,,ii  #aac? ,,congress  #b;d ,session   
,s4 #bbbi  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,april #i1 #bjad ,mr4  
,s&]s introduc$ ! foll[+ bill2 :i* 0    
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to exp& prim>y c>e access4  
#a4  ,%ort title  ,?is ,act may be cit$ 
z ! ,exp&+ ,prim>y ,c>e ,access &       
,work=ce ,act4  #b4  ,s*ol>%ips & ,loan 
,repaym5t ,opportunities = ,prim>y ,c>e 
,provid]s  7a7  ,fund+ = ! ,national    
,heal? ,s]vice ,corps  ,section #cch ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #bedk7 is am5d$ by add+ at !  
end ! foll[+3  7c7  ,s*ol>%ip & loan    
repaym5t opportunities = prim>y c>e     
provid]s  7#a7  ,9 g5]al  ,!re is       
au?oriz$ to be appropriat$1 & !re is    
appropriat$1 out ( any am\nts 9 !       
,treasury n o!rwise appropriat$1        
#d1ijj1jjj1jjj = ! p]iod ( fiscal ye>s  
#bjae ?r\gh #bjbj1 to provide = a       
cont9uation & expansion ( ! program )   
respect to requir$ prim>y heal? s]vices1

 z def9$ 9 section #ccj7;b71 "u ?is     
subp>t4  7#b7  ,supplem5tal fund+       
,am\nts appropriat$ "u ?is subsection   
%all be us$ to supplem5t & n supplant   
o!r am\nts appropriat$ to c>ry out      
programs "u ?is subp>t4  4  7b7         
,s*ol>%ip program & /ud5t loan repaym5t 
program  ,section #cch;,h ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bedq7 is am5d$ by add+ at ! end !      
foll[+3  7d7  ,di/ribution ( funds  ,9  
allocat+ funds made available to !      
,heal? ,res\rces & ,s]vices             
,adm9i/ration = ! ,national ,heal?      
,s]vice ,corps1 ! ,secret>y %all provide
 loan repaym5t aw>ds to at lea/ #f      
individuals 9 ea* ,/ate & s*ol>%ips to  
at lea/ #c individuals 9 ea* ,/ate4  4  
7c7 ,public in=mation programs 9        
designat$ areas ,section #ccb7;h7 ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;e7h77 is am5d$ by ins]t+ 
7directly1 or by grant1 contract1 or    
coop]ative agreem5t7 aft] conduct4  7d7 
,pr(essional developm5t ,section        

#ccf7;d77#a7 ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bed;h-#a7;d77#a77  
is am5d$ by ins]t+ 7directly1 or by     
grant1 contract1 or coop]ative agreem5t7
 aft] %all assi/4  #c4  ,fund+ = heal?  
c5t]s ,section #ajejc7;b77#a7 ( !       
,pati5t ,protection & ,af=dable ,c>e    
,act ( #bjaj 7#db ,u4,s4,c4 #bed;b-#b7  
is am5d$-- 7#a7 9 subp>agraph 7,d71 by  
/rik+ & at ! end2  7#b7 9 subp>agraph   
7,e71 by /rik+ & at ! end2 &  7#c7 by   
ins]t+ aft] subp>agraph 7,e7 ! foll[+3  
7,f7 #c1hjj1jjj1jjj = fiscal ye> #bjaf2 
7,g7 #d1cjj1jjj1jjj = fiscal ye> #bjag2 
7,h7 #d1ijj1jjj1jjj = fiscal ye> #bjah2 
7,i7 #e1fjj1jjj1jjj = fiscal ye> #bjai2 
&  7,j7 #f1djj1jjj1jjj = fiscal ye>     
#bjbj2 &  4  #d4 ,increas+ ! ,prim>y    
,c>e ,provid] ,work=ce  7a7             
,reau?orization ( ! tea*+ heal? c5t]s   
program ,section #cdj;,h ( ! ,public    
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bef;h7 is am5d$-- 7#a7 9 subsection    
7a71 by /rik+ subsection 7h77#b7 &      
ins]t+ subsection 7i77#b72  7#b7 9      

