ADJUSTMENT TO THE MEDICARE INPATIENT HOSPITAL PROSPECTIVE PAYMENT SYSTEM WAGE INDEX TO REVISE THE LABOR-RELATED SHARE OF SUCH INDEX.

SEC. 403. ADJUSTMENT TO THE MEDICARE INPATIENT HOSPITAL PROSPECTIVE PAYMENT SYSTEM WAGE INDEX TO REVISE THE LABOR-RELATED SHARE OF SUCH INDEX.(a) Adjustment.—(1) In general.—Section 1886(d)(3)(E) (42 U.S.C. 1395ww(d)(3)(E)) is amended—(A) by striking “wage levels.—The Secretary” and inserting “wage levels.—“(i) In general.—Except as provided in clause (ii), the Secretary”; and(B) by adding at the end the following new clause:“(ii) Alternative proportion to be adjusted beginning in fiscal year 2005.—For discharges occurring on or after October 1, 2004, the Secretary shall substitute ‘62 percent’ for the proportion described in the first sentence of clause (i), unless the application of this clause would result in lower payments to a hospital than would otherwise be made.”.(2) Waiving budget neutrality.—Section 1886(d)(3)(E) (42 U.S.C. 1395ww(d)(3)(E)), as amended by subsection (a), is amended by adding at the end of clause (i) the following new sentence: “The Secretary shall apply the previous sentence for any period as if the amendments made by section 403(a)(1) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 had not been enacted.”.(b) Application to Puerto Rico Hospitals.—Section 1886(d)(9)(C)(iv) (42 U.S.C. 1395ww(d)(9)(C)(iv)) is amended—(1) by inserting “(I)” after “(iv)”;(2) by striking “paragraph (3)(E)” and inserting “paragraph (3)(E)(i)”; and(3) by adding at the end the following new subclause:“(II) For discharges occurring on or after October 1, 2004, the Secretary shall substitute ‘62 percent’ for the proportion described in the first sentence of clause (i), unless the application of this subclause would result in lower payments to a hospital than would otherwise be made.”. 117 STAT. 2266