42 U.S.C. 1396r-4: Adjustment in payment for inpatient hospital services furnished by disproportionate share hospitals

2024

• Pub. L. 118–158 substituted "April 1" for "January 1" in introductory provisions of cl. (i) and in cl. (ii). (American Relief Act, 2025) Law text · (f)
• Pub. L. 118–42, in introductory provisions of cl. (i), substituted "For the period beginning January 1, 2025, and ending September 30, 2025, and for each of fiscal years 2026" for "For the period beginning March 9, 2024, and ending September 30, 2024, and for each of fiscal years 2025" and, in cl. … (Consolidated Appropriations Act, 2024) Law text · (f)
• Pub. L. 118–35 substituted "March 9, 2024" for "January 20, 2024" in introductory provisions of cl. (i) and in cl. (ii). (Further Additional Continuing Appropriations and Other Extensions Act, 2024) Law text · (f)

2023

• Pub. L. 118–22, §301(1), substituted "January 20, 2024" for "November 18, 2023" in introductory provisions. (Further Continuing Appropriations and Other Extensions Act, 2024) Law text · (f)
• Pub. L. 118–15, §2341(1), substituted "For the period beginning November 18, 2023, and ending September 30, 2024, and for each of fiscal years 2025 through 2027" for "For each of fiscal years 2024 through 2027" in introductory provisions and inserted "or period" after "the fiscal year" wherever app… (Continuing Appropriations Act, 2024 and Other Extensions Act) Law text · (f)
• Pub. L. 118–22, §301(2), substituted "January 20, 2024" for "November 18, 2023". (Further Continuing Appropriations and Other Extensions Act, 2024) Law text · (f)
• Pub. L. 118–15, §2341(2), substituted "for the period beginning November 18, 2023, and ending September 30, 2024, and for each of fiscal years 2025 through 2027." for "for each of fiscal years 2024 through 2027". (Continuing Appropriations Act, 2024 and Other Extensions Act) Law text · (f)

2021

• Pub. L. 117–2, §9819(a)(1), substituted "subparagraphs (E) and (F)" for "subparagraph (E)". (American Rescue Plan Act of 2021) Law text · (f)
• Pub. L. 117–2, §9819(a)(2), added subpar. (F). (American Rescue Plan Act of 2021) Law text · (f)
• Pub. L. 117–7 added par. (3). Law text · (g)

2020

• Pub. L. 116–260, §201(1)(A), substituted "For each of fiscal years 2024 through 2027," for "For the period beginning December 19, 2020, and ending September 30, 2021, and for each of fiscal years 2022 through 2025" in introductory provisions. (Consolidated Appropriations Act, 2021) Law text · (f)
• Pub. L. 116–215 substituted "December 19, 2020" for "December 12, 2020" in introductory provisions. (Further Continuing Appropriations Act, 2021, and Other Extensions Act) Law text · (f)
• Pub. L. 116–159, §2303(1), substituted "December 12, 2020" for "December 1, 2020" in introductory provisions. (Continuing Appropriations Act, 2021 and Other Extensions Act) Law text · (f)
• Pub. L. 116–136, §3813(1), substituted "December 1, 2020, and ending September 30, 2021, and for each of fiscal years 2022" for "May 23, 2020, and ending September 30, 2020, and for each of fiscal years 2021" in introductory provisions. (Coronavirus Aid, Relief, and Economic Security Act" or the "CARES Act) Law text · (f)
• Pub. L. 116–260, §201(1)(B), substituted "equal to $8,000,000,000 for each of fiscal years 2024 through 2027" for "equal to— (Consolidated Appropriations Act, 2021) Law text · (f)
• Pub. L. 116–215 substituted "December 19, 2020" for "December 12, 2020". (Further Continuing Appropriations Act, 2021, and Other Extensions Act) Law text · (f)
• Pub. L. 116–159, §2303(2), substituted "December 12, 2020" for "December 1, 2020". (Continuing Appropriations Act, 2021 and Other Extensions Act) Law text · (f)
• Pub. L. 116–136, §3813(2)(A), substituted "December 1, 2020, and ending September 30, 2021" for "May 23, 2020, and ending September 30, 2020". (Coronavirus Aid, Relief, and Economic Security Act" or the "CARES Act) Law text · (f)
• Pub. L. 116–136, §3813(2)(B), substituted "2022" for "2021". (Coronavirus Aid, Relief, and Economic Security Act" or the "CARES Act) Law text · (f)
• Pub. L. 116–260, §201(2), substituted "2027" for "2025". (Consolidated Appropriations Act, 2021) Law text · (f)
• Pub. L. 116–260, §203(a), amended subsec. (g) generally. Prior to amendment, subsec. (g) related to limit on amount of payment to hospital. (Consolidated Appropriations Act, 2021) Law text · (g)