subsection 7g7-- 7,a7 by /rik+ su* sums 
& all t foll[s ?r\gh ! p]iod at ! end & 
ins]t+ #hjj1jjj1jjj = ! p]iod ( fiscal  
ye>s #bjaf ?r\gh #bjbj42 &  7,b7 by add+
 at ! end ! foll[+3 ,any am\nts         
appropriat$ "u ?is subsection = any (   
fiscal ye>s #bjaa ?r\gh #bjbj & rema9+  
unexp5d$ at ! end ( ! fiscal ye> involv$
 may be us$ 9 subsequ5t fiscal ye>s to  
c>ry out ?is section42  7#c7 9          
subsection 7h77#b7-- 7,a7 9 ! p>agraph  
head+1 by add+ at ! end ! foll[+3 2     
submission to ,congress2 &  7,b7 by add+
 at ! end ! foll[+3  7,c7 ,submission to
 ,congress ,! ,secret>y %all annually   
submit to ,congress a report t conta9s a
 compilation ( ! data submitt$ to !     
,secret>y "u p>agraph 7#a7 = ! ye>      
involv$4  2  7#d7 by r$esignat+         
subsections 7h7 ?r\gh 7j7 z subsections 
7i7 ?r\gh 7k71 respectively2 &  7#e7 by 
ins]t+ aft] subsection 7g71 ! foll[+3   
7h7 ,limitation ,! ,secret>y %all       
e/abli% a m9imum p] resid5t p] ye>      
paym5t am\nt = fund+ ( all approv$ tea*+

 heal? c5t] graduate m$ical education   
positions "u ?is section t %all be n    
less ?an ! p] resid5t p] ye> paym5t     
am\nt z ( ,janu>y #a1 #bjac1 & ensure t 
n less ?an su* am\nt is provid$ to all  
tea*+ heal? c5t] graduate m$ical        
education programs = all approv$        
positions4  4  7b7 ,tea*+ heal? c5t]s   
developm5t grants ,section #gdi;,a7g7 ( 
! ,public ,heal? ,s]vice ,act 7#db      
,u4,s4,c4 #bicl-#a7;g77 is am5d$ by     
/rik+ ea* fiscal ye> !reaft] & ins]t+   
ea* ( fiscal ye>s #bjac ?r\gh #bjbj &   
ea* fiscal ye> !reaft]4  7c7 ,national  
,heal? ,c>e ,work=ce ,commission        
,section #eaja ( ! ,pati5t ,protection &
 ,af=dable ,c>e ,act 7#db ,u4,s4,c4     
#bidq7 is am5d$--  7#a7 9 subsection    
7h7-- 7,a7 by /rik+ p>agraphs 7#a7 &    
7#b7 & ins]t+ ! foll[+3  7#a7           
,appropriations  ,!re are au?oriz$ to be
 appropriat$1 & !re are appropriat$1 out
 ( any monies 9 ! ,treasury n o!rwise   
appropriat$1 #aj1jjj1jjj = ea* fiscal   
ye> to c>ry out ?is section4  2 &  7,b7 

by r$esignat+ p>agraph 7#c7 z p>agraph  
7#b72 &  7#b7 9 subsection 7d7-- 7,a7 9 
p>agraph 7#g71 by add+ at ! end ,:5ev]  
feasible1 ,congress & ! ,dep>tm5t (     
,heal? & ,human ,s]vices %all recognize 
& implem5t su* recomm5dations42 &  7,b7 
by add+ at ! end ! foll[+3  7#i7 ,data  
track+  7,a7 ,data track+ me*anism ,!   
,commission %all develop1 or ent] into a
 contract ) ano!r entity to develop1 a  
me*anism = track+ in=mation on ! c>e]   
pa?s ( graduates ( m$ical s*ools &      
resid5cy programs1 z describ$ 9         
subp>agraph 7,b71 & %all make su*       
in=mation publicly available4  7,b7     
,recordkeep+ ,! ,commission %all collect
 or ensure ! collection ( data1 us+ !   
me*anism develop$ "u subp>agraph 7,a71  
conc]n+-- 7i7 ! specialty & subspecialty
 tra9+ ( all graduates ( m$ical s*ools  
receiv+ ,f$]al fund+2 &  7ii7 !         
pr(essional trajectory ( all graduates (
 m$ical s*ools receiv+ ,f$]al fund+ = n 
less ?an #ae ye>s aft] ea* individual   
graduates f m$ical s*ool1 includ+ data  

