SEC. 411. TWO-YEAR EXTENSION OF HOLD HARMLESS PROVISIONS
FOR SMALL RURAL HOSPITALS AND SOLE COMMUNITY HOSPITALS UNDER THE PROSPECTIVE
PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES.
(a) HOLD HARMLESS PROVISIONS-
(1) IN GENERAL- Section 1833(t)(7)(D)(i)
(42 U.S.C. 1395l(t)(7)(D)(i)) is amended--
(A) in the heading, by striking
`SMALL' and inserting `CERTAIN';
(B) by inserting `or a sole
community hospital (as defined in section 1886(d)(5)(D)(iii)) located in
a rural area' after `100 beds'; and
(C) by striking `2004' and
inserting `2006'.
(2) EFFECTIVE DATE- The amendment made
by paragraph (1)(B) shall apply with respect to cost reporting periods beginning
on and after January 1, 2004.
(b) STUDY; AUTHORIZATION OF ADJUSTMENT- Section
1833(t) (42 U.S.C. 1395l(t)) is amended--
(1) by redesignating paragraph (13)
as paragraph (16); and
(2) by inserting after paragraph (12)
the following new paragraph:
`(13) AUTHORIZATION OF ADJUSTMENT FOR RURAL HOSPITALS-
`(A) STUDY- The Secretary shall conduct a study to determine if, under
the system under this subsection, costs incurred by hospitals located in
rural areas by ambulatory payment classification groups (APCs) exceed
those costs incurred by hospitals located in urban areas.
`(B) AUTHORIZATION OF ADJUSTMENT- Insofar as the Secretary determines under
subparagraph (A) that costs incurred by hospitals located in rural areas
exceed those costs incurred by hospitals located in urban areas, the Secretary
shall provide for an appropriate adjustment under paragraph (2)(E) to reflect
those higher costs by January 1, 2006.'.
