Page:United States Statutes at Large Volume 117.djvu/2313

 117 STAT. 2294

42 USC 1395ww note.

PUBLIC LAW 108–173—DEC. 8, 2003

hospitals (including subsection (d) hospitals and other hospitals) and critical access hospitals, as required under section 1866(a)(1)(T), to submit data regarding the location of residence, or the Secretary may use data from other sources. ‘‘(F) A wage index increase under this paragraph shall be effective for a period of 3 fiscal years, except that the Secretary shall establish procedures under which a subsection (d) hospital may elect to waive the application of such wage index increase. ‘‘(G) A hospital in a county that has a wage index increase under this paragraph for a period and that has not waived the application of such an increase under subparagraph (F) is not eligible for reclassification under paragraph (8) or (10) during that period. ‘‘(H) Any increase in a wage index under this paragraph for a county shall not be taken into account for purposes of— ‘‘(i) computing the wage index for portions of the wage index area (not including the county) in which the county is located; or ‘‘(ii) applying any budget neutrality adjustment with respect to such index under paragraph (8)(D). ‘‘(I) The thresholds described in subparagraph (B), data on hospital employees used under this paragraph, and any determination of the Secretary under the process described in subparagraph (E) shall be final and shall not be subject to judicial review.’’. (b) CONFORMING AMENDMENTS.—Section 1866(a)(1) (42 U.S.C. 1395cc(a)(1)) is amended— (1) in subparagraph (R), by striking ‘‘and’’ at the end; (2) in subparagraph (S), by striking the period at the end and inserting ‘‘, and’’; and (3) by inserting after subparagraph (S) the following new subparagraph: ‘‘(T) in the case of hospitals and critical access hospitals, to furnish to the Secretary such data as the Secretary determines appropriate pursuant to subparagraph (E) of section 1886(d)(12) to carry out such section.’’. (c) EFFECTIVE DATE.—The amendments made by this section shall first apply to the wage index for discharges occurring on or after October 1, 2004. In initially implementing such amendments, the Secretary may modify the deadlines otherwise applicable under clauses (ii) and (iii)(I) of section 1886(d)(10)(C) of the Social Security Act (42 U.S.C. 1395ww(d)(10)(C)), for submission of, and actions on, applications relating to changes in hospital geographic reclassification. SEC. 506. LIMITATION ON CHARGES FOR INPATIENT HOSPITAL CONTRACT HEALTH SERVICES PROVIDED TO INDIANS BY MEDICARE PARTICIPATING HOSPITALS.

(a) IN GENERAL.—Section 1866(a)(1) (42 U.S.C. 1395cc(a)(1)), as amended by section 505(b), is amended— (1) in subparagraph (S), by striking ‘‘and’’ at the end; (2) in subparagraph (T), by striking the period and inserting ‘‘, and’’; and (3) by inserting after subparagraph (T) the following new subparagraph: ‘‘(U) in the case of hospitals which furnish inpatient hospital services for which payment may be made under this title, to be a participating provider of medical care both—

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