,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #cfae  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #f1 #bjbj,ms4     
,murk[ski 7= h]self1 ,mr4 ,b5net1 & ,mr4
 ,sullivan7 introduc$ ! foll[+ bill2 :i*
 0 read twice & ref]r$ to ! ,committee  
on ,f9ance  ,a ,,bill  ,to am5d !       
,m$ic>e ,prescription ,drug1            
,improvem5t1 & ,mod]nization ,act (     
#bjjc to ext5d ! rural community        
hospital demon/ration program4  #a4     
,%ort title ,?is ,act may be cit$ z !   
,rural ,community ,hospital             
,demon/ration ,ext5sion ,act ( #bjbj4   
#b4 ,five-ye> ext5sion ( ! rural        
community hospital demon/ration program 
7a7 ,ext5sion  7#a7 ,9 g5]al ,subsection
 7a77#e7 ( section #daj;,a ( ! ,m$ic>e  
,prescription ,drug1 ,improvem5t1 &     
,mod]nization ,act ( #bjjc 7,public ,law
 #ajh-agc2 #db ,u4,s4,c4 #acieww note71 
is am5d$ by /rik+ #aj-ye> ext5sion p]iod
 & ins]t+ #ae-ye> ext5sion p]iod4  7#b7 
,con=m+ am5dm5ts = ext5sion  7,a7       
,ext5sion ( demon/ration p]iod          

,subsection 7g7 ( su* section #daj;,a is
 am5d$-- 7i7 9 ! subsection head+1 by   
/rik+ ,t5-,ye> & ins]t+ ,fifte5-,ye>2   
7ii7 9 p>agraph 7#a7-- 7,i7 by /rik+    
additional #aj-ye> & ins]t+ additional  
#ae-ye>2 &  7,,ii7 by /rik+ #aj-ye>     
ext5sion p]iod & ins]t+ #ae-ye> ext5sion
 p]iod2  7iii7 9 p>agraph 7#b71 by /rik+
 #aj-ye> ext5sion p]iod & ins]t+ #ae-ye>
 ext5sion p]iod2  7iv7 9 p>agraph 7#c71 
by /rik+ #aj-ye> ext5sion p]iod & ins]t+
 #ae-ye> ext5sion p]iod2  7v7 9 p>agraph
 7#d71 by /rik+ #aj-ye> ext5sion p]iod  
ea* place x appe>s & ins]t+ #ae-ye>     
ext5sion p]iod2  7vi7 9 p>agraph 7#e71  
by /rik+ #aj-ye> ext5sion p]iod & ins]t+
 #ae-ye> ext5sion p]iod2 &  7vii7 9     
subp>agraph 7,a7 ( p>agraph 7#f71 by    
/rik+ #aj-ye> ext5sion p]iod & ins]t+   
#ae-ye> ext5sion p]iod4  7,b7 ,rule =   
hospitals t are n orig9al p>ticipants 9 
! demon/ration ,p>agraph 7#e7 (         
subsection 7g7 ( su* section #daj;,a is 
am5d$-- 7i7 by /rik+ program4--,dur+ &  
ins]t+ program4-- 7,a7 ,,cures ,act     

ext5sion ,dur+  2 &  7ii7 by add+ at !  
end ! foll[+ new subp>agraph3  7,b7     
,additional ext5sion ,dur+ ! ?ird #e    
ye>s ( ! #ae-ye> ext5sion p]iod1 !      
,secret>y %all apply ! provisions (     
p>agraph 7#d7 to rural community        
hospitals t are n describ$ 9 p>agraph   
7#d7 b are p>ticipat+ 9 ! demon/ration  
program "u ?is section z ( ,decemb] #cj1
 #bjai1 9 a simil> mann] z su*          
provisions apply to rural community     
hospitals describ$ 9 p>agraph 7#d74  4  
7,c7 ,solicitation ( applications       
,subp>agraph 7,a7 ( subsection 7g77#f7 (
 su* section #daj;,a is am5d$-- 7i7 by  
/rik+ g5]al4--,! ,secret>y & ins]t+ ,9  
g5]al4-- 7i7 ,,cures ,act solicitation  
,! ,secret>y  2 &  7ii7 by add+ at ! end
 ! foll[+ new clause3  7ii7 ,additional 
solicitation ,! ,secret>y %all1 not)/&+ 
subsection 7a77#b7 or p>agraph 7#b7 (   
?is subsection1 n lat] ?an #abj days    
aft] ! date ( ! enactm5t ( ?is clause1  
issue a solicitation = applications to  
select up to ! maximum numb] (          

additional rural community hospitals    
locat$ 9 any ,/ate to p>ticipate 9 !    
demon/ration program "u ?is section = ! 
?ird #e ye>s ( ! #ae-ye> ext5sion p]iod 
)\t exce$+ ! limitation "u p>agraph 7#c7
 ( ?is subsection4  4  7b7 ,cl>ification
 ( application ( case mix adju/m5t      
,subsection 7b7 ( su* section #daj;,a is
 am5d$ by add+ at ! end ! foll[+ new    
p>agraph3  7#c7 ,case mix adju/m5t ,!   
,secret>y %all provide = an appropriate 
adju/m5t "u ?is p>agraph to take into   
acc\nt v>iations 9 case mix ( rural     
community hospitals1 us+ ! mo/ rec5t    
case-mix data available4  4  7c7 ,*ange 
9 tim+ = report ,subsection 7e7 ( su*   
section #daj;,a is am5d$ by /rik+ ,n    
lat] ?an ,augu/ #a1 #bjah & ins]t+ ,n   
lat] ?an ,augu/ #a1 #bjbc4  7d7 ,cl>ify+
 te*nical am5dm5ts ,su* section #daj;,a1
 z am5d$ by subsections 7a71 7b71 & 7c71
 is fur!r am5d$-- 7#a7 9 subsection     
7a77#a71 by ins]t+ ( ,heal? & ,human    
,s]vices aft] ,secret>y2  7#b7 9        
subsection 7f77#a77;,a77iv7 by ins]t+ ( 

! ,social ,security ,act 7#db ,u4,s4,c4 
#acie;i-#d7 aft] section #ahbj2 &  7#c7 
9 subsection 7g7-- 7,a7 9 ! head+ (     
p>agraph 7#d71 by /rik+ ,hospitals 9    
demon/ration program on date ( enactm5t 
& ins]t+ ,hospitals p>ticipat+ 9 !      
demon/ration program dur+ ! initial     
#e-,ye> p]iod2 &  7,b7 9 clause 7i7 (   
p>agraph 7#f77;,a71 z am5d$ by          
subsection 7a77#b77;,c77i71 by /rik+ n  
lat] ?an #abj days aft] ! date ( !      
enactm5t ( ?is p>agraph & ins]t+ n lat] 
?an ,april #ab1 #bjag4