Page:United States Statutes at Large Volume 117.djvu/2315

 117 STAT. 2296

Effective date.

42 USC 1395nn note.

VerDate 11-MAY-2000

13:59 Aug 30, 2004

PUBLIC LAW 108–173—DEC. 8, 2003

‘‘(iv) Any other specialized category of services that the Secretary designates as inconsistent with the purpose of permitting physician ownership and investment interests in a hospital under this section. ‘‘(B) EXCEPTION.—For purposes of this section, the term ‘specialty hospital’ does not include any hospital— ‘‘(i) determined by the Secretary— ‘‘(I) to be in operation before November 18, 2003; or ‘‘(II) under development as of such date; ‘‘(ii) for which the number of physician investors at any time on or after such date is no greater than the number of such investors as of such date; ‘‘(iii) for which the type of categories described in subparagraph (A) at any time on or after such date is no different than the type of such categories as of such date; ‘‘(iv) for which any increase in the number of beds occurs only in the facilities on the main campus of the hospital and does not exceed 50 percent of the number of beds in the hospital as of November 18, 2003, or 5 beds, whichever is greater; and ‘‘(v) that meets such other requirements as the Secretary may specify.’’. (2) OWNERSHIP AND INVESTMENT INTERESTS IN A RURAL PROVIDER.—Section 1877(d)(2) (42 U.S.C. 1395nn(d)(2)) is amended to read as follows: ‘‘(2) RURAL PROVIDERS.—In the case of designated health services furnished in a rural area (as defined in section 1886(d)(2)(D)) by an entity, if— ‘‘(A) substantially all of the designated health services furnished by the entity are furnished to individuals residing in such a rural area; and ‘‘(B) effective for the 18-month period beginning on the date of the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the entity is not a specialty hospital (as defined in subsection (h)(7)).’’. (b) APPLICATION OF EXCEPTION FOR HOSPITALS UNDER DEVELOPMENT.—For purposes of section 1877(h)(7)(B)(i)(II) of the Social Security Act, as added by subsection (a)(1)(B), in determining whether a hospital is under development as of November 18, 2003, the Secretary shall consider— (1) whether architectural plans have been completed, funding has been received, zoning requirements have been met, and necessary approvals from appropriate State agencies have been received; and (2) any other evidence the Secretary determines would indicate whether a hospital is under development as of such date. (c) STUDIES.— (1) MEDPAC STUDY.—The Medicare Payment Advisory Commission, in consultation with the Comptroller General of the United States, shall conduct a study to determine— (A) any differences in the costs of health care services furnished to patients by physician-owned specialty hospitals and the costs of such services furnished by local

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