,i #aafth ,,congress #b;d ,session ,h4 ,r4 #gdee ,,in ,,the ,,house ,,of ,,representatives ,july #a1 #bjbj,ms4 ,gabbard 7for herself1 ,mr4 ,young1 and ,mr4 ,case7 introduced the following bill2 which was referred to the ,committee on ,ways and ,means1 and in addition to the ,committee on ,education and ,labor1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to authorize the ,secretary of ,health and ,human ,services to make adjustments to payment rates for skilled nursing facilities under the ,medicare program to account for certain unique circumstances4 #a4 ,short title ,this ,act may be cited as the ,equitable ,payments for ,nursing ,facilities ,act of #bjbj4 #b4 ,authorizing the ,secretary of ,health and ,human ,services to make adjustments to payment rates for skilled nursing facilities under the ,medicare program to account for certain unique circumstances ,section #ahhh7;e77#d77;,g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieyy7e77#d77;,g77 is amended by adding at the end the following new clause3 7iv7 ,adjustment for unique circumstances ,the ,secretary may provide for such adjustments as determined appropriate by the ,secretary to take into account the unique circumstances of skilled nursing facilities located in ,alaska or ,hawaii4 4