ELIMINATION OF IME AND DSH PAYMENTS ATTRIBUTABLE TO OUTLIER PAYMENTS.

SEC. 4405. ELIMINATION OF IME AND DSH PAYMENTS ATTRIBUTABLE TO OUTLIER PAYMENTS. (a) Indirect Medical Education.—Section 1886(d)(5)(B)(i)(I) (42 U.S.C. 1395ww(d)(5)(B)(i)(D) is amended by inserting “, for cases qualifying for additional payment under subparagraph (A)(i),” before “the amount paid to the hospital under subparagraph (A)”. (b) Disproportionate Share Adjustments.—Section 1886(d)(5)(F)(ii)(I) (42 U.S.C. 1395ww(d)(5)(F)(ii)(D) is amended by inserting “, for cases qualifying for additional payment under subparagraph (A)(i),” before “the amount paid to the hospital under subparagraph (A)”. (c) Cost Outlier Payments.—Section 1886(d)(5)(A)(ii) (42 U.S.C. 1395ww(d)(5)(A)(ii)) is amended by striking “exceed the applicable DRG prospective payment rate” and inserting “exceed the sum of the applicable DRG prospective payment rate plus any amounts payable under subparagraphs (B) and (F)”. (d) Effective Date.—The amendments made by this section apply to discharges occurring after September 30, 1997.