II 115th CONGRESS 2d Session S. 3599 IN THE SENATE OF THE UNITED STATES October 11, 2018 Mr. Menendez (for himself, Mr. Whitehouse , Mr. Booker , Mr. Reed , Mr. Coons , and Mr. Carper ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to codify and permanently extend the Medicare hospital wage index imputed rural floor.

1. Short title This Act may be cited as the Medicare Wage Index Parity Act of 2018 . 2. Imputed floor on the area wage index Section 1886(d)(3)(E) of the Social Security Act ( 42 U.S.C. 1395ww(d)(3)(E) ) is amended by adding at the end the following new clause: (iv) Floor on wage index for hospitals in all-urban States (I) In general For purposes of applying the area wage index applicable under this subparagraph, for discharges occurring on or after October 1, 2018, the Secretary shall establish a minimum wage index for all-urban States (as defined in subclause (IV)). (II) Minimum wage index For purposes of subclause (I), the minimum wage index for all-urban States shall be established by the Secretary using the methodology described in section 412.64(h)(4) of title 42, Code of Federal Regulations, as in effect for fiscal year 2018. (III) Administration The Secretary shall administer the minimum wage index described in this clause in the same manner described in section 3141 of Public Law 111–148 (through a uniform, national adjustment to the area wage index). (IV) All-urban State defined In this clause, the term all-urban State means a State in which there are no rural areas (as defined in subsection (d)(2)(D) of section 1886 of the Social Security Act ( 42 U.S.C. 1395ww(d)(2)(D) )), or a State in which there are no hospitals classified as rural under such section. .