2019

• Pub. L. 116–94 substituted "May 23, 2020" for "December 21, 2019" in cls. (i) and (ii)(I). (Further Consolidated Appropriations Act, 2020) Law text · (f)
• Pub. L. 116–69 substituted "December 21, 2019" for "November 22, 2019" in cls. (i) and (ii)(I). (Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019) Law text · (f)
• Pub. L. 116–59, §1303(1), in introductory provisions, substituted "For the period beginning November 22, 2019, and ending September 30, 2020, and for each of fiscal years 2021 through 2025" for "For each of fiscal years 2020 through 2025". (Continuing Appropriations Act, 2020, and Health Extenders Act of 2019) Law text · (f)
• Pub. L. 116–59, §1303(2), substituted "for the period beginning November 22, 2019, and ending September 30, 2020" for "for fiscal year 2020". (Continuing Appropriations Act, 2020, and Health Extenders Act of 2019) Law text · (f)

2018

• Pub. L. 115–123, §53101(1), substituted "2020" for "2018" in introductory provisions. (Bipartisan Budget Act of 2018) Law text · (f)
• Pub. L. 115–123, §53101(2), added subcls. (I) and (II) and struck out former subcls. (I) to (VIII) which related to fiscal years 2018 to 2025, respectively. (Bipartisan Budget Act of 2018) Law text · (f)

2015

• Pub. L. 114–10, §219, added cl. (vi). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (f)
• Pub. L. 114–10, §412(1)(A), substituted "2018 through 2025" for "2017 through 2024" in introductory provisions. (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (f)
• Pub. L. 114–10, §412(1)(B), added cl. (ii) and struck out former cl. (ii) which related to aggregate reductions for fiscal years 2017 to 2024. (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (f)
• Pub. L. 114–10, §412(1)(C), added cl. (v). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (f)
• Pub. L. 114–10, §412(2), substituted "2025" for "2024". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (f)

2014

• Pub. L. 113–93, §221(a)(1)(A), substituted "2017 through 2024" for "2016 through 2020" in introductory provisions. (Protecting Access to Medicare Act of 2014) Law text · (f)
• Pub. L. 113–93, §221(a)(1)(B), added subcls. (I) to (VIII) and struck out former subcls. (I) to (IV) which related to amounts for fiscal years 2016 to 2019. (Protecting Access to Medicare Act of 2014) Law text · (f)
• Pub. L. 113–93, §221(a)(2), added par. (8) and struck out former par. (8) which related to special rules for calculating DSH allotments for certain fiscal years. (Protecting Access to Medicare Act of 2014) Law text · (f)

2013

• Pub. L. 113–67, §1204(a)(1)(A), substituted "2016" for "2014" in introductory provisions. Law text · (f)
• Pub. L. 113–67, §1204(a)(1)(B), redesignated subcls. (III) to (VII) as subcls. (I) to (V), respectively, in subcl. (I), substituted "$1,200,000,000" for "$600,000,000", and struck out former subcls. (I) and (II) which read as follows: Law text · (f)
• Pub. L. 112–240 amended par. (8) generally. Prior to amendment, text read as follows: "With respect to fiscal year 2021, for purposes of applying paragraph (3)(A) to determine the DSH allotment for a State, the amount of the DSH allotment for the State under paragraph (3) for fiscal… (American Taxpayer Relief Act of 2012) Law text · (f)
• Pub. L. 113–67, §1204(a)(2), added subpar. (C) and redesignated former subpar. (C) as (D), and in subpar. (D), substituted "fiscal year 2023" for "fiscal year 2022". Law text · (f), (D)

