PUBLIC LAW 106-113—APPENDIX F 113 STAT. 1501A-343 "(C) 2003.— Subject to subparagraph (D), for covered OPD services furnished during 2003, for which the PPS amount is— "(i) at least 90 percent, but less than 100 percent, of the pre-BBA amount, the amount of payment under this subsection shall be increased by 60 percent of the amount of such difference; or "(ii) less than 90 percent of the pre-BBA amount, the amount of payment under this subsection shall be increased by 6 percent of the pre-BBA amount. " (D) HOLD HARMLESS PROVISIONS.— " (i) TEMPORARY TREATMENT FOR SMALL RURAL HOS- PITALS.— In the case of a hospital located in a rural area and that has not more than 100 beds, for covered OPD services furnished before January 1, 2004, for which the PPS amount is less than the pre-BBA amount, the amount of pa3mrient under this subsection shall be increased by the amouEit of such difference. " (ii) PERMANENT TREATMENI^ FOR CANCER HOS- PITALS.— In the case of a hospital described in section 1886(d)(l)(B)(v), for covered OPD services for which the PPS amount is less than the pre-BBA amount, the amount of payment under this subsection shall be increased by the amount of such difference. "(E) PPS AMOUNT DEFINED.— In this paragraph, the term 'PPS amount' means, with respect to covered OPD services, the amount payable under this title for such services (determined without regard to this paragraph), including amounts payable as copayment under paragraph (8), coinsurance under section 1866(a)(2)(A)(ii), and the deductible under section 1833(b). "(F) PRE-BBA AMOUNT DEFINED.— "(i) IN GENERAL.—In this paragraph, the *pre-BBA amount' means, with respect to covered OPD services furnished by a hospital in a year, an amount equal to the product of the reasonable cost of the hospital for such services for the portions of the hospital's cost reporting period (or periods) occurring in the year and the base OPD payment-to-cost ratio for the hospital (as defined in clause (ii)). " (ii) BASE PAYMENT-TO-COST-RATIO DEFINED. —For purposes of this subparagraph, the 'base payment-to- cost ratio' for a hospital means the ratio of— "(I) the hospital's reimbursement under this part for covered OPD services furnished during the cost reporting period ending in 1996, including any reimbursement for such services through costsharing described in subparagraph (E), to "(II) the reasonable cost of such services for such period. The Secretary shall determine such ratios as if the amendments made by section 4521 of the Balanced Budget Act of 1997 were in effect in 1996. "(G) INTERIM PAYMENTS. — The Secretary shall make payments under this paragraph to Iiospitals on an interim basis, subject to retrospective adjustments based on settled cost reports.
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