HEART Act
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HR 4178 — HEART Act
Last action — Sponsor introductory remarks on measure. (CR H8304)
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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2In Committee
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3Passed House
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4Passed Senate
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5To Executive
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6Enacted
This bill died with 115th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.
Summary
Healthcare Enhancement for Americas Rural Towns Act or the HEART Act This bill permanently extends and otherwise revises the Medicare-Dependent Hospital program (which provides increased payments to certain smaller, rural hospitals that serve a proportionally high number of Medicare patients). The bill also extends through FY 2019 the program for increased payments under Medicare for low-volume hospitals.
Bill Text
- Introduced Introduced in House Current html October 31, 2017
Sections of law this bill changes
1 section in 1 lawFrom the bill's own amending language, matched to the official United States Code (current through Public Law 119-121).
Social security · 42 U.S.C. ch. 7 1 section
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§ 1395ww Payments to hospitals for inpatient hospital services Amends
42 U.S.C. § 1395ww — at 1395ww(d)(5)(G), 1395ww(b)(3)(D), and 1395ww(d)(12)
The law today
(a) Determination of costs for inpatient hospital services; limitations; exemptions; “operating costs of inpatient hospital services” defined (1) (A) (i) The Secretary, in determining the amount of the payments that may be made under this subchapter with respect to operating costs of inpatient hospital services (as defined in paragraph (4)) shall not recognize as reasonable (in the efficient delivery of health services) costs for the provision of such services by a hospital for a cost reporting period to the extent such costs exceed the applicable percentage (as determined under clause (ii)) of the average of such costs for all hospitals in the same grouping as such hospital for comparable time periods. (ii) For purposes of clause (i), the applicable percentage for hospital cost reporting periods beginning— (I) on or after October 1, 1982, and before October 1, 1983, is 120 percent; (II) on or after October 1, 1983, and before October 1, 1984, is 115 percent; and (III) on or after October 1, 1984, is 110 percent. (B) (i) For purposes of subparagraph (A) the Secretary shall establish case mix indexes for all short-term hospitals, and shall set limits for each hospital based upon the general mix of types of medical cases with respect to which such hospital provides services for which payment may be made under this subchapter. (ii) The Secretary shall set such limits for a cost reporting period of a hospital— (I) by updating available data for a previous period to the immediate preceding cost reporting period by the estimated average rate of change of hospital costs industry-wide, and (II) by projecting for the cost reporting period by the applicable percentage increase (as defined in subsection (b)(3)(B)). (C) The limitation established under subparagraph (A) for any hospital shall in no event be lower than the allowable operating costs of inpatient hospital services (as defined in paragraph (4)) recognized under this subchapter for such hospital for such hospital’s last cost reporting period prior to the hospital’s first cost reporting period for which this section is in effect. (D) Subparagraph (A) shall not apply to cost reporting periods beginning on or after October 1, 1983. (2) The Secretary shall provide for such exemptions from, and exceptions and adjustments to, the limitation established under paragraph (1)(A) as he deems appropriate, including those which he deems necessary to take into account— (A) the special needs of sole community hospitals, of new hospitals, of risk based health maintenance organizations, and of hospitals which provide atypical services or essential community services, and to take into account extraordinary circumstances beyond the hospital’s control, medical and paramedical education costs, significantly fluctuating population in the service area of the hospital, and unusual labor costs, (B) the special needs of psychiatric hospitals and of public or other hospitals that serve a significantly disproportionate number of patients who have low income or are entitled to benefits under part A of this subchapter, and (C) a decrease in the inpatient hospital services that a hospital provides and that are customarily provided directly by similar hospitals which results in a significant distortion in the operating costs of inpatient hospital services. (3) The limitation established under paragraph (1)(A) shall not apply with respect to any hospital which— (A) is located outside of a standard metropolitan statistical area, and (B) (i) has less than 50 beds, and (ii) was in operation and had less than 50 beds on September 3, 1982. (4) For purposes of this section, the term “operating costs of inpatient hospital services” includes all routine operating costs, ancillary service operating costs, and special care unit operating costs with respect to inpatient hospital services as such costs are determined on an average per admission or per discharge basis (as determined by the Secretary), and includes the c...209 other bills also change this section · Follow it → Official text at uscode.house.gov ↗
Compared against current U.S. Code AI-generated reading aid — verify against the official bill.