2012

• Pub. L. 112–96, §3203(2), substituted "paragraphs (6), (7), and (8)" for "paragraphs (6) and (7)". (Middle Class Tax Relief and Job Creation Act of 2012) Law text · (f)
• Pub. L. 112–96, §3203(1), (3), added par. (8) and redesignated former par. (8) as (9). (Middle Class Tax Relief and Job Creation Act of 2012) Law text · (f), (9)

2010

• Pub. L. 111–148, §2551(a)(1), substituted ", (3), and (7)" for "and (3)". (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–148, §2551(a)(2), substituted "paragraphs (6) and (7)" for "paragraph (6)". (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–148, §10201(e)(1)(A)(i), substituted "Allotment adjustments" for "Allotment adjustments for fiscal years 2007 through 2011 and the first calendar quarter of fiscal year 2012" in heading. (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–152, §1203(b), added cl. (v). (Health Care and Education Reconciliation Act of 2010) Law text · (f)
• Pub. L. 111–152, §1203(a)(1), struck out "or paragraph (7)" after "paragraph (2)" in introductory provisions. (Health Care and Education Reconciliation Act of 2010) Law text · (f)
• Pub. L. 111–148, §10201(e)(1)(A)(ii), added cl. (iii). (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–152, §1203(a)(2), added par. (7) and struck out former par. (7) which related to reduction of State DSH allotments once reduction in uninsured threshold reached. (Health Care and Education Reconciliation Act of 2010) Law text · (f)
• Pub. L. 111–148, §2551(a)(4), added par. (7). Former par. (7) redesignated (8). (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–148, §10201(e)(1)(B)(i), substituted "subparagraphs (E) and (G)" for "subparagraph (E)" in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–148, §10201(e)(1)(B)(ii)(I), added subcls. (I) to (IV) and struck out former subcls. (I) and (II) which read as follows: (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–148, §10201(e)(1)(B)(ii)(II), added subcls. (I) to (IV) and struck out former subcls. (I) and (II) which read as follows: (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–148, §10201(e)(1)(B)(ii)(III), which directed amendment of par. (7)(B) by substituting "50 percent" for "35 percent" in subpar. (E), was executed by making the substitution in par. (7)(E) to reflect the probable intent of Congress. (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–148, §10201(e)(1)(B)(ii)(IV), which directed amendment of par. (7)(B) by adding subpar. (G) at the end, was executed by adding subpar. (G) at end of par. (7) to reflect the probable intent of Congress. (Patient Protection and Affordable Care Act) Law text · (f)
• Pub. L. 111–148, §2551(a)(3), redesignated par. (7) as (8). (Patient Protection and Affordable Care Act) Law text · (f)

