123STA T .478PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9monthperi o ds e l e c ted by the S ecret a ry shall be determined asthes u mo f the amount , estimated based upon total dischar g es for the eligible hospital ( regardless of any source of payment ) for the period, for each discharge up to the 23 , 0 00th discharge as follo w s
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‘(i) F or the first through 1 ,1 49 th discharge, $ 0 . ‘‘(ii) For the 1,1 5 0th through the 23,000th dis - charge, $200. ‘‘(iii) For any discharge greater than the 23,000th, $0. ‘‘( D ) MEDICAR E SH ARE. —T he Medicare share specified under this subparagraph for an eligible hospital for a period selected by the Secretary for a payment year is e q ual to the fraction— ‘‘(i) the numerator of which is the sum (for such period and with respect to the eligible hospital) of— ‘‘( I ) the estimated number of inpatient-bed- days (as established by the Secretary) which are attributable to indi v iduals with respect to whom payment may be made under part A; and ‘‘(II) the estimated number of inpatient-bed- days (as so established) which are attributable to individuals who are enrolled with a Medicare Advantage organi z ation under part C
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‘‘(ii) the denominator of which is the product of— ‘‘(I) the estimated total number of inpatient- bed-days with respect to the eligible hospital during such period; and ‘‘(II) the estimated total amount of the eligible hospital ’ s charges during such period, not including any charges that are attributable to charity care (as such term is used for purposes of hospital cost reporting under this title), divided by the estimated total amount of the hospital’s charges during such period. Insofar as the Secretary determines that data are not avail- able on charity care necessary to calculate the portion of the formula specified in clause (ii)(II), the Secretary shall use data on uncompensated care and may ad j ust such data so as to be an appropriate pro x y for charity care including a downward adjustment to eliminate bad debt data from uncompensated care data. In the absence of the data necessary, with respect to a hospital, for the Secretary to compute the amount described in clause (ii)(II), the amount under such clause shall be deemed to be 1. In the absence of data, with respect to a hospital, necessary to compute the amount described in clause (i)(II), the amount under such clause shall be deemed to be 0. ‘‘( E ) TRA N SI T I O N F ACTOR S P ECIFIED.— ‘‘(i) IN G ENERA L .—Subject to clause (ii), the transi- tion factor specified in this subparagraph for an eligible hospital for a payment year is as follows: ‘‘(I) For the first payment year for such hos- pital, 1. ‘‘(II) For the second payment year for such hospital, 3⁄4 . Dat a .