conc]n+ graduates :o practice m$ic9e--  
7,i7 9 und]s]v$ areas su* z heal?       
pr(essional %ortage areas 7z def9$ by ! 
,national ,heal? ,s]vice ,corps "u      
section #ccb ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bed;e772  7,,ii7 ) 
m$ically und]s]v$ populations 7z def9$ 9
 section #ccj7;b77#c7 ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4            
#bed;b7b77#c7772  7,,iii7 9 ,f$]ally    
qualifi$ heal? c5t]s 7z def9$ 9 section 
#aije7l77#b77;,b7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4                     
#acif;d7l77#b77;,b7772  7,,iv7 rural    
heal? cl9ics 7"u title ,,xviii ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq4772  7,v7 ! heal? c>e sy/em
 ( ! ,dep>tm5t ( ,vet]ans ,affairs2 &   
7,,vi7 cl9ics ( ! ,indian ,heal?        
,s]vices4  4  7d7  ,reau?orization (    
family nurse practition] resid5cy tra9+ 
program  ,section #ecaf7;i7 ( ! ,pati5t 
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #bif;j-#a7;i77 is am5d$ by    
/rik+ su* sums & all t foll[s ?r\gh !   

p]iod at ! end & ins]t+ #ge1jjj1jjj = ! 
p]iod ( fiscal ye>s #bjae ?r\gh #bjai44 
7e7  ,reau?orization ( nurse faculty    
loan program  ,section #hdf;,a7f7 ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bign-#a7;f77 is am5d$ by     
/rik+ #bjad & ins]t+ #bjai4  7f7        
,reau?orization ( prim>y c>e resid5cy   
expansion program ,section #gdg7;c77#a7 
( ! ,public ,heal? ,s]vice ,act 7#db    
,u4,s4,c4 #bick7c77#a77 is am5d$ by     
/rik+ #abe1jjj1jjj & all t foll[s ?r\gh 
! p]iod at ! end & ins]t+ #afh1jjj1jjj =
 ! p]iod ( fiscal ye>s #bjae ?r\gh      
#bjai44  7g7 ,reau?orization ( ! area   
heal? education c5t]s ,section          
#gea7;j77#a7 ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bid;a7j77#a77 is   
am5d$ by /rik+ #bjaj ?r\gh #bjad &      
ins]t+ #bjae ?r\gh #bjai4  #e4 ,increas+
 paym5t = prim>y c>e  7a7 ,requirem5t   
conc]n+ consultation ) organizations or 
o!r entities ,9 det]m9+ physician fees =
 ! purpose ( paym5ts "u ! ,m$ic>e       
program "u title ,,xviii ( ! ,social    

,security ,act 7#db ,u4,s4,c4 #acie et  
seq471 ! ,secret>y ( ,heal? & ,human    
,s]vices %all n consult ) an            
organization or o!r entity repres5t+    
physicians unless at lea/ #ej p]c5t ( ! 
memb]s ( su* organization or entity1 at 
! "t ( su* consultation1 are prim>y c>e 
physicians4  7b7 ,inc5tive paym5t       
program = prim>y c>e s]vices ,section   
#ahcc7x77#a7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciel7x77#a77 is am5d$  
by /rik+ #bjaf & ins]t+ #bjbj4  7c7     
,p]man5t application ( ,m$ic>e paym5t   
rate floor to prim>y c>e s]vices furni%$
 "u ,m$icaid  7#a7 ,9 g5]al ,section    
#aijb7;a77#ac77;,c7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#ac77;,c77 is am5d$ by /rik+ 
& #bjad & ins]t+ or any ye> !reaft]4    
7#b7 ,increas$ ,,fmap ,section          
#aije7;dd7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #acif;d7dd77 is am5d$ by 
/rik+ & be=e ,janu>y #a1 #bjae14  7#c7  
,effective date ,! am5dm5ts made by ?is 
subsection take effect on ,janu>y #a1   

