(a)
Hospital inpatient services—
(1)
In general— Section 1886(d)(3)(E)(i) of the Social Security Act (
42 U.S.C. 1395www(d)(3)(E)) is
amended—
(A)
in clause (i), in the first sentence, by striking “or (iii)” and inserting “, (iii), or (iv)”; and
(B)
by adding at the end the following new clause:
“(iv) Area wage index floor
“(I) In general—For discharges occurring on or after October 1, 2020, the area wage index applicable under this subparagraph to any hospital which is not located in a frontier State (as defined in clause (iii)(II)) may not be less than 0.85.
“(II) Waiving budget neutrality—Pursuant to the fifth sentence of clause (i), this clause shall not be applied in a budget neutral manner.”
(2)
Waiving budget neutrality—
(A)
Technical amendatory correction— Section 10324(a)(2) of Public Law 111–148 is amended by striking “third sentence” and inserting “fifth sentence”.
(B)
Waiver— Section 1886(d)(3)(E)(i) of the Social Security Act (
42 U.S.C. 1395ww(d)(3)(E)(i)) is amended, in the fifth
sentence—
(i)
by striking “and the amendments” and inserting “, the amendments”; and
(ii)
by inserting “, and the amendments made by section 401(a)(1) of the Health Care Improvement Act of 2020” after “Care Act”.
(b)
Hospital outpatient department services— Section 1833(t) of the Social Security Act (
42 U.S.C. 1395l(t)), is
amended—
(1)
in paragraph (2)(D), by striking “(19), the Secretary”and inserting “(19) and paragraph (23), the Secretary”; and
(2)
by adding at the end the following new paragraph:
“(23) Floor on area wage adjustment factor for hospital outpatient department services—With respect to covered OPD services furnished on or after January 1, 2021, the area wage adjustment factor applicable under the payment system established under this subsection to any hospital outpatient department which is not located in a frontier State (as defined in section 1886(d)(3)(E)(iii)(II)) may not be less than 0.85. The preceding sentence shall not be implemented in a budget neutral manner.”