120 STAT. 2982
PUBLIC LAW 109–432—DEC. 20, 2006
SEC. 106. HOSPITAL MEDICARE REPORTS AND CLARIFICATIONS. 42 USC 1395 note.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
(a) CORRECTION OF MID-YEAR RECLASSIFICATION EXPIRATION.— Notwithstanding any other provision of law, in the case of a subsection (d) hospital (as defined for purposes of section 1886 of the Social Security Act (42 U.S.C. 1395ww)) with respect to which a reclassification of its wage index for purposes of such section would (but for this subsection) expire on March 31, 2007, such reclassification of such hospital shall be extended through September 30, 2007. The previous sentence shall not be effected in a budget-neutral manner. (b) REVISION OF THE MEDICARE WAGE INDEX CLASSIFICATION SYSTEM.— (1) MEDPAC REPORT.— (A) IN GENERAL.—The Medicare Payment Advisory Commission shall submit to Congress, by not later than June 30, 2007, a report on its study of the wage index classification system applied under Medicare prospective payment systems, including under section 1886(d)(3)(E) of the Social Security Act (42 U.S.C. 1395ww(d)(3)(E)). Such report shall include any alternatives the Commission recommends to the method to compute the wage index under such section. (B) FUNDING.—Out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Medicare Payment Advisory Commission, $2,000,000 for fiscal year 2007 to carry out this paragraph. (2) PROPOSAL TO REVISE THE HOSPITAL WAGE INDEX CLASSIFICATION SYSTEM.—The Secretary of Health and Human Services, taking into account the recommendations described in the report under paragraph (1), shall include in the proposed rule published under section 1886(e)(5)(A) of the Social Security Act (42 U.S.C. 1395ww(e)(5)(A)) for fiscal year 2009 one or more proposals to revise the wage index adjustment applied under section 1886(d)(3)(E) of such Act (42 U.S.C. 1395ww(d)(3)(E)) for purposes of the Medicare prospective payment system for inpatient hospital services. Such proposal (or proposals) shall consider each of the following: (A) Problems associated with the definition of labor markets for purposes of such wage index adjustment. (B) The modification or elimination of geographic reclassifications and other adjustments. (C) The use of Bureau of Labor Statistics data, or other data or methodologies, to calculate relative wages for each geographic area involved. (D) Minimizing variations in wage index adjustments between and within Metropolitan Statistical Areas and Statewide rural areas. (E) The feasibility of applying all components of the proposal to other settings, including home health agencies and skilled nursing facilities. (F) Methods to minimize the volatility of wage index adjustments, while maintaining the principle of budget neutrality in applying such adjustments. (G) The effect that the implementation of the proposal would have on health care providers and on each region of the country.
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