Page:United States Statutes at Large Volume 107 Part 1.djvu/601

 PUBLIC LAW 103-66—AUG. 10, 1993 107 STAT. 575 "(III) the day outlier percentage for fiscal year 1997 shall be 25 percent of the day outlier percentage for fiscal year 1994. "(vi) For purposes of this subparagraph, the term 'day outlier percentage' means, for a fiscal year, the percentage of ihe total additional payments made by the Secretary under this subparagraph for (uscharges in that fiscal year which are additional pay- ments under clause (i).". (d) EXTENSION FOR REGIONAL REFERRAL CENTERS.— 42 USC i395ww (1) EXTENSION OF CLASSIFICATION THROUGH FISCAL YEAR "°*® 1994. — Any hospital that is classified as a regional referral center under section 1886(d)(5)(C) of the Social Security Act as of September 30, 1992, shall continue to be so classified for cost reporting periods beginning during fiscal year 1993 or fiscal year 1994, unless the area in which the hospital is located is redesignated as a Metropolitan Statistical Area by the Office of Management and Budget for such a fiscal year. (2) PERMITTING HOSPITALS TO DECLINE RECLASSIFICATION. — If any hospital fails to qualify as a rural referral center under section 1886(d)(5)(C) of the Social Security Act as a result of a decision by the Medicare Geographic Classification Review Board under section 1886(d)(10) of such Act to reclassify the hospital as being located in an urban area for fiscal year 1993 or fiscal year 1994, the Secretary of Health and Human Services shall— (A) notify such hospital of such failure to qualify, (B) provide an opportunity for such hospital to decline such reclassification, and (C) if the hospital— (i) declines such reclassification, administer the Social Security Act (other than section 1886(d)(8)(D)) for such fiscal year as if the decision by the Review Board had not occurred, or (ii) fails to decline such reclassification, administer the Social Security Act without regard to paragraph (1). (3) REQUIRING LUMP-SUM RETROACTIVE PAYMENT FOR HOS- PITALS LOSING CLASSIFICATION. — (A) IN GENERAL. —In the case of a hospital described in paragraph (1), the Secretary of Health and Human Services shall make a limip-sum payment to the hospital equal to the difference between the aggregate payment made to the hospital under section 1886 of such Act (excluding outlier payments under subsection (d)(5)(A) of such section) during the period of applicability described in subparagraph (B) and the aggregate payment that would have been made to the hospital under such section if, during the period of applicability, the hospital was classified a regional referral center under section 1886(d)(5)(C) of such Act. (B) PERIOD OF APPLICABILITY. — In subparagraph (A), the "period of applicability'' is the period that begins on October 1, 1992, and ends on the date of the enactment of this Act. (e) EXTENSION FOR MEDICARE-DEPENDENT, SMALL RURAL HOS- PITALS.—

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