,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #ccfe  ,,in ,,the ,,house ,,of  
,,representatives  ,october #bi1        
#bjac,mr4 ,walberg 7for himself1 ,mr4   
,graves of ,missouri1 ,mr4 ,tiberi1 and 
,mr4 ,messer7 introduced the following  
bill2 which was referred to the         
,committee on ,ways and ,means  ,a      
,,bill  ,to exempt certain long-term    
care hospitals operating in a           
single-hospital ,,msa from the ,medicare
 threshold payment adjustment policy for
 long-term care hospitals1 and for other
 purposes4  #a4 ,short title ,this ,act 
may be cited as the ,defending ,rural   
,access to ,long ,term ,acute ,care ,act
 of #bjac4  #b4 ,exemption from         
threshold payment adjustment policy for 
certain long-term care hospitals        
operating in a single-hospital ,,msa    
7a7 ,in general ,the ,secretary of      
,health and ,human ,services shall not  
apply sections #dab4ecd or #dab4ecf of  
title #db1 ,code of ,federal            
,regulations1 to any long-term care     

hospital operating in a single-hospital 
,,msa 7as defined in subsection 7b774   
7b7 ,long-,term care hospital operating 
in a single-,hospital ,,msa defined ,in 
this section1 the term long-term care   
hospital operating in a single-hospital 
,,msa means an entity that meets the    
following criteria on the date of the   
enactment of this ,act3 7#a7 ,the entity
 is a long-term care hospital as defined
 in section #ahfa7;ccc7 of the ,social  
,security ,act 7#db ,u4,s4,c4           
#aciex7ccc771 but is not a long-term    
care hospital described in section      
#ahhf7;d77#a77;,b77iv77,,ii7 of the     
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7d77#a77;,b77iv77,,ii774  7#b7   
,the entity is located in a             
,metropolitan ,statistical ,area 7as    
defined by the ,office of ,management   
and ,budget in ,,omb ,bulletin #ac-ja   
published ,february #bh1 #bjac7 that has
 only one subsection 7d7 hospital 7as   
defined in section #ahhf7;d77#b77;,d7 of
 the ,social ,security ,act 7#db        

,u4,s4,c4 #acieww7d77#b77;,d774  7c7    
,effective date ,subsection 7a7 applies 
to long-term care hospitals for cost    
reporting periods beginning on or after 
,october #a1 #bjac4