Page:United States Statutes at Large Volume 107 Part 1.djvu/657

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PUBLIC LAW 103-66 —AUG. 10, 1993 107 STAT. 631 "(B) HOSPITALS WITH IHGH DISPROPORTIONATE SHARE DEFINED.— In subparagraph (A), a hospital is a 'hospital with high disproportionate share' if— (i) the hospital is owned or operated by a State (or by an instnunentality or a unit of government within a State); and "(ii) the hospital— "(I) meets the requirement described in subsection (b)(l)(A), or (II) has the largest number of inpatient days attributable to individuals entitled to benefits under the State plan of any hospital in such State for the previous State fiscal year. "(C) APPLICABLE MINIMUM AMOUNT DEFINED.— In subp£uragraph (A), the 'applicable minimum amount' for a hospital for afiscalyear is equal to the difference between the amount of the hospital's payment adjustment for the fiscal year and the costs to the hospital of fiimishing hospital services described in paragraph (I)(A) during the fiscal year. ". (2) CONFORMING AMENDMENTS.— Section 1923 is amended— 42 USC i396r-4 (A) in subsection (c) in the matter preceding paragraph (1), by striking "subsection (0" and inserting "subsections (f) and (g)"; and (B) in subsection (e)(2) (as amended by subsection (a)(l)(F)>- (i) by striking "and" at the end of subparagraph (B); (ii) by striking the period at the end of subparagraph (C) and inserting ", and"; and (iii) by adding at the end the following new subparagraph: "(D) subsection (g) shall apply.". (3) EFFECTIVE DATE.— (A) IN GENERAL.—Except as provided in subparagraph (B), the amendments made by this subsection shall apply to payments to States under section 1903(a) of the Social Security Act for payments to hospitals made under State plans after— (i) the end of the State fiscal year that ends during 1994, or (ii) in the case of a State with a State legislature whidi is not scheduled to have a regular legislative session in 1994, the end of the State fiscal year that ends during 1995; without regard to whether or not final regulations to carry out such amendments have been promulgated by either such date. (B) DELAY IN IMPLEMENTATION FOR PRIVATE HOS- PITALS.— With respect to a hospital that is not owned or operated by a State (or by an instrumentality or a unit of government witiiin a State), the amendments made by this subsection shall apply to payments to States under section 1903(a) for payments to hospitals made under State plans for State fiscal years that begin during or after 1995, without regard to whether or not final regulations 42 USC 1396r-4 note.