To help rural health care providers and hospitals receive a fair reimbursement for services under Medicare by reducing tax cuts regarding dividends.

1. Adds SEC. ____. FAIR REIMBURSEMENT FOR RURAL HEALTH CARE PROVIDERS UNDER MEDICARE on page 281, between lines 2 and 3

   Adds a sectionPrinted page

   Inserted: SEC. ____. FAIR REIMBURSEMENT FOR RURAL HEALTH CARE PROVIDERS UNDER MEDICARE.

   Inserted: (a) Reduction of Geographic Disparity Under Medicare.--

   Inserted: (1) In general.--Subject to paragraph (3), the Secretary of Health and Human Services shall promulgate the regulations described in paragraph (2) by December 31, 2004 (unless legislation has been enacted having the effect of such regulations before the conclusion of the first session of the 108th Congress).

   Inserted: (2) Regulations described.--The regulations described in this paragraph are regulations that reduce the geographic disparity in payments under the medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) to health care providers by--

   Inserted: (A) equalizing urban and rural standardized payment amounts under the medicare inpatient hospital prospective payment system under section 1886(d)(3) of such Act (42 U.S.C. 1395ww(d)(3));

   Inserted: (B) improving the medicare incentive payment program under section 1833(m) of such Act (42 U.S.C. 1395l(m)) to ensure that bonus payments under such section are made on behalf of all eligible physicians;

   Inserted: (C) providing fairness in the medicare disproportionate share hospitals adjustment for rural hospitals under section 1886(d)(5)(F) of such Act (42 U.S.C. 1395ww(d)(5)(F));

   Inserted: (D) establishing a medicare inpatient hospital bonus payment for low-volume hospitals under section 1886(d) of such Act (42 U.S.C. 1395ww(d));

   Inserted: (E) adjusting the medicare inpatient hospital prospective payment system wage index to revise the labor-related share of such index to account for 62 percent of such index under section 1886(d)(3)(E) of such Act (42 U.S.C. 1395ww(d)(3)(E));

   Inserted: (F) revising the physician fee schedule wage index under section 1848(e)(1) of such Act (42 U.S.C. 1395w-4(e)(1)) to establish a minimum geographic cost-of-practice index value of not less than 1 for physicians' services furnished under the medicare program;

   Inserted: (G) extending the temporary increase under section 508(a) of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (114 Stat. 2763A-533), as enacted into law by section 1(a)(6) of Public Law 106-554, for home health services furnished in a rural area; and

   Inserted: (H) making any other change to a payment system under the medicare program that the Secretary determines is appropriate.

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   Inserted: (3) Hold-harmless.--The regulations promulgated under paragraph (1) may not result in a lower level of reimbursement for a health care provider under the medicare program under title XVIII of the Social Security Act than such provider would have received but for the enactment of this section.

   Inserted: (b) Funding.--

   Inserted: (1) Appropriation.--There are appropriated, out of moneys in the Treasury not otherwise appropriated, $50,000,000,000 for the purpose of implementing the regulations described in subsection (a)(2).

   Inserted: (2) Reversion of excess funds.--Any funds appropriated under this subsection that are not used to implement such regulations shall revert to the Treasury and shall be used to reduce the Federal deficit.

   Inserted: (c) Funding offset.--Paragraph (2) of section 116(a) (relating to partial exclusion of dividends received by individuals), as added by section 201(a), is amended to read as follows:

   Inserted: "(2) Limitation.--Paragraph (1) shall apply to qualified dividend income of a taxpayer only to the extent such income does not exceed the sum of $500 ($250 in the case of a married individual filing a separate return).".

   Original wording

   On page 281, between lines 2 and 3, insert the following:

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As printed