Page:United States Statutes at Large Volume 111 Part 1.djvu/427

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PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 403 shall exclude the general service wages and hours of personnel associated with a skilled nursing facility that is owned by the hospital of the same municipality and that is physically separated from the hospital to the extent that such wages and hours of such personnel are not shared with the hospital and are separately documented. A hospital that applied for and was denied reclassification as an urban hospital for fiscal year 1998, but that would have received reclassification had the exclusion required by this section been applied to it, shall be reclassified as an urban hospital for fiscal year 1998. CHAPTER 2—PAYMENT OF PPS-EXEMPT HOSPITALS Subchapter A—General Payment Provisions SEC. 4411. PAYMENT UPDATE. (a) IN GENERAL. —Section 1886(b)(3)(B) (42 U.S.C. 1395ww(b)(3)(B)) is amended— (1) in clause (ii)— (A) by striking "and" at the end of subclause (V), (B) by redesignating subclause (VI) as subclause (VIII); and (C) by inserting after subclause (V), the following subclauses: "(VI) for fiscal year 1998, is 0 percent; "(VII) for fiscal years 1999 through 2002, is the apphcable update factor specified under clause (vi) for the fiscal year; and"; and (2) by adding at the end the following new clause: "(vi) For purposes of clause (ii)(VII) for a fiscal year, if a hospital's allowable operating costs of inpatient hospital services recognized under this title for the most recent cost reporting period for which information is available— "(I) is equal to, or exceeds, 110 percent of the hospital's target amount (as determined under subparagraph (A)) for such cost reporting period, the applicable update factor specified under this clause is the market basket percentage; "(II) exceeds 100 percent, but is less than 110 percent, of such target amount for the hospital, the applicable update factor specified under this clause is 0 percent or, if greater, the market basket percentage minus 0.25 percentage points for each percentage point by which such allowable operating costs (expressed as a percentage of such target amount) is less than 110 percent of such target amount; "(III) is equal to, or less than 100 percent, but exceeds % of such target amount for the hospital, the applicable update factor specified under this clause is 0 percent or, if greater, the market basket percentage minus 2.5 percentage points; or "(IV) does not exceed % of such target amount for the hospital, the applicable update factor specified under this clause is 0 percent.". (b) No EFFECT OF PAYMENT REDUCTION ON EXCEPTIONS AND ADJUSTMENTS.— Section 1886(b)(4)(A)(ii) (42 U.S.C. 1395ww(b)(4)(A)(ii)) is amended by adding at the end the following new sentence: "In making such reductions, the Secretary shall treat the applicable update factor described in paragraph (3)(B)(vi)