Page:United States Statutes at Large Volume 117.djvu/2288

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2269

in the unit may resume only after the hospital has demonstrated to the Secretary that the unit meets such requirements.’’. (2) PAYMENT ON A PROSPECTIVE PAYMENT BASIS.—Section 1814(l) (42 U.S.C. 1395f(l)) is amended— (A) by striking ‘‘(l) The amount’’ and inserting ‘‘(l)(1) Except as provided in paragraph (2), the amount’’; and (B) by adding at the end the following new paragraph: ‘‘(2) In the case of a distinct part psychiatric or rehabilitation unit of a critical access hospital described in section 1820(c)(2)(E), the amount of payment for inpatient critical access hospital services of such unit shall be equal to the amount of the payment that would otherwise be made if such services were inpatient hospital services of a distinct part psychiatric or rehabilitation unit, respectively, described in the matter following clause (v) of section 1886(d)(1)(B).’’. (3) EFFECTIVE DATE.—The amendments made by this subsection shall apply to cost reporting periods beginning on or after October 1, 2004. (h) WAIVER AUTHORITY.— (1) IN GENERAL.—Section 1820(c)(2)(B)(i)(II) (42 U.S.C. 1395i–4(c)(2)(B)(i)(II)) is amended by inserting ‘‘before January 1, 2006,’’ after ‘‘is certified’’. (2) GRANDFATHERING WAIVER AUTHORITY FOR CERTAIN 1820(h) (42 U.S.C. 1395i–4(h)) is FACILITIES.—Section amended— (A) in the heading preceding paragraph (1), by striking ‘‘OF CERTAIN FACILITIES’’ and inserting ‘‘PROVISIONS’’; and (B) by adding at the end the following new paragraph: ‘‘(3) STATE AUTHORITY TO WAIVE 35-MILE RULE.—In the case of a facility that was designated as a critical access hospital before January 1, 2006, and was certified by the State as being a necessary provider of health care services to residents in the area under subsection (c)(2)(B)(i)(II), as in effect before such date, the authority under such subsection with respect to any redesignation of such facility shall continue to apply notwithstanding the amendment made by section 405(h)(1) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.’’.

42 USC 1395f note.

Applicability.

SEC. 406. MEDICARE INPATIENT HOSPITAL PAYMENT ADJUSTMENT FOR LOW-VOLUME HOSPITALS.

(a) IN GENERAL.—Section 1886(d) (42 U.S.C. 1395ww(d)) is amended by adding at the end the following new paragraph: ‘‘(12) PAYMENT ADJUSTMENT FOR LOW-VOLUME HOSPITALS.— ‘‘(A) IN GENERAL.—In addition to any payments calculated under this section for a subsection (d) hospital, for discharges occurring during a fiscal year (beginning with fiscal year 2005), the Secretary shall provide for an additional payment amount to each low-volume hospital (as defined in subparagraph (C)(i)) for discharges occurring during that fiscal year that is equal to the applicable percentage increase (determined under subparagraph (B) for the hospital involved) in the amount paid to such hospital under this section for such discharges (determined without regard to this paragraph).

VerDate 11-MAY-2000

13:59 Aug 30, 2004

Jkt 019194

PO 00000

Frm 00205

Fmt 6580

Sfmt 6581

D:\STATUTES\2003\19194PT3.001

APPS10

PsN: 19194PT3

