Page:United States Statutes at Large Volume 114 Part 5.djvu/525

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PUBLIC LAW 106-554—APPENDIX F 114 STAT. 2763A-485 period with a disproportionate patient percentage (as defined in clause (vi)) that— "(I) is less than 19.3, the disproportionate share adjustment percentage is determined in accordance with the following formula: (P-15)(.65) + 2.5; or "(II) is equal to or exceeds 19.3, such adjustment percentage is equal to 5.25 percent, where T' is the hospital's disproportionate patient percentage (as defined in clause (vi)).". (4) HOSPITALS THAT ARE BOTH SOLE COMMUNITY HOSPITALS AND RURAL REFERRAL CENTERS.— Such section is further amended, in clause (iv)(IV), by inserting after "clause (viii)" the following: "or, for discharges occurring on or after April 1, 2001, the greater of the percentages determined under clause (x) or (xi)". (5) URBAN HOSPITALS WITH LESS THAN loo BEDS.—Such section is further amended— (A) in clause (iv)(II), by inserting after "5 percent" the following: "or, for discharges occurring on or after April 1, 2001, is equal to the percent determined in accordance with clause (xiii)"; and (B) by adding at the end the following new clause: "(xiii) For purposes of clause (iv)(II) (relating to urban hospitals with less than 100 beds), in the case of a hospital for a cost reporting period with a disproportionate patient percentage (as defined in clause (vi)) that— "(I) is less than 19.3, the disproportionate share adjustment percentage is determined in accordance with the following formula: (P-15)(.65) + 2.5; or "(II) is equal to or exceeds 19.3, such adjustment percentage is equal to 5.25 percent, where T' is the hospital's disproportionate patient percentage (as defined in clause (vi)).". SEC. 212. OPTION TO BASE ELIGffilLITY FOR MEDICARE DEPENDENT, SMALL RURAL HOSPITAL PROGRAM ON DISCHARGES DURING TWO OF THE THREE MOST RECENTLY AUDITED COST REPORTING PERIODS. (a) IN GENERAL.—Section 1886(d)(5)(G)(iv)(IV) (42 U.S.C. 1395ww(d)(5)(G)(iv)(IV)) is amended by inserting ", or two of the three most recently audited cost reporting periods for which the Secretary has a settled cost report," after "1987". (b) EFFECTIVE DATE.— The amendment made by this section shall apply with respect to cost reporting periods beginning on or after April 1,200 L SEC. 213. EXTENSION OF OPTION TO USE REBASED TARGET AMOUNTS TO ALL SOLE COMMUNITY HOSPITALS. (a) IN GENERAL. —Section 1886(b)(3)(I)(i) (42 U.S.C. 1395ww(b)(3)(I)(i)) is amended— (1) in the matter preceding subclause (I), by striking "that for its cost reporting period beginning during 1999" and all that follows through "for such target amount" and inserting "there shall be substituted for the amount otherwise determined under subsection (d)(5)(D)(i), if such substitution results in a greater amount of payment under this section for the hospital";