#bjae4  #f4 ,acc\ntability = ,f$]al     
funds at m$ical s*ools  7a7 ,family     
m$ic9e or prim>y c>e dep>tm5t ,a m$ical 
s*ool t receives ,f$]al funds = any     
purpose %all-- 7#a7 ma9ta9 9 su* m$ical 
s*ool a family m$ic9e or prim>y c>e     
dep>tm5t2 &  7#b7 require = all /ud5ts  
at lea/ #h weeks ( rotations 9 family   
m$ic9e or community-ori5t$ prim>y c>e   
dur+ ! ?ird ye> ( tra9+4  7b7 ,report+  
on meet+ heal? c>e work=ce ne$s ,a      
m$ical s*ool t receives ,f$]al funds =  
any purpose %all-- 7#a7 prep>e an annual
 report-- 7,a7 respond+ to ! data )     
respect to su* m$ical s*ool t is        
collect$ "u section #eaja7;d77#i7 ( !   
,pati5t ,protection & ,af=dable ,c>e    
,act 7z add$ by section                 
#d7;c77#b77;,b772 &  7,b7 detail+ !     
actions ! m$ical s*ool is tak+ to meet !
 heal? c>e work=ce ne$s 9 ! s*ool's     
community & across ! ,nation2 &  7#b7   
submit su* report to ! ,secret>y (      
,heal? & ,human ,s]vices & ! ,national  
,heal? ,c>e ,work=ce ,commission4  #g4  

,increas+ opportunities & acc\ntability 
= prim>y c>e resid5cy tra9+  7a7        
,additional resid5cy positions = tra9+ 9
 family m$ic9e  7#a7  ,9 g5]al  ,section
 #ahhf7;h7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #acieww7h77 is am5d$--   
7,a7 9 p>agraph 7#d77;,f77i71 by /rik+  
p>agraphs 7#g7 & 7#h7 & ins]t+ p>agraphs
 7#g71 7#h71 & 7#i72  7,b7 9 p>agraph   
7#d77;,h77i71 by /rik+ p>agraphs 7#g7 & 
7#h7 & ins]t+ p>agraphs 7#g71 7#h71 &   
7#i72  7,c7 9 p>agraph 7#g77;,e71 by    
ins]t+ p>agraph 7#i71 aft] p>agraph     
7#h712 &  7,d7 by add+ at ! end ! foll[+
 new p>agraph3  7#i7  ,additional       
resid5cy positions = tra9+ 9 family     
m$ic9e  7,a7  ,9 g5]al  7i7 ,di/ribution
  ,= fiscal ye> #bjad 7& succe$+ fiscal 
ye>s if ! ,secret>y det]m9es t !re are  
additional resid5cy positions available 
to di/ribute "u subp>agraph 7,d771 !    
,secret>y %all increase ! o!rwise       
applicable resid5t limit = ea* qualify+ 
hospital t submits a timely application 
"u ?is subp>agraph by su* numb] z !     

,secret>y may approve = portions ( co/  
report+ p]iods occurr+ on or aft] ,july 
#a ( ! fiscal ye> ( ! increase4 ,su*    
additional resid5cy positions %all be = 
approv$ m$ical resid5cy tra9+ programs  
7z def9$ 9 p>agraph 7#e77;,a77 9 family 
m$ic9e4  7ii7 ,requirem5ts ,subject to  
clause 7iii71 a hospital t receives an  
increase 9 ! o!rwise applicable resid5t 
limit "u ?is p>agraph %all ensure1 dur+ 
! #e-ye> p]iod beg9n+ on ! date ( su*   
increase1 t-- 7,i7 ! numb] ( full-"t    
equival5t resid5ts 9 family m$ic9e 7z   
det]m9$ by ! ,secret>y71 exclud+ any    
additional positions "u subclause       
7,,ii71 is n less ?an ! av]age numb] (  
full-"t equival5t resid5ts 9 family     
m$ic9e 7z s det]m9$7 dur+ ! #c mo/ rec5t
 co/ report+ p]iods end+ prior to ! date
 ( enactm5t ( ?is p>agraph2 &  7,,ii7   
#ajj p]c5t ( ! positions attributable to
 su* increase are 9 an approv$ m$ical   
resid5cy tra9+ program 9 family m$ic9e  
7z det]m9$ by ! ,secret>y74  7iii7      
,r$i/ribution ( positions if hospital no

 long] meets c]ta9 requirem5ts ,9 ! case
 :]e ! ,secret>y det]m9es t a hospital  
describ$ 9 clause 7ii7 does n meet ei!r 
( ! requirem5ts "u subclause 7,i7 or    
7,,ii7 ( su* clause1 ! ,secret>y %all-- 
7,i7 r$uce ! o!rwise applicable resid5t 
limit ( ! hospital by ! am\nt by :i* su*
 limit 0 increas$ "u ?is p>agraph2 &    
7,,ii7 provide = ! di/ribution (        
positions attributable to su* r$uction 9
 accordance ) ! requirem5ts ( ?is       
p>agraph4  7,b7  ,aggregate numb] (     
increases  ,! aggregate numb] (         
increases 9 ! o!rwise applicable resid5t
 limit "u ?is p>agraph %all be equal to 
#b1jjj4  7,c7  ,tim+  ,! ,secret>y %all 
notify hospitals ( ! numb] ( positions  
di/ribut$ to ! hospital "u ?is p>agraph 
z result ( an increase 9 ! o!rwise      
applicable resid5t limit by ,janu>y #a (
 ! fiscal ye> ( ! increase4 ,su*        
increase %all be effective = portions ( 
co/ report+ p]iods beg9n+ on or aft]    
,july #a ( t fiscal ye>4  7,d7          
,positions n di/ribut$ dur+ fiscal ye>  

#bjad  ,if ! numb] ( resid5t full-"t    
equival5t positions di/ribut$ "u ?is    
p>agraph 9 fiscal ye> #bjad is less ?an 
! aggregate numb] ( positions available 
= di/ribution 9 ! fiscal ye> "u         
subp>agraph 7,b71 ! ,secret>y %all      
conduct an application & di/ribution    
process 9 subsequ5t fiscal ye>s until   
su* "t z ! aggregate numb] ( positions  
di/ribut$ "u ?is p>agraph is equal to ! 
aggregate numb] "u subp>agraph 7,b74    
7,e7  ,consid]ation 9 di/ribution  ,9   
det]m9+ = :i* hospitals ! increase 9 !  
o!rwise applicable resid5t limit is     
provid$ "u ?is p>agraph1 ! ,secret>y    
%all prioritize tra9+ programs ) an     
emphasis on community-bas$ tra9+1 & %all
 prioritize hospitals ) a demon/rat$    
likelihood ( fill+ ! positions )        
resid5ts :o w practice 9 heal?          
pr(essional %ortage areas 7z def9$ by ! 
,national ,heal? ,s]vice ,corps "u      
section #ccb ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bed;e77 or )       
m$ically und]s]v$ populations 7z def9$ 9

 section #ccj7;b77#c7 ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4            
#bed;b7b77#c7771 z det]m9$ by !         
,secret>y4  7,f7 ,def9ition ( o!rwise   
applicable resid5t limit ,9 ?is         
p>agraph1 ! t]m o!rwise applicable      
resid5t limit means1 ) respect to a     
hospital1 ! limit o!rwise applicable "u 
subp>agraphs 7,f77i7 & 7,h7 ( p>agraph  
7#d7 on ! resid5t level 7z def9$ 9      
p>agraph 7#g77;,c77i77 = ! hospital     
det]m9$ )\t reg>d to ?is p>agraph b tak+
 into acc\nt p>agraphs 7#g77;,a71       
7#g77;,b71 7#h77;,a71 & 7#h77;,b74  4   
7#b7  ,,ime  7,a7  ,9 g5]al  ,section   
#ahhf7;d77#e77;,b77v7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#acieww7d77#e77;,b77v771 9 ! second     
s5t5ce1 is am5d$ by /rik+ subsections   
7h77#g7 & 7h77#h7 & ins]t+ subsections  
7h77#g71 7h77#h71 & 7h77#i74  7,b7      
,con=m+ provision  ,section             
#ahhf7;d77#e77;,b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acieww7d77#e77;,b77 is am5d$--  7i7 by 

r$esignat+ clause 7x71 z add$ by section
 #eeje7;b7 ( ! ,pati5t ,protection &    
,af=dable ,c>e ,act 7,public ,law       
#aaa-adh71 z clause 7xi7 & mov+ su*     
clause #d ems to ! left2 &  7ii7 by add+
 aft] clause 7xi71 z r$esignat$ by      
subp>agraph 7,a71 ! foll[+ clause3      
7xii7 ,= dis*>ges occurr+ on or aft]    
,july #a1 #bjad1 ins(> z an additional  
paym5t am\nt "u ?is subp>agraph is      
attributable to resid5t positions       
di/ribut$ to a hospital "u subsection   
7h77#i71 ! indirect tea*+ adju/m5t      
factor %all be comput$ 9 ! same mann] z 
provid$ "u clause 7ii7 ) respect to su* 
resid5t positions4  4  7b7  ,requirem5ts
 ,to improve transp>5cy  7#a7  ,9 g5]al 
,section #ahhf7;h7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acieww7h771 z     
am5d$ by subsection 7a77#a71 is am5d$ by
 add+ at ! end ! foll[+ new p>agraph3   
7#aj7  ,requirem5ts  7,a7  ,9 g5]al     
,not)/&+ ! prec$+ provisions ( ?is      
subsection1 = fiscal ye> #bjad &        
subsequ5t fiscal ye>s1 a hospital %all n

 receive any paym5ts "u ?is subsection  
or subsection 7d77#e77;,b7 7or any o!r  
paym5ts "u ?is title = graduate m$ical  
education co/s7 9 a fiscal ye> unless ! 
hospital complies ) ! foll[+            
requirem5ts1 z det]m9$ by ! ,secret>y3  
7i7 ,! hospital has an approv$ m$ical   
resid5cy program 9--  7,i7 family       
m$ic9e2 or  7,,ii7 adult or all-age     
prim>y c>e4  7ii7 ,ea* fiscal ye>       
7beg9n+ ) fiscal ye> #bjad71 ! hospital 
submits to ! ,secret>y a report t       
conta9s ! foll[+ in=mation ) respect to 
resid5ts ( ! hospital3  7,i7 ,! total   
am\nt ( money g5]at$ by ! resid5ts 7by  
resid5cy type7 9 ea* ye> ( _! resid5cy  
program4  7,,ii7 ,! total am\nt ( ,f$]al
 fund+ provid$ to ! hospital = tra9+    
resid5ts1 by resid5cy type1 9 ea* ye> ( 
! resid5cy program4  7,,iii7 ,! av]age  
numb] ( inpati5t & outpati5t enc\nt]s p]
 ye> by resid5cy type 9 inpati5t &      
outpati5t sett+s4  7,,iv7 ,a            
ju/ification = ! hospital's allocation (
 resid5cy slots across specialties &    

subspecialties t is responsive to local 
& national heal? c>e work=ce ne$s &     
recomm5dations put =? by ! ,national    
,heal? ,c>e ,work=ce ,commission4  7,v7 
,a detail$ breakd[n ( h[ ! hospital uses
 am\nts receiv$ "u ?is subsection & "u  
subsection 7d77#e77;,b74  7,b7  ,public 
availability  ,n lat] ?an #cj days aft] 
receiv+ ! report "u subp>agraph         
7,a77ii71 ! ,secret>y %all po/ !        
in=mation describ$ 9 subclauses 7,i7    
?r\gh 7,,vi7 ( su* subp>agraph on !     
,int]net ,website ( ! ,c5t]s = ,m$ic>e  
,m$icaid ,s]vices4  4  7#b7  ,,ime      
,section #ahhf7;d77#e77;,b7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acieww7d77#e77;,b771 z am5d$ by        
subsection 7a77#b77;,b71 is am5d$ by    
add+ at ! end ! foll[+ new clause3      
7xiii7 ,! requirem5ts "u subsection     
7h77#aj7 %all apply to paym5ts "u ?is   
subp>agraph 9 ! same mann] z su*        
requirem5ts apply to paym5ts "u su*     
subsection4  4  #h4  ,heal? c>e = !     
un9sur$  ,a hospital or heal? c>e       

provid] t accepts any paym5t "u !       
,m$ic>e program "u title ,,xviii ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq47 or ! ,m$icaid program "u 
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq47 %all n    
*>ge an individual )\t heal? insurance  
cov]age an am\nt = any m$ical s]vice t  
exce$s ! am\nt su* hospital or heal? c>e
 provid] receives "u ! ,m$ic>e program =
 su* s]vice4