114 STAT. 2763A-494 PUBLIC LAW 106-554^APPENDIX F (2) for discharges occurring on or after April 1, 2001, and before October 1, 2001, shall, instead of being reduced by 3 percent as provided by clause (ix)(III) of such section as in effect after the date of the enactment of this Act, be reduced by 1 percent. (c) CONFORMING AMENDMENTS REI^TING TO DETERMINATION OF STANDARDIZED AMOUNT.—Sectibn 1886(d)(2)(C)(iv) (42 U.S.C. 1395ww(d)(2)(C)(iv)), is amended— (1) by striking "1989 or" and inserting "1989,"; and (2) by inserting ", or the enactment of section 303 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000" after "Omnibus Budget Reconciliation Act of 1990". (d) TECHNICAL AMENDMENT. — (1) IN GENERAL. — Section 1886(d)(5)(F)(i) (42 U.S.C. 1395ww(d)(5)(F)(i)) is amended by striking "and before October 1, 1997,". (2) EFFECTIVE DATE.— The amendment made by paragraph (1) is effective as if included in the enactment of BBA. (e) REFERENCE TO CHANGES IN DSH FOR RURAL HOSPITALS.— For additional changes in the DSH program for rural hospitals, see section 211. SEC. 304. WAGE INDEX IMPROVEMENTS. (a) DURATION OF WAGE INDEX RECLASSIFICATION; USE OF 3- YEAR WAGE DATA.— Section 1886(d)(10)(D) (42 U.S.C. 1395ww(d)(10)(D)) is amended by adding at the end the following new clauses: "(v) Any decision of the Board to reclassify a subsection (d) hospital for purposes of the adjustment factor described in subparagraph (C)(i)(II) for fiscal year 2001 or any fiscal year thereafter shall be effective for a period of 3 fiscal years, except that the Secretary shall establish procedures under which a subsection (d) hospital may elect to terminate such reclassification before the end of such period. "(vi) Such guidelines shall provide that, in making decisions on applications for reclassification for the purposes described in clause (v) for fiscal year 2003 and any succeeding fiscal year, the Board shall base any comparison of the average hourly wage for the hospital with the average hourly wage for hospitals in an area on— "(I) an average of the average hourly wage amount for the hospital from the most recently published hospital wage survey data of the Secretary (as of the date on which the hospital applies for reclassification) and such amount from each of the two immediately preceding surveys; and "(II) an average of the average hourly wage amount for hospitals in such area from the most recently published hospital wage survey data of the Secretary (as of the date on which the hospital applies for reclassification) and such amount from each of the two immediately preceding surveys.". (b) PROCESS TO PERMIT STATEWIDE WAGE INDEX CALCULATION AND APPLICATION.— (1) IN GENERAL. — The Secretary of Health and Human Services shall establish a process (based on the voluntary process utilized by the Secretary of Health and Human Services under section 1848 of the Social Security Act (42 U.S.C. 1395w-
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