The bill extends and reforms certain payment methodologies for Medicare-dependent hospitals and the low-volume adjustment program.
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42 U.S.C. 1395ww(d)(5)(G)
, and before October 1, 2017→ before October 1, 2018Extends the deadline for certain payment methodologies for Medicare-dependent hospitals by one year.
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42 U.S.C. 1395ww(d)(5)(G)
For fiscal year 2018 and each subsequent fiscal year, in the case of such a subsection (d) hospital, payment under paragraph (1)(A) shall be equal to the sum of the amount determined under paragraph (1)(A)(iii) and the amount determined by the increase factor determined under clause (v) for such hospital and cost reporting period.
Establishes a new payment structure for Medicare-dependent hospitals starting in fiscal year 2018.
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42 U.S.C. 1395ww(d)(5)(G)
, and before October 1, 2017→ before October 1, 2018Further extends the deadline for additional payment methodologies for Medicare-dependent hospitals.
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42 U.S.C. 1395ww(d)(5)(G)
Subject to subclause (II), for purposes of clause (i), for fiscal year 2019 and each subsequent fiscal year with respect to a subsection (d) hospital which is a medicare-dependent, small rural hospital, the Secretary shall determine an increase factor to apply to such hospital with respect to discharges occurring during such fiscal year. When determining such increase factor, the Secretary may take into account a methodology that results in a similar amount of reimbursement to such hospital for such fiscal year as such amount that would have been determined if the first sentence of clause (i) applied with respect to such fiscal year.
Introduces a new increase factor for Medicare-dependent small rural hospitals starting in fiscal year 2019.
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42 U.S.C. 1395ww(d)(5)(G)
The aggregate amounts determined for all subsection (d) hospitals which are medicare-dependent, small rural hospitals by application of the increase factors determined under clause (v) for such hospitals shall not exceed a total of-- (I) for fiscal year 2019, $100,000,000; and (II) for each subsequent fiscal year, the amount specified in this clause for the previous fiscal year increased by the market basket percentage increase (as defined in subsection (b)(3)(B)(iii)) as determined prospectively by the Secretary for such subsequent fiscal year.
Caps the total increase in payments to Medicare-dependent small rural hospitals at $100 million for fiscal year 2019, with annual adjustments thereafter.
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42 U.S.C. 1395ww(b)(3)(D)
, and before October 1, 2017Removes the previous deadline for the target amount related to Medicare-dependent hospitals.
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42 U.S.C. 1395ww(b)(3)(D)
through fiscal year 2017→ through fiscal year 2018Extends the target amount calculations for Medicare-dependent hospitals to include fiscal year 2018.
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42 U.S.C. 1395ww(d)(12)
and for discharges occurring in fiscal year 2020 and subsequent fiscal yearsEliminates the deadline for discharges under the Medicare low-volume adjustment program.
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42 U.S.C. 1395ww(d)(12)
fiscal years 2011 through 2017→ fiscal years 2011 through 2019Extends the time frame for low-volume adjustment eligibility to include fiscal year 2019.
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42 U.S.C. 1395ww(d)(12)
Temporary applicable percentage increase→ Applicable percentage increase beginning with fiscal year 2011Changes the language to clarify the applicability of the percentage increase starting with FY 2011.
Action History
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Sponsor introductory remarks on measure. (CR H8304)
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Introduced in House
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Introduced in House
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Referred to the House Committee on Ways and Means.
Sponsors
- Jodey C. Arrington · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 546 not signed on
Sponsors (1)
- Arrington, Jodey C. Republican
Co-sponsors (0)
None.
Not signed on (546)
546 members have not signed on to this bill.
Show all 546 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does HR 4178 do?
- Healthcare Enhancement for Americas Rural Towns Act or the HEART Act This bill permanently extends and otherwise revises the Medicare-Dependent Hospital program (which provides increased payments to certain smaller, rural hospitals that serve a proportionally high number of Medicare patients). The bill also extends through FY 2019 the program for increased payments under Medicare for low-volume hospitals.
- Who sponsors HR 4178?
- HR 4178 is sponsored by Arrington, Jodey C. (Republican).
- What is the current status of HR 4178?
- This bill died with 115th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track HR 4178?
- Track HR 4178 free on One Click Politics — get push/email alerts when it moves.
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