Page:United States Statutes at Large Volume 117.djvu/2316

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2297

full-service community hospitals within specific diagnosisrelated groups; (B) the extent to which specialty hospitals, relative to local full-service community hospitals, treat patients in certain diagnosis-related groups within a category, such as cardiology, and an analysis of the selection; (C) the financial impact of physician-owned specialty hospitals on local full-service community hospitals; (D) how the current diagnosis-related group system should be updated to better reflect the cost of delivering care in a hospital setting; and (E) the proportions of payments received, by type of payer, between the specialty hospitals and local full-service community hospitals. (2) HHS STUDY.—The Secretary shall conduct a study of a representative sample of specialty hospitals— (A) to determine the percentage of patients admitted to physician-owned specialty hospitals who are referred by physicians with an ownership interest; (B) to determine the referral patterns of physician owners, including the percentage of patients they referred to physician-owned specialty hospitals and the percentage of patients they referred to local full-service community hospitals for the same condition; (C) to compare the quality of care furnished in physician-owned specialty hospitals and in local full-service community hospitals for similar conditions and patient satisfaction with such care; and (D) to assess the differences in uncompensated care, as defined by the Secretary, between the specialty hospital and local full-service community hospitals, and the relative value of any tax exemption available to such hospitals. (3) REPORTS.—Not later than 15 months after the date of the enactment of this Act, the Commission and the Secretary, respectively, shall each submit to Congress a report on the studies conducted under paragraphs (1) and (2), respectively, and shall include any recommendations for legislation or administrative changes. SEC. 508. ONE-TIME APPEALS PROCESS FOR HOSPITAL WAGE INDEX CLASSIFICATION.

(a) ESTABLISHMENT OF PROCESS.— (1) IN GENERAL.—The Secretary shall establish not later than January 1, 2004, by instruction or otherwise a process under which a hospital may appeal the wage index classification otherwise applicable to the hospital and select another area within the State (or, at the discretion of the Secretary, within a contiguous State) to which to be reclassified. (2) PROCESS REQUIREMENTS.—The process established under paragraph (1) shall be consistent with the following: (A) Such an appeal may be filed as soon as possible after the date of the enactment of this Act but shall be filed by not later than February 15, 2004. (B) Such an appeal shall be heard by the Medicare Geographic Reclassification Review Board. (C) There shall be no further administrative or judicial review of a decision of such Board.

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