To amend title XIX of the Social Security Act to Temporarily increase the floor for treatment as an extremely low DSH State and to provide for an allotment adjustment for certain States.

1. Inserts new text at the end of subtitle F of title III

   Inserts

   In S. 1054 · Placed on Calendar Senate

   (2) imply congressional approval of any waiver, experimental, pilot, or demonstration project affecting the State children's health insurance program under title XXI of such Act that has been approved as of such date of enactment.

   Inserted: SEC. ____ . MEDICAID DSH ALLOTMENTS.

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

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

   Inserted: (A) by striking "In the case of" and inserting the following:

   Inserted: "(A) In general.--In the case of"; and

   Inserted: (B) by adding at the end the following:

   Inserted: "(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--

   Inserted: "(i) by substituting 'fiscal year 2002' for 'fiscal year 1999';

   Inserted: "(iii) by substituting 'Centers for Medicare & Medicaid Services' for 'Health Care Financing Administration';

   Inserted: "(ii) by substituting 'August 31, 2003' for 'August 31, 2000';

   Inserted: "(iv) by substituting '3 percent' for '1 percent' each place it appears;

   Inserted: "(v) by substituting 'fiscal year 2004' for 'fiscal year 2001'; and

   Show 16 more inserted paragraphsShow less

   Inserted: "(vi) without regard to the second sentence.".

   Inserted: (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.

   Inserted: (b) Allotment Adjustment for Certain States.--

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

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

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

   Inserted: "(6) Allotment adjustment for certain states.--

   Inserted: "(A) Tennessee.--Only with respect to fiscal year 2004, if the statewide 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 paragraph) is revoked or terminated, the Secretary shall--

   Inserted: "(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

   Inserted: "(ii) provide for purposes of this subsection for computation of an appropriate DSH allotment for the State for fiscal year 2004 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.

   Inserted: "(B) Hawaii.--The Secretary shall compute a DSH allotment for the State of Hawaii for each of fiscal year 2004 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).".

   Inserted: (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--

   Inserted: (A) in paragraph (1), in the matter preceding subparagraph (A), by striking "Payment" and inserting "Subject to paragraph (3), payment"; and

   Inserted: (B) by adding at the end the following:

   Inserted: "(3) Special rule.--The limitation of paragraph (1) shall not apply in the case of Tennessee with respect to fiscal year 2004 in the case of a revocation or termination of its statewide waiver described in subsection (f)(6)(A).".

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

   Original wording

   At the end of subtitle F of title III, add the following:

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As printed