Page:United States Statutes at Large Volume 117.djvu/2211

 117 STAT. 2192

to the hospital under section 1886 with respect to such services; and ‘‘(B) with respect to specific inpatient hospital services provided to an enrollee, the hospital demonstrates to the satisfaction of the Secretary that the hospital’s costs of such services exceed the payment amount described in subparagraph (A). ‘‘(2) PAYMENT AMOUNTS.—The payment amount under this subsection for inpatient hospital services provided by a subsection (d) hospital to an enrollee in an MA regional plan shall be, subject to the limitation of funds under paragraph (3), the amount (if any) by which— ‘‘(A) the amount of payment that would have been paid for such services under this title if the enrollees were covered under the original medicare fee-for-service program option and the hospital were a critical access hospital; exceeds ‘‘(B) the amount of payment made for such services under paragraph (1)(A). ‘‘(3) AVAILABLE AMOUNTS.—There shall be available for payments under this subsection— ‘‘(A) in 2006, $25,000,000; and ‘‘(B) in each succeeding year the amount specified in this paragraph for the preceding year increased by the market basket percentage increase (as defined in section 1886(b)(3)(B)(iii)) for the fiscal year ending in such succeeding year. Payments under this subsection shall be made from the Federal Hospital Insurance Trust Fund. ‘‘(4) ESSENTIAL HOSPITAL.—In this subsection, the term ‘essential hospital’ means, with respect to an MA regional plan offered by an MA organization, a subsection (d) hospital (as defined in section 1886(d)) that the Secretary determines, based upon an application filed by the organization with the Secretary, is necessary to meet the requirements referred to in paragraph (1) for such plan.’’. (d) CONFORMING AMENDMENTS.— (1) RELATING TO MA REGIONS.—Section 1853(d) (42 U.S.C. 1395w–23(d)) is amended— (A) by amending the heading to read as follows: ‘‘MA PAYMENT AREA; MA LOCAL AREA; MA REGION DEFINED’’; (B) by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively; (C) by amending paragraph (1) to read as follows: ‘‘(1) MA PAYMENT AREA.—In this part, except as provided in this subsection, the term ‘MA payment area’ means— ‘‘(A) with respect to an MA local plan, an MA local area (as defined in paragraph (2)); and ‘‘(B) with respect to an MA regional plan, an MA region (as established under section 1858(a)(2)).’’; (D) by inserting after paragraph (1) the following new paragraph: ‘‘(2) MA LOCAL AREA.—The term ‘MA local area’ means a county or equivalent area specified by the Secretary.’’; and (E) in paragraph (4), as so redesignated— (i) in subparagraph (A), by inserting ‘‘for MA local plans’’ after ‘‘paragraph (1)’’;

Definition.

VerDate 11-MAY-2000

13:59 Aug 30, 2004

PUBLIC LAW 108–173—DEC. 8, 2003

Jkt 019194

PO 00000

Frm 00128

Fmt 6580

Sfmt 6581

D:\STATUTES\2003\19194PT3.001

APPS10

PsN: 19194PT3

