Save Rural Hospitals Act of 2021

II 117TH CONGRESS 1ST SESSION S. 999 To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments. IN THE SENATE OF THE UNITED STATES MARCH 25, 2021 Mr. WARNER (for himself, Mrs. BLACKBURN, Mr. CORNYN, Mr. WARNOCK, and Mr. KAINE) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Save Rural Hospitals 4 Act of 2021’’. 5 SEC. 2. ENSURING FAIRNESS IN MEDICARE HOSPITAL PAY- 6 MENTS. 7 (a) HOSPITAL INPATIENT SERVICES.— 8 VerDate Sep 11 2014 22:46 Apr 18, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S999.IS S999 kjohnson on DSK79L0C42PROD with BILLS 2 •S 999 IS (1) IN GENERAL.—Section 1886(d)(3)(E) of 1 the Social Security Act (42 U.S.C. 2 1395www(d)(3)(E)) is amended— 3 (A) in clause (i), in the first sentence, by 4 striking ‘‘or (iii)’’ and inserting ‘‘, (iii), or (iv)’’; 5 and 6 (B) by adding at the end the following new 7 clause: 8 ‘‘(iv) AREA WAGE INDEX FLOOR.— 9 ‘‘(I) IN GENERAL.—For dis- 10 charges occurring on or after October 11 1, 2021, the area wage index applica- 12 ble under this subparagraph to any 13 hospital which is not located in a fron- 14 tier State (as defined in clause 15 (iii)(II)) may not be less than 0.85. 16 ‘‘(II) WAIVING BUDGET NEU- 17 TRALITY.—Pursuant to the fifth sen- 18 tence of clause (i), this clause shall 19 not be applied in a budget neutral 20 manner.’’. 21 (2) WAIVING BUDGET NEUTRALITY.— 22 (A) TECHNICAL AMENDATORY CORREC- 23 TION.—Section 10324(a)(2) of Public Law 24 VerDate Sep 11 2014 22:46 Apr 18, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S999.IS S999 kjohnson on DSK79L0C42PROD with BILLS 3 •S 999 IS 111–148 is amended by striking ‘‘third sen- 1 tence’’ and inserting ‘‘fifth sentence’’. 2 (B) WAIVER.—Section 1886(d)(3)(E)(i) of 3 the Social Security Act (42 U.S.C. 4 1395ww(d)(3)(E)(i)) is amended, in the fifth 5 sentence— 6 (i) by striking ‘‘and the amendments’’ 7 and inserting ‘‘, the amendments’’; and 8 (ii) by inserting ‘‘, and the amend- 9 ments made by section 2(a)(1) of the Save 10 Rural Hospitals Act of 2021’’ after ‘‘Care 11 Act’’. 12 (b) HOSPITAL OUTPATIENT DEPARTMENT SERV- 13 ICES.—Section 1833(t) of the Social Security Act (42 14 U.S.C. 1395l(t)), is amended— 15 (1) in paragraph (2)(D), by striking ‘‘(19), the 16 Secretary’’ and inserting ‘‘(19) and paragraph (23), 17 the Secretary’’; and 18 (2) by adding at the end the following new 19 paragraph: 20 ‘‘(23) FLOOR ON AREA WAGE ADJUSTMENT 21 FACTOR FOR HOSPITAL OUTPATIENT DEPARTMENT 22 SERVICES.—With respect to covered OPD services 23 furnished on or after January 1, 2022, the area 24 wage adjustment factor applicable under the pay- 25 VerDate Sep 11 2014 00:46 Apr 22, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S999.IS S999 kjohnson on DSK79L0C42PROD with BILLS 4 •S 999 IS ment system established under this subsection to 1 any hospital outpatient department which is not lo- 2 cated in a frontier State (as defined in section 3 1886(d)(3)(E)(iii)(II)) may not be less than 0.85. 4 The preceding sentence shall not be implemented in 5 a budget neutral manner.’’. 6 Æ VerDate Sep 11 2014 22:46 Apr 18, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\S999.IS S999 kjohnson on DSK79L0C42PROD with BILLS