Page:United States Statutes at Large Volume 96 Part 1.djvu/375

 PUBLIC LAW 97-248—SEPT. 3, 1982

96 STAT. 333

"(i) 50 percent of the amount by which the target amount exceeds the amount of the operating costs, or "(ii) 5 percent of the target amount, whichever is less; or "(B) are greater than the target amount, the amount of the payment with respect to such operating costs payable under part A on a per discharge or per admission basis (as the case may be) shall be equal to (i) the target amount, plus (ii) in the case of cost reporting periods beginning on or after October 1, 1982, and before October 1, 1984, 25 percent of the amount by which the amount of the operating costs exceeds the target amount; except that in no case may the amount payable under this title with respect to operating costs of inpatient hospital services exceed the maximum amount payable with respect to such costs pursuant to subsection (a). "(2) Paragraph (1) shall not apply to cost reporting periods of hospitals beginning on or after October 1, 1985. "(3)(A) For purposes of this subsection, the term 'target amount' "Target means, with respect to a hospital for a particular 12-month cost amount.' reporting period— "(i) in the case of the first such reporting period for which this subsection is in effect, the allowable operating costs of inpatient hospital services (as defined in subsection (a)(4)) recognized under this title for such hospital for the preceding 12-month cost reporting period, and "(ii) in the case a later reporting period, the target amount for the preceding 12-month cost reporting period, increased by the applicable percentage increase under subparagraph (B) for that particular cost reporting period. "(B) For purposes of subparagraph (A), the 'applicable percentage "Applicable increase' for any 12-month cost reporting period shall be equal to 1 percentage percentage point plus the percentage, estimated by the Secretary, by increase.' which the cost of the mix of goods and services (including personnel costs but excluding non-operating costs) comprising routine, ancillary, and special care unit inpatient hospital services, based on an index of appropriately weighted indicators of changes in wages and prices which are representative of the mix of goods and services included in such inpatient hospital services, for such cost reporting period exceeds the cost of such mix of goods and services for the preceding 12-month cost reporting period. "(4)(A) The Secretary shall provide for an exemption from, or an exception and adjustment to, the method under this subsection for determining the amount of payment to a hospital where events beyond the hospital's control or extraordinary circumstances, including changes in the case mix of such hospital, create a distortion in the increase in costs for a cost reporting period (including any distortion in the costs for the base period against which such increase is measured). The Secretary may provide for such other exemptions from, and exceptions and adjustments to, such method as the Secretary deems appropriate, including those which he deems necessary to take into account a decrease in the inpatient hospital services that a hospital provides and that are customarily provided directly by similar hospitals which results in a significant distortion in the operating costs of inpatient hospital services. "(B) Paragraph (1) shall not apply to payment of hospitals which is otherwise determined under paragraph (3) of section 1814(b). 42 USC 1395f.

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