Page:United States Statutes at Large Volume 111 Part 1.djvu/537

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PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 513 (b) LIMITATION ON PAYMENTS TO INSTITUTIONS FOR MENTAL DISEASES. —Section 1923 of the Social Security Act (42 U.S.C. 1396r-4) is amended by adding at the end the following: "(h) LIMITATION ON CERTAIN STATE DSH EXPENDITURES.— "(1) IN GENERAL. —Payment under section 1903(a) shall not be made to a State with respect to any payment adjustments made under this section for quarters in a fiscal year (beginning with fiscal year 1998) to institutions for mental diseases or other mental health facilities, to the extent the aggregate of such adjustments in the fiscal year exceeds the lesser of the following: "(A) 1995 IMD DSH PAYMENT ADJUSTMENTS.— The total State DSH expenditures that are attributable to fiscal year 1995 for payments to institutions for mental diseases and other mental health facilities (based on reporting data specified by the State on HCFA Form 64 as mental health DSH, and as approved by the Secretary). " (B) APPLICABLE PERCENTAGE OF 1995 TOTAL DSH PAY- MENT ALLOTMENT. —The amount of such pa3anent adjustments which are equal to the applicable percentage of the Federal share of payment adjustments made to hospitals in the State under subsection (c) that are attributable to the 1995 DSH allotment for the State for payments to institutions for mental diseases and other mental health facilities (based on reporting data specified by the State on HCFA Form 64 as mental health DSH, and as approved by the Secretary). "(2) APPLICABLE PERCENTAGE.— "(A) IN GENERAL.— For purposes of paragraph (1), the applicable percentage with respect to— "(i) each of fiscal years 1998, 1999, and 2000, is the percentage determined under subparagraph (B); or "(ii) a succeeding fiscal year is the lesser of the percentage determined under subparagraph (B) or the following percentage: "(I) For fiscal year 2001, 50 percent. "(II) For fiscal year 2002, 40 percent. "(Ill) For each succeeding fiscal year, 33 percent. " (B) 1995 PERCENTAGE.—The percentage determined under this subparagraph is the ratio (determined as a percentage) of— "(i) the Federal share of payment adjustments made to hospitals in the State under subsection (c) that are attributable to the 1995 DSH allotment for the State (as reported by the State not later than January 1, 1997, on HCFA Form 64, and as approved by the Secretary) for payments to institutions for mental diseases and other mental health facilities, to "(ii) the State 1995 DSH spending amount. " (C) STATE 1995 DSH SPENDING AMOUNT.— For purposes of subparagraph (B)(ii), the 'State 1995 DSH spending amount', with respect to a State, is the Federal medical assistance percentage (for fiscal year 1995) of the payment adjustments made under subsection (c) under the State plan that are attributable to the fiscal year 1995 DSH