2009

• Pub. L. 111–5, §5002(1), substituted "paragraph (6) and subparagraph (E)" for "paragraph (6)". (American Recovery and Reinvestment Act of 2009) Law text · (f)
• Pub. L. 111–5, §5002(2), added subpar. (E). (American Recovery and Reinvestment Act of 2009) Law text · (f)
• Pub. L. 111–3, §616(1), substituted "2011 and the first calendar quarter of fiscal year 2012" for "2009 and the first calendar quarter of fiscal year 2010" in heading. (Children's Health Insurance Program Reauthorization Act of 2009) Law text · (f)
• Pub. L. 111–3, §616(2)(A), in concluding provisions, substituted "fiscal years 2008, 2009, 2010, and 2011, the DSH allotment for Tennessee for" for "fiscal years 2008 and 2009, the DSH allotment for Tennessee for such portion of" and "2012 for the period ending on December 31,… (Children's Health Insurance Program Reauthorization Act of 2009) Law text · (f)
• Pub. L. 111–3, §616(2)(B), substituted "2010, 2011, or for period in fiscal year 2012" for "or for a period in fiscal year 2010". (Children's Health Insurance Program Reauthorization Act of 2009) Law text · (f)
• Pub. L. 111–3, §616(2)(C)(i), substituted "2011 and the first calendar quarter of fiscal year 2012" for "2009 and the first calendar quarter of fiscal year 2010" in heading. (Children's Health Insurance Program Reauthorization Act of 2009) Law text · (f)
• Pub. L. 111–3, §616(2)(C)(ii), substituted "2010, 2011, or for a period in fiscal year 2012" for "or for a period in fiscal year 2010". (Children's Health Insurance Program Reauthorization Act of 2009) Law text · (f), (II)
• Pub. L. 111–3, §616(3)(A), substituted "2007 through 2011" for "2007 through 2009" and "2012 for the period ending on December 31, 2011" for "2010 for the period ending on December 31, 2009". (Children's Health Insurance Program Reauthorization Act of 2009) Law text · (f)

2008

• Pub. L. 110–275, §202(1), substituted "fiscal years 2007 through 2009 and the first calendar quarter of fiscal year 2010" for "for fiscal year 2007 and portions of fiscal year 2008" in heading. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (f)
• Pub. L. 110–275, §202(2)(A), in concluding provisions, substituted "fiscal years 2008 and 2009" for "fiscal year 2008 for the period ending on June 30, 2008", struck out "¾ of" before "the amount specified in the previous sentence", and inserted "Only with respect to fiscal ye… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (f)
• Pub. L. 110–275, §202(2)(B), substituted ", 2008, 2009, or for a period in fiscal year 2010" for "or for a period in fiscal year 2008". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (f)
• Pub. L. 110–275, §202(2)(C), substituted "fiscal years 2007 through 2009 and the first calendar quarter of fiscal year 2010" for "fiscal year 2007 and fiscal year 2008" in heading and ", 2008, 2009, or for a period in fiscal year 2010" for "or for a period in fiscal year 2008… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (f)
• Pub. L. 110–275, §202(3), substituted "each of fiscal years 2007 through 2009" for "fiscal year 2007" in first sentence, inserted last sentence, and struck out former last sentence which read as follows: "Only with respect to fiscal year 2008 for the period ending on June 30, … (Medicare Improvements for Patients and Providers Act of 2008) Law text · (f)

2007

• Pub. L. 110–173, §204(1), inserted "and portions of fiscal year 2008" after "fiscal year 2007" in heading. (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (f)
• Pub. L. 110–173, §204(2)(A), inserted concluding provisions. (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (f)
• Pub. L. 110–173, §204(2)(B), inserted "or for a period in fiscal year 2008 described in clause (i)" after "fiscal year 2007" and "or period" after "such fiscal year". (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (f)
• Pub. L. 110–173, §204(2)(C), inserted "and fiscal year 2008" after "fiscal year 2007" in heading, "or for a period in fiscal year 2008 described in clause (i)" after "fiscal year 2007" in subcls. (I) and (II), "or period" after "for such fiscal year" in subcl. (I), and "or pe… (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (f)
• Pub. L. 110–173, §204(3), inserted at end "Only with respect to fiscal year 2008 for the period ending on June 30, 2008, the DSH allotment for Hawaii for such portion of the fiscal year, notwithstanding the table set forth in paragraph (2), shall be $7,500,000." (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (f)

2006

• Pub. L. 109–171 under each of the columns for FY 00, FY 01, and FY 02, substituted "49" for "32" in the entry for the District of Columbia. (Deficit Reduction Act of 2005) Law text · (f)
• Pub. L. 109–432 amended heading and text of par. (6) generally, substituting provisions relating to allotment adjustments for fiscal year 2007 in Tennessee and Hawaii for provisions relating to allotment adjustments with respect to fiscal year 2004 or 2005 in any State if a statewid… (Tax Relief and Health Care Act of 2006) Law text · (f)

