123STA T . 1 0 3 PUBLIC LA W 111 – 3 —FE B. 4, 200 9(3)isobl i gated to se rv e all p atie n ts , regardless o f abilit y to pay
( 4 )islo c ated w it h ina S tandard M etropolitan Statistical A rea (SMSA) that incl u des at least 3 States; ( 5 ) provides services as a tertiary care provider for patients residing within a 12 5 -m ile radius; and ( 6 ) meets the criteria for a disproportionate share hospital under section 1 9 23 of such Act (42 U. S. C . 1396r – 4) in at least one State other than the State in which the center is located. SEC.61 6.E XT E N S IO NO FM E D IC A ID DS H A L LOTMENTS FO R TEN - NESSEE AND HA W AII. Section 1923(f)(6) (42 U.S.C. 1396r–4(f)(6)), as amended by section 2 0 2 of the Medicare I mprovements for P atients and Pro- viders Act of 200 8 (Public L aw 110–2 7 5) is amended — (1) in the paragraph heading, by stri k ing ‘ ‘ 20 0 9ANDTHEFIRS T C A L ENDAR QU ARTER O F FISCAL Y EAR 20 1 0 ’ ’ and inserting ‘‘2011 AND THE FIRST CALENDAR QUARTER OF FISCAL YEAR 2012’’; (2) in subparagraph (A)— (A) in clause (i)— (i) in the second sentence— (I) by striking ‘‘and 2009’’ and inserting ‘‘, 2009, 2010, and 2011’’; and (II) by striking ‘‘such portion of’’; and (ii) in the third sentence, by striking ‘‘2010 for the period ending on D ecember 31, 2009’’ and inserting ‘‘2012 for the period ending on December 31, 2011’’; ( B ) in clause (ii), by striking ‘‘or for a period in fiscal year 2010’’ and inserting ‘‘2010, 2011, or for period in fiscal year 2012’’; and (C) in clause (iv)— (i) in the clause heading, by striking ‘‘2009 AND THE FIRST CALENDAR QUARTER OF FISCAL YEAR 2010’’ and inserting ‘‘2011 AND THE FIRST CALENDAR QUARTER OF FISCAL YEAR 2012’’; and (ii) in each of subclauses (I) and (II), by striking ‘‘ or for a period in fiscal year 2010’’ and inserting ‘‘2010, 2011, or for a period in fiscal year 2012’’; and (3) in subparagraph (B)— (A) in clause (i)— (i) in the first sentence, by striking ‘‘2009’’ and inserting ‘‘2011’’; and (ii) in the second sentence, by striking ‘‘2010 for the period ending on December 31, 2009’’ and inserting ‘‘2012 for the period ending on December 31, 2011’’. SEC. 61 7 . G AO RE P ORT ON MEDICAID MANAGED CARE PA Y MENT RATES. N ot later than 18 months after the date of the enactment of this Act, the Comptroller G eneral of the United States shall submit a report to the Committee on F inance of the Senate and the Committee on E nergy and Commerce of the H ouse of R epresent- atives analy z ing the e x tent to which State payment rates for med- icaid managed care organizations under Medicaid are actuarially sound.
