Ill STAT. 400 PUBLIC LAW 105-33 —AUG. 5, 1997 SEC. 4404. MEDICARE CAPITAL ASSET SALES PRICE EQUAL TO BOOK VALUE. (a) IN GENERAL. —Section 1861(v)(l)(0) (42 U.S.C. 1395x(v)(l)(0)) is amended— (1) in clause (i)— (A) by striking "and (if applicable) a return on equity capital"; (B) by striking "hospital or skilled nursing facility" and inserting "provider of services"; (C) by striking "clause (iv)" and inserting "clause (iii)"; and (D) by striking "the lesser of the allowable acquisition cost" and all that follows and inserting "the historical cost of the asset, as recognized under this title, less depreciation allowed, to the owner of record as of the date of enactment of the Balanced Budget Act of 1997 (or, in the case of an asset not in existence as of that date, the first owner of record of the asset after that date)."; (2) by striking clause (ii); and (3) by redesignating clauses (iii) and (iv) as clauses (ii) and (iii), respectively. 42 USC I395x (b) EFFECTIVE DATE. —The amendments made by subsection note. (a) apply to changes of ownership that occur after the third month beginning after the date of enactment of this section. SEC. 4405. ELIMINATION OF IME AND DSH PAYMENTS ATTRIBUTABLE TO OUTLIER PAYMENTS. (a) INDIRECT MEDICAL EDUCATION.— Section 1886(d)(5)(B)(i)(I) (42 U.S.C. 1395ww(d)(5)(B)(i)(I)) is amended by inserting ", for cases qualifying for additional payment under subparagraph (A)(i)," before "the amount paid to the hospital under subparagraph (A)". (b) DISPROPORTIONATE SHARE ADJUSTMENTS. —Section 1886(d)(5)(F)(ii)(I) (42 U.S.C. 1395ww(d)(5)(F)(ii)(I)) is amended by inserting ", for cases qualifying for additional payment under subpgiragraph (A)(i)," before "the amount paid to the hospital under subparagraph (A)". (c) COST OUTLIER PAYMENTS.— Section 1886(d)(5)(A)(ii) (42 U.S.C. 1395ww(d)(5)(A)(ii)) is amended by striking "exceed the applicable DRG prospective payment rate" and inserting "exceed the sum of the applicable DRG prospective payment rate plus any amounts payable under subparagraphs (B) and (F)". 42 USC 1395WW (d) EFFECTIVE DATE.—The amendments made by this section note. apply to discharges occurring after September 30, 1997. SEC. 4406. INCREASE BASE PAYMENT RATE TO PUERTO RICO HOS- PITALS. Section 1886(d)(9)(A) (42 U.S.C. 1395ww(d)(9)(A)) is amended— (1) in the matter preceding clause (i), by striking "in a fiscal year beginning on or after October 1, 1987,", (2) in clause (i), by striking "75 percent" and inserting, "for discharges beginning on or after October 1, 1997, 50 percent (and for discharges between October 1, 1987, and September 30, 1997, 75 percent)", and (3) in clause (ii), by striking "25 percent" and inserting, "for discharges beginning in a fiscal year beginning on or after October 1, 1997, 50 percent (and for discharges between October 1, 1987 and September 30, 1997, 25 percent)".
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