2003

• Pub. L. 108–173, §1001(a)(1), (c)(1), substituted "Except as provided in paragraph (6), the DSH" for "The DSH" and "subparagraphs (B) and (C)" for "subparagraph (B)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f)
• Pub. L. 108–173, §1001(a)(2), added subpars. (C) and (D). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f), (D)
• Pub. L. 108–173, §1001(b)(1), (2), (4), struck out "extremely" before "low DSH States" in heading, designated existing provisions as subpar. (A) and inserted subpar. heading, and added subpar. (B). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f)
• Pub. L. 108–173, §1001(b)(3), which directed insertion of "before fiscal year 2004" after "In subsequent years", was executed by making the insertion after "In subsequent fiscal years" to reflect the probable intent of Congress. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f)
• Pub. L. 108–173, §1001(c)(2), (3), added par. (6) and redesignated former par. (6) as (7). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f), (7)
• Pub. L. 108–173, §1001(d), added subsec. (j). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (j)

2000

• Pub. L. 106–554, §1(a)(6) [title VII, §701(b)(2)(A)], inserted "(including such patients who receive benefits through a managed care entity)" after "the proportion of low-income and medicaid patients". (Consolidated Appropriations Act, 2001) Law text · (a)
• Pub. L. 106–554, §1(a)(6) [title VII, §701(b)(2)(B)], inserted "(regardless of whether such patients receive medical assistance on a fee-for-service basis or through a managed care entity)" after "a State plan approved under this subchapter in a period". (Consolidated Appropriations Act, 2001) Law text · (b)
• Pub. L. 106–554, §1(a)(6) [title VII, §701(b)(2)(C)], inserted "(regardless of whether the services were furnished on a fee-for-service basis or through a managed care entity)" after "under a State plan under this subchapter". (Consolidated Appropriations Act, 2001) Law text · (b)
• Pub. L. 106–554, §1(a)(6) [title VII, §701(a)(1)(A)(i)], substituted "Subject to paragraph (4), the DSH allotment" for "The DSH allotment" in introductory provisions. (Consolidated Appropriations Act, 2001) Law text · (f)
• Pub. L. 106–554, §1(a)(6) [title VII, §701(a)(2)(B)], inserted "and paragraph (5)" after "subparagraph (B)". (Consolidated Appropriations Act, 2001) Law text · (f)
• Pub. L. 106–554, §1(a)(6) [title VII, §701(a)(1)(A)(iii)], added par. (4). Former par. (4) redesignated (6). (Consolidated Appropriations Act, 2001) Law text · (f)
• Pub. L. 106–554, §1(a)(6) [title VII, §701(a)(2)(A)], added par. (5). (Consolidated Appropriations Act, 2001) Law text · (f)
• Pub. L. 106–554, §1(a)(6) [title VII, §701(a)(1)(A)(ii)], redesignated par. (4) as (6). (Consolidated Appropriations Act, 2001) Law text · (f)

1999

• Pub. L. 106–113, §1000(a)(6) [title VI, §608(s)], substituted comma for period at end. (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (c)
• Pub. L. 106–113, §1000(a)(6) [title VI, §601(a)], under each of the columns for FY 00, FY 01, and FY 02, substituted "32" for "23" in the entry for the District of Columbia, "33" for "16" in the entry for Minnesota, "9" for "5" in the entry for New Mexico, and "0.1" for "0" in the e… (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f)

