,,ii  #aafth ,,congress  #b;d ,session  
,s4 #dacg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,july #a1      
#bjbj,mr4 ,schatz 7for himself1 ,ms4    
,murkowski1 ,ms4 ,hirono1 and ,mr4      
,sullivan7 introduced the following     
bill2 which was read twice and referred 
to the ,committee on ,finance  ,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