Page:United States Statutes at Large Volume 111 Part 1.djvu/399

 PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 375 this paragraph on the basis of any comparison between the average hourly wage of the hospital and the average hourly wage of hospitals in the area in which it is located.". (b) CONTINUING TREATMENT OF PREVIOUSLY DESIGNATED CEN- TERS.— (1) IN GENERAL.— Any hospital classified as a rural referral center by the Secretary of Health and Human Services under section 1886(d)(5)(C) of the Social Security Act for fiscal year 1991 shall be classified as such a rural referral center for fiscal year 1998 and each subsequent fiscal year. (2) BUDGET NEUTRALITY.—The provisions of section 1886(d)(8)(D) of the Social Security Act shall apply to reclassifications made pursuant to paragraph (1) in the same manner as such provisions apply to a reclassification under section 1886(d)(10)ofsuchAct. SEC. 4203. HOSPITAL GEOGRAPHIC RECLASSIFICATION PERMITTED FOR PURPOSES OF DISPROPORTIONATE SHARE PAY- MENT ADJUSTMENTS. (a) IN GENERAL.— For the period described in subsection (c), the Medicare Geographic Classification Review Board shall consider the application under section 1886(d)(10)(C)(i) of the Social Security Act (42 U.S.C. 1395ww(d)(10)(C)(i)) of a hospital described in 1886(d)(1)(B) of such Act (42 U.S.C. 1395ww(d)(l)(B)) to change the hospital's geographic classification for purposes of determining for a fiscal year eligibility for and amount of additional payment amounts under section 1886(d)(5)(F) of such Act (42 U.S.C. 1395ww(d)(5)(F)). (b) APPLICABLE GUIDELINES. —The Medicare Geographic Classification Review Board shall apply the guidelines established for reclassification under subclause (I) of section 1886(d)(10)(C)(i) of such Act to reclassification by reason of subsection (a) until the Secretary of Health and Human Services promulgates separate guidelines for such reclassification. (c) PERIOD DESCRIBED. —The period described in this subsection is the period beginning on the date of the enactment of this Act and ending 30 months after such date. SEC. 4204. MEDICARE-DEPENDENT, SMALL RURAL HOSPITAL PAYMENT EXTENSION. (a) SPECIAL TREATMENT EXTENDED.— (1) PAYMENT METHODOLOGY. — Section 1886(d)(5)(G) (42 U.S.C. 1395ww(d)(5)(G)) is amended— (A) in clause (i), by striking "October 1, 1994," and inserting "October 1, 1994, or beginning on or after October 1, 1997, and before October 1, 2001,"; and (B) in clause (ii)(II), by striking "October 1, 1994," and inserting "October 1, 1994, or beginning on or after October 1, 1997, and before October 1, 2001,". (2) EXTENSION OF TARGET AMOUNT.— Section 1886(b)(3)(D) (42 U.S.C. 1395ww(b)(3)(D)) is amended— (A) in the matter preceding clause (i), by striking "September 30, 1994," and inserting "September 30, 1994, and for cost reporting periods beginning on or after (October 1, 1997, and before October 1, 2001,"; (B) in clause (ii), by striking "and" at the end; (C) in clause (iii), by striking the period at the end and inserting ", and"; and 42 USC 1395WW note. 42 USC 1395WW note.

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