1997

• Pub. L. 105–33, §4711(c)(2), substituted "1396a(a)(13)(A)(iv)" for "1396a(a)(13)(A)". (Balanced Budget Act of 1997) Law text · (a)
• Pub. L. 105–33, §4721(c), added subpar. (D). (Balanced Budget Act of 1997) Law text · (a)
• Pub. L. 105–33, §4711(c)(2), substituted "1396a(a)(13)(A)(iv)" for "1396a(a)(13)(A)". (Balanced Budget Act of 1997) Law text · (e)
• Pub. L. 105–33, §4721(a)(1), amended heading and text of subsec. (f) generally. Prior to amendment, subsec. (f) related to denial of Federal financial participation for payments in excess of certain limits. (Balanced Budget Act of 1997) Law text · (f)
• Pub. L. 105–33, §4721(b), added subsec. (h). (Balanced Budget Act of 1997) Law text · (h)
• Pub. L. 105–33, §4721(d), added subsec. (i). (Balanced Budget Act of 1997) Law text · (i)

1993

• Pub. L. 103–66, §13621(a)(1)(A), substituted "requirements" for "requirement". · (a)
• Pub. L. 103–66, §13621(a)(1)(B), substituted "requirements" for "requirement" in introductory provisions. · (b)
• Pub. L. 103–66, §13621(b)(2)(A), substituted "subsections (f) and (g)" for "subsection (f)" in introductory provisions. · (c)
• Pub. L. 103–66, §13621(a)(1)(C), substituted "Requirements" for "Requirement" in heading. · (d)
• Pub. L. 103–66, §13621(a)(1)(D), added par. (3). · (d)
• Pub. L. 103–66, §13621(a)(1)(E), added cl. (C). · (e)
• Pub. L. 103–66, §13621(a)(1)(F)(i), inserted "(other than the last sentence of subsection (c))" before "shall not apply". · (e)
• Pub. L. 103–66, §13621(a)(1)(F)(ii)–(iv), added subpar. (C). · (e)
• Pub. L. 103–66, §13621(b)(2)(B), added subpar. (D). · (e)
• Pub. L. 103–66, §13621(b)(1), added subsec. (g). · (g)

1991

• Pub. L. 102–234, §3(b)(2)(A)(i), substituted "subsections (c) and (f)" for "subsection (c)". · (a)
• Pub. L. 102–234, §3(c), added par. (4). · (b)
• Pub. L. 102–234, §3(b)(2)(A)(ii), substituted "Subject to subsection (f), in order" for "In order". · (c)
• Pub. L. 102–234, §3(b)(1), added subsec. (f). · (f)

1990

• Pub. L. 101–508, §4702(a), inserted at end "In this paragraph, the term 'inpatient day' includes each day in which an individual (including a newborn) is an inpatient in the hospital, whether or not the individual is in a specialized ward and whether or not the individual remains in… · (b)
• Pub. L. 101–508, §4703(c), inserted before semicolon at end "or the hospital's low-income utilization rate (as defined in paragraph (b)(3))". · (c)
• Pub. L. 101–508, §4703(a), added par. (3). · (c)
• Pub. L. 101–508, §4703(b), struck out "during the 3-year period" before "beginning on". · (e)

1989

• Pub. L. 101–239 designated portion of existing provisions as cls. (A) and (B), and in cl. (A) designated existing provisions as subcl. (i) and added subcl. (ii). · (e)

