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II
116TH CONGRESS
2D SESSION
S. 3665
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
MAY 7, 2020
Mr. ALEXANDER (for himself, Mr. WARNER, Mr. SHELBY, Mrs. BLACKBURN,
Mr. CORNYN, Mr. JONES, Mr. PERDUE, and Mr. KAINE) introduced the
following bill; which was read twice and referred to the Committee on Fi-
nance
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 2020’’.
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SEC. 2. ENSURING FAIRNESS IN MEDICARE HOSPITAL PAY-
6
MENTS.
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(a) HOSPITAL INPATIENT SERVICES.—
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•S 3665 IS
(1) IN GENERAL.—Section 1886(d)(3)(E)(i) 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)’’;
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and
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(B) by adding at the end the following new
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clause:
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‘‘(iv) AREA WAGE INDEX FLOOR.—
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‘‘(I)
IN
GENERAL.—For
dis-
10
charges occurring on or after October
11
1, 2020, the area wage index applica-
12
ble under this subparagraph to any
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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.
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‘‘(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.’’.
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(2) WAIVING BUDGET NEUTRALITY.—
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(A) TECHNICAL
AMENDATORY
CORREC-
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TION.—Section 10324(a)(2) of Public Law
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•S 3665 IS
111–148 is amended by striking ‘‘third sen-
1
tence’’ and inserting ‘‘fifth sentence’’.
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(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—
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(i) by striking ‘‘and the amendments’’
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and inserting ‘‘, the amendments’’; and
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(ii) by inserting ‘‘, and the amend-
9
ments made by section 2(a)(1) of the Save
10
Rural Hospitals Act of 2020’’ after ‘‘Care
11
Act’’.
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(b) HOSPITAL OUTPATIENT DEPARTMENT SERV-
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ICES.—Section 1833(t) of the Social Security Act (42
14
U.S.C. 1395l(t)), is amended—
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(1) in paragraph (2)(D), by striking ‘‘(19), the
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Secretary’’and inserting ‘‘(19) and paragraph (23),
17
the Secretary’’; and
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(2) by adding at the end the following new
19
paragraph:
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‘‘(23) FLOOR
ON
AREA
WAGE
ADJUSTMENT
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FACTOR FOR HOSPITAL OUTPATIENT DEPARTMENT
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SERVICES.—With respect to covered OPD services
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furnished on or after January 1, 2021, the area
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wage adjustment factor applicable under the pay-
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•S 3665 IS
ment system established under this subsection to
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any hospital outpatient department which is not lo-
2
cated in a frontier State (as defined in section
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1886(d)(3)(E)(iii)(II)) may not be less than 0.85.
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The preceding sentence shall not be implemented in
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a budget neutral manner.’’.
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Æ
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