Page:United States Statutes at Large Volume 117.djvu/2282

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2263

(ii) in subclause (II), by striking the period at the end and inserting ‘‘; and’’; and (E) by adding at the end the following new clause: ‘‘(iii) for a fiscal year beginning after fiscal year 2003, for hospitals located in all areas, to the product of— ‘‘(I) the applicable standardized amount (computed under subparagraph (A)), reduced under subparagraph (B), and adjusted or reduced under subparagraph (C) for the fiscal year; and ‘‘(II) the weighting factor (determined under paragraph (4)(B)) for that diagnosis-related group.’’. (2) TECHNICAL CONFORMING SUNSET.—Section 1886(d)(3) (42 U.S.C. 1395ww(d)(3)) is amended— (A) in the matter preceding subparagraph (A), by inserting ‘‘, for fiscal years before fiscal year 1997,’’ before ‘‘a regional adjusted DRG prospective payment rate’’; and (B) in subparagraph (D), in the matter preceding clause (i), by inserting ‘‘, for fiscal years before fiscal year 1997,’’ before ‘‘a regional DRG prospective payment rate for each region,’’. (3) ADDITIONAL TECHNICAL AMENDMENT.—Section 1886(d)(3)(A)(iii) (42 U.S.C. 1395ww(d)(3)(A)(iii)) is amended by striking ‘‘in an other urban area’’ and inserting ‘‘in an urban area’’. (c) EQUALIZING URBAN AND RURAL STANDARDIZED PAYMENT AMOUNTS UNDER THE MEDICARE INPATIENT HOSPITAL PROSPECTIVE PAYMENT SYSTEM FOR HOSPITALS IN PUERTO RICO.— (1) IN GENERAL.—Section 1886(d)(9)(A) (42 U.S.C. 1395ww(d)(9)(A)), as amended by section 504, is amended— (A) in clause (i), by striking ‘‘and’’ after the comma at the end; and (B) by striking clause (ii) and inserting the following new clause: ‘‘(ii) the applicable Federal percentage (specified in subparagraph (E)) of— ‘‘(I) for discharges beginning in a fiscal year beginning on or after October 1, 1997, and before October 1, 2003, the discharge-weighted average of— ‘‘(aa) the national adjusted DRG prospective payment rate (determined under paragraph (3)(D)) for hospitals located in a large urban area, ‘‘(bb) such rate for hospitals located in other urban areas, and ‘‘(cc) such rate for hospitals located in a rural area, for such discharges, adjusted in the manner provided in paragraph (3)(E) for different area wage levels; and ‘‘(II) for discharges in a fiscal year beginning on or after October 1, 2003, the national DRG prospective payment rate determined under paragraph (3)(D)(iii) for hospitals located in any area for such discharges, adjusted in the manner provided in paragraph (3)(E) for different area wage levels. As used in this section, the term ‘subsection (d) Puerto Rico hospital’ means a hospital that is located in Puerto Rico and that would be a subsection (d) hospital (as defined in paragraph (1)(B)) if it were located in one of the 50 States.’’.

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