1988

• Pub. L. 100–360, §411(k)(6)(A)–(B)(ix), as amended by Pub. L. 100–485, §608(d)(26)(F), amended Pub. L. 100–203, §4112, so as to redesignate section 4112 of Pub. L. 100–203 as this section.
• Pub. L. 100–360, §411(k)(6)(B)(iv), struck out "of Health and Human Services" after "to the Secretary" wherever appearing in pars. (1) and (2). · (a)
• Pub. L. 100–360, §411(k)(6)(B)(ii), (iii), substituted "A State plan under this subchapter" for "A State's plan under title XIX of the Social Security Act", and made technical amendment to reference to section 1396a(a)(13)(A) of this title involving underlying provisions of original… · (a)
• Pub. L. 100–360, §411(k)(6)(A)(i), substituted "April 1, 1989" for "such date" and inserted before period at end ", effective for inpatient hospital services provided on or after July 1, 1989". · (a)
• Pub. L. 100–360, §411(k)(6)(A)(ii), substituted "April 1, 1990" for "such date" and inserted before period at end ", effective for inpatient hospital services provided on or after July 1, 1990". · (a)
• Pub. L. 100–485, §608(d)(15)(C), realigned the margin of subpar. (C). · (a)
• Pub. L. 100–360, §302(b)(2), added subpar. (C). · (a)
• Pub. L. 100–360, §411(k)(6)(A)(iii), inserted par. (3) designation and substituted "90 days after the date a State submits an amendment" for "June 30 of each year in which the State is required to submit an amendment". · (a)
• Pub. L. 100–360, §411(k)(6)(A)(iii)(II), (III), (B)(v), inserted par. (4) designation and made technical amendment to reference to section 1396n(b)(4) of this title involving underlying provisions of original act. · (a)
• Pub. L. 100–360, §411(k)(6)(A)(iv), substituted "a State plan" for "the State plan". · (b)
• Pub. L. 100–360, §411(k)(6)(B)(vi), as amended by Pub. L. 100–485, §608(d)(26)(F), substituted "under this subchapter" for "under subchapter XIX of this chapter". · (b)
• Pub. L. 100–360, §411(k)(6)(B)(vi), as amended by Pub. L. 100–485, §608(d)(26)(F), substituted "under this subchapter" for "under subchapter XIX of this chapter" in last sentence. · (b)
• Pub. L. 100–360, §411(k)(6)(B)(vi), as amended by Pub. L. 100–485, §608(d)(26)(F), substituted "under this subchapter" for "under subchapter XIX of this chapter". · (b)
• Pub. L. 100–485, §608(d)(26)(D), inserted "of subparagraph (A)" after "clause (i)(II)". · (b)
• Pub. L. 100–360, §411(k)(6)(A)(v), inserted ", less the portion of any cash subsidies described in clause (i)(II) in the period reasonably attributable to inpatient hospital services" after "charity care in a period". · (b)
• Pub. L. 100–485, §608(d)(26)(E), substituted "this subsection" for "subsection (c)" in concluding provisions. · (c)
• Pub. L. 100–360, §411(k)(6)(A)(vi)(I), (II), (V), in concluding provisions, substituted "paragraphs (1)(B) and (2)(A) of subsection (a)" for "paragraphs (2)(A) and (2)(B)", "such paragraph (1)(B)" for "paragraph (2)(A)", and "such paragraph (2)(A)" for "paragraph (2)(B)" and inserted "at least" bef… · (c)
• Pub. L. 100–360, §411(k)(6)(A)(vi)(VI), inserted at end "In the case of a hospital described in subsection (d)(2)(A)(i) (relating to children's hospitals), in computing the hospital's disproportionate share adjustment percentage for purposes of paragraph (1)(B) of this subsection, the disproportion… · (c)
• Pub. L. 100–360, §411(k)(6)(A)(vi)(III), inserted "at least" after "equal to". · (c)
• Pub. L. 100–360, §411(k)(6)(A)(vi)(IV), as amended by Pub. L. 100–485, §608(d)(26)(A), inserted "(without regard to whether the hospital is described in subparagraph (A) or (B) of subsection (b)(1))" after "payment) and". · (c)
• Pub. L. 100–360, §411(k)(6)(B)(vi), as amended by Pub. L. 100–485, §608(d)(26)(F), substituted "under this subchapter" for "under subchapter XIX of this chapter". · (d)
• Pub. L. 100–360, §411(k)(6)(B)(vii), made technical amendment to reference to section 1395ww of this title involving underlying provisions of original Act. · (d)
• Pub. L. 100–360, §411(k)(6)(A)(vii), as amended by Pub. L. 100–485, §608(d)(26)(B), (C), designated existing provisions as par. (1), inserted "based on a pooling arrangement involving a majority of the hospitals participating under the plan" after first reference to "payment adjustment… · (e)