S.Amdt. 591

SA 591. Mr. KERRY (for himself and Mrs. Lincoln) submitted an amendment intended to be proposed by him to the bill S. 1054, to provide for reconciliation pursuant to section 201 of the concurrent resolution on the budget for fiscal year 2004; which was ordered to lie on the table; as follows:

On page ____, between lines ____ and ____, insert the following:

SEC. ____. MEDICAID DSH ALLOTMENTS.

(a) Temporary Increase in Floor for Treatment as an Extremely Low DSH State under the Medicaid Program.--

(1) In general.--Section 1923(f)(5) of the Social Security Act (42 U.S.C. 1396r-4(f)(5)) is amended--

(A) by striking “In the case of” and inserting the following:

“(A) In general.--In the case of”; and

(B) by adding at the end the following:

“(B) Temporary increase in floor for fiscal year 2004.--During the period that begins on October 1, 2003, and ends on September 30, 2004, subparagraph (A) shall be applied--

“(i) by substituting ‘fiscal year 2002' for ‘fiscal year 1999';

“(iii) by substituting ‘Centers for Medicare & Medicaid Services' for ‘Health Care Financing Administration';

“(ii) by substituting ‘August 31, 2003' for ‘August 31, 2000';

“(iv) by substituting ‘3 percent' for ‘1 percent' each place it appears;

“(v) by substituting ‘fiscal year 2004' for ‘fiscal year 2001'; and

“(vi) without regard to the second sentence.”.

(2) Effective date.--The amendments made by paragraph (1) take effect on October 1, 2003, and apply to DSH allotments under title XIX of the Social Security Act only with respect to fiscal year 2004.

(b) Continuation of BIPA Rule for Determination of Allotments for Fiscal Year 2003.--

(1) In general.--Section 1923(f)(4) of the Social Security Act (42 U.S.C. 1396r-4(f)(4)) is amended--

(A) in the paragraph heading, by striking “and 2002” and inserting “through 2003”;

(B) in subparagraph (A)--

(i) in clause (i), by striking “and” at the end;

(ii) in clause (ii), by striking the period and inserting a semicolon; and

(iii) by adding at the end the following:

“(iii) fiscal year 2003, shall be the DSH allotment determined under clause (ii) increased, subject to subparagraph (B) and paragraph (5), by the percentage change in the Consumer Price Index for all urban consumers (all items; U.S. city average) for fiscal year 2002.”; and

(C) in subparagraph (C)--

(i) in the subparagraph heading, by striking “2002” and inserting “2003”; and

(ii) by striking “2003” and inserting “2004”.

(3) Conforming amendments.--Section 1923(f)(3) of such Act (42 U.S.C. 1396r-4(f)(3)) is amended--

(A) in the paragraph heading, by striking “2003” and inserting “2004”; and

(B) by striking subparagraph (A) and inserting the following:

“(A) In general.--The DSH allotment for any State--

“(i) for fiscal year 2004, is equal to the DSH allotment determined for the State for fiscal year 2002 under the table set forth in paragraph (2), increased, subject to subparagraph (B) and paragraph (5), by the percentage change in the Consumer Price Index for all urban consumers (all items; U.S. city average), for each of fiscal years 2002 and 2003; and

“(ii) for fiscal year 2005 and each succeeding fiscal year, is equal to the DSH allotment determined for the State for the preceding fiscal year under this paragraph, increased, subject to subparagraph (B) and paragraph (5), by the percentage change in the Consumer Price Index for all urban consumers (all items; U.S. city average), for the previous fiscal year.”.

(4) Effective date.--The amendments made by this subsection shall take effect as if included in the enactment of section 701 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, as enacted into law by section 1(a)(6) of Public Law 106-554 (114 Stat. 2763A-569).

(c) Allotment Adjustment for Certain States.--

(1) In general.--Section 1923(f) of the Social Security Act (42 U.S.C. 1396r-4(f)) is amended--

(A) by redesignating paragraph (6) as paragraph (7); and

(B) by inserting after paragraph (5) the following:

“(6) Allotment adjustment for certain states.--

“(A) Tennessee.--If the State-wide waiver approved under section 1115 for the State of Tennessee with respect to the requirements of this title (as in effect on the date of enactment of this subsection) is revoked or terminated, the Secretary shall--

“(i) permit the State of Tennessee to submit an amendment to its State plan that would describe the methodology to be used by the State (after the effective date of such revocation or termination) to identify and make payments to disproportionate share hospitals, including children's hospitals and institutions for mental diseases or other mental health facilities (other than State-owned institutions or facilities), on the basis of the proportion of patients served by such hospitals that are low-income patients with special needs; and

“(ii) provide for purposes of this subsection for computation of an appropriate DSH allotment for the State that provides for the maximum amount (permitted consistent with paragraph (3)(B)(ii)) that does not result in greater expenditures under this title than would have been made if such waiver had not been revoked or terminated.

“(B) Hawaii.--Effective for DSH allotments beginning with fiscal year 2003, the Secretary shall compute a DSH allotment for the State of Hawaii in the same manner as DSH allotments are determined with respect to those States to which paragraph (5) applies (but without regard to the requirement under such paragraph that total expenditures under the State plan for disproportionate share hospital adjustments for any fiscal year exceeds 0).”.

(2) Treatment of institutions for mental diseases.--Section 1923(h)(1) of the Social Security Act (42 U.S.C. 1396r-4(h)(1)) is amended--

(A) in paragraph (1), in the matter preceding subparagraph (A), by inserting “(subject to paragraph (3))” after “the lesser of the following”; and

(B) by adding at the end the following new paragraph:

“(3) Special rule.--The limitation of paragraph (1) shall not apply in the case of Tennessee in the case of a revocation or termination of its statewide waiver described in subsection (f)(6)(A).”.

(3) Effective date.--The amendment made by this subsection shall take effect as if enacted on October 1, 2002.

(d) Funding.--Of the amount appropriated in section 371(e) for fiscal year 2003 (after the application of section 1903(x) of the Social Security Act), an amount equal to the amount required to carry out the amendments made by this section for each of fiscal years 2003 through 2013 shall be transferred and made available from the amount so appropriated in section 371(e) (after such application) to the Secretary of Health and Human Services to carry out the amendments made by this section.