,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #ihf  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,m>* #f1 #bjac ,mr4   
,s*ock 7= himself1 ,mr4 ,braley ( ,i[a1 
,mr4 ,huiz5ga ( ,mi*igan1 ,mrs4         
,mc,morris ,rodg]s1 & ,mr4 ,wald57      
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xviii ( !     
,social ,security ,act to ensure !      
eligibility ( eligible pr(essionals     
practic+ 9 rural heal? cl9ics =         
electronic heal? records & quality      
improvem5t inc5tives "u ,m$ic>e1 & = o!r
 purposes4  #a4 ,%ort title ,?is ,act   
may be cit$ z ! ,rural ,heal? ,cl9ic    
,fairness ,act ( #bjac4  #b4 ,ext5sion (
 ,m$ic>e ,,ehr inc5tives to eligible    
pr(essionals practic+ 9 rural heal?     
cl9ics  7a7 ,9 g5]al ,section           

#ahdh7o77#e77;,a7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciew7o77#e77;,a77 
is am5d$ by ins]t+ be=e ! p]iod at ! end
 ! foll[+3 &1 ) respect to paym5t ye>s  
aft] #bjac1 includes rural heal? cl9ic  
s]vices 7z def9$ 9 section              
#ahfa7;aa77#a77 furni%$ by an eligible  
pr(essional4  7b7 ,(fsett+ r$uction     
,section #ahdh7o77#a77;,b7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7o77#a77;,b77 is am5d$--  7#a7 
9 clause 7ii71 by /rik+ clauses 7iii7   
?r\gh 7v7 & ins]t+ ! succe$+ clauses2 & 
7#b7 by add+ at ! end ! foll[+ new      
clause3  7iv7 ,budget neutrality        
adju/m5t ,! ,secret>y %all r$uce !      
applicable am\nts t w\ld o!rwise be     
det]m9$ "u ?is subp>agraph ) respect to 
#bjad & ea* succe$+ ye> by an am\nt t ! 
,secret>y e/imates w\ld ensure t e/imat$
 aggregate paym5ts "u ?is subsection =  
su* ye> is n increas$ z a result ( !    
am5dm5t made by section #b7;a7 ( !      
,rural ,heal? ,cl9ic ,fairness ,act (   
#bjac4  4  #c4 ,ext5sion ( ,m$ic>e e,rx 

& quality report+ inc5tives to rural    
heal? cl9ics  7a7 ,9 g5]al ,section     
#ahdh7m77#f77;,a7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciew7m77#f77;,a77 
is am5d$ by ins]t+ be=e ! p]iod at ! end
 ! foll[+3 1 except t ! t]m cov]$       
pr(essional s]vices %all1 ) respect to  
report+ p]iods = #bjad or a subsequ5t   
ye>1 include rural heal? cl9ic s]vices  
7z def9$ 9 section #ahfa7;aa77#a77      
furni%$ by an eligible pr(essional4  7b7
 ,(fsett+ r$uction ,section #ahdh7m77#a7
 ( su* ,act 7#db ,u4,s4,c4              
#aciew7m77#a77 is am5d$--  7#a7 9       
subp>agraph 7,b71 by /rik+ ,= purposes &
 ins]t+ ,subject to subp>agraph 7,c71 = 
purposes2 &  7#b7 by add+ at ! end !    
foll[+ new subp>agraph3  7,c7 ,budget   
neutrality adju/m5t ,! ,secret>y %all   
r$uce ! applicable quality p]c5t t w\ld 
o!rwise be det]m9$ "u subp>agraph 7,b7 =
 #bjad by an am\nt t ! ,secret>y        
e/imates w\ld ensure t e/imat$ aggregate
 paym5ts "u ?is subsection = su* ye> is 
n increas$ z a result ( ! am5dm5t made  

by section #c7;a7 ( ! ,rural ,heal?     
,cl9ic ,fairness ,act ( #bjac4  4