,,ii ,calendar ,no4 #aha #aadth         
,,congress  #ast ,session  ,s4 #fjg     
,report ,no4 #aad-ajb ,,in ,,the        
,,senate ,,of ,,the ,,united ,,states   
,february #bg1 #bjae,mr4 ,grassley 7for 
himself1 ,mr4 ,bennet1 ,ms4 ,murkowski1 
,mr4 ,moran1 ,mr4 ,udall1 ,mr4          
,sullivan1 ,mr4 ,thune1 ,mr4 ,wicker1   
,mr4 ,roberts1 ,mrs4 ,ernst1 ,mr4       
,franken1 ,mr4 ,cochran1 ,mr4 ,gardner1 
,mrs4 ,fischer1 and ,mr4 ,rounds7       
introduced the following bill2 which was
 read twice and referred to the         
,committee on ,finance  ,july #cj1      
#bjae,reported by ,mr4 ,hatch1 with an  
amendment and an amendment to the       
title,strike out all after the enacting 
clause and insert the part printed in   
italic  ,a ,,bill  ,to amend title      
,,xviii of the ,social ,security ,act to
 provide for a five-year extension of   
the rural community hospital            
demonstration program1 and for other    
purposes4  #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 and  
7,c7 by striking #e-year extension      
period and inserting #aj-year extension 
period each place it appears 4  7b7     
,change in timing for report ,subsection
 7e7 of such section #daj;,a is amended 

by striking ,not later than #f months   
after the completion and inserting ,not 
later than #b years prior to the        
completion4  #a4 ,short title ,this ,act
 may be cited as the ,rural ,community  
,hospital ,demonstration ,extension ,act
 of #bjae4  #b4 ,five-year extension of 
the ,medicare 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#c71 by adding at the end the
 following new sentence3                
,notwithstanding the preceding sentence1
 after the date of the enactment of this
 sentence1 only hospitals described in  
paragraph 7#d7 or 7#e7 may participate  
in demonstration program under this     
section4  7,e7 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,f7 by adding at the end the  
following new paragraph3  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  4  7b7 ,change in   
timing for report ,subsection 7e7 of    
such section #daj;,a is amended by      
striking ,not later than #f months after
 the completion and inserting ,not later
 than ,august #a1 #bjah4  ,amend the    
title so as to read3 ,a bill to provide 
for a five-year extension of the        
,medicare rural community hospital      
demonstration program44 ,july #cj1      
#bjae,reported with an amendment and an 
amendment to the title