PAYMENTS TO HOSPITALS FOR DIRECT COSTS OF GRADUATE MEDICAL EDUCATION OF MEDICARE+CHOICE ENROLLEES.

SEC. 4624. PAYMENTS TO HOSPITALS FOR DIRECT COSTS OF GRADUATE MEDICAL EDUCATION OF MEDICARE+CHOICE ENROLLEES. Section 1886(h)(3) (42 U.S.C. 1395ww(h)(3)) is amended by adding after subparagraph (C) the following: “(D) Payment for managed care enrollees.— “(i) In general.—For portions of cost reporting periods occurring on or after January 1, 1998, the Secretary shall provide for an additional payment amount under this subsection for services furnished to individuals who are enrolled under a risk-sharing contract with an eligible organization under section 111 STAT. 4791876 and who are entitled to part A or with a Medicare+Choice organization under part C. The amount of such a payment shall equal the applicable percentage of the product of— “(I) the aggregate approved amount (as defined in subparagraph (B)) for that period; and “(II) the fraction of the total number of inpatient-bed days (as established by the Secretary) during the period which are attributable to such enrolled individuals. “(ii) Applicable percentage.—For purposes of clause (i), the applicable percentage is— “(I) 20 percent in 1998, “(II) 40 percent in 1999, “(III) 60 percent in 2000, and “(IV) 80 percent in 2001, and “(V) 100 percent in 2002 and subsequent years. “(iii) Special rule for hospitals under reimbursement system.—The Secretary shall establish rules for the application of this subparagraph to a hospital reimbursed under a reimbursement system authorized under section 1814(b)(3) in the same manner as it would apply to the hospital if it were not reimbursed under such section.”.