,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #cddd  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,octob] #cj1 #bjac,mr4
 ,wald5 7= himself & ,mr4 ,k9d7         
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means  ,a     
,,bill  ,to am5d title ,,xviii ( !      
,social ,security ,act to provide       
flexibility 9 ! mann] 9 :i* b$s are     
c\nt$ = purposes ( det]m9+ :e!r a       
hospital may be designat$ z a critical  
access hospital "u ! ,m$ic>e program4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,critical ,access ,hospital           
,flexibility ,act ( #bjac4  #b4         
,flexibility 9 ! mann] 9 :i* b$s are    
c\nt$ = purposes ( det]m9+ :e!r a       
hospital may be designat$ z a critical  
access hospital "u ! ,m$ic>e program    
7a7 ,9 g5]al ,section #ahbj7;c77#b7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acie;i-#d7;c77#b77 is am5d$-- 7#a7 9   
subp>agraph 7,b77iii71 by ins]t+ subject
 to subp>agraph 7,f71 be=e provides n m2
 &  7#b7 by add+ at ! end ! foll[+3     

7,f7 ,alt]native b$ numb] det]m9ation   
7i7 #bj-;b$ alt]native ,9 ! case ( a    
facility t 0 designat$ z a critical     
access hospital be=e ! date ( ! enactm5t
 ( ! ,critical ,access ,hospital        
,flexibility ,act ( #bjac1 su* facility 
may satisfy ! requirem5t "u subp>agraph 
7,b77iii7 by provid+ inpati5t c>e = a   
p]iod t does n exce$1 z det]m9$ on an   
annual1 av]age basis1 #if h\rs p] pati5t
 & by-- 7,i7 provid+ n m ?an #be acute  
c>e inpati5t b$s 7meet+ ! /&>ds e/abli%$
 by ! ,secret>y "u su* subp>agraph72 or 
7,,ii7 provid+ n m ?an #bj acute c>e    
inpati5t b$s 7z det]m9$ on an annual1   
av]age basis & meet+ any applicable     
/&>ds e/abli%$ by ! ,secret>y "u su*    
subp>agraph :i* d n conflict ) ?is      
subclause74  7ii7 ,occupi$ b$s only ,9  
det]m9+ ! numb] ( b$s = purposes (      
clause 7i7 & subp>agraph 7,b77iii71 only
 b$s t are occupi$ %all be c\nt$4  4    
7b7 ,effective date ,! am5dm5ts made by 
?is section take effect on ,janu>y #a1  
#bjad4