,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #cadd  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,septemb] #ai1        
#bjac,mr4 ,mc,dermott introduc$ ! foll[+
 bill2 :i* 0 ref]r$ to ! ,committee on  
,ways & ,means  ,a ,,bill  ,to am5d     
title ,,xviii ( ! ,social ,security ,act
 to provide ,m$ic>e cov]age ( ext5d$ c>e
 s]vices )\t reg>d to a requirem5t = a  
#c-;day prior hospitalization1 & = o!r  
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,fairness = ,b5efici>ies   
,act ( #bjac4  #b4 ,m$ic>e cov]age (    
ext5d$ c>e s]vices )\t a #c-;day prior  
hospitalization  7a7 ,9 g5]al           
,subsection 7f7 ( section #ahab ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acie;d7 is am5d$ to read z foll[s3  7f7
 ,cov]age ( ext5d$ c>e s]vices )\t a    
#c-;,day prior hospitalization  7#a7 ,9 
g5]al ,cov]age %all be provid$ "u ?is "p
 = an individual = ext5d$ c>e s]vices 9 
a skill$ nurs+ facility t are n         
po/-hospital ext5d$ c>e s]vices if1 be=e
 ! individual is admitt$ to ! skill$    

nurs+ facility1 a physician or o!r      
qualifi$ heal? c>e practition] describ$ 
9 section #ahad7;a77#b7 makes a         
det]m9ation t ! provision ( ext5d$ c>e  
s]vices to ! individual is m$ically     
necess>y & has made ! c]tification      
describ$ 9 subp>agraph 7,b7 ( su*       
section ) respect to su* s]vices 7&     
cont9ues to h su* a c]tification made 9 
! same mann] z = po/-hospital ext5d$ c>e
 s]vices74  7#b7 ,cont9u$ application ( 
c]tification & o!r requirem5ts &        
provisions ,! requirem5ts ( p>agraphs   
7#b7 & 7#f7 ( section #ahad7;a7 & !     
provisions ( subsections 7b77#b7 & 7e7 &
 sections #aheb7l71                     
#ahfa7v77#a77;,g77i71 #ahfa7v77#b77;,a71
 #ahfa7v77#c71 #ahfa7y71                
#ahfa7tt77#a77;,b71 #ahfb7;a77#ah71     
#ahff7;a77#a77;,h77ii77,i71 #ahhc7;d71  
#ahhc7;f71 & #ahhh7;e7 %all apply to    
ext5d$ c>e s]vices provid$ "u ?is       
subsection 9 ! same mann] z !y apply to 
po/-hospital ext5d$ c>e s]vices4  7#c7  
,,mac det]m9ations  7,a7 ,publication ( 

requirem5ts = det]m9ations ,n lat] ?an  
#f mon?s aft] ! date ( ! enactm5t ( ?is 
p>agraph1 ! ,secret>y %all publi% a set 
( uni=m requirem5ts t w enable ! m$ic>e 
adm9i/rative contractors to make        
det]m9ations z to :e!r an admission     
describ$ 9 p>agraph 7#a7 is m$ically    
necess>y4  7,b7 ,,mac audits ,a m$ic>e  
adm9i/rative contractor may audit       
det]m9ations describ$ 9 p>agraph 7#a7   
bas$ on ! uni=m requirem5ts e/abli%$ "u 
subp>agraph 7,a74 ,9 any adm9i/rative   
proce$+ to review su* det]m9ations1 !   
uni=m requirem5ts e/abli%$ by !         
,secret>y %all be b9d+ on adm9i/rative  
law judges4  4  7b7 ,effective date ,!  
am5dm5t made by subsection 7a7 %all     
apply to ext5d$ c>e s]vices furni%$ on  
or aft] ! date t is #a ye> aft] ! date (
 ! enactm5t ( ?is ,act4