in paragraph (3)(D)(ii), by striking "a rural area" each place it appears and inserting "other areas"; and

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