Page:United States Statutes at Large Volume 97.djvu/190

 97 STAT. 158 PUBLIC LAW 98-21 —APR. 20, 1983 "Sole community hospital. " 42 USC 1395y. Publication in Federal Register. 42 USC 139500. be deemed, for this purpose, a reference to paragraph (3)). In the case of a sole community hospital that experiences, in a cost report- ing period (beginning on or after October 1, 1983, and before October 1, 1986) compared to the previous cost reporting period, a decrease of more than 5 percent in its total number of inpatient cases due to circumstances beyond its control, the Secretary shall provide for such adjustment to the payment amounts under this subsection as may be necessary to fully compensate the hospital for the fixed costs it incurs in the period in providing inpatient hospital services, including the reasonable cost of maintaining necessary core staff and services. For purposes of this subparagraph, the term 'sole community hospital' means a hospital that, by reason of factors such as isolated location, weather conditions, travel conditions, or ab- sence of other hospitals (as determined by the Secretary), is the sole source of inpatient hospital services reasonably available to individ- uals in a geographical area who are entitled to benefits under part A. "(iii) The Secretary shall provide by regulation for such other exceptions and adjustments to such payment amounts under this subsection as the Secretary deems appropriate (including exceptions and adjustments that may be appropriate with respect to hospitals involved extensively in treatment for and research on cancer). "(iv) The Secretary may provide for such adjustments to the payment amounts under this subsection as the Secretary deems appropriate to take into account the unique circumstances of hospi- tals located in Alaska and Hawaii. "(D)(i) The Secretary shall estimate the amount of reimbursement made for services described in section 1862(a)(14) with respect to which payment was made under part B in the base reporting periods referred to in paragraph (2)(A) and with respect to which payment is no longer being made. "(ii) The Secretary shall provide for an adjustment to the payment for subsection (d) hospitals in each fiscal year so as appropriately to reflect the net amount described in clause (i). "(6) The Secretary shall provide for publication in the Federal Register, on or before the September 1 before each fiscal year (beginning with fiscal year 1984), of a description of the methodology and data used in computing the adjusted DRG prospective payment rates under this subsection, including any adjustments required under subsection (e)(1)(B). "(7) There shall be no administrative or judicial review under section 1878 or otherwise of— "(A) the determination of the requirement, or the propor- tional amount, of any adjustment effected pursuant to subsec- tion (e)(1), and "(B) the establishment of diagnosis-related groups, of the methodology for the classification of discharges within such groups, and of the appropriate weighting factors thereof under paragraph (4). " (e)(1)(A) For cost reporting periods of hospitals beginning in fiscal year 1984 or fiscal year 1985, the Secretary shall provide for such proportional adjustment in the applicable percentage increase (oth- erwise applicable to the periods under subsection (b)(3)(B)) as may be necessary to assure that— "(i) the aggregate payment amounts otherwise provided under subsection (d)(l)(A)(i)(I) for that fiscal year for operating costs of

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