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97 STAT. 152 PUBLIC LAW 98-21—APR. 20, 1983 96 Stat. 339. 42 use 1395WW. 42 u s e 1395f. methodology) by which rates or amounts to be paid for hospital services during a specified period are established under the system prior to the defined rate period, and "(iii) hospitals covered under the system will make such reports (in lieu of cost and other reports, identified by the Secretary, otherwise required under this title) as the Secre- tary may require in order to properly monitor assurances provided under this subsection; "(C) the State has provided the Secretary with satisfactory assurances that operation of the system will not result in any change in hospital admission practices which result in— "(i) a significant reduction in the proportion of patients (receiving hospital services covered under the system) who have no third-party coverage and who are unable to pay for hospital services, "(ii) a significant reduction in the proportion of individ- uals admitted to hospitals for inpatient hospital services for which payment is (or is likely to be) less than the antici- pated charges for or costs of such services, "(iii) the refusal to admit patients who would be expected to require unusually costly or prolonged treatment for rea- sons other than those related to the appropriateness of the care available at the hospital, or 'Xiv) the refusal to provide emergency services to any person who is in need of emergency services if the hospital provides such services; "(D) any change by the State in the system which has the effect of materially reducing payments to hospitals can only take effect upon 60 days notice to the Secretary and to the hospitals the payment to which is likely to be materially affected by the change; and "(E) the State has provided the Secretary with satisfactory assurances that in the development of the system the State has consulted with local governmental officials concerning the impact of the system on public hospitals. The Secretary shall respond to requests of States under this para- graph within 60 days of the date the request is submitted to the Secretary. "(6) If the Secretary determines that the assurances described in paragraph (1)(C) have not been met with respect to any 36-month period, the Secretary may reduce payments under this title to hospitals under the system in an amount equal to the amount by which the payment under this title under such system for such period exceeded the amount of payments which would otherwise have been made under this title not using such system.". (d) Subsection (d) of such section, as added by section 110 of the Tax Equity and Fiscal Responsibility Act of 1982, is amended— (1) by striking out "section 1814(b)" in paragraph (2)(A) and inserting in lieu thereof "subsection (b)", and (2) by redesignating the subsection as subsection 0) and trans- ferring and inserting such subsection at the end of section 1814 of the Social Security Act under the following heading: 96 Stat. 331. 42 use 1395WW. "Elimination of Lesser-of-Cost-or-Charges Provision". (e) Such section 1886 is further amended by adding at the end the fjoUowing new subsections: