,,ii  #aadth ,,congress  #ast ,session  
,s4 #ccb  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,february #b1       
#bjae,mr4 ,grassley 7for himself and    
,mr4 ,schumer7 introduced the following 
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to amend title ,,xviii of the ,social
 ,security ,act to make permanent the   
extension of the ,medicare-dependent    
hospital 7,,mdh7 program and the        
increased payments under the ,medicare  
low-volume hospital program4  #a4 ,short
 title ,this ,act may be cited as the   
,rural ,hospital ,access ,act of #bjae4 
#b4 ,extension of the                   
,medicare-dependent hospital 7,,mdh7    
program  7a7 ,extension of payment      
methodology ,section #ahhf7;d77#e77;,g7 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acieww7d77#e77;,g77 is       
amended-- 7#a7 in clause 7i71 by        
striking 1 and before ,april #a1 #bjae2 
and  7#b7 in clause 7ii77,,ii71 by      
striking 1 and before ,april #a1 #bjae4 

7b7 ,conforming amendments  7#a7        
,extension of target amount ,section    
#ahhf7;b77#c77;,d7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acieww7b77#c77;,d77 is amended-- 7,a7  
in the matter preceding clause 7i71 by  
striking 1 and before ,april #a1 #bjae2 
and  7,b7 in clause 7iv71 by striking   
through fiscal year #bjad and the       
portion of fiscal year #bjae before     
,april #a1 #bjae and inserting or a     
subsequent fiscal year4  7#b7           
,permitting hospitals to decline        
reclassification ,section #aceja7;e77#b7
 of the ,omnibus ,budget ,reconciliation
 ,act of #aiic 7#db ,u4,s4,c4 #acieww   
note7 is amended by striking fiscal year
 #bjjj through the first #b quarters of 
fiscal year #bjae and inserting a       
subsequent fiscal year4  #c4 ,extension 
of the increased payments under the     
,medicare ,low-,volume ,hospital        
,program ,section #ahhf7;d77#ab7 of the 
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7d77#ab77 is amended-- 7#a7 in   

subparagraph 7,b71 in the matter        
preceding clause 7i71 by striking and   
for discharges occurring in fiscal year 
#bjae 7beginning on ,april #a1 #bjae71  
fiscal year #bjaf1 and subsequent fiscal
 years2  7#b7 in subparagraph 7,c77i7-- 
7,a7 by striking fiscal years #bjaa     
through #bjad and fiscal year #bjae     
7before ,april #a1 #bjae7 each place it 
appears and inserting fiscal year #bjaa 
and each subsequent year2 and  7,b7 by  
striking or portion of fiscal year after
 during the fiscal year2 and  7#c7 in   
subparagraph 7,d7-- 7,a7 by striking    
fiscal years #bjaa through #bjad and    
fiscal year #bjae 7before ,april #a1    
#bjae71 and inserting fiscal year #bjaa 
and each subsequent fiscal year2 and    
7,b7 by striking or the portion of      
fiscal year after fiscal year4