TITLE V--PROVISIONS RELATING TO PART A
Subtitle A--Inpatient Hospital Services
SEC. 501. REVISION OF ACUTE CARE HOSPITAL PAYMENT UPDATES.
(a) IN GENERAL- Section 1886(b)(3)(B)(i) (42 U.S.C. 1395ww(b)(3)(B)(i))
is amended--
(1) by striking `and' at the end of subclause (XVIII);
(2) by striking subclause (XIX); and
(3) by inserting after subclause (XVIII) the following
new subclauses:
`(XIX) for each of fiscal years 2004 through 2007, subject to clause
(vii), the market basket percentage increase for hospitals in all areas;
and
`(XX) for fiscal year 2008 and each subsequent fiscal year, the market
basket percentage increase for hospitals in all areas.'.
(b) SUBMISSION OF HOSPITAL QUALITY DATA- Section 1886(b)(3)(B)
(42 U.S.C. 1395ww(b)(3)(B)) is amended by adding at the end the following new
clause:
`(vii)(I) For purposes of clause (i)(XIX) for each of fiscal years 2005
through 2007, in a case of a subsection (d) hospital that does not submit data
to the Secretary in accordance with subclause (II) with respect to such a
fiscal year, the applicable percentage increase under such clause for such
fiscal year shall be reduced by 0.4 percentage points. Such reduction shall
apply only with respect to the fiscal year involved, and the Secretary shall
not take into account such reduction in computing the applicable percentage
increase under clause (i)(XIX) for a subsequent fiscal year.
`(II) Each subsection (d) hospital shall submit to the Secretary quality
data (for a set of 10 indicators established by the Secretary as of November
1, 2003) that relate to the quality of care furnished by the hospital in
inpatient settings in a form and manner, and at a time, specified by the
Secretary for purposes of this clause, but with respect to fiscal year 2005,
the Secretary shall provide for a 30-day grace period for the submission of
data by a hospital.'.
(c) GAO Study and Report on Appropriateness of Payments Under
the Prospective Payment System for Inpatient Hospital Services-
(1) STUDY- The Comptroller General of the United States,
using the most current data available, shall conduct a study to determine--
(A) the appropriate level and distribution of payments
in relation to costs under the prospective payment system under section
1886 of the Social Security Act (42 U.S.C. 1395ww) for inpatient hospital
services furnished by subsection (d) hospitals (as defined in subsection
(d)(1)(B) of such section); and
(B) whether there is a need to adjust such payments
under such system to reflect legitimate differences in costs across different
geographic areas, kinds of hospitals, and types of cases.
(2) REPORT- Not later than 24 months after the date of
the enactment of this Act, the Comptroller General of the United States shall
submit to Congress a report on the study conducted under paragraph (1) together
with such recommendations for legislative and administrative action as the
Comptroller General determines appropriate.
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