,,ii  #aad? ,,congress  #a/ ,session    
,s4 #ccb  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,febru>y #b1 #bjae,mr4 
,grassley 7= himself & ,mr4 ,s*um]7     
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
make p]man5t ! ext5sion ( !             
,m$ic>e-dep5d5t hospital 7,,mdh7 program
 & ! increas$ paym5ts "u ! ,m$ic>e      
l[-volume hospital program4  #a4 ,%ort  
title ,?is ,act may be cit$ z ! ,rural  
,hospital ,access ,act ( #bjae4  #b4    
,ext5sion ( ! ,m$ic>e-dep5d5t hospital  
7,,mdh7 program  7a7 ,ext5sion ( paym5t 
me?odology ,section #ahhf7;d77#e77;,g7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acieww7d77#e77;,g77 is am5d$-- 7#a7 9 
clause 7i71 by /rik+ 1 & be=e ,april #a1
 #bjae2 &  7#b7 9 clause 7ii77,,ii71 by 
/rik+ 1 & be=e ,april #a1 #bjae4  7b7   
,con=m+ am5dm5ts  7#a7 ,ext5sion ( t>get
 am\nt ,section #ahhf7;b77#c77;,d7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   

#acieww7b77#c77;,d77 is am5d$-- 7,a7 9 !
 matt] prec$+ clause 7i71 by /rik+ 1 &  
be=e ,april #a1 #bjae2 &  7,b7 9 clause 
7iv71 by /rik+ ?r\gh fiscal ye> #bjad & 
! portion ( fiscal ye> #bjae be=e ,april
 #a1 #bjae & ins]t+ or a subsequ5t      
fiscal ye>4  7#b7 ,p]mitt+ hospitals to 
decl9e reclassification ,section        
#aceja7;e77#b7 ( ! ,omnibus ,budget     
,reconciliation ,act ( #aiic 7#db       
,u4,s4,c4 #acieww note7 is am5d$ by     
/rik+ fiscal ye> #bjjj ?r\gh ! fir/ #b  
qu>t]s ( fiscal ye> #bjae & ins]t+ a    
subsequ5t fiscal ye>4  #c4 ,ext5sion ( !
 increas$ paym5ts "u ! ,m$ic>e          
,l[-,volume ,hospital ,program ,section 
#ahhf7;d77#ab7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acieww7d77#ab77 is 
am5d$-- 7#a7 9 subp>agraph 7,b71 9 !    
matt] prec$+ clause 7i71 by /rik+ & =   
dis*>ges occurr+ 9 fiscal ye> #bjae     
7beg9n+ on ,april #a1 #bjae71 fiscal ye>
 #bjaf1 & subsequ5t fiscal ye>s2  7#b7 9
 subp>agraph 7,c77i7-- 7,a7 by /rik+    
fiscal ye>s #bjaa ?r\gh #bjad & fiscal  

ye> #bjae 7be=e ,april #a1 #bjae7 ea*   
place x appe>s & ins]t+ fiscal ye> #bjaa
 & ea* subsequ5t ye>2 &  7,b7 by /rik+  
or portion ( fiscal ye> aft] dur+ !     
fiscal ye>2 &  7#c7 9 subp>agraph 7,d7--
 7,a7 by /rik+ fiscal ye>s #bjaa ?r\gh  
#bjad & fiscal ye> #bjae 7be=e ,april   
#a1 #bjae71 & ins]t+ fiscal ye> #bjaa & 
ea* subsequ5t fiscal ye>2 &  7,b7 by    
/rik+ or ! portion ( fiscal ye> aft]    
fiscal ye>4