,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #gdee  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #a1 #bjbj,ms4   
,gabb>d 7= h]self1 ,mr4 ,"y1 & ,mr4     
,case7 introduc$ ! foll[+ bill2 :i* 0   
ref]r$ to ! ,committee on ,ways &       
,means1 & 9 addition to ! ,committee on 
,education & ,labor1 = a p]iod to be    
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
au?orize ! ,secret>y ( ,heal? & ,human  
,s]vices to make adju/m5ts to paym5t    
rates = skill$ nurs+ facilities "u !    
,m$ic>e program to acc\nt = c]ta9 unique
 circum/ances4  #a4 ,%ort title ,?is    
,act may be cit$ z ! ,equitable ,paym5ts
 = ,nurs+ ,facilities ,act ( #bjbj4  #b4
 ,au?oriz+ ! ,secret>y ( ,heal? & ,human
 ,s]vices to make adju/m5ts to paym5t   
rates = skill$ nurs+ facilities "u !    
,m$ic>e program to acc\nt = c]ta9 unique
 circum/ances ,section                  

#ahhh7;e77#d77;,g7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acieyy7e77#d77;,g77 is am5d$ by add+ at
 ! end ! foll[+ new clause3  7iv7       
,adju/m5t = unique circum/ances ,!      
,secret>y may provide = su* adju/m5ts z 
det]m9$ appropriate by ! ,secret>y to   
take into acc\nt ! unique circum/ances (
 skill$ nurs+ facilities locat$ 9       
,alaska or ,hawaii4  4