,,ic  #aadth ,,congress  #b;d ,session  
,s4 #fjg  ,,in ,,the ,,house ,,of       
,,representatives  ,january #be1 #bjaf  
,referred to the ,committee on ,ways and
 ,means  ,,an ,,act  ,to provide for a  
five-year extension of the ,medicare    
rural community hospital demonstration  
program4  #a4 ,short title ,this ,act   
may be cited as the ,rural ,community   
,hospital ,demonstration ,extension ,act
 of #bjae4  #b4 ,five-year extension of 
the rural community hospital            
demonstration program  7a7 ,extension   
,section #daj;,a of the ,medicare       
,prescription ,drug1 ,improvement1 and  
,modernization ,act of #bjjc 7,public   
,law #ajh-agc2 #db ,u4,s4,c4 #acieww    
note71 as amended by sections #cabc and 
#ajcac of the ,patient ,protection and  
,affordable ,care ,act 7,public ,law    
#aaa-adh71 is amended--  7#a7 in        
subsection 7a77#e71 by striking #e-year 
extension period and inserting #aj-year 
extension period2 and  7#b7 in          
subsection 7g7--  7,a7 in the subsection

 heading1 by striking ,five-,year and   
inserting ,ten-,year2  7,b7 in paragraph
 7#a71 by striking additional #e-year   
and inserting additional #aj-year2  7,c7
 by striking #e-year extension period   
and inserting #aj-year extension period 
each place it appears2  7,d7 in         
paragraph 7#d77;,b7--  7i7 in the matter
 preceding clause 7i71 by inserting each
 #e-year period in after hospital       
during2 and  7ii7 in clause 7i71 by     
inserting each applicable #e-year period
 in after the first day of2 and  7,e7 by
 adding at the end the following new    
paragraphs3  7#e7 ,other hospitals in   
demonstration program ,during the second
 #e years of the #aj-year extension     
period1 the ,secretary shall apply the  
provisions of paragraph 7#d7 to rural   
community hospitals that are not        
described in paragraph 7#d7 but are     
participating in the demonstration      
program under this section as of        
,december #cj1 #bjad1 in a similar      
manner as such provisions apply to rural

 community hospitals described in       
paragraph 7#d74  7#f7 ,expansion of     
demonstration program to rural areas in 
any ,state  7,a7 ,in general ,the       
,secretary shall1 notwithstanding       
subsection 7a77#b7 or paragraph 7#b7 of 
this subsection1 not later than #abj    
days after the date of the enactment of 
this paragraph1 issue a solicitation for
 applications to select up to the       
maximum number of additional rural      
community hospitals located in any      
,state to participate in the            
demonstration program under this section
 for the second #e years of the #aj-year
 extension period without exceeding the 
limitation under paragraph 7#c7 of this 
subsection4  7,b7 ,priority ,in         
determining which rural community       
hospitals that submitted an application 
pursuant to the solicitation under      
subparagraph 7,a7 to select for         
participation in the demonstration      
program1 the ,secretary--  7i7 shall    
give priority to rural community        

hospitals located in one of the #bj     
,states with the lowest population      
densities 7as determined by the         
,secretary using the #bjae ,statistical 
,abstract of the ,united ,states72 and  
7ii7 may consider--  7,i7 closures of   
hospitals located in rural areas in the 
,state in which the rural community     
hospital is located during the #e-year  
period immediately preceding the date of
 the enactment of this paragraph2 and   
7,,ii7 the population density of the    
,state in which the rural community     
hospital is located4  4  7b7 ,change in 
timing for report ,subsection 7e7 of    
such section #daj;,a is amended-- 7#a7  
by striking ,not later than #f months   
after the completion of the             
demonstration program under this section
 and inserting ,not later than ,august  
#a1 #bjah2 and  7#b7 by striking such   
program and inserting the demonstration 
program under this section4  ,passed the
 ,senate ,january #bj1 #bjaf4;,julie ,e4
 ,adams1,secretary